Tag Archives: chemo

Live Blogging from the Chemo Chair: Cycle 1, Tuesday

As I write this, I’m sitting in a recliner hooked up to a machine that’s pumping the mighty Gemma (AKA Gemzar®) into my bloodstream to combat the evil Siggy. Instead of “Kill the wabbit! Kill the wabbit!” I’m singing “Siggy must die! Siggy must die!” I am no longer a chemo virgin.

Bev gets hooked up to receive chemo

Yes. I wore the Viking Helmet!

Treatment is about 90 minutes. First is blood work to check my levels. Then 20 minutes of anti nausea medicine (through the port). Then 30 minutes to port in Gemma. No real pain–just a few little tweaks and stings–in spite of the still raw-ish wounds I have from yesterday’s port installation. I also received a little education on what to expect and how to care for my port and how to prep my port for the next session.

The chemo chair view

My view from the chemo chair

I’ve decided that I’m going to do my best to turn each one of the Chemo Sessions into a fun event.

My pal Cindy is with me today. We had a lovely lunch at the Boro Bistro. I had the steak burrito–but I could only eat half. Cindy had a huge panini sandwich–she also left with a to-go bag. I took my first Zofran with my lunch.

Cindy and Bev selfie

Selfie with Cindy behind the receptionist desk at Bigger Road.

Then we attended the ribbon cutting at the new Bigger Road Veterinary Clinic (right next door to the restaurant. Bigger Road has been my vet clinic for 19 years and I’m thrilled that they’re expanding into a larger space that looks delightful (it’s set up like a little interior village with oak trees and exam rooms that have each have a different cottage facade), and has so much to offer (acupuncture, Puppy Montresori, doggie day care, do-it-yourself dog wash, a beautiful surgery suite, and a retail space.) It’s the area’s first and only pet spaw!

Ribbon cutting at the new Bigger Road Veterinary Clinic

The ribbon cutting including all the staff in attendance.

Then off we went to Chemo City. We arrived a little early, but they had a seat available for me. Cindy and I had a delightful couple of hours just talking and doing little odds and ends online (there’s wi-fi). Seriously, the time flew by. 

(SIDEBAR: I want to give a shout-out to my local Walgreens. Before we went to lunch, Cindy took me to our local store because I had to return the thermometer I bought last week–it kept telling me my temperature was 99 or 100 degrees. I had tossed the packaging and the receipt, but they took it back no questions asked! The store manager told me that’s their policy on any Walgreens-branded product!)

So. Here begins the new adventure, the new step to bring me back to health. I WILL eradicate that stinking Siggy!!!!

 

NOTE: Portions of this post originally appeared elsewhere. Also, I have backdated this post to preserve chronological order

The Chemo Plan

Shelley and Bev

Yes, I wore the hat.

I saw my oncologist today (thank you Shelley, my Queen of Chemo, for coming with me). Chemo treatments start next week.

First I’ll need a port installed in my upper chest so I’m scheduled for out-patient surgery next Monday. The port is the gateway to one of my big veins allowing easy delivery of my chemo cocktail.

I’ll have one treatment per week for three weeks, with the fourth week as a holiday. This will go for four months. If I seem to be tolerating the treatment, we’ll stretch it to six months.

The chemo drug of choice for me is Gemcitabine, AKA Gemzar®. Side effects include but are not limited to: muscle pain, fever, headache, chills, fatigue, nausea, vomiting, skin rash, mouth sores, difficulty sleeping, and the chemo trade mark–hair loss (though I understand the hair loss may only be hair thinning on Gemzar®). I’ve been assured the Gemzar® is very well tolerated.

I feel a need to give my chemo cocktail a name — to make it feel more friendly. In spite of the side effects it’s about to subject me to, it really is my friend and alley in the war I’m fighting and not the enemy. I thought of calling it Gemmy, but that now seems a little wimpy. Then it occurred to me that there’s a very fierce “Gemma” out there. The matriarch from “Sons of Anarchy,” a TV show that’s on the FX network. Katey Sagal plays Gemma — I’ve been her fan since “Married… with Children,” so she’s like an old pal. And she’s such a gorgeous woman! How could you not want this fierce warrior for your alley?

