Saturday, August 27, 2011

the first bite is the sharpest

Now that radiation is over and Paul was given a short two week break to recover, the real chemo begins. We are on what they call the first line chemo regimen which consists of Oxaliplatin and Xeloda, also referred to as Xelox. Paul is not the type of person to read up on his illness. He doesn't want to know what the stats are or what possible side effects he might get. As he says, "That's why I have you." So of course, I spent hours reading up on this new chemo he was being given and was already anticipating the side effects which kick in pretty much immediately.

When he was just on Xeloda, the major side effects include something called hand-foot syndrome, which is a nasty case of extremely dry hands and feet that turn bright red and peel constantly. To combat this, patients are told to lotion their extremities multiple times a day every day with specific ointments (something my English patient is not adhering to that well). Also patients shouldn't be exposed to excessively warm temperatures and should refrain from chemicals such as washing up liquid. Yes, that means that all the housework is left to me since he can't be doing dishes (rubber gloves aren't the answer since they just trap in heat). His hands have peeled numerous times and he says that the skin feels so tight that he can hardly bend his fingers. Both his hands and feet are also bright red which is a result of the chemo seeping out his capillaries.

Now that they are adding Oxali to the mix, new side effects will include something called the first bite syndrome, which is basically a spasm in the jaw when you take your first few bites after infusion. Other lovely side effects are a sensitivity to anything cold, which is the last thing you need when it's 100 degrees outside and all you want is the air conditioning blasting cold air and something cold to drink. Of course, there are possible stomach/bathroom issues and nausea, fatigue, hair thinning, etc. But so far he's only had a few of them.

Most people have a port installed in their chest to help preserve their veins as Oxali can burn them out quite quickly but Paul refuses and we all have to honor his wishes with this and just hope that he doesn't do irreparable damage to himself.

The first infusion took about five hours. First we visit the oncologist for a check up and he collects bloodwork to make sure that his body can handle the infusion. Then we shuttle across the hall to the infusion center. You can just imagine the other patients' faces when we walk in since we are by no means the typical patient couple - him being the old rocker and me with my fire engine red hair. The infusion center is mainly made up of rows of big comfy reclining chairs with optional TV's that have DVD players attached. So we are introduced to our chemo nurse, Kat, who explains that first he will receive an IV of pre-chemo meds such as Decadron, a steroid which will halt any allergic reaction, along with some Zofran for nausea. He has already been taking Zofran orally and we have nicknamed it the dissolvey pill because you just put it on your tongue and it dissolves. Once that is finished, it's time for the big bag of Oxaliplatin. Kat warns us about the cold sensitivity and to call the doctor immediately if he has a fever of over 100.3 or if he starts to vomit.

The infusion goes smoothly and we return home and Paul goes to have something to eat and sure enough I hear him scream "What the f**k was that?" I asked him if it hurt when he took the first bite and he says that it did and what was it and why didn't I warn him. I told him that not all patients get that side effect and how I wasn't too sure what it was going to feel like and reassured him that it's normal and to remember to relax when it happens. This all spurs him to start singing "The First Bite is the Sharpest" ala Rod Stewart's The First Cut is the Deepest. Yes, we are easily amused.

Unfortunately the steroids that they gave him also caused him to be up all night. He likened it to being on speed and just lying awake in bed until the sun started rising but without any of the fun. Luckily the anti-nausea pills have worked but this whole steroid thing is getting to him. I'm sure as we continue this line of treatment his body will start adjusting to it. In the meantime, I'm envisioning him laying on the couch watching his beloved Ealing comedies to keep himself occupied.

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