Sunday, December 18, 2011

The Chemo Cycle

Steve finished his third round of Chemotherapy last Friday. Since he is scheduled for 6 cycles of chemo, we are officially at the halfway point. Like a Wednesday afternoon, it feels good to be on the downside of things, knowing the finish line for phase one of his treatment is in sight. Once the chemo is completed, Steve will enter phase 2 of his treatment and receive two more years of Rituxin. Dr. Liao is debating whether to give Steve the Rituxin one dose every 2 months for two years or two doses every three months for 2 years. There is not a lot of research about the effectiveness of one treatment plan over the other; however, the latest and greatest medical recommendations point toward giving Rituxin every two months for optimum results.

Steve and I did some research into Rituxin. This is an amazing, relatively newer drug that is used to fight non-Hodgkin's Lymphomas, Leukemias, and even Rheumatoid Arthritis. It is called a monoclonal antibody and attacks the protein CD20, which is primarily found on the surface of B cells. Somehow, although scientists aren't exactly sure why, Rituxin is able to go after the bad B cells, target them for destruction, and wipe them out. Since Steve's cancer is in his B Cells, Rituxin is a HUGE part of his treatment.

Although many folks would argue otherwise, Rituxin is not chemotherapy; it is a targeted therapy but is administered through his port.  The Rituxin maintenance therapy should help keep any cancer in his body from advancing. At over $6400 per bag, Rituxin is not a cheap medication. We are fortunate that insurance covers this medication, otherwise we would be putting our house on the market and selling off our 401K plans!

Here is an informative video about Rituxin for those of you interested!

Steve has found a predictable pattern with the Chemo cycle. He basically has about five side effects that vary in intensity from day to day:
1) heartburn, indigestion, and nausea
2) sleeplessness
3) fatigue
4) weakness
5) hiccups

During first week after chemo, Steve experiences the greatest number of side effects.  After about the tenth day post-chemo, he is basically feeling back to his normal self and his strength is renewed.  He then has about a week and a half before the next dose and the cycle repeats itself.  I thought I could best illustrate this cycle using a line graph.  I asked Steve to rate each side effect on a scale from 1-10 with 10 being the worst.  Here's what it looks like:

Steve's 10 Day Chemo Cycle
As you can by the yellow line, his worst days are on days 6 and 7 (Wednesday and Thursday) following Chemo.  After that, the side effects begin to subside and his overall well being begins to improve greatly.  Knowing that the cycle has some level of predictability helps us to plan and schedule our time.  Steve typically gets Neupogen injections to help raise his white blood cell count on day 3, 5, 7 and 9. 

Last Saturday, the day after chemo, Steve had a little accident.  He was unhitching and moving a utility trailer off our our SUV when he slipped on some wet leaves and came crashing, head first, onto the spare tire bolt on tongue of the trailer.  I was upstairs putting on my pajamas when I heard him cry for help in the driveway.  I ran outside only to see him holding is head with his hands and yelling, "I am hurt, I am really hurt!"  He was covered with blood and it was dripping down his face.  It was a good thing he was wearing his stocking cap, because it helped absorb a lot of the blood.  I got him inside, gave him a clean towel, and had him apply pressure to the gaping wound.  After a minute or so, I told him to let me take a look to assess the damage.  One look and it was obvious...we were going to pay a visit to the emergency room.

I think we are almost on a first-name basis with those good folks at Good Samaritan Hospital Emergency in Puyallup.  I remembered our nurse, Todd, and the technician, Angel, from our previous visits.  Steve was even put back in emergency room number one.  Felt like dejevu.  Instead of stitches, they decided to use another procedure.  Angel cleaned Steve up real good and the doctor came in and super-glued his two wounds back together again.  The wound on the top of his head was about two inches long and about a quarter inch deep.  I was surprised that didn't choose to stitch or staple him back together!

Sometimes I think it is really true that we learn best from the school of hard knocks. Steve may have not given a second thought to moving a small utility trailer prior to chemotherapy, but anything that puts him at risk for injury or sickness should be avoided.  Hindsight is also twenty-twenty.  If I had known he was going to try to move the trailer himself, I would have gladly helped him.  I think he needs to reconsider what he does and does not do in order to preserve himself for these next few months.  Hopefully he will be more cautious.

With Christmas only a week away, we find ourselves approaching the holidays with a whole new perspective.  We look forward to time spent with friends and family, being together and enjoying each others' company.  We are filled with joy and hope; trusting and believing in our Savior to bring complete healing to Steve and grant him a long and healthy life. 

Steve and I wish you all a very merry Christmas and a new year filled with the same hope and joy that we profess.  May you find and experience love and the true meaning of Christmas this holiday season.  We are so thankful for our friends and family who continue to stand with us daily.

Please continue to pray for:
  • The Chemotherapy to completely kill every cancerous cell in Steve's body without damaging or compromising his health.
  • Protection from all sickness, disease, injury or trauma.
  • Strength for each day.

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