Gemma, courtesy of Wikipedia

Gemma, courtesy of Wikipedia

But getting back to what’s about to become my chemo experience, I think the thing that bothers me most is that I’m going to have to limit my exposure to crowds because my immune system is going to be AWOL. So all those girlfriend lunches I’ve been planning, trips to the gym, visits to farmers markets, and various other field trips will have to be delayed or modified somehow to lower my risk. And you cannot come to see me if you have even a hint of a cold or other sickness. Even just a tickle

So, next step is the Chemo Class — yes, there’s a class — which is scheduled for Wednesday morning. Stay tuned!

The Chemo Doctor Rings In…

12-21-05Electric-Bailey
Last night, I heard from Dr. Fulton who is the chemo specialist at Med-Vet. The conversation felt a little cold and clinical, but I guess you have to be when you’re a doctor who’s patients are all gonna die soon.

Here’s what she said:

With the surgery alone (Option #1), Bailey will probably live 5 to 6 months more. She feels that this is an aggressive cancer (which is not what I got from Dr. Prescott) because it was so small in the anal gland and yet spread to the lymph nodes.

Option #2 is radiation and chemo. Not gonna happen for my dog, so don’t even mention it. Option #3 is chemo.

Chemo is a drug therapy. It is given less frequently and in lower dosages than for people because the goals are slightly different. For people, they want to do everything they can to prolong life. For dogs, they want to do everything they can to maximize the quality of life for as long as possible. Because it’s in lower dosages, only 20% to 25% of dogs have mild flu symptoms which include nausea, vomiting, loose stools, and lack of appetite. These symptoms usually resolve themselves in 12 to 24 hours.

For Bichons, there is also hair loss–so Bailey would need a coat when it’s cold and a tee shirt to protect her from sun burn in the warm months. Because the chemo drug kills all rapidly dividing cells, there’s the possibility of anemia (it kills red blood cells) and immune problems (it kills white blood cells).

She told me about 3 chemo treatments:

1. An oral medicine called melphalan. She said the research on this med is anecdotal, so she is not really certain how good it is. The dog gets a pill once a day for 7 days, then is off for 3 weeks for the rest of the dog’s life. You pay $3 per pill plus the costs of blood tests to monitor the cancer. I could do this at home.

2. An intravenous cocktail made up of doxorubicin (or mitoxantrone) and carboplatin. Once every 3 weeks, for 6 to 8 dosages over between 18 to 24 weeks. This has been shown to be most successful in anal sack carcinomas. It costs between $250 and $300 a cocktail. This would probably have to be done at Med Vet.

3. Immunotherapy–where you try to turn the dog’s immune system on against the cancer. This is done with something called piroxicam which is an NSAID. Side effects are mild–although it might cause ulcers because it is a cox 2 inhibiter so the dog also takes an OTC ulcer drug like Pepsid. It could cause liver or kidney problems. This drug is not intended for cancer therapy, but has been shown to work (they don’t know why). She would stay on it for 6 to 10 months and it would cost approximately $60 a month for the pills. I could do this at home.

THE DOWN SIDE: All of these drugs have only a 50-50 chance of even WORKING! Half the dogs who do chemo have NO CHANCE OF IMPROVEMENT WHAT SO EVER! And the half that do have improvement live for 2 to 3 years.

I’m still not 100% sure what’s the right thing to do, but I think the door is closing on chemo.

She pooped!

I take back everything I said in my previous post about Med Vet–they are some of the nicest, most empathetic people I’ve ever come across!

Bailey had her surgery on Tuesday–Dr. Schertel called me around 10:30 am to let me know the surgery was done and she was in recovery (I also found out later that he called my vet, Dr. B. to let her know what was going on). It was actually 2 surgeries–the first one was to “strip” the 2 sub-lumbar lymph nodes. They did that through an incision that runs from about 3 inches below her rib cage nearly to her little “private parts” down her abdomen. The 2nd surgery was to remove the left anal gland–an incision that runs a little over an inch out from her anus.

We picked her up on Wednesday afternoon. Poor little sweetheart–she looked like some demented Poodle groomer had gotten ahold of her. Her front legs had Poodle puffs around her “ankles” then she was clipped down to her skin around her “calves” with her “thighs” being furry. She has a bare skin patch on the lower part of her back, and her little heiny is totally bare all the way around her private parts and her underbelly up to her rib cage (gives new meaning to “bare-ass nekid!”)

The incisions look healthy, but scary. She has stitches and metal sutures in her belly incision. The little incision off her anus has stitches.

They told me to keep the e-collar on her at all times–but she doesn’t rest well with it on. She behaves as if she’s being punished. So I’ve spent the past 3 days in the bed room with her as much as possible to keep an eye out that she doesn’t mess with her stitches (thank the Good Lord that I can work from home!). She’s stayed mostly quiet. I’ve not had much sleep.

