3rd Cycle-A different experience & approach

May 25 (Day 2 of cyle 3)

Day 1 of cycle 3 (when I went to get my chemo done)was mostly spent in the ward of the medical center. It was about 9 pm by the time I reached home and was kind of exhausted after the whole day's activities. So this account will be a combined account of what happened on May 24 and 25. Whatever I can recall that is. I should have brought my laptop to the ward but didn't anticipate that I will be warded for that long.



Picture: Of Kuching Beach in July 2006 when I was there to join the much talked about Rainforest World Music Festival. A beautiful experience of live music, a truly universal language enjoyed by all, young & old, all citizens of the world. I only have pleasant thoughts of my visit there and that's one of my favourite visualisation exercises, being in the ancient rainforest, at peace with nature and forgetting about the sometimes crazy world outside of the soothing green enclave....intoxicating. Champs Elysees, The Lake District may have their charms, but our very own "olde world charms" at our doorsteps are there to be discovered and savoured, and sadly often overlooked as we aimed for the horizon....


May 24 (Day 1 of chemo)

I did my FBC at 9.30 and results was out about an hour later. Although the wbc is 5.4 (an improvement over the interim done on May 11 which was 2.4) but a slight decline vs the 2nd prechemo count on May 3 which registered at 6.4. Hmmm, I will need to try and get back to at least 6.4 for the next one.

My review with my Onco DDIW went very well. He prescribed a pre-chemo injection of Kytril and Dexa ( the steroids) to take care of the early onset of nausea, but suggested I continue with Emend for 3 days to manage the later stage nausea (the 5 days post chemo). He also prescribed the 8 dexa tablets per day for the first 3 days plus 4 sodium choride tablets per day to be taken on the days I take Emend as emend robs the body of salt. I probably had not increased my intake as much as I should during the last cycle (not used to taking too salty foods). And the best part, to address the constipation, he prescribed a nice tasting syrup Duphalec syrup with Lactulose np that I have to take for the first 5 nights (20 ml) whether or not I am constipated. I felt better already just as he was prescribing those medications. For the extended fatigue, he advised to continue with my own multivites (Centrum) and will administer by drip some additional dosage of vitamins prior to the chemo.


As the chemo day care lounge was full of patients, I decided to get myself admitted for half a day so that whatever is required to be done pre chemo can be done in the ward (like the vitamin infusion). Besides, I noticed some of the waiting family members were happily sneezing and coughing away in the guest waiting area which is just in the far corner. It doesn't take a stretch of the imagination to think of the millions of virus and germs that might be floating in the air and I mentioned that to the onco nurse.


I decided to have my lunch before settling in the ward to wait for my Vitamin infusion. I had a long wait to 3 pm before it was my turn. It was a double room and my ward-mate is a Medical Officer from the new Ampang GH who suffered from a slipped disc, getting out of bed, 2 mornings ago! Poor thing, she was in such pain that momentarily a question popped in my mind-who is in a "better" situation? She or I? I believe yet again, that these are challenges dished out by the Almighty to remind us of pain, an opportunity to take a break from our normal daily routine to enable us time to reflect on whatever it is in our life that requires reflection but we are sometimes too busy to take even a minute to do it.


The Vitamin infusion was completed by 2 pm, and half an hour later a nurse came to wheel me to the Chemo ward. As I could walk ( I was feeling fine) I declined the wheel chair. At 2.30 the pre-chemo infusion of Kytril and dexa(the "tingling" injection) was administered and I was also given the first Emend tablet orally. Half an hour later, the all too familiar FEC/CEF WMD routine started again.


I must admit, the sight of the cup of ice-cubes ( and even writing about it now) made my stomach turn. Yuck and double yuck. It is the mind and the association with the post chemo nausea that turned my stomach. I had to close my eyes and while sucking ice, imagined myself at Kucing Beach, The Holiday Inn at Santubong, lovely chalets and beach with fine sand and I am on a beach chair with a good book, a cool ice lemon tea and the sea breeze caressing my face and hair ( until I remembered I had none left!).


By 5 pm, we were done and I was wheeled to my ward. This time I needed the wheel chair as any jolting movements might set of a wave of nausea. I rested in the room chatting with my room mate who was still quite groggy over the painkillers that she had to take to mitigate the piercing pain in her spine. My tea of Milo and blackbean pau was waiting, so I tried to eat that and managed to consume it without too much dificulty. The challenge from now on is to eat and retain what I eat.


