More Drama At Chemo

After my big surprise at Times Square (which I wrote about in my previous post), Cousins N and C and I made our way across town to the NYU Cancer Center for what was hopefully going to be my last round of chemo ever, stopping along the way at Korea Town for coffee for Cousin N and a muffin for me.  We met my friend and former realtor, the man who found my and Josh’s apartment, P.L.M. on the 5th floor.  P.L.M. is a gorgeous black gay man who looks like he could  be a model in GQ, seriously.  He also happens to be a riot who can entertain me endlessly with tales of his crazy exploits – definitely someone I wanted to have, together with my cousins, at what I hoped would be a celebratory last day of chemo.  As it turned out, I’m not sure I would call my last day of chemo “celebratory”.  

After Rosemarie, the nurse, stuck a big-ass needle (thank goodness for numbing cream!) into my port, she drew blood from said port for the 12th time in six months, at least she tried to do so.  But the blood wouldn’t flow.  That was a first and immediately put me on edge.  Despite the lovely surprise of that morning, I was extremely tense heading into my last chemo session, and the unusual difficulty in drawing blood only served to make me more tense.  I knew my CEA was going to be tested, and that always makes me nervous.  More than anything though, I was frightened about stopping chemo; I was scared of letting go of my most powerful weapon in this war.  I was afraid of being defenseless, afraid of what was going to come next.  Rosemarie had me drink some water and infused a bag of fluids, after which the blood flowed easily into the multiple vials she had to fill.  I and my little entourage marched up to the 8th floor to see my oncologist, Dr. A.C.  Josh met us there and we were seven people (including the doctor himself and his nurse practitioner, Natalia) crammed into an exam room.  My once always perfect blood pressure was high (170/90), a trend that had started, and gotten gradually worse, with the introduction of Avastin halfway through my treatment, but I’d been reluctant to start any blood pressure medication with the hope that I might cease the Avastin soon and then my blood pressure would go back to normal.  It would always skyrocket at the cancer center and be somewhat normal at home – gee, I wonder why.  My temperature, pulse and oxygen level were fine, as always.

Josh and I asked Dr. A.C.:  What are the next steps? Would there be more chemo? Would there be maintenance chemo?  What is the likelihood of recurrence – 70, 80, 90%?  His answers:  a PET and MRI scan within the next couple weeks; it depends on the scan results, but I reserve the right to put you on maintenance chemo depending on what the scans show; I suspect these scans will be clean; maybe not such a high likelihood of recurrence but I can’t really say; don’t worry, we’ll be monitoring you very closely with blood tests every month and scans every three.  I was worried, very worried.  I couldn’t help it.

The blood test results (other than the CEA which would take a few more hours), came back fine so off we all marched again down to the 5th floor to begin the infusions, minus Josh, who had returned to the office.  While we ordered our very late lunch, Rosemarie began infusing all the pre-meds – two different types of anti-nausea medications and steroids to bolster the effectiveness of the chemo drugs, all of which took about 45 minutes.  Next, came the 30 minute infusion of Avastin.  While all this was happening, we were eating Thai food, and P.L.M. showed us recent pictures of Britney Spears in concert in Vegas (over which we all made catty comments about her not-so-attractive body) and then photos of him with Food Network star and friend, Tyler Florence (at said concert); I immediately demanded of P.L.M. that he arrange a meeting for me with Tyler Florence – I love him and so does Cousin C!

I digress.  After the Avastin, we were ready for the big gun, the two hour infusion of oxaliplatin, the power horse, the “ox” in Folfox (the name of my chemo regimen).  By this time, Cousin C had left to return to Connecticut and her children and P.L.M. had stepped out for an appointment to return shortly.  Cousin N was the only one with me.  Within seconds of the oxaliplatin entering my body, I began to itch.  I told the nurse.  She asked, “Where?”  I said, “In my butt.”  Hahaha, we all kind of laughed.  I told her to keep the infusion going, that I’d experienced some itching previously with the steroids and that I was sure it would pass.  A minute later, I sneezed three times in immediate succession; my nose became congested to the point where I couldn’t breathe at all through my nose, the insides of my ears started itching and visible hives appeared on my ears and my back.  “That’s it.  I’m shutting it down!” Rosemarie announced as she shut off the IV.  Another nurse brought in the machine to test my vitals; my blood pressure was in the 190s/100s and my pulse was 97.  Another nurse called my doctor.  Rosemarie started me on an immediate infusion of steroids and Benadryl (which almost made me pass out).  I told Cousin N to call Josh to let him know what was going on.  The nurses gave me a nebulizer with oxygen and inserted little tubes into my nose with I-don’t-know-what-substance to alleviate the congestion.  Natalia, was there in minutes, listened to my lungs and inspected the hives on my back.  “You’re done with oxaliplatin,” she declared.  I recovered within 15 minutes.

