Buckle up the seat belts and prepare for lift-off - Prepare for the worst and expect the unexpected

I’m on the last few days of prednisone.  The rash is 98% gone.  The top layer of skin is peeling and is the cause of some current unsightliness of the area.  As long as I apply over the counter ointment (cortisone 10) it looks OK. 

I had an echocardiogram yesterday.  The good news is, the attendant didn’t stop and bring in throngs of health workers to ‘witness’ something found (as what transpired during my breast ultrasound).  The better news I received today, and for all you nay-Sayers: my heart is functioning normally. 

I had chemo orientation today.  I thought there would be scores of health care professionals meeting with me but there was no need after meeting with Sandra Creamer, PHD OCN. She was extremely learned and took time to explain pretty much everything.  Even as I had my next question queued up to ask, she inherently anticipated it and provided an answer without my needing to ask.  Impressive.

Not only were items validated today, but I also received new information.  For example, my chemo AC is made up of two drugs doxorubicin (Adriamycin) and cyclophosphamide.  It's a very pretty color red (my favorite red is ruby) and until it passes through the system (up to 48 hours), tears, sweat, and urine will be red.  I once ate an extra large helping of a baked beet and brussel sprouts and was shocked to see red urine (and more).  I thought I had internal bleeding.  So knowing about the AC side effect is helpful.Cyclophosphamide can cause swelling in the sac around the heart. [In the eighth grade I did a term paper on the heart and I think this is also referred to as the 'bundle of hiss'.]  

This chemo is truly toxic.  Extra care is taken that it doesn't spill from, or out of, the vein.  Sandra told me that it will literately 'burn' my skin tissue. So I asked, "If this burns skin, what does it do to the vein?".  She said that the movement of blood in the vein prevents it from pooling and causing damage.  She asked if I was going to have a VAD or Port-a-cath?  I has asked Dr. Mehta this and he said that I will not.  However, Sandra did say that if the veins can't take it anymore (or collapse), they will most likely place a port.  Seeing I can only have IV in my right arm (due to lymph node removal in my left), there 'may' be a chance I would need the port.  [Who is taking bets?]

Cyclophosphamide isn't my friend for sure.  It can cause bleeding in my bladder due to inflammation and cysts.  Because of the toxicity, it highly recommended to drink lots and lots of water and empty the bladder as much as possible.  "Don't hold it in", she said. There is also a chance of scarring on the lung tissue. Symptoms of this include coughing, shortness of breath, difficulty breathing, wheezing, tiredness. There is also a chance (although remote) of developing a serious skin condition. So the bottom line is to be highly aware of my body and various symptoms. And report any and all.

Because everyone is different, it's totally up to me what I choose to eat.  There are few restriction and it's based on what I can 'stomach', but I also must be very mindful of Nadir. [Not Ralph.  His name is spelled differently and I don't think he'd bother sticking around to haunt me. Although one of the other drugs I may need to take (discussed later) may cause hallucinations, so maybe I shouldn't get that Covair after all.]

Nadir (and not Nirvana) is that period in my treatment cycle when my white blood cell count is the lowest.  Other than cancer itself, it's the risk of infection that's the largest threat.  During Nadir, I should be extra vigilant to stay away from crowds, germs and uncooked vegetables.  Weekly blood tests will determine when this period is.  It is estimated to be within 10-15 days of the chemo injection.  I will need to be overly cognizant of my body temperature daily.  I've created a spreadsheet to record my temp: morning, noon and night.  I've been told that if my temperature goes above 100, then I need to call the doctor.  Boy, that's not much wiggle room since normal is 98.6.

Of course there's the nausea that chemo is so noted for.  I was given a 90 day supply of these two scary drugs. The Internet provided the following:

Ondansetron is used to prevent nausea and vomiting that may be caused by surgery or by medicine to treat cancer (chemotherapy).

Call your doctor at once if you have:

• fast or pounding heartbeats;
• jaundice (yellowing of the skin or eyes);
• blurred vision or temporary vision loss (lasting from only a few minutes to several hours); or
• high levels of serotonin in the body - agitation, hallucinations, fever, fast heart rate, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination, fainting.

Common Ondansetron side effects may include:

• diarrhea or constipation;
• headache;
• drowsiness; or
• tired feeling.

Prochlorperazine is an antipsychotic and is used for controlling severe nausea and vomiting and treating schizophrenia. It may also be used for other conditions as determined by your doctor.

Prochlorperazine is a phenothiazine. It is not known exactly how it works. (WHAT?)

Possible side effects of prochlorperazine:

All medicines may cause side effects, but many people have no, or minor, side effects.

Check with your doctor if any of these most COMMON side effects persist or become bothersome:

• Agitation
• Constipation
• Dizziness
• Drowsiness
• Dry mouth
• Enlarged pupils
• Jitteriness
• Nausea (hmmm The CURE is The CAUSE)
• Stuffy nose.

To combat these possible (and most likely) side effects, I stocked up on Biotene, alcohol-free Listerine, Kaopectate, MiraLax, a straight-jacket and restraints. [Just kidding on the restraints.]

Sandra also touched on other side effects I knew of through my research and various consultations, but she did talk briefly about chemo-brain.

I had read a few articles on chemo-brain and I was piqued by her mentioning the topic.  Of course like most side effects, it depends on the person, but if and when it does happen (to me) I'm asking all be to lenient. [I don't expect it to get as bad as Aunt Clara of Bewitched fame.]  I've always been noted for my iron trap memory, but this could be my (temporary) undoing. I am a creature of habit, so I'm hoping my innate regimen of order will prevail over any temporary lapse.

Tomorrow is the big day.  Kind of scary -  the unknown.  It's going to be a very bumpy ride. I hope to see everyone on the other side.

 Three; Two; One;

Lift-off  !!!!