The new chemo regimen

I did not get into the clinical trial, and the reason given leads me to believe I never will get into any. Apparantly my "primary cancer" is unclear. I remember way back when I was initially treated being told that my cells had some evidence of endometroid and some of ovarian but the endometroid dominated. For clinical trials they need it to be clear because they are researching ovarian cancer or endometrial cancer... but never a questionable origin. So I'm SOL on the new, promising trials.

So instead I am doing adriamyacin, without the cisplatin. Not sure why we didn't include that. I had to have a MUGA test Thursday morning to make sure my heart was working well enough to proceed. That involves placing an IV and drawing 3ml of blood which is then infused with radioactive material. After 30 minutes, it's reinjected through the IV, the IV is removed and you lay on a table for about 20 minutes while they take pictures of your heart beating for several minutes. From that they can tell what volume of blood your left ventricle pumps out. This test will have to be repeated while I'm on this chemo because it is notoriously hard on your heart and kidneys.

The nice thing is that the chemo treatment takes about 1.5 hours, most of that is taken up with giving the premeds. The chemo is injected by hand into the port by the nurse in two 50ml syringes, and you're done. That's a hell of a lot better than a day and a half in the hospital. So I can work mornings and get infused in the afternoon. If I do it Thursday, I can also work Friday. I do feel more prone to nausea, but the meds have taken care of that so far. I'm also pretty fatigued. That may be related to having less steroids and more benedryl/ativan this time around. I'm pretty tired and sleepy.

Now we'll see what the next few days hold. Sunday night to Monday night were always the worst with the taxol/carbo. I'm keeping my fingers crossed this is less harsh.

Meeting with oncologist and options

I met with my oncologist this morning and I am definitely done with the taxol/carboplatin regimin. He's trying to get me accepted into a clinical trial that has shown some good results for edometrial cancer. He won't know until Tuesday if I meet the criteria. If I do, they will bring me in on Wednesday to review the trial and sign me up if I agree. Then I would start that treatment when I get back from Kodiak.

If I can't get into the trial, they will try cisplatin with something other than taxol (also done in the hosptial with the desensitization process) and see how I tolerate that. If I can't handle both drugs, they'll do single agent. But sounds like my chemo options are running out.

Here's hoping I'm accepted into the clinical trial.

No more chemo this week

But something new is coming down the line. I finally heard from my oncologist's office that I'll just come in for an appointment Friday morning to discuss a new chemo regiment. Makes me nervous, of course, because I've used the same thing since 2003. But maybe this will be something I can do in the infusion center and won't require overnight hospitalization. That would be a plus.

The other good news this week is that side effects from this most recent treatment have been milder. Hopefully I'll be ready to get back to work tomorrow. And have a good trip to Kodiak next week.

Keeping my fingers crossed. :-)

Round Two: Carboplatin failure

Things were looking up at first for yesterday's round 2 of chemo. Blood tests showed things were back to normal. I got checked in and was allowed to leave to get breakfast since everyone knew it would be hours before things really got started. Then we relaxed in the family room until the phlebotomist arrived to access my port. Shortly after that the chemo was ready so we actually got it started around 1pm. At that rate I had a shot at an early morning release. I wasn't counting on it though because it seems something always happens.

Sure enough things were going swell until I was nearly done with my second bag of carboplatin about 8:15pm when my palms started itching and turned bright red. I called the nurse in and she shut off the flow and called the doc for the next steps. As time passed, my arms got red and itchy, and eventually my knees. They finally got some more steroids and benadryl in me and the itching and redness went away. After some discussion they decided to try to proceed with more steroids. We finished bag 2 and got 2/3s through bag three. I was trying to sleep but my scalp started itching badly. I sat up and turned on the light and within a minute my arms and face were bright red and itching. The nurse came in and shut off the flow. By the time she checked in with the doc I was red from head to toe... except for my hands. I even had some hives. No problems breathing though...fortunately. They got it under control but decided to stop the carbo for the night until the doc could see me in the morning.

So I at least got a good night's sleep without the frequent interuptions. I slept until 9, when Darcy got there, with just a couple early morning interuptions. We finally heard from the doc that we're stopping carboplatin and likely switching to cisplatin, but they couldn't do that today because my treating physician wasn't around to make the final decision. So I'll hear from them Monday on the next plan of attack, which may include a return to the hospital next week for the cisplatin.

