This morning was the final check for cycle 1 of my 6 cycle chemo regime. Each cycle consists of 5 days on and 16 days off (3 weeks), a Neulasta injection in week 2, and as of now I know WAY more than I ever thought I would about chemo.
The short story is it has been a relatively easy 1st cycle, which is to be expected I am told, since it takes multiple cycles for the big cumulative effects to build up in one's body, as well as the ramp up in quantity of drugs administered. However, putting 3,350ml of weird chemicals to kill cancer into your body is certainly not without its effects. So I guess I write both to those who have asked, "how's it going?" as well as to those who may be entering into a chemo regime.
As I have mentioned to many, there are many types of chemos out there, and often they differ quite a bit. I am on DA-EPOCH-R which is the tried and hopefully true treatment plan for NHL B cell patients. Specifically, I have primary mediastinal diffuse large B cell NHL (Non Hodgkin's Lymphoma). EPOCH-R is the preferred method over the standard Lymphoma R-CHOP.
Day 1-5 I am blessed with 5 days of a 100mg dose of Prednisone (NO! not again!). Then its chemo first thing Monday morning with an 850ml bag dripping for 4-5 hours into my chemo port which was installed under my skin just below my right side clavicle a few weeks back. They have nice reclining chairs at Va oncology and make things pretty comfortable, but man is it weird watching this stuff drip into you day 1. I was actually able to work from the clinic with a laptop, their wifi, and some headphones which makes the time fly by. As a hint, for anyone about to enter this sort of thing headphones are a good idea as you will be in a room full of people also getting chemo who speak at different volumes with all kinds of different content, share their music with you, and so on. After that, I get a to-go order of a red 500ml solution which pumps from a bag into me for 24 hours while I work, sleep, and carry on as usual. I go back to the docs office 24 hours later and get another to-go bag of joy and repeat this through Thursday's to go bag of joy. Friday they disconnect me from the bag, do a final different 500ml drip onsite, for about an hour or so, and then I am done for the 5 days.
I cannot tell you how liberating the Friday afternoon session is to get rid of the to-go bag of joy fun for the week, get my last drip done, and bust out for the weekend. With that comes a pretty cool system where they do a time released injection of Neulasta, which fires Saturday evening for 45 minutes and pushes 6mg of that drug into your arm. It is essentially a patch which has a circuit board, the drug, a needle, and a beeper to let you know when it starts and stops. Very cool...very expensive. That runs about $8k per injection. Its $7k to go in, so what the heck...? With each 3 week cycle running $60k or so what's another grand between friends to not have to go back on Saturday evening.
Day 7 Sunday - the Neulasta kicks in. I experienced an elevated heart rate (100-120 bpm relaxed), which freaked me out, I wound up in the ER where they ran some tests, and then I got sent home. That elevated heart rate is an allergic reaction to the drug and of course is rare. Why is it that I always wind up being the anomaly? At any rate, Neulasta is a wonder drug, aside from its side effects, that causes your white blood cell count, which have been nuked by chemo, to go way up fast...Like 3-4x what it normally would be way up. That essentially puts your immune system back on track temporarily which is nice if you want to stay active, out, and about.
Day 8 - 12...Neulasta is beating a brother down. Bone pain, which is the most common side effect, and is due to your bone marrow producing white blood cells and getting your immune system back on track. The back pain escalated up through Friday at which point they gave me stronger pain meds to help me sleep and function more easily. [hint] Get these earlier than the Friday after chemo is done (7 days later) and you will likely sleep better all week and not get to this point.
Then, like nothing happened, I woke up on day 13 of cycle 1 [Saturday] at 100% in Kill Devil Hills. Was this all a dream? :-) Anyway, no back pain, no need for meds, nothing. WOW...Now this sounds like a good day to go out on the beach, drink beer, stay up late with friends, and generally speaking totally over do it in celebration, and hope for the best! Ok maybe not my brightest move, but come on, give me a break! Lesson learned...take it easy and cut the go wild thing.
Days 14 - Day 19 [today] - I have had a little back pain, tapered back off of the stronger pain meds, and generally done fine. Bring on tomorrow!
All in all, Isaiah 40:31 is my verse and it works. Faith and hope in the Lord, leaning on family and great friends, and the one thing I can control...my attitude, remain the key elements to get through this and as the verse says, soar on wings of eagles, run and not grow weary, walk and not be faint.
