Chemo 2

Chemo went well yesterday and I felt pretty good the rest of the day and today has been good too. I’ve been drinking a lot more water before and after treatment, which has really helped along with walking as much as I can. No nausea so far, but I didn’t notice any problems the first time until after the bag came off. We’ll see how it goes this time around. Right now my biggest problem is sensitivity to cold from the Oxaliplatin. My hands are especially sensitive and anything cold I touch feels like a hundred needles jabbing into my skin. I can’t wash my hands unless the water is warm, otherwise the pain is just too intense. Sometimes it feel like needles and other times it feel like big shock similar to grabbing an exposed electrical wire. Either way, it’s not very pleasant. As long as I stay warm and eat/drink things that are room temp or warmer there’s no problem. I’m thankful that the weather is warmer now. I can’t imagine going through this during the winter months. My cell counts have started to drop a little bit, but nothing too serious yet. Hopefully, I can squeak by without having to take Neulasta (bone marrow stimulant) as I hear this can cause the bones to ache. That’s two treatments down and ten to go.

Aftermath

Nausea and extreme fatigue had kicked in over the weekend and continued through Monday, but I was able to make it back to work this morning. Having been on 5-FU earlier in the year I didn’t expect the side effects to hit me so soon, but combined with Oxaliplatin it’s like a double whammy.

Chemo 1 - back in black

Treatment started at 8:00 AM this morning. The nurse accessed my port and started administering premeds, which included a steroid called decadron (dexamethasone), a powerful anti-inflammatory agent and aloxi (palonosetron), which is used as an anti-emetic. Next, an IV consisting of Oxaliplatin and Leukovorin along with 5% dextrose (D5) was administered over a two hour period. I got a bolus injection of 5-FU over a 2 minute period. Afterwards the nurse connected my portable 5-FU pump. This time I got the basic black European carryall instead of the burgundy colored bag I carried earlier in the year. Treatment lasted just under 4 hours and I would need to report back at 10:00 AM on Friday to disconnect the portable pump. The first treatment went pretty well, but I felt very tired afterwards and wondered if I was going to be able to work that afternoon, but I powered through it.

Post surgical gameplan

I met with oncologist to discuss follow up treatment. He wanted to do some additional testing on the tumor that was removed at surgery. Specifically, he wanted to test for microsatellite instability (MSI), which is involved in DNA mismatch repair. He said there’s a population of patients with colorectal cancer patients, about 15% that are high MSI and these patients do not respond well to follow up chemo with FOLFOX. However, neoadjuvant treatment shrunk the tumor so much that there may not be enough tissue left to do additional testing. He put a call into the pathologist who read my slides to see if indeed there was enough tissue remaining to test for MSI and was waiting to hear back from him. In the meantime, treatment would proceed 

The upshot is that that I have an appointment on May 9th. Hopefully, there will be enough tissue remaining that the test can be performed and we can get the results back before the 9th. As is stands now we will be moving forward with the standard 6 month FOLOFOX chemo regimen (12 cycles), e.g. every 2 weeks I go into the office for a 4-6 hour infusion of Oxaliplatin, Leukovorin and 5-FU in the chair followed by a 46 hour infusion of 5-FU (European carryall). He said that patients may experience problems with neuropathy around the 7th or 8th cycle and since I’m diabetic we’ll need to watch this closely and may need to stop chemo at that point. I’m not sure when I will be starting chemo. All I know is that it will be sometime after May 9th.

Back to work

I retuned to work this morning just three weeks to the day from surgery. Everyone was happy to see me and it felt great getting back to work and being able to work with such a great group of people.

Follow up with surgeon

I had a post-surgical follow up appointment with my surgeon this afternoon. He said my incision was healing nicely and that I could go back to work next week if I was ready. My rash had faded, but my skin was still darkened. We discussed the problem and we concluded that it must have been contact dermatitis from the compression sleeves.

Rash saga continues

 The rash was really getting bad on both legs today and my wife took me to the ER to get it checked out. They ran some blood work and everything came back fine. The ER doc thought it looked like contact dermatitis and said to continue taking Benadryl and that it should clear up in a few days. It itched like crazy and I couldn’t stand anything clothing touching that part of my skin.