Hospital Admission was just a big mistake

I spoke with the doc covering for my oncologist's office this morning after my post and she told me when she talked with Urgent Care about the blood test results last night, they initially said the ANC (Absolute Neutrophil Count) was 700. They later said it was 300, which would require hospitalization. They couldn't explain that discrepancy to the doc satisfactorily so she had to admit me to run their own tests.

After IV antibiotics last night and further blood tests this morning, my ANC is low, but not so low as to require hospitalization. My total white blood cells had improved overnight so I was already on the mend. So they discharged me at 11:30. Needless to say, I pretty pissed at Urgent Care. The gave me a sleepless night, a bunch of stress, another sick day used over nothing.

Greetings from the hospital again

After chemo last week, I would normally start feeling better by Tuesday, but this go around, I didn't perk up as soon as I should have. In fact, I got a sore throat and started running a low grade fever by Tuesday evening. I ended up missing work all week. I felt a little better Saturday morning and met some friends for an event, but left early and crashed again after I got home. Felt bad all day Sunday as well. By Sunday night my throat was so sore I finally took a vicodan and was able to gt some sleep. Yesterday morning I felt much better, though I had no voice. I went to work and held up pretty well, though all the talking really made my throat hurt by the end of the day.

I was scheduled for a blood test at the oncologist's and I asked them about the sore throat. They said to see my primary care physician if I wanted treatment for that. After the test, they called and left a message that my white blood cell count was "a tad bit low" and I should see my primary care physician. I didn't get that message until after 5 because my voice mail is screwed up. So I got the earliest appointment I could get which was Wednesday morning. In an abundance of caution I decided to call the consulting nurse at Group Health to see if it was ok to wait that long. She told me to go to Urgent Care that night. After 4 hours and a bunch of tests, turns out my neutrofils were alarmingly low. They talked with the oncologist's office and had me admitted to Swedish about 1am. Got about 2 hours of sleep last night.

Spoke with the resident this morning and they are still running tests looking for signs of infection. They will give me a shot to boost my production of white blood cells, then let me go when my counts are closer to normal. I'm not looking forward to this. I hear those shots hurt.

Out of the Hospital after Round 1

I had high hopes of getting out early this time given that all the chemo orders got submitted early and I was showing up at 8am. I had my port accessed shortly after 9am... and the waiting commenced once again. From 9am to 2pm... nothing. Finally the pre-meds began a little after 2pm. Major frustration. I didn't finish the Taxol until 6:30 in the evening. Then... more waiting. The carboplatin had not been mixed yet and it was shift change. Finally we started with more pre-meds and the carboplatin commenced at 9pm. That put me on a release schedule of about 2pm Saturday afternoon. It also assured I would be awakened repeatedly all night. They gave me a big dose of benedryl to knock me out, then woke me up every 45 minutes to either take vital signs or change the carbo bag until 1:45 in the morning when they started the final bag. They decided to run it at a 10 hour rate instead of the usual 12 hour rate which put me back on pace to be out of there before noon. And from that point, I was only awakened every hour and a half for vital signs. Despite that, I still felt like I slept OK. I was so zonked from the drugs I barely woke when needed and fell right back to sleep. I love the night nurse. I remember her from my last go around.

I got a visit from the doc making rounds about 7am and got up and ordered breakfast. Then I got a surprise visit from my oncologist, too. That was nice of him to visit me while seeing his surgical patients. I asked about my CT scans and he said he got them, and didn't remember there being anything noteworthy in them. He also noticed my iPad and asked about it. I showed him a few things and said I loved it. By the time he left he said he would probably be getting one soon. Ha!

So I finished the last bag and they had everything ready to check me out. The nurse came right in, removed the access needle and I was on my way before noon.

I have decided I just need to be zen about the whole thing and just anticipate being there until Saturday around noon each time. I might try telling the nurse I will be downstairs until noon and to call if they get things ready earlier. That 5 hour wait drove me nuts. They did a good job of keeping me medicated and hydrated this time. That was encouraging. They even gave me a new 3 day nausea med, twice, and the usual zofran.

So now to get through the next 3 days. Sunday night to Monday night should be the worst. Then I climb out of the hole slowly... then wait to lose my hair again. Boo-hoo!