Lester Link: March 2006

Thursday, March 30, 2006

My tri-weekly checkup went well today. The doc said he was so happy with how well I have tolerated the chemo and that I am on a "rough regimen". He said I looked great(well duh?) and to keep up the good work. All of my bloodwork looks great, he said my bloodwork was probably better than his and Joel's! Not too shabby! He also said he was very excited to get to the end of the 6th cycle and re-run the CT and see the results and he is very encouraged by the fact that the surgeon asked to meet with me after he presented my results at the last tumor board meeting. So, happy day at the island!

Monday is chemo day, so I am going to live it up this weekend. I am finally feeling 100% again and I have a lot of energy, so I have to expend it all before I get zapped again! This cancer is going to realize it picked the wrong chick to mess with when I get done with it!! I am off to a sushi dinner tonight, I think it has been an entire month since the last time I was well enough to eat it. So I am way past due!

Wednesday, March 29, 2006

I am having good cancer days now. Just trying to build myself up for Monday. Tomorrow should be uneventful at the island, just need to get good bloodwork back so I can do chemo.

Tuesday, March 28, 2006

I am feeling much better these days. My energy level is returning and I am able to get out of the house and run errands before my next round of marinade on Monday. We see my oncologist on Thursday to get the all clear and have the orders written for Monday's chemo.

I have really begun to dread the blood draw these days. I have never had issues with needles and IV's, I used to get 3 allergy shots a week when I was only 11 or 12 years old. But since this whole cancer thing, I really feel like they have taken more than their fair share of my blood. It messes with your head when you go at least every 3 weeks for 3 months and watch them fill up all those bottles each time. And the actual blood draw center at the Island is like a cattle ranch. There are always at least 50-60 people overflowing into the hall waiting for their names to be called. Then they call about 10-15 people at a time to line up at the door, then as you make your way down and around 3 hallways they just fill up each room along the way. Within each room there are about 5-6 people waiting their turn so you have to watch every body else's blood being taken. That freaks me out more than watching my own being taken. It does run very smoothly but you definitely feel like you are being "herded" through the system. I shouldn't complain b/c that is probably the only part of the hospital that you don't have to wait for hours to get called back!

Sunday, March 26, 2006

I think I am almost over this sinus mess. My head is still congested and you can hear it in my voice, but the coughing is almost all gone. I hope to shake it completely before my next chemo, a week from Monday. It was hard to limit my exposure to the elements this weekend b/c the weather was so beautiful!

One of Joel's friends at work has offered to dog-sit our 2 labs while we are visiting Joel's family in Arkansas over the Easter holiday. Thanks Kathy! So we took the pups over to Kathy's today to introduce them to her family. Her 3 kids had a blast playing with them and Abby & Pearl both behaved very nicely. They were worn out after we left and they slept in the car the whole way home. Today's activities should keep them worn out for at least a couple of days!

Saturday, March 25, 2006

Yesterday I was feeling pretty good. My friend Sherry and I grabbed a quick lunch and she treated me to a hot stone pedicure, my feet have never been so happy! I had a nice chat with my bossman at work,(He likes to be called a co-worker, but I am pretty sure my co-workers don't sign my paychecks!) I can't begin to explain how wonderful they have been to me during this whole ordeal! I am so lucky to have found such a wonderful extended family!

For dinner, Britt, Sarah, Joel and I had our Lenten seafood dinner and met up with some friends to celebrate Alina's 31st Birthday. Every year we all wear themed T-shirts, I don't remember how we started this but it has become a tradition. So I was sporting my "Cancer Sucks" T-shirt this year, that my friend Suzanne sent me. I almost convinced Joel to wear his, but I let him off the hook, only the girls participate in the T-shirt tradition. I petered out pretty fast and it turned out that the seafood dinner was a little too ambitious for me and I paid the price last night.

I feel much better today and the weather is gorgeous, I hope to soak up some of this sunshine today, of course I will need a gas mask to protect me from the great outdoors! I am sure Joel and I can rig some kind of contraption! I am so pumped to finally get off the couch for 2 days in a row. These last 2 weeks have been miserable, I was getting stir crazy stuck in the house sick the whole time. The one thing I have learned with this chemo experiment is you have to get going like crazy when you feel like it, b/c the next day you may not feel well enough to get out of bed!

