Saturday, 21 July 2012

Was the second IVE chemotherapy any better than the first?

The second IVE chemotherapy session involved the same treatment as the first session, but this time was administered via my recently inserted hickman line; The daily blood samples were taken from the hickman line too.  I find having pretty much all of the tests and treatment done using the hickman line to be much better really - It's not that I'm bothered by needles; It's just that given the choice of being used as a pin cushion or not, then choosing "not" doesn't exactly require much thought.

You might expect that after having countless blood samples taken and cannulas inserted etc, I'd be even less bothered about needles now than I was originally, as it would all just be routine, but it actually bothers me a little bit (not much) more these days - It's not that it feels any different now, or even that it hurts for that matter; I guess it's just the expectation that it will take several attempts before being successful, and I'll probably end-up with a bunch more bruises on my hands and/or arms, which sometimes take weeks to fade away and can become a bit of a reminder of being ill.

Needles aside, the treatment itself went fine, and other than having a couple of red blood cell transfusions just involved being hooked-up to the IV machine for about eighty-one hours!  If you do the math, the treatment is therefore pretty much constant for about three and a half days; the only time it really stops is when waiting for a nurse to disconnect the empty bag and connect either some saline solution (to flush through the remainder of the chemotherapy drug, if about to switch to a different one) or another full bag.  Usually once a day, when disconnecting and connecting the fluids, the nurse will also take a blood sample, and give you the opportunity to get a shower, hence if you factor-in the various stops and starts the full treatment tends to take more like four days in total.

Despite having a hickman line, I did still end-up having to have a cannula inserted, as it was needed for the red blood cell transfusions: the hickman line couldn't be used (at the same time) for both the chemotherapy and the red blood cell transfusions, and the chemotherapy couldn't be stopped whilst the transfusions took place, so given the chemotherapy is pretty much constant for a few days there wasn't another option.  A couple of nurses each had one slightly reluctant try to insert a cannula, as being anemic my veins were even harder to find than usual, before finally requesting a doctor to come and do it.  The doctor actually put the cannula in the top of my forearm, which is somewhere I've never even seen nurses or doctors look before (let alone try there), but it went in fine and did the job nicely; About three hours later, the red blood cell transfusions were complete and the cannula was removed.

In terms of the side effects for the second IVE chemotherapy session, it definitely wasn't as bad as the first one: The nausea was similar and my sense of taste was affected a lot more, but I didn't really lose my appetite (or further weight), nor feel anywhere near as tired or out-of-breath.  Interestingly, I did still find I'm itching a fair bit, albeit slightly less, so perhaps the doctor and myself were wrong about what caused the itching, i.e. perhaps it was actually a side effect of the chemotherapy itself.  I'm also told I didn't look "nearly dead" this time too - The black around my eyes the first time was pretty bad!

After four nights in the hospital ward, I was discharged with the same medications as last time (only without the Allopurinol), and with the knowledge that in the next couple of weeks, before the third (hopefully final) IVE chemotherapy session, I'd need to come back: a couple of times for blood tests and getting the hickman line flushed, just in case I needed any further transfusions and to keep the line working properly; for a lung function test, which involves breathing using a tube connected to a computer, so that it can analyse your lung capacity etc; for another echocardiogram (and perhaps electrocardiogram) to ensure fluid is not building-up around my heart again; and for a PET scan to see whether the cancer is responding to/shrinking as a result of the IVE chemotherapy.

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