Adjusting to Chemotherapy


Ann's chemotherapy is going reasonably well but it has required a lot of adjustments.

On the day of her treatment, Friday 2/14/03, we started the day with a wonderful breakfast at Walker Brother's Original Pancake House in Wilmette. Ann's nurse told me that she should have a good breakfast so I was just obeying doctor's orders that Valentine's Day.

  http://chicago.citysearch.com/review/3492085/editorial/?cslink=cs_profile_standalone_review

It took several hours to administer the drugs but the time passed very quickly as we were visited by Ann's oncologist, a physiologist, and pharmacist.

One upshot of these consultations is that we changed the medication that will be given to Ann to stimulate the production of white blood cells. We had planned on Nello giving Ann shots of Neupogen at home for several days after each chemotherapy. Instead, we changed to having Ann receive just one shot of Neulasta at the hospital a day or so after each chemotherapy. We made the change solely for insurance reasons. The reimbursement for Neulasta is better than for Neupogen since is administered at the hospital rather than at home. The two drugs are essentially the same.

   Filgrastim (brand name: Neupogen; other name: G-CSF)
<HTMLCode>&nbsp;&nbsp;http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a692033.html">http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a692033.html <br />
&nbsp;&nbsp;http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202628.html
">http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202628.html
 </HTMLCode>

  Pegfilgrastim (brand name: Neulasta)
nbsp; http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/500371.html

By the time we left on Friday afternoon Ann was feeling tired but otherwise fine.

After a few hours at home Ann was absolutely exhausted and starting to feel nauseas. By this time she'd had three drugs to treat chemotherapy side effects, including nausea and vomiting:

  Dexamethasone (brand names: Decadron, Dexameth, Dexone, Hexadrol)
nbsp; http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a682792.html
nbsp; http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202018.html

  Lorazepam (brand name: Ativan)
nbsp; http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a682053.html
<HTMLCode>nbsp;&nbsp;http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202084.html
">http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202084.html
</HTMLCode>

  Ondansetron (brand name: Zofran)

<HTMLCode>nbsp;&nbsp;http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202424.html
">http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202424.html
</HTMLCode>
<HTMLCode>nbsp;&nbsp;http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a601209.html
">http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a601209.html
</HTMLCode>

Since Ann was still feeling very uncomfortable, we decided to break out the heavy-duty stuff, saltine crackers and cola syrup. I'm pleased to say that these old-fashioned nausea remedies helped a great deal.

Stomach queasiness was a big problem last week but Ann never vomited. Her saltine crackers were always nearby and she experimented with some over-the-counter medications for heartburn. Some cancer survivors describe the discomfort as similar to morning sickness during pregnancy. One went so far as to recommend that Ann try Preggie Pops, lollipops marketed to pregnant women.

  http://www.preggiepop.com/preg/product.asp

Nevertheless, almost every day brought it's own chemotherapy-related adventure.

On Monday (2/17/03) she got up a little too quickly from a nap and fainted. Fortunately I was giving her a hug when she blacked out; I just held tightly and lowered her gently after her knees buckled. When she came to she asked why she was on the floor; she had no recollection of what happened. That afternoon we managed to get her to Evanston Hospital for her Neulasta shot without further mishap. Her nurse checked her over and decided that there was nothing serious wrong with her. While we were at the Hospital we spoke to an outpatient dietitian regarding her suggestions for dealing with Ann's nausea. In the evening, Ann attended her first meeting with a cancer survivor support group at the Cancer Wellness Center in Northbrook, IL.

On Tuesday (2/18/03) Ann went back to work. With no new chemotherapy adventures we thought that we had her routine all figured out!

Early Wednesday morning (2/19/03), however, she had a low-grade fever. She had intermittent, low-grade fevers (high of 99.8) every day from Wednesday through Saturday. She stayed home from work the rest of the week.

Sunday's (2/23/03) adventure was an early-morning nose bleed and a rash on her hand. But there was no fever and her heartburn was gone so something was going right!

Monday (2/24/03) Ann worked from home in the morning and went to her office in the afternoon. She told me that she feels good. It's the first time I've heard that since our Valentine's Day breakfast. Maybe we've turned the corner on this cycle of chemotherapy.

Now that the first week of chemotherapy is behind us she's learned some lessons in coping. She's learned to ask for help with things to conserve her strength. She takes naps. She pays attention to how she's feeling and doesn't wait until things are really bad before reacting.

In summary, the side-effects haven't been terrible but they have an impact on her lifestyle and require some adjustments. She never lost her appetite. Food still tastes good to her though some particular things, e.g., water, yogurt, and coffee, taste different. Her portion sizes are much smaller so she is eating more often, grazing almost continuously. But she hasn't lost weight; she's getting enough to eat.

We expect that during the next two weeks she will continue to improve...that she will feel good and hopefully re-gain a little strength.

We understand that chemotherapy is a cumulative process so the big unknown for us is whether the side effects from the future chemotherapy cycles will be worse. For now, though, we'll just take it one day at a time.

I don't expect any more news about Ann's cancer treatment until her next chemotherapy cycle when we get her blood counts. So, don't be concerned if you don't get an email update until the week of March 10th; no news is good news!

Thanks again for the cards, emails, and phone calls. Ann and I appreciate your support.

Love,

Ann and Nello

Posted: Mon - February 24, 2003 at 12:00 AM        

©