Thursday, March 23, 2006

Today was actually a lot better than yesterday. I was up all night with stomach issues, but today the nagging cough has let up. I was able to eat a light lunch, then I had to take one of my 12 hour anti-nausea pills b/c I was having a hard time holding it down. But that kicked in fast and I was able to eat a little dinner too. Much improvement from yesterday!

Wednesday, March 22, 2006

Still coughing up a storm. I need a Robitussin I.V., every 4 hours like clockwork I start coughing, just in time for the next dose. I am sick and tired of being sick and tired! Now the second antibiotic is wreaking havoc on my poor stomach, I am still not too keen on eating much these days. I am sure Gatorade is in my near future, gotta love those electrolytes!

I was so cold today in the house, I thought I was feverish again. Then I finally checked the thermostat, and it was 66 degrees in here! No fever, just bone chilling cold in here! So, I cranked up the heater in the middle of March! Crazy Houston weather!

Tuesday, March 21, 2006

I thought I was feeling better... Every time I put it in writing, I jinx myself! For some reason I don't feel very good today at all and my cough has returned fast and furious! Of course, yesterday was my last day on the super duper antibiotic, so I am definitely going to hit the Z-Pack today and see if 7 more days won't knock it out. This crazy cold snap we are experiencing can't be helping me, it's supposed to get down into the 30's in a couple of days!

Sunday, March 19, 2006

I think this sinus mess is on its way out. I have been trying to stay inside my bubble and not expose myself to the great outdoors. I have a couple more days of anti-biotics from the ER, then I start my backup round with a Z-Pack just for a little insurance. I was able to run a couple of errands today, my good friend Sarah came out to the West side and toted me around a couple of places, thanks Sarah! I actually moved past my crackers and bagels diet and ate a mini-meal. The pain I was having the week before chemo has disappeared, so I am pumped about that. I am still sleeping like a champ, I hope all this sleep is helping kill cancer! Two weeks until chemo #6, then 3 weeks after that we will re-run the CT-Scan and check my progress. Everyone keep your fingers crossed for a good report!

Saturday, March 18, 2006

I basically slept through St. Patrick's Day 2006, I did wear green pajamas all day! I am still under the weather with this upper respiratory infection. I feel like my head is full of helium and has detached from my body. I am not eating much which does not help with my energy level, but I did leave the house for the first time today in 5 days. So, I am making some headway. I hope my waking hours will outnumber my sleeping hours pretty soon. Joel is with his friends watching all the NCAA basketball stuff, he needed to get out of the sick house for a while. The Aggies play at 4:40, Gig Em Aggies!

Thursday, March 16, 2006

Greetings from Narcolepsy Land! I cannot believe how much I have been sleeping the last few days. I am so beat down with this sinus mess and the cough syrups, oh and the chemo is not helping me fight this at all. I will just have to stay in my bubble and not expose myself to the great outdoors where every tree, flower, mold, grass and ragweed is blooming. Did I mention I love Spring? Just kidding, it is all very pretty to look at, but no fun to breathe in. I have another doctor's appointment at 10:00am tomorrow, so I will definitely have to hit the hay early to make such an early appointment time! :)

Wednesday, March 15, 2006

Still feeling pretty crummy. I woke up at 1 this afternoon, I guess I am still in sleep debt from Monday night's fiasco. My chest still feels tight and I have a cough and drainage and all that mess. My oncology nurse told me to go see my General Practitioner for non-cancer stuff. So, I went to see Dr. Broussard today and he re-did the chest x-ray, which came back normal, good news! I was a little freaked out about the pneumonia talk from the ER. The antibiotic I was sent home with from the ER is supposed to be very good, Avelox, it takes a couple of days to kick in. My GP gave me a Z-Pack to follow the Avelox just in case. He thinks it is my allergies that are giving me all of this grief, 'tis the season! I am going to take some Claritin D and some cough medicine to try and alleviate some of my symptoms. This nagging cough is really wearing me out. I am so tired, I am off to bed now, even though I have only been awake for 5 hours! Buenas noches!

