Round 4 chemo in the books, not an especially pleasant experience. I started as usual with a Dr 7 appointment and got the results of the recent scan. The good news is that there is a reduction in size of the tumors, the bad news is that it is slight. The radiologist had to change the scale from cm to mm to show the difference in one tumor or it would have been lost to rounding error. Prior to chemo the tumors didn't change size (or scale, LOL) in three months between scans. The good news is the change in the bad tumor shows a reduction in diameter, but likely not enough yet. I'm going back to Dr 6, my surgeon, after the next chemo (earliest appointment) to revisit how much more reduction in size is needed before she can remove all three tumors and whatever else is lurking.
The day before chemo I have labs done to make sure I'm healthy enough for chemo. This is the main reason I don't like shaking hands with people - I'm worried about catching something that will cancel chemo. Any fever or reduction in blood counts could get chemo cancelled and I really don't want that. I almost drive away after the Dr appointment as I've always done the labs first, but not this time (I was hoping for a huge improvement... I'm more of an optimist than I give myself credit for). I had the car in gear and was backing out when I remembered. So back to the lines. A line to pick up the order for the test. A line for the labs. Lunch time so a long wait with one person checking in and doing labs. The second vial won't fill, so the nurse fiddles with the needle (OW!). Then she switches vials and we're back to a gusher. Bad vacuum on that tube. Finally out, home for a late lunch, and back to work. The only work I have now that is scheduled and in the field is the same day as my pre-chemo appointments. Frustrating. Today with a mid-day appointment I did a couple hours and had to go back in the heat of the day. Yuck. 94F with high humidity. That wilts me on a good day. Good thing is it's mostly in the air conditioned car.
So in for chemo the next day and I draw a new nurse, is this planned? Four appointments, four nurses. I see them all since I'm there so long through the day, but one is generally in charge of each patient. The nurse is shocked I don't have a port and proceeds to show me why I need one (I know it wasn't intentional). She gets the left hand since I've got reports to do and it's easier if the IV is in my non-dominant hand, also I was just stuck twice in the right this week for tests, one yesterday and one Friday. First stick, she hits the vein but it won't let her inject saline and blows out. Yuck. Second stick, same again. Two quarter-sized bruises today (I bruise easily remember), good thing they are on my left hand. Another reason not to shake my hand, that's where they've been sticking me for IVs. She calls another nurse over to try again. I hear again how my nurse is one to help the other nurses with difficult sticks. My veins look great (so the nurses say) but today they then blow out when they try to inject anything. F***. So the second nurse tries again in the left hand. She can't hit the "huge" vein she can see (and I can see). She never gets in. STOP.
Let's try the right. I'm like a porcupine on the left since they are leaving the equipment in so it doesn't bleed when they put the tourniquet on. Big bubbles, no troubles, she gets a gusher and gets the IV catheter in. It holds, no pain on injection. Note to self: Next month the labs are on the left and chemo on the right. Note: NONE of these veins has been used before. They're all easy to see and palpate. The chemo nurses don't want to use the ones at my left elbow since one is "hard", it's right under a scar from some herbicide I got into in my 20's doing field work. It was last used in December for a scan, so it's not overuse. The other one was proclaimed "hard" six weeks ago and wasn't checked this time. It is easier for me to type and do other things (remember I'm there seven or more hours) with the IV in my hand than in the elbow, which needs to bend more, and I let the nurse choose where to stick me. Anyway, all in all a disaster at the start. This soon changes.
Dora, my nurse, is extremely efficient with the meds and checks on me often. Now I know it's no mistake they keep me close to the nurses station. Once we straighten out the Benadryl is oral and not IV we rocket through the two oral meds (Benadryl and Tylenol) and the IV pre-meds, one pushed and the others total an hour and a half total with a flush and the usual short wait to change bags. Then on to the chemo drugs, first one for 3 hours and then a flush, then the last for 30-40 min and a flush. I'm out by 4:30 PM. Given the delay at the front end with the IV and Benadryl this is really early - not a bad thing, just efficient use of time and limited down time between IV drugs. I had plenty of time for the oral Benadryl to act still as I didn't react to the chemo as I did on round 1. Yay!
So I'm back to eating white food. I have very little appetite the first week after chemo and what I can stomach seems to be mostly white. Bananas, the protein drinks that KR and SH got me at Sam's, half a bagel, mac and cheese, and bonus - potato casserole in the fridge seemed to pass the eye test today. Hoping to expand into apples. That's my diet the first week, nothing else looks at all like it's edible. I'm going to try to clean up some veg and hummus but don't have high hopes - but I do hate to waste food. With the protein drinks at least I get more than the 500-700 calories I was eating the first cycle. My weight is stable now and I am trying to keep it that way, so I don't fret about eating less the first week and make up for it the next when I have more appetite and tolerance for a variety of food. Remember I was losing weight before treatment started and in the first weeks before I got the protein drinks.
Before round 1 I would not have imagined writing about round 4. Onwards!
