CHEMOTHERAPY / CHIMIOTHERAPIE
 

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Dec. 2007 treatment 

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Introduction

I had a total of 6 cycles of chemotherapy. At first, I was supposed to have 3 cycles then surgery then 3 more cycles. But since the surgeon was in vacation at the time when the surgery should have been scheduled, my oncologist decided to administer four cycles of chemotherapy before the surgery and two after.

Regimen summary

The chemo regimen was as followed:

cycle#1: high dose ifosfamide

cycle#2: high dose ifosfamide

cycle#3: cisplatin and doxorubicin (also called adriamycin)

cycle#4: high dose ifosfamide

cycle#5: high dose ifosfamide

cycle#6: cisplatin and doxorubicin

The high dose ifosfamide was administered for 5 days in a row in each cycle.

The cisplatin was administered for one day followed by 2 days of doxorubicin in each cycle.

What's in the IV?

The high dose ifosfamide combo

During a typical high dose ifosfamide day, I was given the following IVs:

IV#1: 5% dextrose (sugar), water 1050ml, potassium acetate (a salt) 40meq rate 300ml/hr infuse 1070ml over 3H50min 2 units dispensed

IV#2: sodium bicarbonate (baking soda) 500ml rate 250ml/hr

IV#3: Dextrose 5% + water 55ml+ dexamethasone (counteract harmful side effects of treatment) 50MG infuse 60ml over 6H50 60ml/15min

IV#4: sodium chloride 250ml for 15 min at rate 248ml/hr (flush to counteract harmful side effects of treatment).

IV#5:  same as IV#3

IV#6: Sodium chloride 0,9% 55ml + granisetron (anti nausea and vomiting also called kytril) 2000MCG infuse 57ml over 25minutes

IV#7: Sodium chloride 0,9% 1050ml + ifosfamide 5GM + Mesna  (to protect bladder and kidneys) 5GM infuse 1150ml over 4 Hrs

IV bags to take home for the night:

IV bag#1: Ifosfamide 5GM + Mesna 5GM 100ml day1 rate= 5,6ml/hr x 18hr day 2 rate= 5ml/hr x 20 hrs

IV bag#2: Dextrose 5% water 1050ml ondansetron (anti-nausea also called Zofran) 32MG dexamethasone 20MG infuse 1068ml over 18 hrs : 59,3ml/hr x 18 hrs

The cisplatin / doxorubicin combo

During a typical cisplatin / doxorubicin cycle, I was given the following IVs:

1st day:

IV#1: Sodium chloride 0,9% 250ml

IV#2: 5% dextrose, 0.9% sodium chloride 1050ml, potassium chloride (to avoid potassium deficiency due to cisplatin) 20MEQ, magnesium sulfate (to treat low concentraton of magnesium in blood due to cisplatin) 1GM, calcium gluconate (To treat low calcium level in blood due to cisplatin) 0.256M, infuse 1069.5ML over 3.50HR IV

IV#3: 2x alteplase 1MG Total volume 1ML (to remove clogging from mediport)

IV#4: Sodium chloride 0,9% 55ml + granisetron 2000MCG infuse 57ml over 25minutes (for nausea)

IV#5: 5% dextrose, water 110ml, mannitol (To reduce renal damage caused by cisplatin) 25% 12.5GM infuse 160ml over 25 minutes by IV

IV#6: 5% dextrose, water 55ml, dexamethasone 50 MG, infuse 60 ml over 50 minutes by IV

IV#7: Mannitol 20% 500ml, infuse 500ml over 50HRs by IV. Administered 300ml only. It makes me urinate a lot...

IV#8: cisplatin 200 MG, 200ml infused over 4 HRS

2nd day:

IV#1: doxorubicin 120MG, sodium chloride 0.9% 36ml, cadd pump 1 ea, infuse 96ml over 48 hours

IV#2: 5% dextrose, 0.9% sodium chloride 1050ml, potassium chloride 20MEQ, magnesium sulfate 1GM, calcium gluconate 0.256M, infuse 1069.5ML over 3.50HR IV. This is given twice.

IV#3: furosemide (to increase urine excretion) 20MG, sodium chloride 0.% 110ML, 112ml over 25 minutes by IV

IV#4: Sodium chloride 0,9% 250ml , infuse 300ML/HR x 6 hours=1800ML

Other possible anti-nausea IV:

Dextrose 5% water 55ml, diphenhydramine (also called benadryl) 25mg, metoclopramine

25mg, 60,5ml over 50 minutes

Treatment for high temperature

IV#1: Dextrose 5% water 20ml cefepime (antibiotic) 2GM 50minutes

IV#2: Dextrose 5% water 550ml, vancomycin (antibiotic) 1500 MG, infuse 580ML over 2Hours

 Oral medication

 For Ifosfamide Treatment

K-DUR (potassium): 1 tablet (CL 20MEQ), 4 times a day. Replaces the potassium stolen by ifosfamide

Sodium bicarbonate: 4 tablets (650MG), 4 times a day. Keeps urine base. Allows better clearance of chemo

Kytril: 1 tablet (1MG) twice a day. For nausea.

Emend: 1 capsule (125mg) 1 hour before chemo. 1 capsule (80mg) each morning for 2 days following the chemo treament.

Lorazepam (also called Ativan): 4 tablets (0.5mg) under the tongue. 

To maintain mediport

Warfarin: 1 tablet (1MG) once a day. To prevent clogging.

For low blood count

Neupogen or Neulasta: shot to stimulate white blood cells

Cipro: 1 tablet (750MG) twice a day. Antibiotic that helps protect from infection.

 

Noticeable Side effects

Nausea

During the first chemo cycle, I had nausea and vomited. After that, instead of taking just a bag of chemo at home, I would also take the IV bag#2 as described above. This did the trick. I didn't feel great but the vomiting stopped.

Hair loss

Obviously, I lost all my hair during chemotherapy. But when my hair grew back, for about a year  it was the best hair I ever had.

Here are pictures to prove it:

my hair before

my hair during

my hair after

Back pain

I would get low back pain a couple days after the neulasta injection.

Hallucinations

During the high dose ifosfamide IV, I could see a lot of colorful images if I closed my eyes. I guess that's kind of like hallucinations.

Energy rollercoaster

During the chemo, I would be very tired and would sleet a lot.

The week after chemo, I would have boosts of energy followed by a sudden lack of energy. I would be extremely irritable and nervous.

The week before chemo, I would feel great, appreciating fully the small wonders of nature, like the birds singing.

Menstruation

I had my period on the first day of chemo. They stopped quickly after.  I got them back shortly after the end of treatment. The first year after treatment, they were irregular. Now, my cycle is shorter that it used to be but regular.

Others

- Jaw clicking by itself

- Enability to concentrate on people speech

- Stinky urine (during chemo)

- Cough

- Dry skin

- irregular heart beat

- heavy sweating

- vagina dryness and bleeding (Doctor prescribed nystatin and triamcinolone)

- burning sensation in trachea, larynx and lungs.

- Acid reflux

- Wisdom teeth pain (I got them all removed as soon as I could)

- muscle pain

Introduction

Regimen Summary

What's in the IV

Oral medication

Side effects