Thursday, August 13, 2009

Chemo # 6 and Allergies

Today I got chemo # 6, my second round of Taxol. As always, I had to add a little drama to the whole thing, though. Despite the fact that -- as instructed by the nurse -- I had pre-medicated with 5 decadrons the night before chemo, and five more the morning of the chemo, I once again had an allergic reaction the medication. This time it happened not 16 minutes in as the first time, but 29 minutes in. So one way of looking at it is that my body took a full 13 minutes longer than the first time around to react, which must been I'm becoming more tolerant of the medication. Of course the other way of looking at it is that I am truly allergic, either to the medication itself or one of its supposedly inactive ingredients, such as the cremophor solvent. 

Apparently, many people have an allergic reaction as I had it the first time, but then they can tolerate the Taxol for their remaining courses. If a patient, such as myself, develops the same reaction a second time, however, the doctors become a good bit more worried about whether or not the patient can continue to take this medication. So today they called in Dr. V to evaluate me, and  there was even talk of switching my medication. 

Now, if my body will not tolerate the Taxol, then obviously I cannot take it. However, any switch would also mean switching away from my dose dense schedule. Yet dose dense AC followed by dose dense T is what is currently considered the most effective, the gold standard treatment of breast cancer with a high recurrence rate, such as TNBC. So it is truly important to me, and probably for me, that I finish the form of treatment that is most effective. 

Thus, when I once again broke out in sweat, felt warm, and saw the rash rising up from my chest, heading towards my face, I got a bit worried. The nurse had ended her 15 minutes of close observation, and DH had stepped out to get something to drink, effectively leaving me all by myself. But I managed to keep my wits about me and push the call button and summoned the nurse, who acted immediately. Within less than two minutes, there was a crash cart at hand, my nurse had stopped the infusion and administered liquid benadryl and cortisone, and three or more other nurses had rushed in, bringing  supplemental oxygen. I felt a tiny bit short of breath, so I took some oxygen for a while, and felt as the benadryl kicked in, fighting back the allergic reaction. Once everything subsided, and Dr. V had been called and given the go ahead to start up the infusion again, I made the second try at finishing the treatment. 

This time, I got a few more warm, sweaty moments, but I didn't turn red again. So I figure it wasn't an allergic reaction, but perhaps a hot flash or something, particularly since I've been experiencing drenching night sweats recently. I suppose I am currently in chemopause, with the accompanying side effects. It may just be that I do not normally pay such close attention to my body, and thus do not notice the transient sweaty brow. In any case, I lucked out and each little hot flash passed quickly, without accompanying flushing. With the Taxol now entering my body at a slower rate (and consequently extending my already long 3 hour infusion time), we spent all afternoon, i.e. from 1 p.m. to 6:30 p.m. at the Cancer Center -- and they didn't even have to wait for the CBC results as I had those done at the hospital). Maybe I need to make earlier appointments for the last two rounds...

Tonight I'm tired due to the afternoon's excitement, and the high doses of benadryl it necessitated. Given my decadron issues, though, I also took a preemptive Ativan to make sure I get a good night's sleep. For any pain I might develop, I now have a script for Vicodin. Prophylactically, I will also start taking 50 mg of vitamin B6 to prevent/treat any nerve damage the Taxol may cause. Actually I already felt some tingling in this round tonight -- in my feet, where I did not have any problems last time. I am not allowed to have vitamins the day before, the day of, and the day after chemo, so I'll have to wait until Saturday to start the vitamins. If my nutritionist friend is right, as she typically is about these things, it should help me feel better and protect my nerves from permanent damage, which is always a good thing. 

After all that drama, were both surprised and delighted, when we found a little package waiting for us at home. It contained delicious triple chocolate cookies for us, made lovingly by MLS, 2l's lovely sister. Despite the fact that she has a demanding job, a well as two small kids, one of which is only a few months old, she keeps finding time to bake, and is so thoughtful and kind that sends us a batch of her goodies every few weeks. Thank you very much! As always, the cookies are delicious and sure to be gobbled up fast! We really appreciate not only your tasty gifts, but most of all the emotional support that come through them. We feel very lucky to be recipients of such tasty kindness, and we are in awe of all the things you do!

Well, in my first incarnation of this posting, I had a lengthy section on thanking my other friends and my family for all the extra nice things they are doing for me. However, then I lost my wireless connection, and with it that chunk of my posting disappeared forever. Tonight I lack the energy to retype it, so I'm sorry folks, but this will have to wait for another posting, when I have more energy than tonight. I guess that anemia is starting to rear its head...

So I'm off to bed now, hoping we'll all be able to get some restful sleep.

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