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Day 2&3 Chemotherapy

robinbtaylor Cancer, Chemotherapy, Health, Leukaemia, Lymphoma , , ,

So Merry Christmas! I’m feeling in as much the spirit as is reasonably possible. I’m wearing teal striped PJ’s which my mum said looked a bit like the ones the boy in ‘The Snowman’ was wearing, and my socks have baubles on!

Xmas PJ's
Xmas PJ’s

Yesterday was pretty tough going but not anywhere near as difficult as I thought; I was due to have an intrathecal injection (through the spinal column) but that has been delayed due to shortage of staff.

Here’s the low down of my chemotherapy treatment over the last 48 hours:

The chemicals day 2 (Christmas Eve):

Each morning at about 6:30 the nurse wakes me up to take blood samples before breakfast, they also check my blood pressure, temperature and heart rate to make sure I’ve had no effects during the night (these “obs'” are performed regularly throughout the day. I went through the usual round of intravenous flushes and bladder protecting compounds (along with anti sickness tablets and others that I’m losing track of)

Rituximab

This chemical is from a group of chemicals called ‘monoclonal antibodies’ which can accurately pinpoint specific cells via proteins. In this case, as my cancer is related to ‘B-lymphocytes’ which have a protein spot called CD20, the manufactured antibodies attach to this compound so that my body can break down and destroy these cells. The downside, is that at the same time, they attack good cells (which my body will eventually replenish) this can lead to certain side effects.

Although this is a very effective treatment, it can lead to allergic reactions such as itchy rash and sickness. I was also given an antihistamine to reduce this risk. During infusion, the nurses start the drip very slowly and take observations at 30 minute intervals to check how I’m coping. If all is well, they notch up to the next flow rate and so on. To start with I felt fine, but after about the 3rd hour, I started getting short breath, light headedness and my blood pressure had dropped slightly so they continued at this rate for a while. I also experienced some severe stomach cramps which I’m told could be due to the growth receding and my bowels moving around.

The drip lasted for about 7 hours, and by the end all I was feeling was a little light headed and lethargic.

Cyclophosphamide

Finally I was given a bag of cyclophosphamide, this is one of the main chemicals used in my treatment and most of the days of my schedule I will be having this.

This drip lasted for an hour and at the end I was starting to feel quite tired. I watched Skyfall on ITV and then was given a sleeping tablet to help me drop off!

Day 3 – Christmas Day

Today the schedule is thankfully a little more relaxed, I’ve had the usual pre-meds and tests, and I am due to have another round of cyclophosphamide in a moment. This should last for about an hour.

I’m still a little tired this morning and felt a little dizzy coming out of the shower but I feel much less pressure around my abdomen. I opened my bowels this morning too which as ridiculous and disgusting as it may sound, was probably the most comfortable passing I’ve had for weeks. I will regard this as the first Christmas present of the day!

I was left with a stocking of gifts by my mum and have just received a present from the nurses on the ward which is gratefully appreciated. I am also looking forward to seeing my family this afternoon to exchange gifts (I had a bit of a logistical nightmare getting people to buy, collect and wrap presents for each other on my behalf, but I think I managed to pull it off!)

anyway, that’s me for today- wishing everyone a merry Christmas.

Day 1 Chemotherapy

robinbtaylor Cancer, Chemotherapy, Leukaemia ,

Today has been a busy day, I’ve had a bone marrow biopsy, a PICC line inserted (both of which I’ll talk about in further detail under the “procedures” section) and I’ve started the first days treatment.

Over the last couple of days, I’ve had a supply of saline solution, to keep my bladder clear. I’ve had steroids to keep me alert and to restrict the tumour growth a little (this has had the effect of making me feel quite good) and I’ve also had a couple of drugs to protect my stomach lining (all in tablet form).

Due to the size and fast growing (and therefore fast shrinking) nature of this tumour, there are concerns that my bladder and kidneys will not be able to keep up, so I’ve also been given an intravenous drug called rasburicase to help my bladder break down the dead cells to release into my urine.

How does Chemotherapy Work?

Obviously this is a very complex topic, but out of interest, I’ve been talking to the doctors here to learn as much as I can. As I understand, the range of chemicals introduced attack cells as they divide, the more quickly and frequently a cell divides, the more likely they are to be affected by the drug. In our bodies we have some cells that divide and replenish regularly (like your hair follicles) and some which divide much more slowly. Cancer cells tend to divide more quickly, which gives the chemicals a chance to attack and kill these cells in order to break down the tumour. During this time, good cells are also killed which leads to side effects such as hair loss. One other fast growing cell  structure is the gut lining and mouth, so I expect to have a sore mouth and bowels as the treatment starts.

During this time, after the first round of treatment, my immune system will be very low. In fact they expect me to have 0% white blood cells and very low platelet count. They call this neutropenia. 

Because of this, I have to be very careful about hygiene and washing so as to minimise risk of infection. I have single use toothbrushes, regular mouthwashes, and visitors must wear aprons and gloves.

What are the chemicals and what are they like?

Due to a delay with the PICC line, they changed the schedule slightly but the main chemicals used are as follows:

Cyclophosphamide

this lasted for just over an hour, I had some friends over so It seemed like no time at all. It’s mixed with saline solution so is a clear liquid. Due to the location of the PICC line, there’s no feeling or sensation of it going in, and I feel surprisingly well after this treatment.

Doxorubicin

The chemical in this bag was smaller and lasting about 30 minutes. Again clear in colour. I was starting to feel a little light headed at this stage, with a strange taste in my mouth, but nothing serious.

Vincristine

This third chemical is red in colour and in the smaller 30 minute bag. I was told that this could colour my urine so not to worry!

Each chemical was followed by a saline flush, as due to the nature of the PICC line, the nurses minimise the amount of times that the drip is disconnected at my end. All handling is done with specially packed gloves.

As a safety measure all drugs are double checked by two nurses to make sure the right person gets the right drugs and the outer container is placed over the drip so that it is instantly visible that the drip is a chemotherapy drug.

Chemotherapy drip
Chemotherapy drip