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Tuesday, September 11, 2007

Chemo Day: Better Than Last Time!

I was quite apprehensive about today.... Would it be another 11 hour chemo-day-from-hell? Would it be a "normal" 4 hour day? How could I plan for it? I tried asking the doctor, but he said there was no way to know what to expect.

And, of course, there were the ramifications: if it takes "too long" again, then, in the future, we would split up the Herceptin into three doses and I would have to come in for a third of the Herceptin every week of the three-week-cycle. Read: I would lose my "vacation" days!

(Currently, I come in for the first two of the three weeks. And, unless my bone medication, which is on a four-week-cycle, falls out on that day, I have "off" every third week. So, out of every 16 weeks, I get three weeks "off". And I don't want to lose those.)

So, I wanted to make sure that it doesn't go too slowly.

On the other hand, I didn't want to do anything that might jeopordize getting the Herceptin, which is a life-saving drug for HER2 cancer patients (like me). So, I didn't want to get the drug too fast and have another adverse reaction.

I got to the hospital around 9:30, earlier than usual for me. But I spent almost 3 hours just waiting! By around 11:00, every time the doctor passed, I smiled and reminded him that "I'm not hooked up yet". (you can imagine my anxiety, as crucial time just ticked away)

It turns out that Alan, my "coffee and chemo" date for the day, is good friends with one of the pharmacists. When the pharmacist brought the drugs to the ward, she sat with us for a few minutes. In passing she mentioned that, thanks to Alan's earlier call, she tried to get the drug ready a little faster. Apparently, somewhere along the way, someone had made a mistake and the pharmacy department hadn't received my prescription; so they hadn't prepared the drug in advance. Moreover, the pharmacy department had to wait until they received a prescription, which must be written by a doctor. (did I mention that mid-morning my doctor left for physical therapy?) So, there was quite a significant delay.

Meanwhile, I had great company. So, that helped distract me from the stress.

We talked about life, and religion, and travelling, and family. And that was only in the first hour!

I was finally hooked up at 12:15! They started the drip slowly, on 40, which was the rate I received the Herceptin last time. Approximately every hour, they raised the rate another 20. At around 80, I felt a bit of pressure in my chest, but it wasn't too bad. By 120, the pressure was still okay, though a bit stronger. But still, this rate was 3 times as fast as the last time!

I was feeling pretty optimistic. Until the doctor breezed in. He suggested that next time we split up the dosage. "I don't want to do that", I answered. No ambiguity there. "Do you feel pressure?", he asked (knowing the answer). "But the drip is on 120, that's 3 times the rate..." But the doctor was already breezing out. "I don't want to do that", I called after him. No response. "So tell them to up the dosage", I called desperately, my words reverberating on walls of the now nearly empty oncology day ward.

My delicate ballance was in an upset. I could feel the tears welling up. I called Moshe right away, and he helped to calm me: "You'll talk to him", Moshe counselled, "you've changed his mind in the past..." (I wasn't convinced that this would be as easy as getting a half-dosage of anti-histamine, but it helped to ground me. Nothing was set in stone yet...)

It was now nearly 3:30 and the nurse upped the rate to 140. The pressure in my chest stayed constant; the discomfort more bearable than the thought of losing my vacation days!

Luckily, Alan had cleared his entire day for me and provided excellent entertainment! We spoke about everything and, most importantly, we laughed a lot! And we looked at many pictures from all his wonderful escapades in the far east! It was fun. I love looking at good photographs and analyzing the composition! And he had a lot of good photographs!

I could almost forget the discomfort... and the stress...

Then, finally, the Herceptin was done! It was 4:00. I jumped up and searched for a nurse (I still had to get the Navalbine). I spotted the doctor. "I'm not giving up without a fight", I warned him (I already had the arguments lined up in my head: the technical mistakes that caused delays that morning, the increased pace of the drip, the psychological importance of getting time off, etc). "I knew you wouldn't", he answered.

I wondered: did he just "play me"? Was the "threat" meant to motivate me to get the drip faster? But I hadn't told anyone not to raise the rate! What was this? I hate it when things are "thrown out" with no time to discuss things. I had to remind myself that nothing would be decided without consulting us. But I was disconcerted.

At 4:30, when the head nurse came to disconnect me, she also suggested that it might be better for me to split up the dosages. So I gave her the arguments. And I focussed on the fact that, had the drug been ready, I would have been done by 1:30/2:30, which is totally normal!

The nurse agreed that my analysis was accurate. So, I promised to call next time, on my way to the hospital, so that everything would be ready....

Now to convince the doctor....

Please daven (or send happy, healing thoughts) for RivkA bat Teirtzel.

With love and optimism,
RivkA

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