Cancer Update – Part 50

21 August 2023

I set me alarm for 6 am but I was out of bed at 5:30 am. You never can tell how traffic will be on I-95 so I wanted to get a head start on my day. Breakfast was water watermelon and blueberries with yogurt. With two cups of coffee, crossword worked, and bag packed, I headed out the door at 8:40 am for a 9:15 “arrive by” time. They called me in for the infusion at 9:35 am.

My nurse is Jullianne and she’s very efficient (and overworked with 5 patients today). There was some confusion as to whether I would receive only Taxol today so she zipped an email to Dr. Velez who, after the blood draw, appeared at my chair side. He explained that it would be Taxol first and then Herceptin today. I’ll do that 9 weeks and then be on Herceptin only for the remainder of a year’s time. I’m glad I checked.

Dr. Velez went above and beyond, explaining how careful he is being to make sure I won’t have trouble with diarrhea. He told me to take Imodium 2 tabs at a time, every 4 hours and keep up with the Lomotil twice a day. He scheduled another appointment earlier for next Monday in case I need a solution to prevent dehydration but said if my stools were not watery, I could cancel the appointment. He indicated that with the four drug regimen I was given, there was a 60% chance of diarrhea. On the two drug regimen I am on, it drops to 6%. I’m on board with that.

Then he gave me his personal cell number to text him with any questions. Very few physicians will go that extra distance. I like the way he works.

My blood work was a mixed bag but nothing that would prevent me from receiving the infusion. My eGFR which tests kidney issues was back to normal so that’s a relief. I can testify my kidneys work quite well. It’s only 12:30 pm and I’ve been to the toilet four times since I’ve arrived. I would blame it on the coffee they provided me but I also suspect it’s the Ringer’s solution along with the infusions.

My sodium level was low, my glucose was high (190) but I had eaten breakfast) my red blood cell (RBC) count was low, hemaglobin low(anemic) and hematocrit low (anemic). This may explain my lack of energy.

My neutrophil relative was high which means my body is fighting an infection (could be the result of the Klebsiella infection) and the lymphocyte relative was low (infection). In addition the neutrophils absolute level was high which leads to high white blood cell (WBC) count and lymphocyte absolute was low which means I’m at a higher risk of infection.

At 10:50 am, Jullianne administered Decadron (Dexamethasome) to prevent nausea and waited 15 minutes. Then I was administered Benadryl (to mitigate any bad reactions I may have to Taxol) then Zofran (anti-nausea) and Pepsid to coat my stomach. The Decadron was an injection into the port as well as the other drugs.

At 12:35 pm, I’m receiving Herceptin (250 ml bag). Jullianne will wait 15 minutes after that infusion before administering the Taxol (250 ml bag). The Herceptin should be 30 minutes since I’ve previously been exposed to the drug.

Jullianne programed the Taxol at 25% of the normal rate of flow for 30 minutes, then 50% for 30 minutes, then 75% for 30 minutes and then the normal rate of flow.

I figure I’ll be out of here around 2 or 2:30 pm. The Oreos are already consumed.

This time I am in a different section of the infusion center – the one that I could see through the window from my last fiasco of infusion. I’m in 7b this time.

As you can see from the photo with me and the cubicle, it’s cold. I wore jeans, long sleeved shirt, socks, shoes, and even then I had to put on a jacket. I declined the pillow and blanket at first but had to ask for them later. Next infusion I’m wearing long johns. I’m not kidding here. My hands are cold! I may bring gloves next time.

The only reaction I seem to have from anything was when Jullianne administered the pre-drug routine. I got a little loopy, as in dizzy, and had trouble focusing. That’s gone now and I”m just waiting for the Taxol drip to end.

What follows next may not make any sense. I started to feel nauseous and notified Jullianne. She checked with the pharmacist as to what to give me since I already had a dose of Zofran. The pharmacist recommended more Pepcid to coat the stomach and apparently Jullianne took it upon herself to contact Dr. Velez who recommended Ativan. Ativan is used as an anti-anxiety drug as well as a anti-nausea drug. When Ativan kicked in, I had no problems.

She stopped the Taxol drip at 2:oo pm and injected the Pepsid and Ativan. I started to feel very good about 15 minutes later. She then zoomed the Taxol into my system and I was out of there by 3:15.

Anyone who seems nauseous is given an Emesis bag. I’ll let you look that one up.

This is the second one they have provided me. The night they took me to the emergency room I got one. Pretty soon I’ll have a collection. Personally, I think they could have called it vomit bag.

At 3:15, Jullianne unplugged me and I headed to the car. I was definitely a little woozy. I may start asking people for rides. I then picked up my this year note cards I designed and proceeded to give out five sets to the people at the surgery center. I’ve mentioned the receptionist and her coworker – each got one. Lorraine and Kathy who have been exceptionally helpful got one each and one of the other nurses that I don’t know her name but came and got me the day the drain was removed and stayed with me got one. Again, I think they all could be empathy trainers for all businesses.

I have to feel positive about this session. It ran 6 hours but will probably be less time eventually. She had to release the Taxol very slowly. She said every session, it would be released more quickly than before. Now, I await the side effects. They could be very mild or very severe. That’s why Dr. Velez game me his phone number so I can text him. For the 9 week period of every Monday (1 more of those) or every Tuesday, I now have 8 more sessions to go. After that, it’s strictly the monoclonal antibody Herceptin.

Jullianne took very good care of me but I bribed her with a King Leo peppermint. Next time I’m gonna have to up my game. Another patient brought his mother’s famous chili recipe. She raved over it as did some of the other nurses. I asked if she does get the recipe I want a copy. Hmmm. Now what can I get her to one up the other guy?

Stay tuned!