January 29, 2015

First Chemo Treatment!

It was a long day, a lot longer than I thought.  We got there on time for an 8:45 appointment.  Things got going with the puncture of the port – which is through the skin, obviously.  Some infusion centers spray a little novocaine or lidocaine to numb the port area, but not at PAMF.  The puncture was actually pretty bad, and while I adjusted to it, I was surprised at how much it hurt.  I’m no wimp, and I’ve been poked and punctured a lot – donating blood, blood tests, IVs for 5 major surgeries and sedation procedures – but this hurt.  I’ve now got a numbing cream, EMLA, ($45 later) to put on about 30 minutes before my next port puncture.

The first thing to go in was saline to flush the port.  That was for about 10 minutes, and then the pre-meds – no, not undergraduate students, but Decadron (steroid) and Zofran (anti-nausea) which took about 20 minutes.  So my first drug, Perjeta, didn’t get started until about 9:45.  That infusion took 60 minutes, which went just fine.  There was a 30 minute break, and then the second drug Herceptin, got started.  This first time, Herceptin was a 90 minute infusion.  The next chemo treatment the Herceptin will be 60 minutes, and then 30 minutes after that each time – which is good because that’s the targeted chemo drug that I will need to have for 52 weeks.

Each infusion is given mixed with a saline solution; that with all the liquid I’m supposed to drink meant that I went to bathroom a lot!  and I really should have taken a potty break between the Herceptin and the Taxotere!  Taxotere is the drug that the nurses watch very carefully while it’s being administered.  It was started right away, first with a saline flush, then a slow drip of 50 mls over 30 minutes, then increased to 100 mls for 30 minutes, then the last 220 mls or so over 45 minutes.  I was told to hold a cup of ice for possible neuropathy and asked if I wanted to put my feet in a cold bath to help with possible neuropathy, and then asked to eat ice chips.  The nurses asked if I was getting itchy or a rash, and whether I had any back pain repeatedly.  I had none of those symptoms, but by the end my face was flushed, as if I’d had a drink.  So they took my vitals, and decided to give me a saline flush for 30 minutes, then retake my vitals.  My vitals after the flush were more back to what they’d been all day (although the vitals right after the Taxotere weren’t terrible).  So it was decided that my face was flushed more likely from the steroid than the Taxotere.

After a quick break, the final drug of the day was given, Carboplatin.  Only a 30 minute infusion, it seemed to finish in no time flat.  Then it was about 30 mls of saline flush for the port, then Heparin in the port to prevent clotting, the needle removed, and I was pretty much good to go – at 4:45!  8 hours in the infusion center.  Wow.

Well, I was sort of good to go. I had to make an appointment to get a Neulasta shot for tomorrow. Neulasta stimulates the bone marrow, and can cause extreme bone pain. Fortunately, my friend Lori pointed me to recent research about taking Claritin with Neulasta, so I’m going to be proactive and take Claritin.  I’d rather avoid bone pain, thank you very much.

I also had to make appointments for my next chemo treatment, which isn’t as easy as you might think.  I have to have a blood draw at least 2 hours before a doctor’s appointment, because I’m choosing to have the blood draw through my port (although if EMLA doesn’t work, I may choose to having a regular blood draw) and generally the doctor’s appointment is the day before chemo.  And because it was suggested that Neulasta be given by the injection specialist in the infusion center, I’m going to have chemo on Thursdays, rather than Fridays, if I can.  Otherwise I have to receive the Neulasta shot at Urgent Care, and most likely not by an injection expert.  Neulasta is pretty thick and is best given in a really fleshy part of the body (my arms are way fleshy, so I think I’ll spare my butt).  So I’ll have doctor’s appointment on Wednesdays, chemo infusion on Thursday, and work from home on Friday with time for a Neulasta shot.  I was able to do some work today, and some knitting, but my sister and I talked a bunch, which was great.  Thank you notes and other work will have to wait until tomorrow.

The only thing that was disappointing today was I learned that Dr. Priya is on medical leave from February 9 until April 13, which means I won’t see her until right before my 5th treatment!  I’m so sad.  I just hope Dr. Kushlan is just as good.

I finally wrote out all the drugs and supplements I need to take from Day 0 through Day 7, because they all have times to be taken and different dosages.  I could probably keep it all straight in my mind, but it helped to write it all out.

I have so much support from all over, but I have to give kudos to my sisters for today. Lucy picked me up this morning and Chris met us at Oncology.  Lucy stayed for about an hour and then had to go, but Chris stayed until about 3:15.  Lucy came back around 3:30 until the end, and then took me to run errands and home.  It was great to have my sisters there for this first session.  I would have been fine, but it was awesome to have them there.  And of course, Ted was home with dinner and just made me cherry-mango popsicles, so the awesomeness continues.

Pretty long day, and I feel as if I should head to bed, but right now I’ve got Loa purring on my lap and the Sharks are beating the crap out of the Ducks, so life is good!

7 thoughts on “January 29, 2015

  1. tturner1 says:

    Caroline, thank you for your eloquent and detailed account of this long day. Please know I’m sending warm thoughts, virtual hugs, and lifting you and your caregivers up in prayer.

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  2. thesamthatiam says:

    I’m glad to hear that things sound like they were pretty routine for you and not a lot of fear here and there. Some advice on EMLA…. I used it for electrolysis back before laser hair removal. Not all doctors kniwnit comes in an extra-strength so if regular is not strong enough then you have another option. Also, apply it 20-30 mins beforehand

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  3. thesamthatiam says:

    ooops…

    Apply the EMLA then cover – seal as mych as possible – the area in plastic wrap which you don’t take off until the moment of puncture. The body heat really revves-up the EMLA!

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  4. Lucy 2 says:

    Wow, that was a big day! Thanks for sharing all the details. I was unhappy with my first pamf oncologist and after shopping around at Stanford and in menlo Park I found Dr Kushlan. She is one of my favorite docs. We had a lot less to cover but I hope you like her as much as I do!!

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  5. Jeannine Mahoney-Sexton says:

    I understand what you are going through, Caroline. Stay warm and cozy during treatment. I had my chemo at PAMF as well. (the one in mountain view). I got to know the nurses and made sure my favorite nurse was on shift to puncture my port. She got to know me too and it made it a little bit better. I did not scheduled anything until I knew she was on duty.

    Big hug to you.
    Jeannine

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