On Thursday, November 18, 2010, Carl got his chemotherapy with the main chemotherapy drugs Irinotecan and Vincristine. I say main drugs, because there are other drugs that they give along side of the chemotherapy drugs. They got blood drawback from his port (after a time) without the use of TPA. Carl got oral doses of 8mg Zolfran (also known as Ondancetron), and 10 mg Dexamethasone. Through the IV they gave him 0.2 mg of atropine. These first 3 drugs are given to prevent side effects from the main chemo drugs. The main chemo drugs follow - Carl was given 241 mg of Irinotecan in saline through the IV over 60 minutes, followed by 2 mg vincristine in saline over 15 minutes. We spent the time watching the parts of Buffy the Vampire Slayer, Season 1.
I hope these drugs are effective and that Carl can continue getting them for quite some time. At the end of the month the Doctors will check to see if the drugs are holding back the tumor.
Thank you again for all the encouragement and prayers.
Showing posts with label drug: Ondansetron. Show all posts
Showing posts with label drug: Ondansetron. Show all posts
Thursday, November 18, 2010
Monday, March 8, 2010
Chemotherapy Round No. 4 done
Carl completed his 4th round of chemotherapy (third round of inpatient Chemotherapy) on Friday, March 5, 2010. He was in the Froedtert Hospital continuously from Monday, March 1, 2010 through Friday.
Carl and I think he is tolerating the chemotherapy very well, although Carl said Thursday and Friday were really bad. I tried to get him to define it, and he said that Thursday alone felt like 40 hours of having the flu. The bed is always moving and he thinks he was awake almost every 2 hours.
Here is a photo of Carl on Thursday. On Thursday, he can hardly open his eyes. It was a hugely busy week for the children and me, and only Miranda got a chance to visit Carl in the Hospital, and only on Thursday. (Visiting earlier in the week is preferred.) The other three children wanted to stay home. I'm not sure what to think about that, but Miranda and I had a nice visit.
The photo below shows what Carl and Miranda think of chemotherapy. But we don't hate the chemo, oh no. Hate the cancer, love the treatments. Or at least tolerate them. Technology and prayers will keep Carl alive.
So this is what the inpatient rounds of chemotherapy infusions are like (approximately- don't go using this as a recipe for in-home care) for treating Carl's sarcoma (Mon-Friday Jan 18-22, 2010; Mon-Friday Feb 8-12, 2010; Mon-Friday March 1-5, 2010).
Chemotherapy for Round 2, 3, and 4:
24 hours after the end of the in-patient chemotherapy, on either Saturday or Sunday, Carl has to go back to the Medical complex, this time the Cancer Center's 3rd floor Day hospital, for the Neulasta shot.
This is a picture of the Neulasta (also known as pegfilgrastin) injection. The instructions say "do not shake tube". So now I wonder, what happens if you shake the tube? Will it blow up? Or just not work? Whatever. Don't shake it. We want it to do whatever it is that it does.
(Dr. Seuss could say it better.)
[Neulasta promotes the white blood cell count, since the chemotherapy just wiped out all the white blood cells as a side effect, and white blood cells are kind of nice to have around.]
And finally, here is Carl walking out of the 3rd floor Cancer Center Day Hospital. Maybe someday I will tell you a funny story about this picture.
The Cancer Center is a beautiful facility that just opened in May 15, 2008. (I think the Cancer Center is officially called The Froedtert and Medical College of Wisconsin Clinical Cancer Center, [that's 10 words...] I've also seen it referred to as the MCW Clinical Cancer Center - much more catchy.) The titles leave me wondering: just what does the work "Clinical" add to the name, besides three syllables, I mean. A warm and fuzzy feeling? Whatever. Beautiful building, $95 million dollars of technology, and Carl can't wait to leave.
P.S. The MCW acronym is frequently referred to as M-COW. Very Wisconsin like, don't you think?
Carl and I think he is tolerating the chemotherapy very well, although Carl said Thursday and Friday were really bad. I tried to get him to define it, and he said that Thursday alone felt like 40 hours of having the flu. The bed is always moving and he thinks he was awake almost every 2 hours.
Here is a photo of Carl on Thursday. On Thursday, he can hardly open his eyes. It was a hugely busy week for the children and me, and only Miranda got a chance to visit Carl in the Hospital, and only on Thursday. (Visiting earlier in the week is preferred.) The other three children wanted to stay home. I'm not sure what to think about that, but Miranda and I had a nice visit.
