Monday, December 21, 2009

Wrapping My Head Around the Information

So this is a day later than I expected but I've really needed the time to digest all of the information we've been given on my treatment. As I stated on Friday, we have no further information on the diagnosis (no PET scan results as of yet, probably tomorrow) however that will not change the treatment which I will be given (ah such a gift!). So, this blog entry will discuss the treatment, the side effects, and the immune issues I will be dealing with for the next 6 months or so. I apologize in advance, but it's a little difficult to remain upbeat while talking about what's going to happen to me.
I previously had mentioned ABVD therapy in an earlier blog. This is indeed the regimen we'll be following for treatment. My treatment, I believe, will go something like this: the Friday prior to treatment I will go to the Cancer Centre (aka Tom Baker) and do my labs and then meet with my nurse, S, and/or hemaetologist. They will asses whether I can do chemo and if I am given the green light, I will have chemo administered on Monday morning (Day 1). Chemo will be given intravenously and will start with an anti-nauseant. Next will come "A" (Adriamycin) which is bright red in colour. If the needle is incorrectly placed and the drug seeps out at all into your system it will give a nasty chemical burn to your skin. Additionally, it makes you pee red (that ain't nearly so bad!). Other side effects include: nausea and vomiting, lowered white blood cell counts, lowered platelet counts, hair loss, mouth sores, and pain, redness, swelling, itching or irritation at the injection site. Long term effects are possible heart problems. You can only take so much of this drug over a lifetime (thank goodness!!). "B" (Bleomycin) is yellow (no idea why the colour is important but it does make me think of a rainbow going into my body) and is the next drug administered to me via iv. It's side effects are flu-like symptoms (fever, chills, sweating), skin and nail changes, hair loss, mouth sores, coughing, and shortness of breath. Long term there is a risk for some patients to develop lung problems, and again, there is a limit as to how much you can have over a lifetime. "V" (Vinblastine) seems to be the mildest of the four and is administered following "B". It's side effects include lowered white blood cell counts, lowered platelet counts, pain and irritation around the injection site, and nausea and vomiting (apparently mild....hahaha). The last iv drug is "D" (Dacarbazine). This drug is administered after "V" and is administered with an additional line of glucose water at the same time. This is to avoid it's nasty side effect of muscle and joint aches and lock jaw. Yeehaw! Other wonderful side effects include (but are not limited to): nausea and vomiting (a popular side effect), lowered white blood cell counts, lowered platelet counts, pain and irritation around the injection site, flu-like symptoms, decreased appetite (ya think?!), altered taste, and weight loss. This whole treatment takes 2-3 hours and then you go home and take more anti-nauseant medication for a few days. Wait 13 days and repeat treatment. Two treatments make up a cycle and I am slated for 6 cycles.
You may have noticed that white blood cells and platelet counts get pounded by these drugs. I suppose being a cancer of the lymphatic system that it makes sense. Unfortunately it means I have to be incredibly sensitive to my immune system and keep myself from getting an infection. To put it into perspective here are a few more pieces of information I was given about my immune system. They told me that between days 7 and 10 of my treatment cycle my white blood cell counts will be at their lowest. They told me to avoid crowds and to institute a strict hand washing policy in my house for household and guests. Additionally, with my white blood cell counts being as low as they'll be, my body won't be able to produce the warning signs of infection namely mucous and phlegm. Because of this, I will have to be aware of my body and if I get a sustained fever of 38 C (normal body temp is 37) for 4 hours, I need to phone the Cancer Centre for instructions for care and if it hits 38.5C I need to hit the road and get to the emergency room and give them a sheet which contains specific instructions (specific blood tests and if my neutrophils are low, broad spectrum antibiotics, isolation, and chest xrays) for the ER from my Hemaetologist/Oncologist. Neutrophil....the most important microbe-eating cell in the blood as it is the main cell which comats infection. Anyhoo.....

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