Wednesday, November 4, 2015

Chemo #10 and #11

Chemo is actually tougher as it goes forward.  My theory (based on no medical experience) is that there is no cancer - so it's attacking the good stuff.  ☺

Our routine is pretty set now.  First Brett puts gel (a prescription) on his port site which helps numb it - and we cover it with Glad Press-n-Seal (we love that stuff!).  We pack snacks and soda/water (they have some there - but their water doesn't taste that great) in our thermal tote.  Gather up our laptops and magazines/books and then we go to get breakfast out somewhere (IHOP, Perkins, George Webb) so he can get a good bunch of calories in him because we know he won't eat for 2-3 days.

At the Cancer Center - we park in the same spot/area (so we never have to look for the van or wonder what floor we were on).

2nd Floor/Lab:  We check into the Lab by about 8:30-8:40am and it's usually pretty crowded!  It was here that startles the new patients... seeing everyone bald and wearing masks, or in wheelchairs, etc.  And very somber... The staff is amazing and calls in patients to the lab chairs one-by-one.  I don't go back but wait with all of our stuff.  They put the catheter into his port and draw blood for the tests.

What's the name of the
lymph node you took out?
I think it was the super-vena-cava something...
4th Floor/Grace Clinic:  Usually about 9:15-9:30am.  We wait and then when he's called, he gets weighed and then placed into a room.  We typically see a Julie - a Nurse Practitioner that asks Brett the usual questions and we ask crazy questions (what causes this? how big was my biggest tumor? how long before this woulda killed me?... you name it we probably asked).  And then Dr. Fenske comes in (or they are in at the same time) and they ask Brett about fatigue, appetite, go over his blood work, and check him physically for lumps and bumps and listen to his lungs, etc.  They order the chemo drugs based on his weight, etc. and then we check out to make sure any follow-up appointments are scheduled (or other tests, or to return for IV fluids, etc.).

Aunt Lisa came with us for #10!
3rd Floor/Day Hospital (or "Chemo floor").  We usually arrive here about 10-10:30 and they are happy to see him.  He gets a new wrist band and cut off the one he got in the Lab (not sure why?).  We go back to his mini-room/big cubicle type thing and either Kariann or Judy are his nurse for the day.  They start the saline IV and ask him the usual questions (again) and do BP and such.  Then we wait for the chemo drugs to come up!

Anti-nausea cocktail comes first!  This is a small bag of some steroids, etc. I think it's 3 drugs total.  These help with the side affects and it's because of these that Brett doesn't have the affect that has been the case in aggressive chemo in years' past!  He doesn't vomit or have those affects.  He doesn't eat - and might feel queezy, but we'll take it over the alternative.  Medicine is amazing stuff.

Chemo:  Brett's regimin includes 4 drugs, known as ABVD (If you Wiki/Google them, you can read all the horrific side-effects):
•(A)driamycin (also known as Doxorubicin/(H)ydroxydaunorubicin, designated as H in CHOP chemo treatments for those that might be familiar with that).  It's red and comes in a big syringe and she has to administer it with the syringe into his port over a period of 10 minutes.  It's BRIGHT RED and they have to stop and be sure his line his clear.  Infiltration can cause the tissue/vein to die. 
(B)leomycin is pretty toxic to the lungs.  He gets a teeny bag of this over 30 minutes - very slow drip.  It can cause all sorts of problems, including permanent lung-scarring.  They are cautious about his lungs - and even held off on one of the treatments and didn't give it to him until they got (another) pulmonary function test done to be sure no adverse affects were already taking place.
(V)inblastine is a common chemo drug for brain, bladder, testicular cancer - and lymphoma. This is the culprit that makes him not want to eat anything.  It's also the one that causes the hair loss... and kills off his white blood cells.  This is administered by bag, but she needs to attend it and check his port/line every so many minutes to be sure there isn't infiltration.
(D)acarbazine (similar to (P)rocarbazine, designated as P in MOPP and in COPP chemo regimins - usually for non-Hodgkin's lymphoma from what I've read).  Causes fatigue, and of course inhibits cell growth for fast-growing cells (cancer.. but also hair, mouth, etc.)

Brett usually falls asleep, or he becomes glassy-eyed and isn't interested in his iPad/laptop or much of anything.  We sit quietly and wait for the beeps to switch drugs, etc.

The nurse calls in a 2nd nurse to verify his information for every drug... and verify his name and birthdate (for ever drug) and the dosage and administration.  Pretty toxic and I'm glad there is verification for each.

#10!!!  Only 2 left!! 

The chemo nurses and volunteers are all amazing... asking if we want warm blankets (but it's usually pretty warm in those rooms), or something to drink or eat.  The ones that have worked with Brett before always come in and say Hi and ask how things are going.  

Occasionally we see a new person come in - and you can tell they are new... they look scared and don't really know where to go or where the bathrooms are, etc.  It makes me sad to realize that they are beginning their journey.
We're here for #11!  Only 1 left!!!  

Brett didn't like that his eyes were closed
in the pictures... so he opened
them really big.  Dork!

Most of what I see during chemo.  Eric was with
us for this one, too :)

Chemo is always on Wednesday (every other Wednesday)... and the last few times, we come back on Friday for Brett to receive IV fluids.  He doesn't really drink or eat for the 2 days after chemo (and I mean barely a swallow of water to go with his pills each day), so he was getting dehydrated and it was making him take longer to recover.  So Fridays early morning we come back to the Day Hospital to hook him up again for a couple hours to receive fluids.  It really helps and he usually already feels a little bit better.
Getting fluids on Friday after chemo Wednesday.
So that's the routine!  For the days following, Brett doesn't usually leave his room and sleeps a lot.  Very low energy and just hard to watch him feel so bad. 

After this there is ONE MORE LEFT!  We couldn't be happier!!  Brett was diagnosed on May 28th - and his last chemo will be on November 18th (if he doesn't get sick, etc.)  

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