Chemo #1

Wednesday, August 24 (one day after our 31st anniversary) was Ack's first chemo treatment. 

We got there at 8 am for blood tests. Then sat around waiting for the lab to work the numbers. My liver was out of whack for a while and while steroids were helping to get numbers within range, the doctors needed to be sure I was near normal. Alas, no, the bilibrubin was 2.7 (reference range is 0.2 - 1.3 mg/dL); it has been holding at around 2.5 for the last few tests (after being at 11.7). So, what that meant was in the R-CHOP treatment, they had to cut back on the H and O to half the full treatment (more on that below).  So, after that was all sorted out....

10:30 We were moved to the chemo-cancer-cubical (a private little room off a hallway and with a window). Meredith, the nurse for the day, started me off on IV of saline solution to hydrate me before they added the strong chemicals.

The pharmacist came in to tell us of all the pills I'll be taking. More than I thought (9, I think?). Some will be taken just on weekends - holiday pills!  I look forward to those.  Some nausea prevention ones that are optional, but I've taken them already just to avoid the problem.

So, R-CHOP stands for the chemicals they give me:
R- rituzimab

C cyclophospamide

H- doxrubicin (there is some historic reason why this is an H instead of a D)

O - oncovin/vincristine

P- prednisone - I take that in pill form for 5 days after the IV, given it is a steroid - then I crash!

Because of liver still not behaving correctly (but no sign of cancer there), H and O are reduced by half. They did not have to reduce R or P dosage.

At 11:20 the nurse started R treatment that would last about 3-4 hours. That is the one that people can have a strong negative reaction to - rash, low blood pressure etc. so they gave that slowly at first. I did not have any reaction to it.

At 3:40 they moved onto the H part (yeah, C came later). They also gave me some pills - anti nausea and things. I also got to suck on an ice cream Popsicle, something about keeping the mouth cold so the 'medicine' would concentrate and that might help prevent mouth sores. This only lasted 10 minutes (I mean, how slowly can you eat a Popsicle?), then she moved on to administering the O and C parts of CHOP. That lasted about 40 minutes. Then they flushed everything with another saline solution. By the time we got home it was close to 6 pm. Dinner at home was fend for yourself - which means I had a great chicken salad sandwich and some of Anne's great Peach Pie (with a few blueberries).

By 8:30 I was fighting to stay awake. In bed early and slept sound, though a bit of the night sweats. In the morning (7 am) I took my suite of pills, then fell asleep on the couch. I woke up after 9 and got to work around 10 am. Stayed at work til about 4:20.  Good energy level and no side effects.

As Anne noted: "It was pretty boring too though the staff were lovely and kind, and his room had a window though not much of a view - just of the beautiful day we were missing."  But we did get to watch the animated movie Tangled - it's all about the horse!

I'm scheduled to go in for the next three Wednesdays: next week for blood tests, the following week for blood tests with a doctor consult, and the third Wed (Sept 14, Eileen's b-day) for the next chemo cycle.