I was confident that if I can fight the nausea, insya Allah, the food will not be expelled, and I need to eat. Never mind that the weighing in session prior to consultation with DDIW showed yet another kg increase in my weight! 1 kg between each chemo cycle means by the time I complete all 6 cycles , I would be plus 6 kgs compared to the time I started. Gee Wheeze. Focus on treatment should be my prime objective and I will trim the chemo-gain once the last cycle is completed. The slowing down of activities is a major contributor I think plus the good appetite soon after the booster period when nausea would be unknown.


My friend RJ offered to pick me up from the Medical Center and take me home and it was kind of her to stay over to keep me company. We also had a bit to catch up on, so by 8.30 I was home, with Kakak waiting to get in. We had a late dinner, and of course as expected I couldn't eat. Just managed the soup and a few chunks of carrots. If I take just a wee morsel more I knew I would be sick and throw up. So much for Kytril and whatever.


I settled myself on the living room sofa and chatted with RJ as I didn't feellike climbing the stairs yet without feeling seasick. I got a shocking piece of news when a friend called to tell me that our common friend broke her leg just 2 weeks after her retirement! Oh dear, oh dear.....she is too nice to have this kind of thing happening to her but the Almighty has all this as part of his Masterplan, so there will be some hikmah in it. I was determined that nausea or not, if RJ is game, we would visit her the next day to hear the full story and how come she did not inform us of what happened.


I slept quite well ( thank God so far, sleep has been good, no insomnia) except that I would fall asleep on the sofa and if I did, I should not be woken up until I wake up by myself and if I feel fine to be upright, I would find my way to the bedroom, step,by step climbing the stairs at 2 or 3am in the morning!


May 25 (Day 2 of Cycle 3)

After solat, I took Emend which had to be taken an hour before meals. RJ was already up and chatting with Kakak, who will be leaving for workplace by 7 am. We had breakfast, and I couldn't manage the oats and just had half a pretzel (plain, no spread) and ovaltine and some fruits....very slowly in between chats as I just couldn't get rid of the nausea, but need to line my tummy for the dexamethasone tablets and salt tablets to be taken after the meal.


We were about to get ready to go to the NCSM and to visit my friend SM who broke her leg when UZUN dropped by to see how I was getting on. She was on her way back from visiting her Mum's pusara at Kiara. We caught up on what's been happening, and before we knew it , we really had to rush to cross town before the Friday jam started. I also had a pleasant call from Syabas to inform me that their committee had approved the waiver of my excessive bill and that cured my nausea for the morning! They confirmed that I should be receiving a letter from them soon. Some battles are worth fighting for.....


We got to the NSCM at about 11.30 am and was trying to scout for Raden to find out how her session with Dr Sulaiman went. I couldn't spot anyone who looked like her blog-potrait, and when I checked with the officer next to Dr Sulaiman's office, I was told that she had left. I went to the Resource Center in case she might be up there with Adeline, but she wasn't. I did my registration for the June 2 Relay for Life event and left for Melawati to visit my friend.


I had carried a few plastic bags just in case I get sick, but fortunately was able to fight it. We had a light snack at SM' s place ( will write about the visit in my other blog, I am glad I went to visit her) and was home by 3 pm when RJ dropped me off and she went on home.


I surprised myself at dinner time by finishing what was on my plate! A typical dinner first few days of chemo would be a fried egg on rice because I couldn't swallow anything else. But tonight , I had rice, fried kacang botol, rendang hati ayam with long bean beans, gulai lemak telor ikan (which SNA brought with her when she and her son came to join us for dinner on her way back from her sister's house) and kari ayam! At this rate I may even put on 2 kg by my 4th chemo! Rule: No pantang during chemo other than what the doctor had listed as no-no.


Syukur Alhamdullillah no nasty retching dos today despite all the "activities" as I tried to practice leaning back and watching my breathing and visualised, visualised, and visualised whenever the urge presented itself. And syukur Alhamdullillah, I am halfway into the chemo regime, 3 down and only 3 to go, Insya Allah it will get better each time. Just need to keep the blood count maintained to enable treatment to proceed. It was unfortunate that one of my chemo buddies there couldn't proceed with hers as her wbc was low at 1.8 and had to go on boosters again and she will try again for Monday.


The nausea did sneak up on me before I was about to retire for the night, so I ended up on the sofa until 4 am, when I woke up and found my way slowly to my room, and remembered to take the anti-constipation syrup before I slept.