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Monday, 13 December 2010

13th Dec - back from the hospital

I had my pre-therapy assessment this morning with a lovely nurse called Raj.
Anyway, she had to go through some 'stuff' with me to make sure that I understood.
It was quite difficult to write it down and listen, so I hope that I have got all of the following right!!!

The chemo dose/mix is dependant on the patient, and would be mixed in accordance with the body surface area.
It is mixed with a 5% leeway allowance.
This is why it is important that I am weighed at each visit.
If I feel that I have lost weight, then I need to inform the hospital and go an be weighed to ensure that the correct dosage is 'mixed'.
This is pre-mixed, so if I have lost or gained weight and not enough notice is given, the next treatment will have to be postponed by a day to give time for the correct and safe dosage to be mixed.

A record book that I keep is updated at each visit. This looks at the different compounds within the blood..
white cells, red cells, platelets and bone marrow.

Chemotherapy is indiscriminate and will destroy not only the cancer cells that are fast growing, but all other fast growing cells.
This is why the side side effects are as they are, because they are associated with other needed fast growing cells within the body.

Red cells
These carry oxygen.
It is expected that this will become low, the chemo will induce lethargy and tiredness.
If I become short of breath and have difficulty climbing stairs,
this needs to be reported to the hospital immediately and may require a blood transfusion.

White Cells
These deal with the immune system.
The neutrofiles are a specific white blood cell, they are crucial for a normal functioning immune system.
When these specific cells are low this can compromises the immune system. These being low during chemo is common.
This can lead to risk of serious infections which may be fatal.
This is called neuropenic sepsis.
This is not probable but it is possible. In the event of this happening a blood transfusion will be required.
The main symptoms are high temperature, fever and/or shivers,
 this is why is is crucial that I take my temperature  2 - 4 times daily and report to the hospital if it should be higher than my personal norm.

The deal with clotting.
The signs are symptoms of these being dangerously low are nose bleeds and blue patches to the skin. This too will have to be reported to the hospital, (I can't remember if this would require a blood transfusion or not).

What to expect tomorrow
A heat pack will be placed over my arm and hand.
This is because the drugs that are going into my viens is very cold, and the veins need to be kept warn to keep them open.
A needle and cannula (the plastic thing that holds the needle in place and has the 'drug infusions and saline' drips attached), will be put in place.
I will be on a saline drip for the whole period as this also helps to keep the vein open.
Anti-sickness medication will be given intravenously before the chemo meds
This will take 6 -8 hours..

The chemo drugs that I will be given intravenously will be Etoposide and Cisplatin.
One of these I will be taking orally as well, but I can't remember which one.

Most common side effects.
This is the one that effects the bloods cells and bone marrow as described above.
Loss of hair.
Nausea and vomiting.
Changes to the nail beds.
Continence issues.
Affecting kidneys and urethra. (Urethra is the tube that carries urine from the bladder to the 'outside world').
Symptoms - lower back pain.
Numbness to fingertips and toes. These are irreversible. Symptoms are being unable to do up buttons and zips.
Change in sense of taste.
Low Blood pressure.
Sore mouth and moth ulcers.
Taste of metal (One of the compounds in one of the drugs is metal, it is platinum based).
Tinnitus and changes in hearing.
Loss of appetite
There is a possibility of anaphyllactic shock due to an allergic reaction to the drugs.
Side effects to cysplatin should show themselves by day 14, Etoposide by day 18-23

What can be done
There are medicines to counteract most of the common side effects.
Blood transfusions.

Advice given
Drink at least 1 1/2 ltrs each day.
Don't drive yourself to the therapy.
Make sure some one is with you to go home.
Buy a very soft tooth brush
Make sure you have laxatives at the ready
Make sure you have rennies or gaviscon to hand
Put hand cream on regularly through out the day
Keep your lips moisturised
Get some mouth wash with no alcohol and rinse your mouth after every thing that you eat.
Keep moving to help with constipation.
If anyone out there wants to buy me a WII Fit.........!

Do not eat
Yoghurt with bacteria

It is expected that
After this chemo - 3 x 3 week cycles
Then radiotherapy
Then more chemo

Please see

On the 'Up Side'.....
Free wig
Make over
Apparently Debenhams have donated £200.00 worth of stuff to paper us!!!! (And pamper us!! Lol!!) Whoooohoooo!!
Thanks Debenhams!!!!!

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