Wednesday, May 23, 2012

chemo faq's

We have reached the next big treatment milestone and chemotherapy has begun.  Wes had his first treatment a few weeks ago.  I was preparing for the worst and was expecting a week full of his head in the toilet.  I was pleasantly surprised to find his symptoms were manageable.  I didn't realize the hard part was making sure his white blood cell count was high enough each time to make sure he can get his next dose safely.  We were sent home a couple of days ago for this very reason.  
Each time we go to the cancer center they access his port and draw some blood to check his levels.  Every time we have been to the infusion center it has been packed.  Cancer patients are everywhere hooked up to toxic drugs.  Some with no hair, some young, but most are old and slightly angry.  If his blood levels are fine they go ahead and mix his special chemo concoction.  I had no idea there were so many types of chemo and so many combinations that could be used.  Wes's treatment and side effects are different and specific to the kind of chemo that he gets for his type of cancer.  

Does he have a port? How does he get chemo?
Wes had a port placed near his collar bone the day before his first treatment.  It is placed under his skin and threaded through his vein close to his heart.  Chemotherapy is very hard on veins and they have found that the bigger ones close to the heart handle it better.  It looks like a large bug bulging under his skin.  Each time he goes for treatment he can rub numbing creaming on it so it isn't as painful when they access it with a needle.  
Some people can get chemo through a pill, but for Wes's cancer it has to come through an IV. 

How often does he have treatment?
Every two weeks Wes has to go to the cancer center where they pump him full of anti-nausea medication and then one type of drug for about 3 hours.  A nurse will then attach a pump containing another chemo drug that he brings home and will continue to pump into him for the next two days.  After two days he goes back and they remove the pump.  He will get twelve of these treatments which means he will be doing this for the next six months.

What symptoms will he have?  
Part of Wes's drugs contain something called oxaliplatin.  This drug has certain side affects that are a little different than any chemo side affects I have heard of.  Oxaliplatin makes it hard to touch or drink cold things.  We are told when you try to drink something cold it feels like you are drinking shards of glass.  Wes is honestly the most proactive patient I have seen and has been practicing drinking luke warm drinks for weeks.  When you touch something cold, even putting your hand in the refrigerator it can shock you.  As you get more and more of this drug your fingers and toes begin to go numb and tingle.  If the tingling and numbness doesn't go away after a few days they sometimes have to stop giving this drug early.  They try to get at least 6 treatments of this kind in you before they consider stopping it.  
Loss of appetite is a big deal for us.  Wes is so thin that when he tells me nothing sounds good and he will throw up if he eats it gives me anxiety.  He lost a few pounds his last treatment because he didn't want to eat anything for 2 or 3 days.  
The chemo in his at home pump makes him very tired and he sleeps a lot for a couple of days.
Diarrhea is another big side affect that worries us.  The large intestine absorbs a lot of the water that we drink.  When they removed his large intestine his body had no way of absorbing water so dehydration is always a concern.  He has to really watch his fluids and make sure he is getting enough to keep his body hydrated.  The chemo drugs cause diarrhea.  This is especially concerning because of his ileostomy. He is more susceptible to dehydration, add diarrhea to that and he is hardly absorbing any water.  Luckily he is determined to take care of himself and makes himself drink even when he isn't feeling well.  The cancer center also has an infusion floor that they can hook him up to fluids any time if he is feeling dehydrated.

Will he lose his hair?
The silver lining is he will not lose his hair!

What about nausea and vomiting?
Cancer centers have become better at managing nausea.  The nurse was telling us that even five years ago they would hook cancer patients up to their drugs and hand them a bag to vomit in.  For half an hour they are pumping Wes full of anti nausea medication.  This will stay in his system for the first 48 to 72 hours after they have accessed his port.  This seemed to manage his nausea and he didn't vomit at all the first few days.  As the IV drugs wore off the nausea was pretty intense, but he was given some prescriptions that manage it pretty well.  He only threw up once during this first treatment.  Crossing my fingers that we can continue to keep this under control.

How does it make him feel?
Like I said, I was pleasantly surprised the first treatment because he seemed to handle it well.  He took medication when he felt nauseous and was a little tired.  Chemotherapy supposedly has an accumulative affect and he may feel worse and worse as the treatments continue.  He feels the affects of everything for about a week and then he slowly starts to recover the second week just to feel well enough to do it all over again.  He can't do much but lay around and try to feel better.  I just tell myself over and over that it is busy season and to get in busy season mindset when it comes to taking care of the girls and the house.  Except this doesn't end on the weekends or at the end of March, and oh yeah it is way more stressful when you're worried about your husband's health on top of everything. 

Can he go out in public?
Chemotherapy kills the fastest growing cells in your body.  When you have cancer, those are the fastest growing cells and chemo will kill those.  However, chemo can not distinguish between cancer cells and healthy cells, so it will also kill healthy fast growing cells.  These happen to be the white blood cells, the cells that make up your immune system and attack infections.  So chemo basically kills cancer and his immune system.  This is why it is scary for chemo patients to get sick.  Their bodies just don't have the equipment it needs to fight off seemingly harmless germs. We try to keep him at home as much as possible.  He doesn't share food with the girls anymore.  He sanitizes.  He is allowed to go to church if he comes late and leaves early so no one comes up to him trying to shake his hand.  We were told wearing a mask could make things worse as it traps in germs, so it it best to just stay out of public places if you can avoid them.  He will definitely not miss important events.  Chemo couldn't stop him from seeing Halle in her ballet recital!

All I know is, if the chemo is going to do all that to his body and life it better be killing that darn cancer!

3 comments:

Christy said...

wow, i had no idea about some of the side effects that are possible with chemo. you are right, these sound a lot different than the side effects that my niece has had. how nice he doesn't have to lose his hair! we're thinking about you guys always. we'll be there in a month for a visit and hope we can come see you guys!

Megan said...

I'm glad the first treatment wasn't as bad as you expected, but goodness... Wes is a brave, brave man! Doing treatments for 6 months will surely put all new meaning to the word "endure", I'll continue to pray for both of you to have the strength to go through it!

Unknown said...

Thank you for the update! I've been reading your family blog for a while now, and all I can say is your family is an amazing and strong family. You have chosen to be positive when it would be so easy to be angry or bitter. Over the last couple of months, I've shared with my husband your story, and he says he hopes he would have your husbands strength and attitude if he were in the same situation. I just wanted to hank you for being an example of faith, love, strength, and keeping a positive attitude. I will pray for you and your continued strength!