Tuesday, February 13, 2007 - Chemo School

Dear What's Her Name,

Here it is, only Tuesday, and I must admit I feel like I've put in a full week. But it's only been two days!! Ok, yesterday's blog entry described the two appts. I went to, the first being with Dr. Brown and the second being with the Radiation dept. at the Cancer Agency. I have to admit, I was pretty wiped out by the time I got home... and this is BEFORE I start on any treatments.

Today, was what Jo, Steve and I called "Chemo School". Hehehe... it wasn't really a class, but where we met with a Cancer Agency Nurse who went over in detail the chemo drugs I'd be taking as well as the meds I'd be taking to counter-act any of the possible side affects the chemo drugs might give me. Jo met me on the 2nd floor where we were to meet with the nurse (Jo was working at the Cancer Agency today), but Steve was still on location for Smallville so couldn't make it. I told him not to worry... I'm a big girl, and Jo would be there too, so we'd be fine. Here is a brief summary of the drugs I'll be taking and we went over them with the nurse and a few things I learned today:

When I first recorded what kinds of chemo I'd be getting, I said there were two different types that they'd be giving me... but, I found out today I'll actually be getting 3 types of chemo:

1) Oxaliplatin (OX-ah-le-plat-in) is a drug that is used to treat cancer. It is a clear liquid that is injected into a vein.

2) Leucovorin (loo-koe-VOR-in) is a drug that is used with anticancer drugs to treat some kinds of cancer. It is used to "rescue" normal cells (but not cancer cells) from the effects of an anti-cancer drug called methotrexate. This helps to prevent harmful side effects. Leucovorin is also used to increase the anti-cancer effects of a drug called fluorouracil. It is a clear liquid that is injected into the vein.

Both these chemos (1 and 2) will be injected through the IV port that will have been installed just under my collarbone. Both bags will be inserted into the IV at the same time and will take approx. 2 hours each session to complete.

3) Fluorouracil (flure-oh-yoor'-a-sil) is a drug that is used to treat many types of cancer. It is a clear liquid that is injected into a vein. This is the drug they will start while I'm at the Agency, but they will hook it up to a portable little pump (about the size of a small baby bottle) that can be carried in a fanny pack type container and it will stay with me for 2 days.

All three drugs can cause burns if it leaks under the skin (one of the main side effects of all three drugs), but I won't have to worry about that possibility because I get to have the IV port installed, rather than them install an IV in my arm each session.

I will also be given a prescription for two meds that is used to prevent nausea. I will be taking these 30 minutes before the chemo session and then given instructions how often to take them for a few days after the chemo session (usually twice/day, 12 hours apart). The nurse explained that it would be good to take them at 7am and then 7pm because if I took them any later (say 9am and 9pm) then I would NOT be able to sleep at night. Apparently they can make you quite "speedy" ;) These two drugs are:

1) Dexamethasone (for premedication) is a drug that is usedto prevent or reduce nausea and vomiting caued by cancer chemotherapy. It is also used to prevent allergic reactions caused by some chemotherapy drugs. It can be given by injection or taken by mouth.

2) Ondansetron is a drug that is used to prevent or reduce nausea or vomiting caused by cancer chemotherapy. It can be given by injection or taken by mouth.

Ok... so there we have the chemo and side affect drugs that I'll be taking. Keep in mind, that depending on what kind of cancer a person has, the kind of drugs and for how long can be very different.

The nurse did confirm that, in my case, we are assuming that all the cancer was removed when Dr. Brown (surgeon) did the complicated surgery... but there is no way of knowing if there are stray cells left in my system, whether from the surgery or from the lymph node system. Because 1 lymph node of 17 tested positive for cancer, it could mean that was the ONLY lymph node, or there may have been others that were not included in the sample 17 nodes. Even if there was only 1 cancerous lymph node, it could have started spreading cells into the lymph node system. That being the case, the chemo should be able to zap any and all individual cancer cells that might be floating about.

The radiation, on the other hand, will only benefit the one area it focuses on, which will be the area of the abdominal wall where the abscess was stuck to. Again, that is in case any cells from the abscess managed to escape the abscess and are thinking of making their home in the abdominal wall. IF they were to do that and we didn't use the radiation, then that cell(s) would eventually grow into a tumour. Even if we found out there was a tumour starting to grow, I'd be in big trouble because the abdominal wall is not a part of the body a surgeon can cut out. So radiation becomes important to zap this area... but the this radiation we are doing doesn't benefit any other part of the body, since radiation focuses on one area.

The one thing I did learn today that I had no idea and it sort of threw me as far as my planning goes is... they recommend that I do NOT drive myself to/from the chemo or radiation sessions. I just assumed that, as long as I'm feeling ok, that I could drive myself. It never entered my mind that I couldn't. But, as the nurse said, they have no way of knowing how I'm going to react... whether from the first session or maybe the 10th session. Everyone is different. But if I do drive myself and then find I am having a tough time, I would have to call someone to pick me up, meanwhile my car would be left in the parking (which would end up costing an arm and a leg). So she highly advises that I get someone to drive me to/from both the chemo and the radiation sessions.

Soooo.. hehehe... I'm looking for volunteer drivers in the area (grin). Actually, I know I have a wonderful support group that all happens to live fairly near by, so I don't think it will be a problem. BUT, if it turns out that no one is available, then the Cancer Agency does have a Volunteer Driver Program. You just have to call them 24-48 hours ahead of time, so we shall see how that goes. The worst case scenerio, I could always take a cab to/from sessions. I think that between friends and cabs and, if need be, the Volunteer Program, I will get there when I have to

I felt MUCH better today when our appt. was over. After talking to the nurse and going over "my treatment drug plan", it took away some of that anxiety that was creeping up after yesterday's appt. where I was getting more information than my brain could handle.

Soooo, I'm in darn good spirits today/tonight. I'm back on track with my original thinking that I can handle this, even if it does get a little rough at times. The nurse did say that if there are things I enjoy doing... taking walks with the dog, going shopping, the theatre, movies, etc... then by all means DO them. The exercise, the fresh air, and the distraction will all help to get me through this. I'm just not to take on things that would require hours because when I get tired, then I'm not to push it. Naps are fine and will be needed... but people who end up staying in bed are doing themselves a total disfavour and making it harder on themselves.

Ok... this is it for tonight! Tomorrow I have to go to the walk-in clinic up the street to have my dressing changed and re-packed, but then I get to give my brain a rest for a couple of days.

Ciao for now!

Cheryl