Tuesday, March 14, 2006

I definitely didn't bring my "A" game to chemo yesterday! What an awful day and night we had. I did fine until about the last hour of the infusion, which is only calcium and magnesium, I made it through the hard stuff just fine. I began to feel nauseous and my head was pounding. I was suddenly freezing cold with shivers and I had about a 99 temp, which is high for me b/c my normal is 97.6. My doc's rule is if you hit 100, you have to go to the ER. So, I wasn't about to drive home for us to immediately turn back around when my fever hit 100. So we hung out in the chemo room for a while and I took an anti-nausea pill and slept for about 30 minutes, then they took my temp again and low and behold I was at 100.2. So, they cart me off to the ER which, luckily, was directly below us on the first floor. We only waited about 30 minutes to get called back, which is amazing to me for an ER! My temp was at 100.5 at check-in, then they gave us a private room in the back. The doc came in and wanted to do bloodwork and a chest x-ray. My bloodwork came back okay and I didn't have a catheter infection so they hooked me up with an IV of saline, antibiotics and anti-nausea meds. They also gave me 2 tylenol and within an hour the shivering was gone and my temp went down to 99 something, and my headache turned into a horrendous migraine in the meantime.

Around 11 they took me down for the chest x-ray. When I returned to my room I began sweating and I felt like my insides were on fire, I was finally able to shed my 4 blankets. Turns out around midnight my fever had spiked back up to 101, fun stuff! They gave me some more Tylenol which I thought might finally help my migraine. By the way, the last place you want to be with a severe migraine is an Emergency Room! So many crazy bright lights and nonstop beeping noises and intercom pages, it was a living hell! Joel found a towel for my head, so I used that as a mask to shield the light. It's funny b/c I never saw any of the people's faces that were working on me b/c they would barge in my room and immediately turn all the lights on, so I kept my trusty towel over my eyes to shield the giant fluorescents directly above me. The chest x-ray showed some inflammation and the word pneumonia was thrown around a bit, perfect!

Around 2 or 3 they finally listened to me and offered some meds for my freakin' migraine, which I had gone about 6 hours without any relief. I had to make my headache known by listing a 10 on that stupid pain scale thing with the happy/sick faces on it! Whatever gets their attention! By this time my fever was hovering in high 98's to low 99's, so they offered me painkillers, I wanted migraine meds, which would supposedly take longer b/c they didn't have them on hand. So after some semi-lucid discussion with the doc that is supposed to make my medical decisions for me, I decided on morphine with a little anti-nausea mixed in for flavor. So they hooked it up through my catheter and I was finally out cold for about 3 hours. I awoke to an awful chainsaw sound coming from the floor next to my bed and I thought for sure it was another crazy IV machine noise and maybe it had fallen over or something. Nope, it was my poor husband who had decided he was done with the flimsy chair he was sitting in all night and he had made himself a nice pallet on the hard floor with 2 blankets and no pillow, he was finally comfortable and snoring up a storm! I was sent packing around 6ish, migraine-free, with a nice high from the morphine and a prescription for an antibiotic. We got home and I slept until 3 this afternoon. No fever, no migraine and hopefully no pneumonia!

Thanks to my wonderful husband who is such a champ when it comes to dealing with things like this, he is the best! Thanks to my parents for coming over and letting our pups out and feeding them. And thanks for all the phone calls and emails, we appreciate everyone's concern. I am aiming for a better result from chemo #6, just 3 short weeks away!

We just got home from chemo, yes it is 7am on Tuesday. I have set a new record for my island visits, we arrived 11am on Monday and ran out of that place at 6am Tuesday. We spent the night in the Emergency Room at MDACC b/c of a 101 fever and chills. I am feeling somewhat better, we are just glad to be back home. I will give details later.

