The Beginning of Chemo. Day and Night

Day one:

I had an appointment with a fertility doctor at 11am, planning to get a shot to shut all my hormones down, to try to preserve what I have. It'd be a shot once a month, until I was off the chemo, that keeps everything quiet and just adds an extra level of protection.

Just before the nurse walked in, ready to give me this shot, I turn and look at my mom asking if this is the right thing for me to do. See, my thinking is this: God doesn't just have ones body's hormones shut off. Not at the age of 19 or 20, yes, they shut off, when older, called menopause, but not at a young age. To me, that is just not natural or normal. So, I decided to not get the shot. I figured if God will allow me to have kids, as much as I want them, and boy do I want them, then He'll make it happen. If not, I can adopt, like I've always planned and had the desire to as well.

Next, we moved onto the blood draw before chemo at 12pm. That was kind of painful, just the way they drew the needle in, finding the vein and extracting the needle.

Then we went up to the pharmacy to see the guys who work there because they can give lots of laughs and cheer up ones days, got some lunch, and then went to sign into infusion at 1pm, waited for about a half hour, and then the process really started.

First, the nurse I had wanted to put an IV in my arm, between my wrist and elbow, so that it isn’t in a crook where it would bend, making it easier for them, and for me. Well, first off, I am a hard draw for the most part, and usually, they really can’t get that vein that the nurse wanted to get. Well boy, was I wrong! First try, she got it, barely hurt and everything! Next the pre-meds were started, taking anti-nausea pills, and then getting an IV that lasts 48hrs! Praise the Lord! After the pre-meds, they pumped me with fluids to keep me hydrated, and then started the first cocktail.

ADRIAMYCIN:

CARTOON DIAGRAM OF TWO DOXORUBICIN MOLECULES INTERCALATING DNA

They started off with 70mg of
Adriamycin, the specific type that it is a cytotoxic antibiotics, interacts with DNA by intercalation and inhibition of macromolecular biosynthesis This inhibits the progression of the enzyme topoisomerase II, which relaxes supercoils in DNA for transcription. Doxorubicin stabilizes the topoisomerase II complex after it has broken the DNA chain for replication, preventing the DNA double helix from being resealed and thereby stopping the process of replication. The only downsides to this drug is it can cause heart damage if using more than 550 mg, and it causes palmar plantar erythrodysesthesia (PPE). PPE can cause holes in the arms and legs if the drugs touch the skin directly, which is why the medicine is administered on sight, through a syringe, rather than a drip line. The side effects that are almost immediate are nausea and when taking the nausea medicine, causes restlessness, and finally, hair loss.

CISPLATIN:
They continued with an hour of fluids, and then an hour of my next cocktail, cisplatin. Cisplatin is an alkylating agent; their ability to alkylate many molecules, including proteins, RNA and DNA. This ability to bind covalently to DNA via their alkyl group is the primary cause for their anti-cancer effects. DNA is made of two strands and the molecules may either bind twice to one strand of DNA (intrastrand crosslink) or may bind once to both strands (interstrand crosslink) reacts in vivo, binding to and causing crosslinking of DNA, which ultimately triggers apoptosis (programmed cell death). Nerve damage, nausea, and a ringing in the ears of high pitched sounds are side effects that happen immediately. After the cisplatin is given, I have two hours of fluid afterwards again.

INTERFERON:

Next, I’m given interferon, which is given in the fatty part of my stomach, or the back of my arm, just a quick injection. They allow for communication between cells to trigger the protective defenses of the immune system that eradicate pathogens or tumors. Basically, they target the rapidly dividing cells, which is good because they target the tumor/bad cells, but they also target the good cells in our body. So with this, I am more susceptible to getting infections. Along with infections are mouth sores that are side effects while on the medicine.

FLUOROURACIL:

Fluorouracil or more commonly known as 5-FU is an anti-metabolite. Anti-metabolites are a group of molecules that impede DNA and RNA synthesis. Many of them have a similar structure to the building blocks of DNA and RNA. The building blocks are nucleotides; a molecule comprising a nucleobase, a sugar and a phosphate group. The nucleobases are divided into purines (guanine and adenine) and pyrimidines (cytosine, thymine and uracil). Nausea is one of the only side effect that happens immediately.




I am given all four of these drugs on the first day, and then the last three drugs days 2, 3, and 4. Afterwards, I am off for 3 weeks, and then the cycle repeats for 6 months straight.

Yesterday being my first day of chemotherapy went fine and I felt fine up until around midnight when I tried to fall asleep and that took a while, giving me hot flashes and being freezing. Finally falling asleep for only a few hours, I was woken up at 3 to have to go to the bathroom, about every 20 minutes, along with a headache, and restlessness that I couldn’t figure out why, until my doctor saw me today and told me that the anti-nausea medicine causes restlessness. So for an hour of trying to fall asleep, thinking it really had been about 2 hours, at least, around 4am, I took a hot shower and soaked in the tub for a while and then headed back to bed. By 5 or 5:30am, I was sound asleep, until 7:30 when my sister was up getting ready for work, and my mom was up also. But now, I feel good.

Day two of chemo:

I had my cisplatin, with an hour of fluids before, the cisplatin for an hour, and two hours of fluids after, my interferon, given in the fatty part of my stomach, just a 2 minute shot, and then my 5-FU for 15 minutes. All together it’s a 5 hour day, versus yesterday which was a 9 hour day!

Today, unlike yesterday, we won’t be leaving the hospital when the nurses are walking out at 9pm.