Blog / Random thoughts and musings.

Chemo Class

Kathie and I had our two-hour “chemo class” last week. Most of the class was reviewing how the chemo affects the body, especially regarding blood cell production. We went over red blood cells, white blood cells, neutrophils, and platelets, and what the normal levels of each are in the bloodstream, and how each one is affected by chemotherapy. Since the chemo drugs kill lots of blood cells in addition to cancer cells, I’ll be getting a blood test halfway between each chemo session, and another right before the next session to make sure my counts are within allowable limits. The sessions are two weeks apart, and two sessions is a “cycle”. I’ll have 6 cycles of chemo, which means about 6 months. Since they know the chemo will affect my white cell count, I go back the day after each session to get a shot of Neulasta which increases new white cell production in the bone marrow. If the blood tests show the red count dropping as well, then they’ll give me something to counteract that. About a week after each chemo session is when the white count is going to be lowest, which will make me more susceptible to infection, so I’ll need to be sure to avoid sick people and other germ sources as much as possible.

I got prescriptions for Emend which is a relatively new nausea-prevention drug taken before chemo and again the following two mornings, which they said works extremely well at preventing nausea from starting, and Compazine which can be taken if needed after nausea starts.

My schedule is going to be something like this, recurring every two weeks:

• Week 1

• Monday: Blood test to check red/white counts

• Wednesday: Take first Emend (nausea-prevention) pill in the morning
  Chemo via IV in doctor’s office for 4 hours or so

• Thursday: Take second Emend
  Back to the doctor for a shot of Neulasta (white cell growth factor)

• Friday: Third (final) Emend
  Compazine as needed for nausea going forward

• Wednesday: Doctor visit / check-up and mid-cycle blood test

I’m hoping I can work Monday and Tuesday of week 1, and all of week 2, but I won’t know for sure until I see how the chemo affects me. A few people seem to be able to work 8-9 out of the 10 work days, most seem to work 6-7 days, and a few can only work a little. Some people on the Hodgkin’s forum say it’s common to sleep 16 hours a day for a couple days after receiving each chemo treatment (the fatigue is caused by the red blood cell count dropping dramatically after treatment). Time will tell!

All in all, I’m not too worried about it. The Hodgkin’s ABVD treatment is one of the less harsh chemotherapy regimens, and the drugs they have to counteract the side effects are getting better and better. I’m hoping I have minimal nausea and fatigue, except maybe for the day or two after treatment, and I’m not overly concerned about losing my hair!