We’ve had 2 traumas.

Trauma 1: Around 6pm on Thursday, Bailey vomited. This was scary because I got the e-collar off her just in time for her to urp (I had only put it on her 15-minutes prior, this was the defining moment for me and the e-collar–I now hate it as much as Bailey does). I heard her whining–she hardly ever whines–I popped off the collar and she threw up a mass of yellow bile (will need to get the stain out of the carpet soon), with a little bit of kibble thrown in (I had managed to hand-feed her 8 kibbles that morning). I called Med Vet. This is where my mediocre opinion about them changed.

I spoke with Dr. Jenny Lang–she works with Dr. Schertel and had been part of my original consult with him. She was more concerned over the vomit than I was (WHAT??). She told me to discontinue the Carprofen–she thought that might be upsetting Bailey’s tummy. She was also a little worried that Bailey had not been eating (see Trauma 2). She said she could prescribe a new pain med from a local pharmacy, if I thought it was needed, and for me to call her back in the morning.

Around midnight Bailey was restless–up to now she had seemed mostly sleepy and content to lay in her bed. I called Med Vet. The Emergency Room vet tech was incredibly empathetic to me–she took the Walgreens phone number (God bless the person who decided that Walgreens would be open 24/7!), and she contacted Dr. Jenny to find out what pain med should be prescribed (probably woke her up at home!). By 1:30am I was giving Bailey her new pain med (Tramadol) and by 2am she was fast asleep. (All of this happening during a massive snow storm–when I drove to Walgreens the only other vehicles I saw were snow plows!)

Trauma 2: Bailey has not eaten anything since Monday night–the night before her surgery. On Thursday morning I managed to hand-feed her some kibbles, but she urped them. When I spoke to Dr. Jenny on Friday morning she said to try anything to get her to eat–chicken and rice or canned food. I called my vet (wonderful Dr. B.) and got a prescription for EVD Low Residue canned food.

OMIGOSH! I gave her a couple of healthy tablespoons with a little chicken broth and you would think she was starving the way she attacked her food! (I guess she was, poor baby, with nothing in her tummy since Monday night!). We did small servings all day on Friday. She seemed to be a little perkier.

At 7pm Mom and I sat down for supper in the great room (first time that we’ve had supper together since Monday night). Guess who joins us! Little Miss Puppy Butt comes out of the bed room (she had not voluntarily left her bed since she came home), not at her usual frisky trot, but at a kinda nervous gait plopping herself down at my Mom’s feet (the best spot for fallen tid bits). She stayed there the entire time we ate supper, then minced nervously back to her bed.

Later on, she “asked” to come up onto the bed with me. She has not done that all week. Around 4:15 this morning she jumped off the bed before I could lift her down and headed for her pee pad. She did a massive pee (first time she’s used the pee pad since the surgery–I’ve been putting a coat on her and “forcing” her to go outside to pee–she hasn’t wanted to leave her bed). Then, wonder of wonders (!), she started to do the poopy dance.

[OK, if you’re reading this you probably think I’m nuts, but my dog exhibits definite, definable movements when she’s getting ready to have a bowel movement. She does a poopy dance. I don’t know how to catalogue it, but I can recognize it when she does it. Just like I can recognize the way she moves when she is uncomfortable (like when she joined us for supper last night). Her moves are fast and jerky, her tail is at half-mast, and she moves to her destination without stopping for anything–not even an interesting smell.]

The whole BM thing has had me worried because–remember–she has this incision held together with stitches at 8 o’clock coming off of her anus. But out popped 2 little poops with no apparent problem! They came out easily, and she did not seem to experience any pain when they did. I felt like doing my own dance. Bailey re-settled herself on her bed with the opinion that I was silly to be dancing around the bedroom in the middle of the night.

Her stitches/sutures come out next Friday. We will also see the radiologist then. I am not convinced that I should put Bailey through radiation or chemo, I hate the idea of making her suffer anymore than she already has! But I’m going to hear what the radiologist has to say.

These past couple of days I find I am able to talk about Bailey’s cancer without crying, maybe I’ve begun to accept it (even as I type this I feel my eyes stinging and tearing up). And I am amazed and humbled at the number of friends and acquaintances who have come forward, asking about Bailey and offering support. I’m still not in much of a holiday mood, but I’ve begun to think I might make it to January.