I had an immediate allergic reaction to the oxaliplatin, a drug that I had handled incredibly well through 11 rounds.  I am allergic to virtually nothing.  Once during my senior year of college, I developed some bumps on my arms on the Day 9 of 10 of a sulfa-based antibiotic, and ever since then I always tell medical professionals that I’m allergic to sulfa-based medications (even though my reaction was so mild).  Other than that, I have no other known allergies.  At the 8th round of chemo, my nurse had told me that they would start monitoring me for allergic reactions to the oxaliplatin because that was when it tended to happen to patients, but when nothing happened at the 8th, 9th, 10th and 11th infusions, I pretty much forgot about the possibility.

It was only a few hours later as Cousin N and I were walking back into my apartment building after a very long day – for I was still infused with the leucovorin and sent home with the 5-FU pump after the allergy drama – that I remembered what my acupuncturist had told me five days earlier at my weekly acupuncture treatment.  (I’ve written about her and her declarations of my cancer-free state in The Marvels of Acupuncture)   She had felt my pulse as she usually does before every treatment and said, “You have an allergy to something.”  “What?” I asked, “I’m not allergic to anything.”  She said, maybe it’s the cold (because that was the week when it was -8 degrees with the wind chill factor).  I said, maybe or maybe it was the cold I was coming down with or maybe it was just the side effects of chemo.  Maybe, she said.  And then I promptly forgot about the conversation because I never have allergies to anything, that is until I had an allergic reaction to the oxaliplatin five days later.  How weird is that?

I was already worried about going off chemo, and now I was worried that I wouldn’t be able to receive the cancer-killing benefits of my 12th dose of oxaliplatin.  I was disappointed in my body.  Dammit!  Why couldn’t you just suck it up and take one more dose?  You failed!  You failed!  I ranted silently at my body.  I don’t handle failure well.  Those of you who know me know this about me and those of you who only know me through my blog I’m sure won’t find that at all surprising.  Then, my CEA came back – 4.3 – 0.3 higher than a month ago, although it was still in the normal range.  More disappointment.  More fear.  More apprehension.  More nervousness.

Allergies to oxaliplatin develop because of cumulative toxicity.  In some people, it happens early on, at which point there are desensitization protocols put in place – pre-meds to combat the allergy received a day or two in advance, very slow drips and reductions in dosage – to ensure that patients receive oxaliplatin; that’s how much doctors want patients to receive the benefits of the drug.  I know of people who couldn’t do more than six or eight or ten rounds, even with dosage reductions.  Because I’d received 11 rounds of oxaliplatin, there was no need for me to go through any desensitization protocols to get the 12th dose.

I should be happy that my body was strong enough to handle it through 11 rounds.  My body didn’t want it anymore.  I suppose it was telling me, Enough of this.  We don’t need anymore of this.  It’s done its job; let’s move on.  This was what Cousin N was trying to tell me as I sat there in the cancer center in shock, disappointment, anger and frustration.  It took me awhile to let go of all those negative emotions.  At some point, I realized, I have to love my own body; I have to forgive it; I have to listen to it; I have to believe in it again if I want it to work for me; my body is not my enemy; the cancer is.  It’s important to remember that.

My last day of chemo (hopefully) was indeed a crazy and memorable day, during which I must have felt every emotion that can be felt, from happiness and love in the morning to shock, anger, disappointment, nervousness, fear and so much more in the afternoon and evening.  I came home that night to a package from my sister-in-law, M.F.  Within it were cards from people I knew and didn’t know wishing me well, rooting for me.  M.F. must have sent hundreds of messages to my Facebook friends.  It took me two hours to read everyone’s messages.  Thank you to all of you who took the time to send me a card and to M.F. for undertaking this monumental project.  Know that, although the cards didn’t arrive in time for Christmas (as had been the original intent), they, with their messages of love, arrived at a time, and after a grueling day at the cancer center, when I really needed them most.

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1 Comment (+add yours?)

  1. Belle Piazza
    Feb 03, 2014 @ 12:19:49

    Wow! You really went out with a bang! My port won’t draw blood about once a month so they have to flush it with what I call “roto-rooter”. It’s pretty common. I hated oxi. I made it through 10 rounds in 2008 before my port had to be removed due to complications and we just skipped the last 2 rounds of it. Please don’t beat yourself up – that’s a really hard drug for anyone to tolerate. Enjoy Paris – I can’t wait to read about it!

    Reply

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