October 1, 2014

Taking a Chemo-Break and Recharging the Battery

I had a CT scan yesterday, and saw the nurse practitioner who works with my oncologist today. Nine weeks after starting the latest round of chemo in March, the first CT showed a decrease in tumor size across the board. Nine weeks later there was no change, The latest scan nine weeks later again showed no decrease. While the nine rounds of infusion have arrested the growth of my tumors, they have also done something of a number on my red blood cell (RBC) count. The count has been in steady decline across the months. The nurse said, the decline in my hemoglobin associated with the RBC decrease is the equivalent of loosing two units of blood--perhaps 25-33%. No wonder I've been dragging around and tiring easily. My fatigue was the worst from 5-9 days after my last infusion when my RBC count was probably at its lowest. I've learned that even with high blood oxygen readings thanks to my supplemental oxygen, a shortage of RBCs can leave me easily fatigued. On Saturday we went on a short hike in Guanella Pass south of Georgetown, CO with my cousin Jodi and her husband Darrell. That mild exertion at 8-9,000 feet and almost three weeks after the infusion left me very short of breath even with supplemental oxygen. It was so bad that I saw red flashes in my visual field for the first and hopefully the last time.

Consequently, I'm taking a break to let my RBC count get back to a reasonable level. In looking over my infusion history since starting to receive pemetrexed in Colorado in December 2011, I found that I have had infusions about half of the time. I proposed (and my oncologist accepted) that we try a pattern of nine-weeks on chemo followed by nine weeks off which will provide chemo 50% of the time. Since I just completed 27 weeks on chemo, I started my nine weeks off today. In five weeks I'll go in to have my port flushed, and I'll get a CBC at the same time which will tell how well my body is replenishing my supply of red blood cells.

Four weeks later, I'll have a CT and meet with the doctor to see if it's time to begin chemo again. I look forward to having more energy and getting in better physical condition.

David

1 comment:

  1. What was your H&H? Did they not feel your counts were low enough for a transfusion? The average RBC(not under attacked conditions) is around for about 120 days, and functional for 90 days. Do they ever check anything about your bone marrow?

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