Today Was a Decent Day

The title of this painting is "The Musicians".   With all that chemo splashing around in his veins, it will be interesting to see what his next painting looks like!

The title of this painting is “The Musicians”.
With all that chemo splashing around in his veins, it will be interesting to see what his next painting looks like!

For the first time in weeks it seems, today was a decent day.  It started off a little rocky, there was some nausea, but as the day progressed my husband started to visibly improve.  He knew that today had to be heavy on the proteins.  The chemo has gone through him and wiped out all his blood cells so he needs the protein to rebuild.  The toxins from the chemotherapy also still need to be flushed out – so a day that would also be heavy on fluid intake.  He was game.  By mid afternoon he was starting to perk up.  This was a good thing.  His taste buds are still off – at dinner tonight he informed me that most of the food I served him was a little “off” but since it didn’t seem to bother me, he ate the food anyway.  This was quite funny really – the two big culprits were white rice and water.

He’s busy painting a submission for an art exhibition right now – which is another good thing.  We’ve rigged up an arrangement where he can keep his left leg elevated in deference to his blood clot and still paint at an easel.  The clot is still very apparent and his leg is still very swollen.  By the end of the day his foot is smooth and shiny and his ankle is completely puffed up.  Despite the swelling the pain has begun to subside which suggests he is well on the way to recovery.  Not out of the woods completely but hopefully close.

There’s always a hitch though.  On the 20th of this month he goes for a CT scan.  There are three potential outcomes: 1) the chemotherapy is not working; 2) the chemotherapy has managed to stop the progression of the cancer, and 3) the chemotherapy has managed to reduce the presence of some of the existing cancer.   He told me tonight that the chemotherapy has taken a significant toll on him physically and mentally and that, depending on the outcome of the CT scan, he has decided that he may take a break from the treatment.   I know that when he starts to feel better, like he is now, he’s loath to go back in for another treatment.   It’s important that he have a sense of control in his own wellbeing, and also the knowledge that he can and will feel better.  There will be much more conversation in this regard prior to the 20th but for now there will be no more dialogue on this topic – decisions will be made after we get the CT scan results.

The sun shone today in more ways than one.

The Blood Clot and the Injection

This is a preloaded injection that is given daily in treatment of the bloodclot.

This is a preloaded injection that is given daily in treatment of the blood clot.

Part of the ongoing treatment for the blood clot my husband has in his leg is a daily injection of dalteparin sodium (trade name of Fragmin®).  Same time every day, likely for the balance of his chemo treatment and maybe a bit beyond.  Every day a needle to his belly.  He could use another part of his body, but he already uses his thigh for his insulin injection, so the belly is pretty much his only choice.   And in case you haven’t seen it the preloaded  Fragmin® needle is not a small needle, it’s big.  Needless to say it hurts but the benefit it provides outweighs the pain.  He needs the injection but do we have other choices as to how it is delivered?

Today I had to renew his prescription and I called in to the Pharmacist.  I inquired about the size of the needle for the preloaded Fragmin®.  The Pharmacist stated that with the preloaded syringes it only comes in the one needle size.  As an alternative the Pharmacist indicated that we can get a vial of the Fragmin® and load (draw up) our own injections, and if we do, then we can select a smaller size needle.  Some people may not be comfortable with drawing up their own injections, but in our case this is absolutely the way we will go.  We have to try it to determine if a smaller needle will reduce some of the pain and discomfort associated with the injection.

This is where consumer feedback to the manufacturer is needed.  First of all, why can’t they preload a number of doses into a single pen in the same manner as insulin?  This would save on packaging as well as allow people to select their preferred needle tips.  Hell,  they can develop their own tips and make more money on the product even.  Secondly, has anyone at the manufacturer injected themselves in the belly with this needle just to understand the degree of discomfort associated with it?  I suspect they trialled it and assessed the drug for its effectiveness – not the delivery mechanism.  However, if the present administration of the drug causes pain that can be alleviated through a product adjustment, such as the delivery mechanism (in this case the needle and syringe), then the manufacturer should be responsive to consumer needs.  Obviously this is one suggestion that I will be forwarding to the manufacturers at Fragmin® in the immediate future.

Post Chemo Treatment 3 – Day 2

It’s been two days since my husband had his third chemo treatment.  His response after this treatment has not been as severe as after his second treatment.  I have to say the second treatment must have been distorted by the developing blood clot and thrush.  So far this treatment appears to have been better, however, it is still too early to tell.

