First Chemo Update

At 4am I awoke this morning, because that's what happens when you take several naps throughout the day from chemo; you awake at weird hours of the night.  I checked my email, because what else are you going to do at 4am.  I had an email from my wonderful Bishop in Phoenix wanting an update.  I figured since it has been a few day's, you all are probably also wanting an update too.  So here it is:

 Thursday I had the port surgically placed in my right chest and into my jugular vein.  That meant 2 cuts instead of 1 like before.  It was placed by the Interventional Radiologist who was fantastic.  And the nurses were there from start to finish and were exceptional!  This has been very sore compared to the last one which was placed in the right subclavian artery 2 years ago.  I'm pretty bruised and still tender from this procedure, but with ice and Tylenol it seems to be improving. It is very strange to have something inserted into my jugular vein, to say least.  The port sits in the chest and the tubing goes up to the neck, which is why I had to have 2 incisions.

It probably didn't help that not 24 hours later on Friday morning they accessed the port with a gigantic needle (without numbing cream because of the dermabond over the incision) to do my first round of chemo.  I slept through most of the chemo infusion and since then.  I also haven't had much of an appetite, water doesn't even sound good and my love for candy has gone down the drain.

I was so happy to see my Auntie Thalia come to my bedside while having chemo.  I love this aunt of mine.  The first time I was diagnosed and in the hospital for 15 days she came every day except 2.  She works as a nurse at St. Lukes where I have treatment and she is one smart lady, loving kind and talented.

We have decided to go with 2 medications that I will receive on day 1 and then only 1 of the medications a week later with a week off, which will be repeated 6 times, meaning if my counts all remain high it will end the last week in October.  This is totally dejavu, because I started Chemo the first time on July 9 2013 and this time on July 10. 

The treatment that I'm doing will allow me to keep my hair, which brings me so much happiness.  That is for now.  There are a dozen different medications that we could choose and it all depends on which ones kill the cancer.  Given that a platinum drug killed the cancer before we are using one of those classes of drugs called Carboplatin.  It works like this:  Cancerous tumors are characterized by cell division, which is no longer controlled as it is in normal tissue.   "Normal" cells stop dividing when they come into contact with like cells, a mechanism known as contact inhibition.  Cancerous cells lose this ability.  Cancer cells no longer have the normal checks and balances in place that control and limit cell division.  The process of cell division, whether normal or cancerous cells, is through the cell cycle.  The cell cycle goes from the resting phase, through active growing phases, and then to mitosis (division).
The ability of chemotherapy to kill cancer cells depends on its ability to halt cell division.  Usually, the drugs work by damaging the RNA or DNA that tells the cell how to copy itself in division.  If the cells are unable to divide, they die.  The faster the cells are dividing, the more likely it is that chemotherapy will kill the cells, causing the tumor to shrink.  They also induce cell suicide (self-death or apoptosis).
Chemotherapy drugs that affect cells only when they are dividing are called cell-cycle specific.  Chemotherapy drugs that affect cells when they are at rest are called cell-cycle non-specific.  The scheduling of chemotherapy is set based on the type of cells, rate at which they divide, and the time at which a given drug is likely to be effective.  This is why chemotherapy is typically given in cycles. (taken from the carboplatin drug information)

They are also using an old drug but new for me called Gemzar.  Gemzar belongs to the family of drugs called antimetabolites.  Antimetabolites are very similar to normal substances within the cell.  When the cells incorporate these substances into the cellular metabolism, they are unable to divide.  Antimetabolites are cell-cycle specific.  They attack cells at very specific phases in the cycle.  Antimetabolites are classified according to the substances with which they interfere. (taken from the gemzar drug information).

After 3 cycles we will repeat the CT scan to see if there has been improvement in decreasing the size of the cancer and tumors.  If they have shrunk we will keep going, if not we will have to try other drugs.  Will you pray along with me that these drugs will be the ones that kill the cancer? 

The effects of the chemo and the port placement have made me extremely tired and I sleep more than I'd like, however my sleep cycles are a little off as well.  This isn't new from the previous chemo treatments.  At least this time I don't have any sores in my mouth or bone pain.  I have felt much more nauseated than before, but with drugs haven't vomited, even though at times I think I would feel better if I could.  I'm experiencing some rather uncomfortable upper abdominal pain, which was improved somewhat last night when my dad and brother-in-law gave me a blessing.  It's still there this morning, but not as bad.  My chest is also sore, but probably all this sitting around isn't helping things.  I'm use to always being on the go and these post chemo days put me down, which I don't like at all.  Hopefully this afternoon I will pop out of it and maybe go for a short walk.

The good part is that the back/tailbone pain doesn't seem to be so bad, I'm not sure if it is because I've rested, been taking more pain medications or because all of the other symptoms are worse.  I did request 2 injections of morphine when I had chemo because the port pain was so uncomfortable, which did help immensely. 

2 years ago it seemed that the next 2-3 days after chemo were down days and then I'd be back to myself until the next treatment and typically the second treatment of the regimen wasn't as bad as the first. 

I probably am trying to push myself too much because of having my family around, but my mom is a stickler when it comes to me getting my rest.  It is so nice to be home.  My mom is taking very good care of me, but she is also taking this much harder than I am and much harder than the first time, but I know that we will get through it again and come out on top!

My mom had to paint my toenails teal before chemo because they were looking rough.

I'm still taking one day at a time and planning to return to MVY on July 21. 

I read a quote this morning by Brigham Young that helped me with my question of why me and why again: 
"Give me patience to wait until I can understand it for myself."