Chemotherapy

Chemotherapy is a tricking thing. Your body must be able to handle the drugs and the attack it will have on your immune system. September 20th Art had a 3rd blood transfusion recieving two units of blood. The following Friday Art had a complete blood work up to make sure he could handle the treatments. The treatments are given over two days with 28 days in between for 6 months. Dr. Veith is Art's Hemotologist and Oncologist. The treatments are given in the Dr.'s office.

There are 7 recliners lined up arm to arm in a small room. Add few more chairs for the caregivers who bring someone with them and the room is crowded. nurses wear protective clothing and a mask while preparing the cocktails of chemo drugs.


Infusion Center at EJGH

Art's special cocktail consist of two chemotherapy drugs. Bendamustine and Ritiximab. Dr. Veith told us he has better success with the combination of these two drugs. For the first time treament of Leukiemia the combination of these two drugs are less toxic and more aggressive in treating stage 111 and lV.

Ritiximab can block cancer growth in different ways. Some block the ability of cancer cells to grow and spread. Others find cancer cells and help kill them or carry cancer-killing substances to them.

Bendamustine works in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. The combination of these two drugs kill more cancer cells. One of the side effects from this drug is Tumor lysis syndrome.

Tumor lysis syndrome ocurrs when large amounts of cancerous cells are rapidly killed by the therapy. These cells are release uric acid, potassium and phrophorus into the blood stream. This can lead to kidney failure. If this is going happen it will occur within 24 - 48 hours of receiving therapy.

09-07 Second Chemo Drug

The first two days of chemo treatments started with Bendamustine. Art's white blood count was to high for the combination of both drugs on the second day. He tolerated the Bendamustine with minimial side effects. Art had more side effects from the IV benadryl. On day three after chemotherapy I started noticing a difference with Art. His color was improving and he his thoughts were clearer.

Friday we had an appointment with the ENT. Dr. Jocob finally got the right combination of medications to keep Art's sinus infection under control. We gave him the name of the chemo drugs to add to Art's growing list of medications. At the end of our visit Dr. Jocab looked at Art and said "I am not trying to offend you by saying this, But you will never be N O R M A L again. Anything that changes from now on with you must seek medical attention." The hardest part for Art is admiting how serious things have become.

Quest Diagnostics dropped the ball with Art's blood work the day before his chemo treatment with Ritiximab. They did the test for his Uric Acid level but did not do the complete workup on the standing orders for his blood counts. The nurse had to draw blood and send it to the hospital. We had to wait for the lab results before they could begin. While we were waiting I started having an anxiety attack. I started tapping my forehead. Art didn't say anything but he knew something was wrong with me. The nurse started the medication. She told us what to watch for if there was a reaction. She told me if he falls asleep and opens his eyes and looks around like what was "that" to be concerned. The Benydrl was making Art sleeply and twitchy. I watched from across the room. Art was becoming agitated and irritable. I called the nurse and she talked to Art about how he was feeling. They dicided to stop the medication and give Art a break for a few minutes. The second time they started the medication I watched all the color drain from Art's face. I became concerned but contiuned to watch for other signs of a reaction. Art opened his eyes and looked around. I asked if he was alright and he said yes. A few minutes later he looked around again this time with the what was that look. I asked if he was alright and he said no. I got the got the nurse. She started asking asking Art questions about the way he was feeling. He said he felt like he wasn't getting any air trying to breathe, he was feeling week and neasuated. Art's blood pressure dropped to 80/50. The nurse stopped the IV and called Dr. Veith. Art got violently ill. Dr. Veith came into the room and started talking to Art and rubbing his back telling him it was going to be aright. They gave him another shot to stop the reaction. In all my years of going to the doctor I have never seen a doctor show so much empathy towards one of his patients. The treatment was discontined. We had to wait for Art to become stable before we could home. They called in a prescription for Allopurinol to lower the uric acid in Art's blood. It should help lower his white blood count so he will be able to tolerate this drug with his next treatment.

I have never been so scared in all my life watching Art go through this. Oct 28th we start round two.