Posts Tagged ‘Neulasta’

In The Home Stretch

June 3, 2014

Thursday, November 7th came upon us like a freight train, leaving behind the memory of our trip with the family somewhere out in the dust, but I had those few days to get me through another session; memories of seeing everyone and knowing they knew I was really okay and still feeling the sting of being slaughtered in all the card games we played late into those two evenings.

If memory serves, this was the day we brought a batch of Lemon Brownies as our now customary offering. Oh, they were so de-yummy-licious. And really, isn’t the flavor of lemon just so clean and refreshing? I craved lemon while I was going through my cancer more than I normally do.

As usual, we were the first ones in, by 8:30am and it was the usual routine–get blood drawn and tested to make sure I was ready for my session, see the doctor for a few minutes to discuss the results and for a general Q&A session. But it was with Dr. P. Dr. David was on vacation.  Doctor P was the one who, when he saw how disfigured I was from all that swelling, when I was still in the hospital, reassured me it was only cosmetic and it would return to normal.  He also was astounded that I was still taking a daily Uloric tablet.  That was to treat the possibility of  Tumor Lysis, a condition similar to gout, where the sloughed off tumor could  crystallize around my joints. He said it’s one of those things that sometimes doctors forget to mention. It wasn’t harmful to keep taking it, only unnecessary since it’s usually stopped after the second treatment.

Then we waited for one of my nurses to come in to prep me for my session with an “okay, a little pinch” and then jabbing the IV needle into my port, get settled in my Chemo chair and wait until either Bea or Kay came over to get me started.
First thing, as always, was the initial flush of saline through the IV which I could taste and despised. It was like a pistol going off at the start of a relay race. Then came the Benadryl and the Zofran and in a little while, “make sure you take the Tylenol”. “Did you take the Tylenol?” “I took it, just like you told me..”

chemo session

Of course we had to stop because, again, the drip began at too high a rate and it made me queasy but after a few moments and some more Zofran I was set back to simmer.

And as usual we were the last ones out for the day, sometime between 3:30 and 4pm and it was time for the cautious ride to the drug store, full of intrigue and mystery–would I need Ariel to pull over so I could be sick?. Would I have to suddenly pee and would I get to my pee bottle in time? “Do you want to come with me or do you want me to drop you at home?” “I’ll go. I’ll be fine. I have my bucket and my bottle”. And he’d park at a remote location in the parking lot so the odds for a little extra privacy, just in case, were greater.

Friday afternoon came and it was time for my Neulasta shot and the waiting period began to see when and where the bone pains would hit. Would it be my thighs again, or my hips? Maybe my forearms or my ankles so I could barely stand. Just please, not my breastbone again. Of all the spots that flared up, that was the worst. I didn’t want to ask to die again.

Ten days later, of course it was mid-point check up day and there was a question whether session number 6 would occur as scheduled, the Wednesday before Thanksgiving, November 27, because it fell inside the three week period and would the insurance company allow it.
The appointment was approved and we got on the schedule, but sadly, it would not be with Dr. David because Wednesdays are his day to for rounds at the hospital. I felt rather sad and in some odd way, it felt anti-climactic. It was my final session and my doctor, my hero, was not going to be there with me. But I had my nurses as usual so that was fine.

But the day went as it usually did only this time the confection was mini no-bake pumpkin cheesecakes with a gingersnap crust, just in time for Thanksgiving. And at the end of the day, as I was about 20 minutes from being released from my confines, one of the nurses suddenly remembered it was Dr David’s birthday, this day he was doing rounds and she called him up. Naturally I chimed in to wish him a happy birthday and I think we all sang to him over the phone. So, in way, he was with me on my final day after all.

Turkey Day was low key, just us and my mother, no fuss no muss and Friday, of course was shot day, but this time we were meeting with Wednesday’s doctor at the hospital, on the Oncology Floor. It was my final shot, at least that’s what we were holding out for and one at a time we were called in to an empty room to get our shots. Dr. Wednesday was not as gentle as the nurses usually were and I felt that shot going in. In face, if I close my eyes and think, I can still feel it. What was he thinking?

But the highlight of that day was when we first got to our floor, who did we cross paths with but Nurse Niki! It was a happy moment for sure and we chatted for a bit and by chance the other nurse who was my second favorite was also on duty that day.
They both thanked me for the “wonderful” letter I’d written to the head nurse about them and the entire staff on that floor. It was posted on the bulletin board in the nurse’s lounge. She said she cried when she read it and then, of course, a tear fell down my cheek as well. But they both needed to tend to their patients and we said our “so-longs” and one more hug and I went to wait with the others until it was my turn for my shot.

green ribbon

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You Should Have Thought of This On Friday

April 29, 2014

Aside from the sporadic feelings of queasiness throughout the day, which the Zofran took care of, and the first few mornings of the Neupogen shots and that blasted quick dissolving gasoline tasting Prednisone tablet, the Uloric tablets to ward off tumor lysis–whereby, much like gout, my joints could suffer when remnants of the dissolving tumor would crystallize on them–and my lounging in a quasi-supine position on the couch in the den, still being propped up with pillows, covered in as many blankets as I could handle without being crushed from their weight (I was constantly freezing), and my mother being here to watch over me, and carrying around my wash basin puke bucket, the first days home from the hospital were quite normal.

