It is 17 June 2009.
I’ve had blood tests, been measured, weighed, tagged, had the usual observations done, and had my medical details recorded yet again. I have a canula in my wrist attached to a collection of tubing linked to a saline drip.
My list of allergies hasn’t grown any more – I’m pleased to say.
The Chemotherapy nurses are great…. its not a job for the faint hearted, pumping assorted coloured fluids into an IV Line. The most spectacular is the RED one. Epirubicin. The nurse comments ‘this is the baddie…the one that makes you lose your hair. Terrific. There are four – yes, four - huge syringes of this stuff. The nurse also warns me that I will have red pee for twenty-four hours from it.
Before she starts filling me with all the nasty stuff, I don the ‘cold cap. This is a frozen gel filled cap about the size of a riding helmet that covers the scalp and is covered with a tight insulating top cap. This stays on for about 30 minutes before any drugs are administered. Hopefully this will prevent hair loss although it doesn’t work for everyone. Fingers crossed. I also have a large horse pill – ‘Emend’ which is the name for Aprepitant, to control sickness and nausea.
After about 30 minutes I get a new cold cap and the nurse injects a steroid into the IV line – again to prevent sickness and nausea. This causes a weird feeling in ..yes I know this sounds odd …… my genital area. A sudden tingling. The sensation only lasts about a minute but it is a bit eye watering.
Then we get onto the heavy stuff. The Epirubicin takes about 15 minutes to inject into the IV – they call this method a ‘bolus’ injection. It is an indication of how toxic these drugs are in that the nurses wear heavy-duty rubber gloves and one who is pregnant is no longer allowed to give the drugs at all.
Next comes a much smaller bolus injection of Fluorouracil. All the while they are looking to see how I am reacting as this is my first time so it all takes a bit longer than it normally would. Finally it is Cyclophosphamide which is administered by an IV pump which will take about 45 minutes or so.
During all of this the cold cap is replaced every 45 minutes.
More coffee arrives and I am left to read my book…until a ‘pastoral’ adviser comes to visit. He assures me he can me a prayer mat if I need it or find a priest if I prefer. He seems a little disappointed when I tell him I am a deliriously happy, committed atheist and ask him if he would like to borrow my copy of Richard Dawkin’s ‘The God Delusion’.
The alarm on the pump signals that I am now full of horrible drugs.
I spend a final 45 minutes with the last cold cap. The pharmacist visits with a wheelie bin full of medication for me to take home. Basically most of it is to prevent sickness but because those meds make you constipated you also get a good supply of Senokot. Lovely.
Free at last of canulas and caps, and feeling a little odd, I camp in the reception area until my partner picks me up.
I actually don’t feel too bad. I was expecting to feel grim but in fact I am only a bit light headed and later that evening I feel tired quite early so go to bed at about 9.30 pm. At about 1.30am I wake up feeling a bit queasy but realise it is my chronic reflux kicking in so a Zantac tablet does the trick and I sleep through the night. The next three days are measured by the meds routine. The light-headedness and early bedtimes wear off after about day four and I play nine holes of golf on the Sunday and go back to work on the following Monday feeling pretty normal. BUT there is one big change……I have lost a lot of my sense of taste – in fact I have a metallic taste in my mouth...so I don’t want to eat as much as usual. Great because I need to lose the weight I have put on through forced inactivity since the operation. And even better, I find that I cannot drink red wine any more…it tastes horrible. I find I can enjoy a very weak gin and slim line tonic. Again perfect for losing some weight. The only other thing is that my mouth is a bit sore on one side. This wears off over the next week or so.
I have become somewhat obsessive about people sneezing and coughing near me when I am traveling to work in the rush hour, washing my hands all the time and being very careful about insect bites, scratches and people who might have swine flu…This is going to be a difficult one. During the three weeks after the first dose the media start to report that Swine flu, although mild in most cases, is now out of control in the population at large. I make a mental note to speak to my oncologist about this. Apart from shutting my partner and myself up in the house – as well as shunning all my nearest and dearest - I cannot see any real way of avoiding it. I could invest in one of those isolation suits I suppose but I doubt I would be able to get my golf shoes on over the top of it and the club are a bit stuffy on their dress regulations.
The big unknown is whether the cold cap system will stop my hair falling out. Only time will tell.
Showing posts with label Cold Caps. Show all posts
Showing posts with label Cold Caps. Show all posts
Thursday, 20 August 2009
10 June - The oncologist and learning about Chemotherapy
Wednesday 10 June. We drive to the new hospital. Dr S is very straightforward and explains the survival rates from my type of cancer, which we are now defining as Stage IIa (T1, N1, M0). This means that the tumor measures 2 centimeters or less, has spread to the axillary lymph nodes on the same side of the body as the breast cancer but that they can be moved around (they aren't matted together by the cancer), and the cancer hasn't spread to another part of the body. In addition my cancer has proved to be estrogen receptive so I will be able to benefit from hormone therapy as well. We are still waiting to hear if it is HER2 positive. This is another factor, which can indicate the need for additional therapy in the form of a drug called Herceptin – more on this once we know.
