Let Me See If I Can Remember Everything...

Okay...today was Terry's first Chemotherapy "treatment." He will have this done on Mondays and Tuesdays at Henry Ford Hospital, but only have a "treatment" every other week. We believe that he will have at least 6 treatments, which will mean about a 3-month time span. However, this will depend upon how he tolerates his chemotherapy. If he becomes ill, they may hold off on a treatment, or change medications, some people even land in the hospital if they become too ill, which would prolong the treatments. So, for now, we are speculationg on the best-case scenario.

On the off weeks, Terry will still have blood drawn and also see his oncologist to determine whether any changes in dosage need to be made and to monitor his overall health. Bloodwork is shared between the transplant doctors and the oncologist, obviously due to how cautious they all must be after a transplant.

Monday's medication is "Eloxatin" (Oxaliplatin injection). Once they start the IV, it takes about 90 minutes to complete the treatment. On Tuesdays, the second drug is administered. This drug is "Gemzar" (gemcitabine HCI). He will be receiving what are considered middle-of-the-road doses, so as not to cause too much trauma to his newly transplanted liver.

Common side effects of Eloxatin combination therapy are: Nausea, Vomiting, Fatigue/Tiredness, Diarrhea, Low White Cell count (neutropenia, which can lead to increased chance of infection), Low Red Blood Cell count (anemia, which can lead to fatigue), Neuropathy (tingling or numbness in fingers and toes). Because of the possibility of Neuropathy, Terry has to protect himself from the cold! He has to AVOID cold foods such as ice cream, cold drinks, or even adding ice cubes to any drink. This is kind of funny, in a weird way, as he is now trying to "detox" from ice cream because he was eating it EVERY evening, causing him to put on some pounds! Of course, avoiding cold weather, keeping hands out of/away from freezers/air conditioners (just in case he begins to lose feeling and can't tell how cold it is), as well as keeping socks on, plus the usual commom sense protections, all apply.

With Gemzar, the side effects include, in order of importance: Low White Cells, Low Platelets, Low Red Blood Cells, Mouth Sores or Sore Throat, Skin Irritation if the drug leaks out of the vein, Nausea and Vomiting, Allergic Reactions, which usually occur within the first 15 minutes or so of administering the drug...so we shall see tomorrow...though this was lowest on the list of side effects.

In the long run, there is much to be aware of, both positive...and negative. Dehydration, making sure to eat good foods with added iron, taking in lots of fluids (which he is supposed to be doing now anyway, while avoiding caffeine as much as possible!), not eating raw fruits and vegetables to avoid bacteria.

It is even more important than ever that Terry avoid groups of people/children due to risk of colds, flu, and all things bacterial that may cause infection. After all, his immune system is at risk from the transplant and ongoing anti-rejection medications, let alone adding chemotherapy! If you see him without a mask...feel free to lecture him. At lecture times, he prefers to suddenly do what he should, rather than listen, for the ten millionth time, to what he knows he should be doing! However, he still prefers to try to sneak around without the mask! *sigh*

Fever or diarrhea are especially something to look out for (causing dehydration), in addition to mouth sores. He may have sudden changes with memory (problems concentrating, remembering). All of this is temporary, and some sypmtoms may not even occur. Of course, we can still tease him about just being OLD, as opposed to the medication causing memory loss! (I, especially, can do this, because I am older than Terry!) As far as the nausea goes, he was told to expect some. Even with the medium range dosage, he was given two types of anti-nausea medications. One to try first, Prochlorper (Compazine Generic), on the mild side, and if that doesn't work, he takes the other, Zofran, a stronger anti-nausea drug.

One update on his transplant medications. Terry was taken off of the Prograf, as they felt it was what might have been giving him the "shakes." He is now on 150 mg of Cyclosporine (Neoral), twice a day. He is decreasing his Medrol (steroid) every two weeks, and should be weaned from this by 9-25-06...if all goes well. When he had his minor rejection, he was immediately put back up to the full dose of Medrol, and had 3 days of steroid IV's. Terry still takes Bactrim 3 days a week, which is the antibiotic. He takes his anti-depression medication, and this is vital, for any problems with the liver, even anything minor, can cause depression!

That's it for now...that's enough!

Thanks for everyone's kind concern...love and positive energy, cards, phone calls, donations...the world really is a wonderful place! And I should know, becuase I'm a Pollyanna...even when I don't want to be! *s* Lora