16/10/19 (2) Chemo Day One

We got there. Day One of Chemotherapy Cycle 1 of Course 1.

A cycle lasts five weeks, the fifth one having no Velcade or steroids but everything else. A course is four to six cycles, depending on blood tests and scans. And after that, the transplant...

I'm on the standard "first line" chemo cocktail of VTD - Velcade/Bortezomib by subcutaneous injection, Thalidomide (yes, really!) and 20mg Dexamethasone for the first two days only of each of the first four weeks of cycle. Only the Velcade on Day One requires a hospital visit to the Chemotherapy Centre, the rest are pills taken at home.

Got that OK?

Then there's a specific antibiotic for pneumonia on just Mondays, Wednesdays, and Fridays and a more general one once a day for everything else, an anti-viral twice a day to keep viruses at bay, and an anti-gout(!) pill once a day because the breakdown products of dead cancer cells can cause release of uric acid, and if that crystallises out it causes the extremely painful symptoms of gout.

Side-effects may include constipation (they've given me something for that in case of need and if my prune juice aperitif isn't potent enough), diarrhoea (and something else for that) and nausea and vomiting (an anti-emetic for that too). And peripheral neuropathy and various nasties including reduced blood cell counts, all of which will mean even more pills and/or changes in dosages or even changing to different drugs. We'll deal with those if and when they turn up.

That's all on top of the Omeprazole (anti-acid) and the Xarelto (blood thinner) and the Amitriptyline (nerve pain from trapped nerve in right thigh) and the Avorstatin (statin) and the Felodipine (blood pressure). And the endless Paracetamols.  Not forgetting the Zometa (bisphosphonate bone-strengthener) that I have on a drip in the Oncology Centre once every 28 days. And the B12 injetion every three months. And the Optivision and turmeric supplements I take every day anyway.

That's why I need all the 7-day pill-boxes and a plan. Spent most of the evening with spreadsheets and checklists for what to take and when.

Next thing, after some good advice, will be to take photos for every pill, including packet and label, to help identify which pill is which when I inevitably lose track or drop a whole day's worth on the floor and have to sort out which is which...

It wasn't the best day at the Oncology Centre. We arrived on time for our 10:30 appointment, but then had to wait for other people to be dealt with before we got called in for the Velcade injection after fifty minutes. That took another ten or so, then we had another wait of an hour before a pharmacist arrived with all the pills and to talk us through them. We know from overheard phone calls that the pharmacy were still making up the prescriptions, even though they must have had the details for days and really should have had it all ready the day before. We can make some allowances because the pharmacy has moved to rather cramped temporary accommodation while its old home is being enlarged and improved.  But they still should have had my stuff sorted well in advance. Overall, we had two hours of waiting time. At least we got a free lunch of egg mayo sandwiches out of it!

Had a short walk in Admiral's Park afterwards - just from the car park down to the first bridge and back with only one stick. I coped OK but still very slow compared to Sue, even though I thought I was doing a decent pace. She would easily have done it twice in the time I took to go round once.
Walking improved later at home, getting around well with no sticks.

The blood glucose test turned out normal as I expected, so no need for a fasting test. And so far at least (02:18 on 17/10/19) the anticipated drowsiness produced by thalidomide and others has failed to appear. Still wide awake, possibly under the influence of being back on the steroids. Trying a new plan today - will stay up for a while longer and then try for sleep if/when I feel more like it. There's always another Big Bang Theory to keep me going... As long as I get four hours or so that'll be OK. Seems to be as much as I need these days, plus occasional naps during the day. Sue would say almost every time I sit down..

Quite a day, one way and another.