KL

Sunday, March 12, 2006

My good friend Evangelina is in town from The Cape, or The Cod as Joel likes to refer to it, so all of us girls have been trying to spend time with her and her kiddos before she leaves us again. Since chemo #5 is tomorrow, I have been trying to pack it all in before I hit the hard stuff. We have to be at the island for our 11:30 reservation in our favorite suite in the chemo wing. Maybe this time they will have a complimentary bottle of champagne waiting for us, room temperature, of course! And maybe some chocolate dipped strawberries too?? Yah right, I am doing good just to get the right drugs these days! :)

Thursday, March 09, 2006

The oncologist visit went well today. My doc said my counts were good, I looked good and to keep on doing whatever I was doing b/c it is definitely working for me. He was very upbeat today and answered all my 200 questions. He thinks I am allergic to the Dexamethasone(steroids) that we tried during my last chemo. Which is odd, he said most people respond favorably to them. Lucky me to have a reaction! He reiterated that the surgeon wanted to meet with me again after my 6th round of chemo, which is very exciting! I am going to have to start sending him flowers and care packages so I can win him over and convince him to cut this stuff out of me. I am beginning to look like a drug addict with all of these track marks on my arms, I wonder if they can draw blood from between my toes like the real drug addicts do to hide the marks? I obviously watch way too much CSI!

I have all of my prescriptions ready and my orders are in for chemo #5 on Monday. I can't believe how fast all of this has happened, my first chemo was on 12/15/05, I should be an old pro by now but the chemo side effects and crazy drug reactions seem to keep all of us on our toes. There are so many drugs available to alleviate the side effects of the chemo, but it is a long, hard process to try each and every one of them until you find what works for you. We are still tinkering with my anti-nausea meds, we are going to try Emend again this round to help with the delayed nausea from the chemo infusion. Fun stuff! :)

And no, I did not see former Governor of Texas, Anne Richards at MD Anderson today, I did look for her, but I did not see her.

Tuesday, March 07, 2006

Today was my first chemo-free day for this round. I am convinced the last few days of insane headaches were directly related to the chemo pill taking. Within an hour of each dose my headaches would intensify. So, today no chemo equals no headache, finally! The pain in my shoulder is still lingering a bit. Today I sneezed while I was driving and I thought I was going to pass out from the pain. So, I am going to have to avoid sneezing, is that possible?

Monday, March 06, 2006

I hit a wall yesterday. I was feeling okay for a few days besides a headache since Friday I was doing alright. Then, late Sunday I crashed, my headache got worse and I was exhausted. I went to bed early and I slept for 12 hours, which usually rids me of a headache. Today I woke up with it still lingering and it continued to get worse by the hour and I have some referred pain in my right shoulder which I haven't had in a couple of months. So, I am going to break down and take a migraine pill and see if another 12 hours of sleep will cure what ails me. I will just attribute my pain to the chemo doing it's magic work. I have my follow up oncologist appointment Thursday and my 5th chemo on Monday. I will have another CT scan and meet with my surgeon again, after my 6th round of chemo which should fall somewhere around the end of April.

Joel is at the Rodeo tonight with his friend Mark, Robert Earl Keen is playing. Yes, we are in Texas and the Houston Livestock Show & Rodeo is a big deal down here. Does anyone have any Pat Green tickets they want to get rid of??

Friday, March 03, 2006

Sorry I have been skipping a few days here and there. Not much exciting to report, my appetite is returning and the nausea seems to be on its way out.

Same cancer, different day!

Wednesday, March 01, 2006

I am starting to feel a little better. You would think these side effects would be a little more predictable by now, but they keep catching me off guard and knocking me down again. Lots of people have had questions regarding chemo and how it works and why my hair hasn't fallen out, etc... I found a pretty good description of how my "platin" drug works if any of you would like to read the specifics. I have copied the article below for your reading pleasure. There will be a quiz on the subject, so study hard! :)

EloxatinTM

Generic name: Oxaliplatin

Eloxatin is the trade name for the generic drug name Oxaliplatin. In some cases, health care professionals may use the trade name Eloxatin when referring to the generic drug name Oxaliplatin.

Drug type: Eloxatin is an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug. Eloxatin is classified as an "alkylating agent." (For more detail, see "How this drug works" section below).

What Eloxatin is used for:

This medication is used to treat colon or rectal cancer that has spread (metastasized), it is often given in combination with other anticancer drugs (fluorouracil and leucovorin).
Note: If a drug has been approved for one use, physicians sometimes elect to use this same drug for other problems if they believe it might be helpful.