Basically chemotherapy moves my chances of not dying from this cancer in the next ten years from 80% to 90%. With additional hormone therapy and radiotherapy the chances go even higher. It is a no-brainer. We go for chemotherapy despite the side effects. The discussion now revolves around what those side effects are, how debilitating they may be and therefore what the timing of the therapy should be…this is important to me as I have a number of things I want to do in the next few weeks and months. I know it sounds a bit strange but I want to live my life as normally as possible despite this sword of Damocles hanging over my head. My partner and I are due to play in a prestigious open golf event in July..and I really want to be able to do this. I am also refereeing an amateur championship and again, I want to be able to do this. So before we set the date for the chemotherapy to begin, we take a couple of days to get the calendar straight.
Basically the chemotherapy will be in six cycles, three weeks apart. The possible side effects are severe sickness, reduced immunity and subsequent risk of infections, mouth ulcers, hair loss, fatigue, and many others. But I decide to take a positive view that I will be reasonably OK and so agree to start the first cycle the next week. The date set is 17 June, which will allow me to do much of my planned activity. An additional bonus is that the chemotherapy will always occur on a Wednesday which fits beautifully with my working pattern of Monday and Tuesday in the office, Wednesday and Thursday off and Friday working from home. This means I can go back to work pretty much as normal. It all helps to put the beastly disease in perspective.
During the discussion with Dr S I ask about something I read about to prevent hair loss from chemotherapy – a cold cap system. Dr S says it is worth trying but that it doesn’t work for everyone and when it does it is not 100 % effective. I decide to give it a go but also to explore the alternative headwear route as well. Best to have all the bases covered.
Having made the decision to start the chemotherapy fairly quickly, I needed to get moving on some more research. Firstly I needed to understand exactly what the chemo was, how it was administered and the timing of side effects etc. The regime I would be having is called FEC –T in shorthand.
FEC–T is named after the initials of the chemotherapy drugs used, which are:
Fluorouracil, which is also called 5FU
Epirubicin
Cyclophosphamide
Docetaxel, which is commonly known as Taxotere®
FEC–T treatment is usually given as a day patient and you are given a number of other drugs to stop the major side effect of sickness and nausea
The side effects kick in at different times. If you are going to get sick, this usually happens within a few hours of having the chemo and can last for several days. Things like mouth ulcers, and a metallic taste in a couple of days, fatigue at any time, and increased risk of infection after between 7 and 14 days after the dose. I would just have to hope for the best.
Basically chemotherapy moves my chances of not dying from this cancer in the next ten years from 80% to 90%. With additional hormone therapy and radiotherapy the chances go even higher. It is a no-brainer. We go for chemotherapy despite the side effects. The discussion now revolves around what those side effects are, how debilitating they may be and therefore what the timing of the therapy should be…this is important to me as I have a number of things I want to do in the next few weeks and months. I know it sounds a bit strange but I want to live my life as normally as possible despite this sword of Damocles hanging over my head. My partner and I are due to play in a prestigious open golf event in July..and I really want to be able to do this. I am also refereeing an amateur championship and again, I want to be able to do this. So before we set the date for the chemotherapy to begin, we take a couple of days to get the calendar straight.
Basically the chemotherapy will be in six cycles, three weeks apart. The possible side effects are severe sickness, reduced immunity and subsequent risk of infections, mouth ulcers, hair loss, fatigue, and many others. But I decide to take a positive view that I will be reasonably OK and so agree to start the first cycle the next week. The date set is 17 June, which will allow me to do much of my planned activity. An additional bonus is that the chemotherapy will always occur on a Wednesday which fits beautifully with my working pattern of Monday and Tuesday in the office, Wednesday and Thursday off and Friday working from home. This means I can go back to work pretty much as normal. It all helps to put the beastly disease in perspective.
During the discussion with Dr S I ask about something I read about to prevent hair loss from chemotherapy – a cold cap system. Dr S says it is worth trying but that it doesn’t work for everyone and when it does it is not 100 % effective. I decide to give it a go but also to explore the alternative headwear route as well. Best to have all the bases covered.
Having made the decision to start the chemotherapy fairly quickly, I needed to get moving on some more research. Firstly I needed to understand exactly what the chemo was, how it was administered and the timing of side effects etc. The regime I would be having is called FEC –T in shorthand.
FEC–T is named after the initials of the chemotherapy drugs used, which are:
Fluorouracil, which is also called 5FU
Epirubicin
Cyclophosphamide
Docetaxel, which is commonly known as Taxotere®
FEC–T treatment is usually given as a day patient and you are given a number of other drugs to stop the major side effect of sickness and nausea
The side effects kick in at different times. If you are going to get sick, this usually happens within a few hours of having the chemo and can last for several days. Things like mouth ulcers, and a metallic taste in a couple of days, fatigue at any time, and increased risk of infection after between 7 and 14 days after the dose. I would just have to hope for the best.
Subscribe to:
Posts (Atom)