I even returned to work. I had to. I needed the distraction. It went slow, I’ll be honest and my bosses all worked with me, knowing my immediate limitations and I can’t be grateful enough for that. I also took naps. I actually planned my days around them. I would carefully lower myself back into my cocoon of Afghans on the couch, set the alarm on my phone and nap for the better part of an hour before going back to work. Of course, lowering myself and getting back up again took up a great deal of my lunch break.

Trying to eat dinner became a chore. I couldn’t eat anything on the dry side. It made me gag. I know I ate more pasta dishes during the first few weeks than I think I’ve eaten my entire life. I was afraid to eat salad, not because a green salad is healthy, but because I couldn’t bear harder food particles going down my throat. And I was force fed water, water, water, water. Everywhere I turned, there was water. Funny story. Ariel was giving me bottled water to drink during the day and I barely drank it. He’d get upset, but it tasted funny, in a bad way, rancid almost. The taste of it made me sick. We tried flavoring it with different juices but only made it sweet repugnance. Afraid I wasn’t hydrating enough, he gave me some from the filtered water faucet and wow, how clean and pure it tasted. So, he got me some sippy cups with screw on lids and had their own straws and I was able to drink my quota each day. The bottled water we figured was a little on the aged side. Crisis averted. AND, I still drink from those cups so I can make sure I measure what I’m supposed to drink. Green one day, orange the next.

For the weekend, my mother went home to take care of her own stuff and she would come back Sunday night. And thank goodness she went home and I was thankful she wasn’t around to witness what went on that Saturday afternoon.

It was a calm sunny day. Ariel and I sat on the patio, armed with my bucket, my water and my coffee and sat in front of the garden. I was feeling somewhat uncomfortable though. It was a sort of pain; not sciatica, and not the back pain which eventually turned out to be cancer–this was an entirely new one, right around my mid-section to the tops of my thighs. I felt as though my bones were breaking and it was non-stop. It had gotten to the point where I could barely walk and at its worst, Ariel was just about carrying me because I could no longer hold myself up as I attempted to get around the patio in hopes of walking it off. Either way, sitting or standing, that bone breaking sensation was full on.

This was the bone pain we knew was coming. Or should I say, Ariel remembered it and I dismissed it, especially at that moment only because the only thing on my mind right then was getting relief and the only thing at my disposal was to try to control my breathing to calm myself and to pray the Hydromorphone tablets (generic Dilaudid) would kick in. Of course it would have been better had I taken them sooner, but this attack came on out of the blue. I’d been taking them at regular 4 hour intervals, but only a fraction of the maximum I was allowed, just enough to stave off any pending discomfort.

I was running low on my Hydromorphone and Ariel tried to get a refill from the drug store and after some finagling, arranged that they would accept a faxed copy of a prescription from the doctor with the promise of handing over the original a few days later after my scheduled appointment with the doctor for my 10-day check up. Plus the folks at the drug store of late were quite well acquainted with me since I’d been living on all sorts of medications over the last month or so.

My regular doctor, Dr. Thomas had originally written that prescription so Ariel called his office. Naturally, being a Saturday, he got the on-call doctor on duty and explained the situation. As I was wincing and clenching the arms of my deck chair and practicing breathing like I was the sole student in a Lamaze class, I could hear a contentious argument transpiring on our end of the phone. Basically, the conversation went something like this: “I don’t know what we’re going to do. I can’t have him be in pain like this. I don’t know what else to do!”. The voice on the other end, I later learned was saying, “I’m sorry, I can’t help you. This is Saturday and we don’t prescribe narcotics on the weekends. You should have thought of this on Friday!”

Oh, drat. I forgot to mention..the on-call doctor that day… Dr. Vera Bitch. And when the time was right, Ariel would report her to Dr. Thomas (and did) but right then he had bigger fish to fry than worry about some ignorant dismissive witch with a medical license. The next thing to do was to call Dr. David’s office in hopes of finding someone there. Making the connection at the oncology office, Ariel once again explained the situation and pretty much before he finished the doctor on call was ready to fax over the prescription to the pharmacy.

I need to mention here, that the bout of bone pain was pretty much on target, timing-wise. It was told to us it would hit me in 7-10 days. Since the Neupogen was administered over a 10-day period, the effects of it were more likely to spike as opposed to the single dose, time-release Neulasta, which I would be receiving after the remaining chemo treatments. It’s beneficial white blood cell building effects would be the same, but hopefully the painful side effects would appear on a more level keel or perhaps even less.

When we saw Dr. David on the following Tuesday for blood work and to get the hard copy of that prescription, we explained what had happened over the weekend and he told us that he was my doctor now, to go through them for anything and everything we needed. This 10-day check up appointment after Chemo would be standard throughout the 18 week period.

I tried to be more vigilant and watch for signs when an attack like this would come on so I could arm myself better against it, but having cancer was all new to me and quite frankly, these episodes could and would strike without a moment’s notice at times and in some very unexpected ways.