So what does having Chemo actually involve?
I thought this time I would explain the procedure I go through at a Chemotherapy Session. My Chemotherapy regime is based on a 21 day cycle. I have treatments on Day 1 and Day 8 and a Day off on Day 15. The day before each session of Chemo I have to attend the hospital for a blood test to check my full blood count, bone profile and kidney function.
This is checked by the Oncologist who then prescribes my GemCis drugs
Gem – Gemcitabine
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Cis – Cisplatin
Preparation for Chemo
Firstly, I am weighed as a baseline as I will be given over 3 litres of fluid and to ensure my kidneys are not damaged and I am not in retention I should weigh no more than 2 kg over the start weight at the end of the session.
I am then settled in my lounging chair - I use the same one each time as it is the one nearest the toilet for reasons which will become clear later. A warming pad is wrapped around my left hand and wrist to try to encourage the veins to come to the surface so the Nurses can insert the butterfly needle.
My blood pressure, O2 Saturation, Pulse, Resp rate and Temperature are all recorded - annoyingly, despite now being relaxed in the unit my BP is always high there, whilst normal at home. This phenomena is called White Coat Hypertension/Syndrome and is common in Clinical care settings.
The blood results from the previous day are checked and then one of the Nurses expertly inserts the butterfly needle. As I am right handed I have so far always managed to have the infusions in a vein in the back of my left hand, a Normal Saline 'flush' is connected to the pump to ensure the line is patent and secured. Fortunately I am not needle phobic - as a former Nurse it would be a bit stupid if I was. I can't say it doesn't hurt but it really isn't too bad.
My ID is checked and I am then given my first dose of oral pills - steroids (Dexamethasone), anti-emetic (Ondansetron) and Ferusemide, which is a diuretic (water tablet). The latter is given to ensure my Kidneys are working well and to prevent urinary retention.
The first litre and having my breakfast!
My first litre of fluid then goes up - this is just a hydration solution with added Magnesium Sulphate to stabilise my electrolyte balance.
At this point I check my blood sugar and give myself a shot of insulin before I have my breakfast.
Yes! I take a bowl of cornflakes with me as it is such an early start, and otherwise I wouldn't have time. At this point the Friends of St Mary's Newspaper man comes around and I buy a Daily Mirror to read while I have my breakfast. This first litre of fluid runs through over an hour. By now the Ferusemide has started working and I have to take my first of many trips to the loo.
The first initial assault on my invader (Boris)
Once this fluid has gone through, another saline flush is put up before my ID is rechecked, and the first Boris Busting drug (Gemcitabine) is commenced. This has a brown cover over it, as it is sensitive to light - although I do joke that it is hidden so Boris can't see it. This also takes an hour to go through.
Next, another flush ensures all the Gemcitabine has gone through, before yet another ID check and another litre bag of Hydration fluid and Magnesium goes up. By this time I will have probably had about 5 trips to the loo and the Ferusemide is wearing off so they kindly give me another couple of tablets to help my kidneys cope with the amount of fluid.
Blood sugar, insulin and a snack!
I usually do another blood glucose test at this point as the Dexamethazone and Breakfast will have had an effect, and I need to judge if the eighteen units of Novarapid Insulin given before breakfast has caused it to be too low. It is vital I keep an eye on my glucose readings I have another shot of insulin depending on how low this reading is .
At this point I have a snack - normally I have Hummus and Carrot sticks, Cherry Tomatoes, Cucumber slices to use as a dip. This time I will have Cottage Cheese and some Crab sticks, as well as the Carrot Sticks, Cucumber and Tomatoes. Ron normally pops in a few Baby Bel cheeses and a small tub of Cashew nuts too.We did try experimenting with Hard boiled eggs, but the smell was just too much, even though they had been cooled quickly and kept in the fridge overnight. I also have a sugar free Yoghurt for dessert.
Any other ideas welcome.
After this Hydration Fluid, another Flush and ID check, the second Chemotherapy drug goes up - Cisplatin. This is also 'hidden from Boris in a 'brown hood'. This is a 500 ml bag and goes through over 30 minutes. When this has finished there is just another flush to clear the tubing.
Once all the infusions have finished I am weighed again, and hopefully have managed to pass enough urine to be below the 2 kg weight gain limit. It is usually about 3 pm by now and Ron turns up to take me home.
Time to go home...
As you can see, apart form my numerous trips to the loo, and potentially 6 hours of boredom, there is nothing to worry about. Obviously there are different Chemo Drug combinations and some of them do cause some horrendous side-effects during and after treatment, so I realise I am really quite lucky. Apart from the battle with my blood sugars and the increased fatigue I experience, which could be the Chemotherapy, the MS or even the Diabetes (I suspect it might be a bit of each).
So to the boredom - the best way to relieve that I have found, (apart from my many sprints to the loo and back),is to download some programmes or films from Netflix, Prime or BBC iPlayer on to my iPad, plus a few magazines, which I end up leaving in the waiting room.
Sometimes there are a bunch of friendly and chatty 'younger' women, by which I mean my age of course! (most seem to have Breast Cancer rather than a Boris living in their liver) and amazingly the atmosphere in the Chemo Suite is lively and positive. Many of the patients bring in food and it seems like a picnic site some weeks.
Different people have different regimes, but I seem to be the only one who has two, six hour sessions during the 21 day cycle. Others have a smaller infusion over an hour or a couple of hours. I suspect that because of my MS the doses of GemCis are smaller so split over two sessions.
When I leave the department I usually feel OK in myself apart from what I call Treacle legs, but I am always gasping for a proper Mug of tea - fortunately Ron makes a pot of tea before he comes to pick me up so it is ready to pour as soon as we get home.
So, that is my Chemo experience - any questions?
