In the Hospital: Days -5 and -4

Chemotherapy Annoyances

So far I've been fortunate and have experienced only minimal side effects from my chemotherapy treatment and that leaves me free to complain about the annoyances associated with chemotherapy treatment in the hospital.

Most annoying is being tethered to the IV pole 23 1/2 hours per day. I generally escape for 1/2 hour in the morning to take a shower. The administration of the chemo I've been getting can take up to 5 hours per day via bags hanging on the IV pole going through a pump via feed lines and ultimately going into an access port of my central venous catheter.

During the chemo and throughout the rest of the day I am receiving hydration in the form of a solution called D5 1/2 NS which is Dextrose, 1/2 normal saline, with potassium and magnesium. The reason for the hydration is to flush the chemo out of my system so it doesn't provide unintended consequences to perfectly innocent organs in my body. The result is frequent urination throughout the day and night.

In the morning, prior to my first chemo infusion of the day, I am infused with an anti-nausea drug called Zofran. In addition I take 5 pills of a steroid called dexamethasone which according to one of the nurses works synergistically with Zofran to prevent nausea.

This is clearly working well since I've experienced almost no nausea.

One of the unfortunate side effects of Zofran is constipation which I've experienced in this and previous chemo treatments. This has been very unpleasant and ends up being treated with stool softeners (Colace) and laxatives (from Milk of Magnesia to Senokot).

Aggravated hemorrhoids caused by the constipation is another consequence and now we're talking about a topical ointment called Anusol and sitz baths to help resolve that problem.

This has been a new world to me but it's something I've got to deal with because even if not life-threatening, it sure makes my life unpleasant.

After tomorrow when I am finished with my chemo infusions, I should be generally untethered from the IV pole unless I need infusions of medications next week to help counteract some of the effects of the chemo associated with dropping blood cell counts. Being generally untethered will be cause for celebration!

Another potential problem is mouth sores and in it's most extreme case is called Mucositis.

From the Cancer Supportive Care web site: www.cancersupportivecare.com/drug.php#sore

Sore Mouth and Throat (Mucositis)

A sore or ulcerated mouth or throat is a frequent side effect of chemotherapy. .....
The mouth and digestive tract are composed of cells (mucosa) that are more sensitive to chemotherapy. The lining, or mucosa, of the gastrointestinal tract, which includes the inside of the mouth and throat, is one of the most sensitive areas of the body. Thus, during or after chemotherapy, a cancer patient may present with mouth problems, ranging from dryness to ulcers. Many chemotherapy drugs can inflame the lining, a condition called mucositis. Mucositis appears as redness (inflammation), sores (ulcerations) and associated discomfort and pain.

... Three to ten days following chemotherapy, patients may experience a burning sensation, followed by ulcers. When ulceration develops, treatment is mostly supportive until the cells regenerate themselves, which takes about 7 to 14 days (most commonly associated with a low white blood cell count). This can impact on oral comfort and nutrition, but adequate care can minimize these effects.

I experienced extreme sensitivity and tenderness of the gums after my 2nd RICE chemo treatment. The hospital provides a rinse of baking soda and salt and recommends rinsing after each meal and before bedtime. I've been doing the rinse 6x per day to try and preempt this problem since it was so unpleasant when I had it after the RICE treatment. Not only was it painful but it took away a lot of the pleasure of eating which is disastrous in my world!

The mouth sores typically occur after the Melphalan chemo which I'll be receiving tomorrow.

And now to totally change the tone and subject of this Blog Post:

My Favorite Computer Programs I've tried and have been using in the past few months:

RoboForm from Siber Systems – www.roboform.com -- it memorizes passwords on your PC

Migo – www.migosoftware.com -- It synchronizes files between PC's and Laptops including Outlook folders (inbox, other email folders, contacts, calendars, etc.). You can buy it as software; I bought it preinstalled on a Kingston 2 GB USB Drive. It works great -- after working on my laptop at some remote location (like the Transplant floor of a hospital) I will bring the USB drive home, run Migo, and it will update my PC (including all predefined Outlook folders) with whatever work I've done on the laptop.

Podcasting download software -- I'm using WNYC Pubcatcher which I got from http://www.nyc.org/about/podcasting.html -- there are many other podcasting download software packages available.

RSS Reader – www.rssreader.com -- from the RssReader web site:RSS (Really Simple Syndication) is a format for syndicating news. I also use it to link to the Fresh Air web site as an easy way to stream audio from that web site in order to listen to shows I've missed and am interested in. There are plenty of other RSS readers available.

SKYPE – www.skype.com -- for VOiP phone calls via one's computer. Free for Skype to Skype calls, I've been speaking to my buddies Don Garrison and Jeff Baker working in Torino, Italy in preparation for the NBC broadcast of the Winter Olympics and my friend and colleague Ray Lowe in New Jersey. It's pretty remarkable -- quality is generally good.

Vonage – www.vonage.com -- I use this VOiP phone service for my home office voice and fax lines. It runs over the internet via my cable modem. It was very easy to set up. For my usage Vonage provided a router with access for two standard phone lines and the Vonage router plugs into my router via a CAT5 cable. I would say I'm 98% satisfied. I've had a few problems with dropped calls (mostly when I talk to Ray Lowe -- maybe there's the problem) and echo but it's been mostly reliable with mostly good quality. Their web based account management tools are pretty lame but they'll probably improve those down the road.

I think that's enough of this for now. In a couple of days my next post will probably talk about my impending stem cell transplant and what I know about that. Until then .... best wishes and much love to all.