Yesterday my husband was able to take a litre of hydration given over the course of 5 hours.  Today he was not so lucky.  When the visiting nurse arrived to set up the drip his blood pressure was remarkably high, we felt it was too high for him to take the hydration.  He’s had heart issues in the past and the saline solution might put too much strain on his heart.  We opted to forgo the treatment for today and try again tomorrow.  This meant that we had to focus on getting him to drink around 2 litres of clear fluid on a day when he felt quite nauseous.  The day is almost over and I am afraid we have missed the mark by between 1/2 to 3/4 of a litre.  The visiting nurse will come by in the morning so we have to hope that his blood pressure is at a more respectable rate.  The hydration is key to flushing out the chemo drugs and improving how he feels.

The blood clot continues to be a concern in his leg.  The swelling is still significant, however, it has not moved to any other area of his body as far as we can see.  He was not able to get much exercise in today at all.  He has very low energy and feels under the weather – which is normal for this point in the chemo cycle.  So a day where very little was said or done but where he has managed to get a lot of rest.  Tomorrow is a new day.

Chemo Treatment #3

One of the stations for chemotherapy at our local hospital.  Lots of windows and natural light.

One of the stations for chemotherapy at our local hospital. Lots of windows and natural light.

We are back at it again today. At the hospital in the Chemo Suite. Interesting how next to no one here wears a mask and yet all around us people are sneezing and coughing. Not my husband – he wears his mask throughout the whole process. It is cold and flu season so why take chances?

My husband woke up with very high blood pressure – remarkably high 172\94. He slept poorly and it showed. He is more anxious this time than for any other treatment. This is because of the blood clot and the fact that he had three weeks of feeling lousy after treatment 2. It was hard to get him going and out the door this morning needless to say.

Fortunately we have a very professional nurse today – very informative. You can tell she loves her job. We spoke about the blood clot and his concern about some slight swelling he has had in his other foot – could it be another clot? The nurse said it was likely just some fluid retention and would be highly unlikely that another clot had formed since he is on a high dose of Fragmin which should prevent the existing clot from worsening and the body from making more.

I watch as the chemo drug flows into his body and see his colour go from healthy to an ashen waxen colour.  His body language is remarkably telling too, his shoulders slump and he appears very fatigued.  By the time the treatment is over it has been five hours and he is beat.  We pack up and head home.  No formal dinner tonight, whatever I can get into him I feel lucky about.  So two bowls of soup, one slice of bread, a couple cups of tea and that’s about it.  I’ve got jello ready for later if he fancies something.  It’s likely fluids for the rest of the evening – but at least it is some sort of nourishment.

We have the visiting nurse coming to the house tomorrow to do a litre of hydration – very slowly, at least a five hour drip.  This is in deference to the blood clot.  To allow his body to process the fluids a bit better.   As always I am thankful when we successfully get through each day (and night).

Pre-Chemo Visit – Our Second Try

Oblio

Oblio

Today was our pre-chemo consultation with the Oncologist.  We’d postponed my husband’s last treatment in an effort to give his body a chance to address both the blood clot and the thrush. The thrush is almost gone and so is no longer an issue.  The blood clot on the other hand, continues to be quite persistent.  His leg from hip to ankle continues to remain swollen.  It remains painful to walk on, but we have commenced daily walks again.  He continues to get his daily injection but the process is slow.  We spoke with the Oncologist about it – is it normally this slow to dissolve a clot.  Her response was yes – it takes quite some time, and he did have a large clot.  I asked about compression stockings – her response was – not yet.  The swelling has to go and then the stockings/socks would be ordered as a preventive measure.

The Oncologist asked my husband if he wanted to defer his chemo treatment for another week.  They chatted for a minute or two about it, and he decided that he would go ahead.  His rationale was that he felt so lousy anyway for the week he took off of chemo, he should have had the treatment.  He continues to experience waves of nausea and lightheadedness.  This we discussed with the Oncologist.  She attributes the lightheadedness to blood pressure.  His blood pressure drops considerably when going from lying to sitting, or sitting to standing – around 14 points.  Slow and steady is his rule for movement.  The nausea could just be his particular experience with the chemo treatment.  It may just be that he needs to use the anti-nausea medication on an ongoing basis to stay ahead of the nausea.  All in all it was a good visit, especially since I didn’t have to do the daily injection – the doctor did it!  I just cannot get used to giving that thing.

So chemo treatment 3 will go ahead on Wednesday – hydration has already been ordered for at least two to three days after his treatment.  After that the moment of truth – he is scheduled for a CT scan to see if the treatments are effective.  The CT scan is set for the 20th of October.  I sure hope the news is good news!