The photo below shows what Carl and Miranda think of chemotherapy. But we don't hate the chemo, oh no. Hate the cancer, love the treatments. Or at least tolerate them. Technology and prayers will keep Carl alive.
So this is what the inpatient rounds of chemotherapy infusions are like (approximately- don't go using this as a recipe for in-home care) for treating Carl's sarcoma (Mon-Friday Jan 18-22, 2010; Mon-Friday Feb 8-12, 2010; Mon-Friday March 1-5, 2010).
Chemotherapy for Round 2, 3, and 4:
- Over 2 hours of time, Simultaneously
- Saline solution, 1400 mg.
- Ondansetron 16 mg - Anti Nausea medication
- Dexamethasone 20 mg - Anti Nausea medication
- Over the next 22 hours of time
- Mesna 700 mg - this protects the kidneys linings from bleeding, which is a side effect from taking Ifosfamide.
- Ifosfamide, 3800 mg in 500 ml of saline solution.
- Adriomycin, 34 mg in 500 ml of saline solution. This is the heavy hitting drug, and the main difference from the outpatient chemotherapy.
- When those bags are empty, a saline flush of the IV ports, followed by heparin, and then Carl is disconnected so that he can take a shower. Once the shower is over, he is connected up again, and the next 22 hours infusion starts. This is done 4 times in all.
- After 4 days, Over the last 6 hours of time
- Saline solution, 1400 mg.
- Mesna 1400 mg - Mesna protects the kidneys linings from bleeding, which is a side effect from taking Ifosfamide.
- When those last bags are empty, a saline flush of the IV ports, followed by heparin, and then Carl is disconnected. And he can go home. Yeah. Tired.
24 hours after the end of the in-patient chemotherapy, on either Saturday or Sunday, Carl has to go back to the Medical complex, this time the Cancer Center's 3rd floor Day hospital, for the Neulasta shot.
This is a picture of the Neulasta (also known as pegfilgrastin) injection. The instructions say "do not shake tube". So now I wonder, what happens if you shake the tube? Will it blow up? Or just not work? Whatever. Don't shake it. We want it to do whatever it is that it does.
(Dr. Seuss could say it better.)
[Neulasta promotes the white blood cell count, since the chemotherapy just wiped out all the white blood cells as a side effect, and white blood cells are kind of nice to have around.]
And finally, here is Carl walking out of the 3rd floor Cancer Center Day Hospital. Maybe someday I will tell you a funny story about this picture.
The Cancer Center is a beautiful facility that just opened in May 15, 2008. (I think the Cancer Center is officially called The Froedtert and Medical College of Wisconsin Clinical Cancer Center, [that's 10 words...] I've also seen it referred to as the MCW Clinical Cancer Center - much more catchy.) The titles leave me wondering: just what does the work "Clinical" add to the name, besides three syllables, I mean. A warm and fuzzy feeling? Whatever. Beautiful building, $95 million dollars of technology, and Carl can't wait to leave.
P.S. The MCW acronym is frequently referred to as M-COW. Very Wisconsin like, don't you think?
Tuesday, January 19, 2010
Chemotherapy Round 1
So this is what the 1st round of chemotherapy (Mon-Dec 28, 2009, Tues-Dec 29, 2009, Wed-Dec 30, 2009 and Thurs-Dec 31, 2009 and Fri-Jan 1, 2010), was like for Carl.
8:00 AM appointment, Carl shows up, Stacey the friendly receptionist asks him his room preference (Chair or bed). Carl selects bed. She assigns him a room and nurse, (special requests should be made now). Stacey informs the nurse that patient Carl is here. The Nurse preps the room for the patient, checks the patients orders, and sets up. After a time period the nurse comes to take patient (Carl and entourage-wife, kids, etc.) back. The nurse weighs patient, and escorts patient to the room.
An IV (Intraveneous) line needs to be set up to get the medicines into the blood. This can be done with a needle in a vein or in a port. Many chemo patients (and Carl) has an port implanted under the skin.
The nurse needs to access the port to set up the IV. The skin over the port site is cleaned and a 90 degree angle bent needle is poked into the port. Needle entry can be felt - Carl usually winces. Some patients ice the skin over the port in advance to numb it. Carl doesn't do that - yet.
A syringe of Heparon is pushed into the IV. Carl can instantly taste a bad taste in his tongue. This means the needle is in the port, and the flow from the port into the vein near the heart is flowing forward.
Then the nurse attempts to suction blood from the body back into the IV line. This doesn't always happen right away. Sometimes proteins can end up lining the tube from the port to the vein, and forward flow works, but backward flow is prevented. The nurse will work though this- more flushes, chemicals to de-block the line, etc. If all else fails, an arm vein could be accessed, but the point of the port is to NOT bruise up the arm with IV's.
