Saturday, December 20, 2014

from last island day to first chemo day

2 weeks ago, it was the last of the island days. the photo above is from the morning of the flight, with the sky turning overcast.

1 week ago, it was the day after getting my "Port", this medical appliance that will make infusions easier during chemotherapy. The port, it isn’t really painful, and it will be more comfortable (or rather: less upsetting) than receiving infusions through the usual injection devices they put on the back of your hand. Also, it is safer, as the risk of a wrong injection that spills into body tissue is less likely)

And today - is the day after the first chemotherapy session. Here's a photo from the chemo room, the application is for running the different medical infusions, some of them run parallel. Such a different scenery.

"You are so brave," a friend worte. "I don’t think I am really brave", I wrote back "it’s just that there isn’t much of an alternative. The recurrence risk of the cancer I have, and that I would live with when I wouldn’t do the treatment is rather high. And on the other hand, the chances with treatment are high for me, as it is localized and detected early. I just looked for a chart, here is the sum of it:

In German, the number they give for that is 95%, but it’s really good. I just wish they wouldn’t name the charts “survival rate”. But then, that’s what it comes down to. If you detect it later, and it isn’t localized any more, chances start to fall. So to sum it up: it’s not really a question of being brave, but of doing what you need to do to get into this safety zone… 

So: chemo day. I was a bit nervous, not really knowing what will happen, and how my body will react to it. On the other side, I was curious for it after the waiting, as it also will give a better idea of the time coming. Altogether, it turned into a mixed day. the chemotherapy session itself went well: we were 6 patients in a friendly room, all of us in breast cancer treatment. The nurse had already prepared things for everyone, and we sat in comfortable chairs that are like tv-chairs, with a rest for the feet that is moveable, and a moveable back, and a cushion.

The treatment for me was 5 different infusions, one was fluid that ran all the time to water the body. the first real infusion is a medication mix for the side effects, and the other were the real chemo stuff, and other additions. The infusions, they worked well with the port. And sitting there together gave a good space to chat and connect, and share experiences. I was the only “first”, the others were further in treatment. I had brought my e-reader, like some of the others, too.

The whole procedure took about 3,5 hours, starting at 8.30. Here's a photo of the infusion list, that's the medical roll I am on. The 2 lines marked red are the actual chemotherapy, the others are accompanying medications for side-effects (more about that further below.)


My partner picked me up after afterwards, and my sister was arriving, too, shortly after we were back. She had brought fresh bread rolls. I felt good, and had appetite to eat, so we had lunch together, which was really nice, this togetherness after the first treatment. After lunch, we went for a walk. It was good to be outside, in the fresh air, and it's nice that it isn't really cold yet. 

Back home, I had a cup of tea,  then my sister left, and I thought I would watch a bit of tv and relax – and about half an hour later, I felt that my body starts to react, feeling a light dizziness. That was still okay, and I dozed for a while. And woke up feeling my with nausea and a tight stomach. I went into bed, and waited to see what would happen, and dozed on and off, and then finally slept for 1,5 hours. Afterwards I felt better and was up again, and had a banana-honey bread and tea.

Today is better, with a slight dizziness, but otherwise I feel okay. We went for a walk, and my appetite is back, too. I also did some yoga, which helps to get back into balance and relax. I am glad I looked for an online yoga channel in summer during the pause of my local yoga course, and now can choose from single sessions with different themes (here's the link: Yoga online). One of their current courses is a Healing Course, and there a short meditations, too, which work really well for me right now.

Next week, there will be an after-chemo-blood test, and then another one in the following week. The next session will be in 3 weeks, so that's okay, giving time to rest and recover before the cycle starts again.

I now started to mark all blog posts about this shadow journey with a tag, you can click here to read them: C is for cancer, and for courage, too 

And here are more more moments from Lanzarote island 


Infusion list / Medication
And here is more about the medication - I got curious for that today, and copied short descriptions from wikipedia. Nausea is the most common side-effect of therapy, and the first days are supposed to be the most affected. The cellular effects of the chemo meds run for a longer time, so my blood levels will be on a low probably about day 10, which also will be the time my hair will fall.

Epirubicin is an anthracycline drug used for chemotherapy. The anthracyclines are among the most effective anticancer treatments ever developed. It can be used in combination with other medications to treat breast cancer in patients who have had surgery to remove the tumor. More here: Epiburicin

Cyclophosphamide is used to treat cancers and autoimmune disorders, here's more.

Aprepitant is effective in helping to prevent CINV ( chemotherapy-induced nausea and vomiting) because it antagonizes the NK1 receptor. This receptor is located at the brain stem nuclei of the dorsal vagal complex and is a crucial part of the regulation of vomiting. . Acute or delayed CINV is an unpleasant side effect experienced by over 80% of patients undergoing initial and repeated highly emetogenic cancer chemotherapy.

Dexamethasone has anti-inflammatory and immunosuppressant effects. Dexamethasone is used for the treatment of many conditions including: rheumatologic problems, a number of skin diseases such as erythema multiforme, severe allergies, asthma, chronic obstructive lung disease, croup, and cerebral edema, in addition to other medications in tuberculosis and a number of other infectious diseases.

Granisetron is a serotonin 5-HT3 receptor antagonist used as an antiemetic to treat nausea and vomiting following chemotherapy. Its main effect is to reduce the activity of the vagus nerve, which is a nerve that activates the vomiting center in the medulla oblongata. Granisetron is metabolized slowly by the liver, giving it a longer than average half-life. One dose usually lasts 4 to 9 hours and is usually administered once or twice daily. This drug is removed from the body by the liver and kidneys.

Mesna is used therapeutically to reduce the incidence of haemorrhagic cystitis and haematuria when a patient receives ifosfamide or cyclophosphamide for cancer chemotherapy

In addition, I got 2 pills for each of the following day, one to prevent CINV, and one to support the immune system.


Laurie Kolp said...

Courageous indeed... and cared for deeply. Hang in there, Dorothee!

Sandra Davies said...

My sister-in-law went through all this a few years ago, with the addition of having to travel off the island where she lived, to stay for five days at a time at the hospital. She's been back to full health and life ever since.
Trust the same will apply to you.

Jean said...

Your intense and careful presence with all of this can only be a good thing, I think - cringing and tensing away must be an added strain on mind and body. Warmest, warmest thoughts and wishes. xx

Dorothee said...

Thanks for your thoughts and encouraging messages. The writing about it, the presence with it, it helps me to process what is happening, and to understand what is going on, both emotional, but also on a bodily level. i slept well again tonight, and feel okay today, too, just a bit dizzy. and it's solstice today ~

Rouchswalwe said...

Happy Solstice, Dorothee! Keep writing and keeping your ears stiff.

Beth said...

I've been thinking of you, Dorothee. Glad the first session is over and that you've felt pretty good so far. My sister-in-law made the same decision - she had surgery but was advised to do the chemo as well. We just talked last night - it's almost five years now, and she's just fine! Bon courage, and know that I'll be here reading and writing back!

Dorothee said...

Hi Beth, hi Rouchswalwe - thanks for reading, and for writing, and sending courage.