How Eloxatin is given:

It is given by infusion into the vein (intravenous, IV).
There is no pill form of Eloxatin.
The amount of this medication you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer you have. Your doctor will determine your dosage and schedule.
Side effects of Eloxatin:
Important things to remember about the side effects of Eloxatin:

Most people do not experience all of the side effects listed.
Side effects are often predictable in terms of their onset and duration.
Side effects are almost always reversible and will go away after treatment is complete.
There are many options to help minimize or prevent side effects.
There is no relationship between the presence or severity of side effects and the effectiveness of the medication.
Infusion related side effects of Eloxatin:

The feeling of difficulty swallowing, shortness of breath, jaw spasm, abnormal tongue sensation and feeling of chest pressure. This has been reported rarely (<5%). It generally starts within hours of Eloxatin infusion and often occurs upon exposure to cold. Avoiding exposure to cold (see self care tips below) helps to prevent this adverse reaction. Future infusions may be given over a longer time frame to help reduce the incidence.
The following side effects are common (occurring in greater than 30%) for patients taking Eloxatin:

Numbness and tingling (peripheral neuropathy) and cramping of the hands or feet often triggered by cold. This symptom will generally lessen or go away between treatments, however as the number of treatments increase the numbness and tingling will take longer to lessen or go away. Your health care professional will monitor this symptom with you and adjust your dose accordingly.
Nausea and vomiting
Diarrhea
Mouth sores
Low blood counts. Your white and red blood cells and platelets may temporarily decrease. This can put you at increased risk for infection, anemia and/or bleeding.
Fatigue
Loss of appetite
The following are less common side effects (occurring in 10-29%) for patients receiving Eloxatin:

Constipation
Fever
Generalized pain
Headache
Cough
Temporary increases in blood tests measuring liver function. (see liver problems).
Allergic reaction: a rare side effect, however, call for help immediately if you suddenly have difficulty breathing, your throat feels like it is closing, or chest pain. Other signs of allergic reaction include rash, hives, sudden cough, or swelling of the lips or tongue.
This list includes common and less common side effects for individuals taking Eloxatin. Side effects that are very rare, occurring in less than 10% of patients, are not listed here. However, you should always inform your health care provider if you experience any unusual symptoms.

When to contact your doctor or health care provider:

Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:

Fever of 100.5º F (38º C), chills (possible signs of infection)
Shortness of breath, chest pain or discomfort, jaw pain, pain or tingling in your arms
The following symptoms require medical attention, but are not emergency situations. Contact your health care provider within 24 hours of noticing any of the following:

Nausea (interferes with ability to eat and unrelieved with prescribed medications)
Vomiting (vomiting more than 4-5 times in a 24-hour period)
Unusual bleeding or bruising
Black or tarry stools, or blood in your stools or urine
Diarrhea (4-6 episodes in a 24-hour period)
Severe abdominal pain
Mouth sores (painful redness, swelling or ulcers)
Signs of infection such as redness or swelling, pain on swallowing, coughing up mucous, or painful urination.
Severe numbness, pain in your joints or muscles (arthralgias or myalgias).
Constipation unrelieved by laxative use.
Extreme fatigue (unable to carry on self-care activities).
Unable to eat or drink for 24 hours or have signs of dehydration: tiredness, thirst, dry mouth, dark and decreased amount of urine, or dizziness.
Always inform your health care provider if you experience any unusual symptoms.

Self Care Tips:

