July 4 ( Day 21 of Cycle 4)-Lots of Coconut Juice to drink (air kelapa)
Tomorrow is D-Day for Cycle 5. Cycle 5 on July 5, a day before I add another year to my already golden status. As I anticiapte a somehat challenging session ( the Onco nurses need to hunt for a "good vein" and then inject a drug to dilate them and clear the way for chemo drugs) I plan to be admitted overnight and not on a day basis as done earlier. I hope I can get away with the request for the doctor to reconsider the dosage if my lip ulcers are still bothering me. The red drug(Epirubicin) apparently is very "heaty" and cause ulcers. My Onco did acknowledge yesterday that the ulcers could be due to the increased dosage at cycle 4. I drank the juice from 2 whole coconuts as advised by friends who told me this can help reduce the heat in my body so that no fresh ulcers will appear.
How was the cycle 4 experience? Certainly vey different from previous cycles due to the increased dosage and the cumulative effects of the side effects. I am sure it will be different for different people based on their baseline health level and their ability to cope, so what I am journalising are the experiences that I went through and the lessons and learnings I get from them.
Pertinent points about Cycle 4:
Wbc count rather high - higher than baseline. 8.7 vs baseline of 6.4 and other interim counts ranging from 1.8-2.8.
Weight gain vs baseline - up 4 kgs (therefore average of 1 kg per cycle so far. All the steroid induced cravings and the need to eat well to maximise cell recovery during 3rd week post chemo.
Onco had prescribed increased dosage for 4th chemo , he upped Epirubicin dosage by 15%.
Given 2 doses of Neupogen during interim blood count (2.4) , sakit pinggang as a result.
Not given booster post 4th chemo as the relief Onco wanted to test if my system could cope and that my bone marrow could recover on its own.
Pre-chemo blood count yesterday showed quite a good count of 3.8 wbc, and if this is maintained and I am within the normal range of 4-11, chemo 5 can proceed tomorrow (assuming they can locate and open up channel in veins.)
Side effects - very different probably due to increased dosage. I felt weakened but refused to let body to wilt too much by the higher dose, so pushed myself to do all kinds of things like having a garage sale! How ever, my spirit was very low during the second week, and my appetite was affected somewhat but was successful in making sure some nutrients get in. Continued to have problems with bowel movement. Not that my bowels ain't moving, they move like clockwork every morning before or after suboh but it has been a daily excruciating experience probably caused by the constipation in cycle 2. I never did recover from the ravages of constipation. The doctor and everyone reminded me to drink up, which I tried to do although plain water now tastes awful and has to be supplemented with juices/flavours. An additional side effect for this cycle are painful mouth ulcers and blisters. The ones inside the outh are manageable as the Gengigel gargle nightly and after meals does help, so is the Gengigel gel to apply. However the ones on my lips just seem to grow deeper and bigger and very, very painful. The doctor prescribed Orabase which I have been applying every 3 hours after meals. Feels okay when the cream is freshly applied but the pain and tingling will stsrt again when the cream has been absorbed or swallowed. I shudder to think what will happen tomorrow when Epirubicin is administered and I am supposed to suck ice (yucks) to protect the lining of my mouth. What happens if the lining of my mouth and lips are already cracking up and painful, will it get worse? I don't even want to think about it now in case I lose some sleep tonite.
I received a number of encouraging sms from friends for me to be strong tomorrow after they hear about my blood being takem from my foot and not from my arm for the blood test yesterday.
I hope and pray the session tomorrow will go smoothly and that I get to rest awhile in the ward and go home the next day, if necessary. I remind myself always that Allah will test us up to the point of our capacity to manage, and Insya Allah, whatever happens tomorrow, I seek His guidance and compassion to grant me the strength to endure whatever challenges the session might bring.
Once I get through tomorrow, Insya Allah, there will be only one more cycle to go in 3 weeks time before I prepare myself for 5 weeks of daily radiation doses.
Ya Allah, please give me the courage and strength to turn up at the Medical center tomorrow and the resilience to tolerate the 3-4 hour process of making myself better while comfronting the treatment. Please guide my Onco and the Onco staff to handle me gently and that they will be able to locate a good vein that will be ready to recieve the chemo drugs that will help my body in its fight against those unseen mutant cells. Amin.
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