Information Onslaught

Yesterday started with a pill as my days often do. This time it was Zyrtec, an anti-histamine to help prevent an allergic reaction to the chemo. Padmatara and I were at the Infusion Center by 8:30am.

We got David the oncology nurse again which was great. Started with a 15-minute infusion of something that sounded like pepsis and an anti-nausea thing which I think was dexamethasone, plus two anti-nausea pills. Then wait 15 minutes and start the three hours of Taxol (Paclitaxel). They gradually increase the rate while looking at you to see if you're having an allergic reaction, which apparently involves turning pink. I did not, which surprised me, since I often turn pink. Then the last half hour is the Carbo (Carboplatin). Toward the end the injection site on my hand started to ache. The carbo actually contains the heavy metal platinum, which is why food starts to taste weird/metallic. So I am no longer golden, I've gone platinum now, for a while. 

Stow Lake

Side effects of the three anti-nausea drugs - zofran, decadron, and ativan (originally an anti-anxiety drug) - include constipation which I am kind of looking forward to. (Or will I be saying, like Dorothy Parker, What fresh hell is this?) I was given loads of info about drugs...

Other than anti-nausea pills for four days, was also prescribed Nupogen, which I am supposed to self-inject for a week starting on Day 4. It's a growth hormone for bone marrow stimulation, to counteract neutropenia and reduce the risk of infection. Unfortunately it is also known to cause bone crushing pain.  There are a few things that can help with this. Dr. T. said 50% of his patients who took Zyrtec do not experience bone pain. There's also vitamin B6, and powdered Glutamine, an amino acid, that can help.

New infusion machine

The doctor will want to know about all symptoms - what happened and how severe. Main problems to look out for during this time:

• If temperature is over 100 degrees for 15 minutes, need blood tests to see if there is an infection. If this happens on weekend, go to emergency room. Don't take Tylenol etc., to reduce fever. 
• Constipation - Try taking senna. Otherwise call oncology nurse's station if during the week. 
• Diarrhea - Immodium only. (But Misha told me it has some toxic ingredients so hopefully won't need to.) 
• Vomiting 
• Bone pain, let doc know right away.
• Neuropathy (numbness), side effect of Taxol. Let doc know right away. 
• Minor aches and pains ok. Try Tylenol and if that doesn't work, switch to vicodin. 

Important stuff to keep track of:

• Maintain weight; keep really good track of weight. Only need to change diet if losing too much weight.
• Hydration
• Energy level
• Walk every day

Chemo schedule is every three weeks for 18 weeks, with a PET scan in the middle to make sure it's working: June 22, July 13, Aug 3, Aug 24, Sep 14, Oct 5. 

Having just gotten off retreat & sat in a small room at Kaiser for 6 hours, driving across San Francisco seemed very strange...But we made it to Misha's. She gave me loads of herbs (pills) to take, the regimen changing with the different phases of chemo, and a new treatment plan.

She has seen people in terrible pain from the Nupogen and asked if I could try not taking it but get blood tests often to make sure my blood counts are OK. She wasn't sure how often I'd need to get the blood tests. I'll talk to Dr. T and David about this on monday. If they don't go for it I'll have to start with the injections that day. Anyway, I had a treatment from Misha and felt great afterwards.

Then we went to Burma Superstar restaurant, and a walk around Stow Lake...

Here's a clip from a 60 Minutes Misha told me about featuring Dr. Lustig from UCSF and his research on sugar consumption. Start at 7:31 for the cancer stuff (focus is on heart disease before that):