My second chemo day (22 September) was an absolute success in comparison to chemo #1!
It went like this:
Two weeks before:
- My Oncologist and I had agreed on a new ‘plan’ for my second chemo, which I was happy with and included a new anti-nausea medication. N.B. I do not tolerate a lot of the normal anti-nausea medications given during chemo so apparently I am a special i.e. difficult case.
- My Oncologist faxed the prescription through to my chemist.
Two days before:
- I picked up the anti-nausea meds from the chemist.
The day before:
- At 9am, I went to the local Laboratory for the pre-chemo blood test. This blood test is important so that the Oncologist can check for a range of things but the main concern is the neutrophil level as neutrophil counts fall temporarily with most chemotherapy drugs. Neutrophils are the most abundant white blood cells in humans; they account for approximately 70% of all white blood cells (leukocytes).
- Unfortunately, I have a problem with veins and it took three attempts, two nurses, half an hour and a wee bit of distress, before anyone could find a vein (and blood).
- The night before and morning of the chemo, I took a prescribed anti-anxiety medication; this is quite normal for many people doing chemo as they feel pre-chemo anxiety.
- I prepared my chemo activity kit (magazines, coloured pencils and paper, Sudoku book, warm clothes etc.).
D Day (or ‘C’ Day)
- I drank 500ml-plus before my appointment at 10am. This ensures the veins are plumped up. I also dressed extra warmly and wore gloves to keep my hands warm (which also helps the veins come to the surface).
- My Mum and I drove an hour to Wellington hospital and parked at the Cancer Society car park. On the way, we picked up: several new magazines, flavoured water (as I am finding that water tastes strange because of the chemo) and hot drinks.
- At the hospital, a nurse weighed me and I was the same weight. Chemo drugs are given on a millilitre per kilo rate so they check weight each time (also chemo drugs can cause rapid weight loss or gain).
- I was taken into a room to meet with my Oncologist. We discussed side effects from the last chemo and how the new chemo medications would work.
- The Oncologist advised that my neutrophil (white blood cell count) was 0.7 and the minimum for chemo is 1.0. So she wanted another blood test to see if my neutrophil count had increased from the day before.
- The blood test result would come back during the chemo session and if my neutrophil count was too low, a drug to stimulate neutrophil production would be given by injection. Sometimes chemo is delayed until the neutrophil count increases (but I just want to get all this chemo over and done with).
N.B. Chemotherapy kills fast dividing cancer cells. It also ends up killing some fast dividing normal cells in the body, like some cells in the bone marrow that maintain the supply of white cells in the blood. The stated normal range for human blood counts varies between laboratories, but a neutrophil count of 2.5–7.5 x 109/L is a standard normal range. Low neutrophil counts are termed neutropenia. Neutropenia can be a side effect of chemotherapy and makes an individual highly susceptible to infections.
- I took the new anti-nausea medication (a pill) an hour before the chemo started plus another anti-nausea pill, which I’d taken last time.
- Then the same process as last time: inserting the cannula into a vein on the back of my left hand, the blood test (first) from the cannula, then a saline IV to flush out the veins and get me hydrated. See pic below.
- Then three different chemotherapy drugs (called CMF) plus Herceptin. No neutrophil related injection was required so my neutrophil count must have increased overnight.
- I felt a lot better than last time. I did start getting a dull headache so took some headache medication while at the hospital.
- We left the hospital around 2.30pm and I felt quite good (comparatively).
- That afternoon, I went to bed and slept. I felt no nausea or headache – just a feeling of being quite drugged.
- For the first two days, I felt quite drugged and very little nausea.
- Side effects continue – I have terrible skin, sore hair (some falling out but not noticeable) and difficulty concentrating, I am more fatigued and am sleeping longer and longer each day.
- I am quite concerned about the neutrophil count and avoiding groups of people or anyone with a cold, and I am washing my hands compulsively
- I am feeling relatively upbeat though. This chemo was not a trauma and I know that I can do two more chemos. In saying that, it isn’t easy but it isn’t as hard as last time. This is a huge deal and I am thankful for my fantastic Oncologist who listened to me and really helped me. Thanks Kate.
(Some material has been referenced from Wikipedia)