Treatment #5

On Wednesday February 8th I went in for my fifth systemic chemotherapy treatment. This time the anti-nausea pre-med was intravenous Emend and it was 100% effective. In the past, I have taken Emend in pill form over a 3-day period with a nausea-free effectiveness of about 90%. This time I was 100% nausea free all day Wednesday, Thursday and until 3PM on Friday. The nausea started at 3PM because that's when I was on my way to have the portable chemo pump unhooked from my port. Each time I've gone to get the pump unhooked, I've found myself miserably nauseous.

I have never been 100% nausea free while doing chemotherapy. I had no idea it as even possible. It's great to have a completely effective anti-nausea med. Now if I can just find an effective anti-feeling-poisoned med to deal with the rest of the side-effects I'll be in great shape!

I believe what had me feel nauseous on Friday afternoon was an anticipatory nausea I experience prior to the start of a treatment or prior the removal of the pump on the third day. I was prescribed Ativan to manage it. It reduces the anxiety so the nausea doesn't start. But unfortunately, once I opened the cupboard to take one, I forgot why I was in there (chemo-brain) and never took it. And once the nausea started, it stuck around for a while. However, it was relatively tolerable, so we did some vocal recordings on a song here at the house until about 10 PM when I decided to go to bed.

By 11 PM I started to experience abdominal pain. Inside my abdomen I felt a sharp pain and burning. It was a pain level of about four out of ten. Once it got to a six out of ten, I took a couple anti-acids. They didn't work and the pain increased to an eight out of ten. So in a last ditch effort, I took some Pepto in hopes of "putting the fire out." Well, within a minute I was bent over the toilet bowl while my body rejected every last bit of the stuff. At that point I called my oncologists office and got into communication with Dr. Bael, the doctor on call. He recommended the Emergency Room for bloodwork and pain relief, and my housemate gave me a ride. Within an hour of being at the hospital, I was on a bed receiving intravenous Dilaudid for the abdominal pain. Blood work was done and the only thing that stood out was my very high white blood cell count which was a result of the Neulasta shot.

The pain from the Neulasta has been brutal for the last four treatments. Yet during my latest meeting with Dr, Kemeney, she mentioned that my white blood cell counts have remained high and perhaps I didn't need the Neualasta shot and could instead go with Neuprogen. The nursing staff at CMC explained that Neuprogen was five shots over five days and perhaps I might prefer to simply do a half shot of the Neulasta (three milligrams instead of six). I went for the half shot and so far it's been a night and day difference. No need for narcotic pain killers to deal with the Neulasta. Instead I have just a little facial pain and some light soreness in my arms and thighs. What a relief.

This morning, I was seen by Dr. Bael. Since the bloodwork from the Emergency Room revealed nothing other than a high white blood cell count, and no liver or pancreas issues that could have caused the pain, Dr. Bael suggested the pain may have been spasming, in response to the chemotherapy. So as a precaution, he wrote me a prescription for Percocet should the pain return today or anytime following future chemotherapy treatments.

Other than having to stand in line in the Emergency Room doubled over over in pain, I'm happy about treatment I received. I felt cared for by the staff which makes a huge difference.