Chemotherapy patient can wear street clothes and walk around while getting the chemotherapy, pulling along the IV machine and fluids on a pole. The IV machine displays the time remaining on the current "infusion".
Chemotherapy for Round 1:
The outpatient chemotherapy are has snacks like cereal, ensure milk shakes, fruit juices, and tins of Campbell soup. Carl is encouraged to drink lots of water. Each chemotherapy chair of bed is private via curtains or walls; and has a TV's able to watch DVD or Videos or multiple cable channels like Cartoon Network, National Geographic, etc.
The length of time a chemotherapy session is depends on the drugs and dosage being administered. Many chemotherapy sessions are just a couple of hours. Carl's first course had substantial doses of strong drugs, which meant that Carl had to be there from about 8:00 AM to 5:30 PM. We rarely left the hospital before 6:00 PM. Carl slept much of the time.
Carl prefers his milk shakes from McDonalds over the ensure shakes provided. Miranda and the other children are OK with both ensure and the McDonald's shakes. Carl also enjoys playing the Game of Life with Miranda.
Carl had his beautiful hair until Jan 16th, 2010.
8:00 AM appointment, Carl shows up, Stacey the friendly receptionist asks him his room preference (Chair or bed). Carl selects bed. She assigns him a room and nurse, (special requests should be made now). Stacey informs the nurse that patient Carl is here. The Nurse preps the room for the patient, checks the patients orders, and sets up. After a time period the nurse comes to take patient (Carl and entourage-wife, kids, etc.) back. The nurse weighs patient, and escorts patient to the room.
An IV (Intraveneous) line needs to be set up to get the medicines into the blood. This can be done with a needle in a vein or in a port. Many chemo patients (and Carl) has an port implanted under the skin. The nurse needs to access the port to set up the IV. The skin over the port site is cleaned and a 90 degree angle bent needle is poked into the port. Needle entry can be felt - Carl usually winces. Some patients ice the skin over the port in advance to numb it. Carl doesn't do that - yet.
A syringe of Heparon is pushed into the IV. Carl can instantly taste a bad taste in his tongue. This means the needle is in the port, and the flow from the port into the vein near the heart is flowing forward.
Then the nurse attempts to suction blood from the body back into the IV line. This doesn't always happen right away. Sometimes proteins can end up lining the tube from the port to the vein, and forward flow works, but backward flow is prevented. The nurse will work though this- more flushes, chemicals to de-block the line, etc. If all else fails, an arm vein could be accessed, but the point of the port is to NOT bruise up the arm with IV's.
Chemotherapy patient can wear street clothes and walk around while getting the chemotherapy, pulling along the IV machine and fluids on a pole. The IV machine displays the time remaining on the current "infusion".Chemotherapy for Round 1:
- Over 2 hours of time
- Saline solution, 1400 mg.
- Over the next 15 minutes of time, Simultaneously:
- Ondansetron 16 mg - Anti Nausea medication
- Dexamethasone 20 mg - Anti Nausea medication
- After above, over 15 minutes of time
- Over the next 2 hours of time
- Mesna 700 mg - this protects the kidneys linings from bleeding, which is a side effect from taking Ifosfamide.
- Over the next 2 hours of time
- Ifosfamide, 3450 mg in 500 ml of saline solution.
- Over the next 2 hours of time
- Saline solution, 1400 mg.
- Break????
- 4 hours after the last of the ifsofamide
- Mesna 1400 mg - Mesna protects the kidneys linings from bleeding, which is a side effect from taking Ifosfamide.
The outpatient chemotherapy are has snacks like cereal, ensure milk shakes, fruit juices, and tins of Campbell soup. Carl is encouraged to drink lots of water. Each chemotherapy chair of bed is private via curtains or walls; and has a TV's able to watch DVD or Videos or multiple cable channels like Cartoon Network, National Geographic, etc. The length of time a chemotherapy session is depends on the drugs and dosage being administered. Many chemotherapy sessions are just a couple of hours. Carl's first course had substantial doses of strong drugs, which meant that Carl had to be there from about 8:00 AM to 5:30 PM. We rarely left the hospital before 6:00 PM. Carl slept much of the time.
Carl prefers his milk shakes from McDonalds over the ensure shakes provided. Miranda and the other children are OK with both ensure and the McDonald's shakes. Carl also enjoys playing the Game of Life with Miranda.
Carl had his beautiful hair until Jan 16th, 2010.
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