My second round of treatments began today. I’ll receive these treatments on Mondays and Tuesdays, every three weeks, for a series of six cycles. On Mondays I’ll receive Rituxan, the same monoclonal antibody treatments that I received weekly in December, but this time around I’ll receive nearly double the dosage. Today’s treatment was fairly uneventful and, since I’d had Rituxan before, I knew what to expect. The main difference was that I received today’s treatment at my doctor’s office rather than at the ATU at the hospital. The treatment room at my doctor’s office has two more chairs than the room at the hospital and perhaps 6 times the space. Like the ATU, however, I was once again the sole representative of my demographic niche.
My Rituxan treatments last about four hours. They begin with a blood draw to see what my levels are for a variety of things and I was pleased to see today that my “iron numbers” are still in the low end of the normal range. Both my blood draws and my treatments are now done using the port that was implanted last week. The port lies beneath the skin in the upper left corner of my chest, just below the collar bone. With this, the nurses are able to do everything that they need to do without trying to find a vein and starting an IV with each treatment. They give me a small shot to numb the area before inserting “the big needle” and while the shot stings a little, it’s not bad. They then give me some benadryl (which makes me very sleepy) and couple of other things to prevent an allergic reaction. Rituxan is grown in mice so the biggest side effect is usually an allergic reaction. It’s now two hours after my treatment ended and, aside from being a little sleepy still, I’m feeling fine.
Tomorrow is the big day when I’ll receive chemo (CVP – cyclophosphamide, vincristine and prednisone) for the first time. I’ll take the prednisone orally, three times/day for 5 days. When I get to the treatment room, they’ll start me on some anti-nausea meds, then give vincristine (a slow IV injection taking just a few minutes), and finish with the cyclophosamide which will be given as a drip over roughly an hour and a half. My appointment is at 10:00 and I should be done around 1:00. The prednisone will make me very alert and hungry and I have a prescription to combat those side effects at night so that I can sleep. “C” and “V” both cause nausea and hair loss so I have a couple of anti-nausea medications to deal with that……..and, of course, a sequined scarf for the hair loss! One of the biggest things to watch out for with cyclophosphamide is bladder damage so I have to drink LOTS of water and spend LOTS of time near a bathroom. “C” causes diarrhea and “V” causes constipation but, I’m gonna be near the bathroom anyway, and hopefully they’ll just cancel each other out! I’m told that I shouldn’t expect any side effects during the treatment so my only worry tomorrow is a shot (Neulasta) that I’ll receive to stimulate my bone marrow. I HATE shots! I got sweaty palms today just thinking about it! The nurse told me, though, that it would be very much like the numbing shot that I receive prior to inserting an IV…..and I can survive that…..so I’ll try not to be too much of a wimp tomorrow but I’m really not looking forward to it! The Neulasta shot often causes a lot of bone pain so I’ve got another prescription to deal with that. So….I guess for the next few months I’ll be the stinky girl in the sequined scarf who rattles as she runs to the bathroom. Isn’t that a charming image!?!
For the next couple of days, following chemo, I’ll most likely feel tired from the anti-nausea medication that I’m taking. Fatigue will occur around “nadir”…..”the point in time between chemotherapy cycles when you experience low blood counts” and then I’ll start to feel better again just in time to begin the next cycle.