While receiving treatment with Eloxatin: avoid cold temperatures and cold objects.
Cover your skin, mouth and nose if you must go outside in cold temperatures.
Do not drink cold drinks or use ice cubes in drinks.
Do not put ice or ice packs on your body.
Other ways to reduce the side effects caused by cold:
Cover yourself with a blanket while you receive your Eloxatin infusion.
Do not breathe deeply when exposed to cold air.
Wear warm clothing in cold weather at all times. Cover your mouth and nose with a scarf, mask or a pull-down cap (ski cap) to warm the air that goes to your lungs.
Do not take things from the freezer or refrigerator without wearing gloves.
Drink fluids warm or at room temperature.
Always drink through a straw.
Do not use ice chips if you have nausea or a sore mouth. Call your health care professional.
Be aware that metals are cold to touch especially in the winter. Wear gloves to touch cold objects including your house door, car door, or mailbox.
Do not run the air conditioner on high either in the house or car in hot weather.
If your body gets cold, warm-up the affected part with warm water.
To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.
Drink 2 to 3 quarts of fluid every 24 hours, unless you were told to restrict your fluid intake, and maintain good nutrition. This will decrease your chances of being constipated, and prevent dehydration.
To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times a day with 1/2 to 1 teaspoon of baking soda and/or 1/2 to 1 teaspoon of salt mixed with 8 ounces of water.
You may be at risk of infection so try to avoid crowds or people with colds and those not feeling well, and report fever or any other signs of infection immediately to your healthcare provider.
Wash your hands often.
Use an electric razor and soft toothbrush to minimize bleeding.
Avoid contact sports or activities that could cause injury.
Peripheral neuropathy (numbness in your fingers and toes) may occur with repeated doses. You should discuss this with your healthcare provider.
Keep your bowels moving. Your health care provider may prescribe a stool softener to help prevent constipation that may be caused by this medicine.
Acetaminophen or ibuprophen may help relieve discomfort from fever, headache and/or generalized aches and pains. However, be sure to talk with your doctor before taking it.
Avoid sun exposure. Wear SPF 15 (or higher) sun block and protective clothing.
In general, drinking alcoholic beverages should be avoided. You should discuss this with your doctor.
Get plenty of rest.
Maintain good nutrition.
If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.
Monitoring and testing:

You will be checked regularly by your health care professional while you are taking Eloxatin, to monitor side effects and check your response to therapy. Periodic blood work to monitor your complete blood count (CBC) as well as the function of other organs (such as your kidneys and liver) will also be ordered by your doctor.

How Eloxatin works:

Cancerous tumors are characterized by cell division, which is no longer controlled as it is in normal tissue. "Normal" cells stop dividing when they come into contact with like cells, a mechanism known as contact inhibition. Cancerous cells lose this ability. Cancer cells no longer have the normal checks and balances in place that control and limit cell division. The process of cell division, whether normal or cancerous cells, is through the cell cycle. The cell cycle goes from the resting phase, through active growing phases, and then to mitosis (division).

The ability of chemotherapy to kill cancer cells depends on its ability to halt cell division. Usually, the drugs work by damaging the RNA or DNA that tells the cell how to copy itself in division. If the cells are unable to divide, they die. The faster the cells are dividing, the more likely it is that chemotherapy will kill the cells, causing the tumor to shrink. They also induce cell suicide (self-death or apoptosis).

Chemotherapy drugs that affect cells only when they are dividing are called cell-cycle specific. Chemotherapy drugs that affect cells when they are at rest are called cell-cycle non-specific. The scheduling of chemotherapy is set based on the type of cells, rate at which they divide, and the time at which a given drug is likely to be effective. This is why chemotherapy is typically given in cycles.

Chemotherapy is most effective at killing cells that are rapidly dividing. Unfortunately, chemotherapy does not know the difference between the cancerous cells and the normal cells. The "normal" cells will grow back and be healthy but in the meantime, side effects occur. The "normal" cells most commonly affected by chemotherapy are the blood cells, the cells in the mouth, stomach and bowel, and the hair follicles; resulting in low blood counts, mouth sores, nausea, diarrhea, and/or hair loss. Different drugs may affect different parts of the body.

Chemotherapy (anti-neoplastic drugs) is divided into five classes based on how they work to kill cancer. Although these drugs are divided into groups, there is some overlap among some of the specific drugs. The following are the types of chemotherapy:

Eloxatin is classified as an alkylating agent. Alkylating agents are most active in the resting phase of the cell. These drugs are cell-cycle non-specific. There are several types of alkylating agents.

Mustard gas derivatives: Mechlorethamine, Cyclophosphamide, Chlorambucil, Melphalan, and Ifosfamide.
Ethylenimines: Thiotepa and Hexamethylmelamine.
Alkylsulfonates: Busulfan.
Hydrazines and Triazines: Altretamine, Procarbazine, Dacarbazine and Temozolomide.
Nitrosureas: Carmustine, Lomustine and Streptozocin. Nitrosureas are unique because, unlike most chemotherapy, they can cross the blood-brain barrier. They can be useful in treating brain tumors.
Metal salts: Carboplatin, Cisplatin, and Eloxatin.