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chemo 2.5.1: transfusion and reaction to Carboplatin®

Posted Aug 28 2009 8:07pm

We started out with blood tests, because this was my return to chemo following the one-week break. Findings: white blood cells low but still chemo worthy and red blood cells low: time for another transfusion and then chemo. The anemia (RBC 8.7) explained my recent wipe out yesterday.

In keeping with his tradition, Marvin went to the cafeteria and the gift shop and returned with our favorite breakfast burritos. I was starving this morning and gobbled mine up in no time. The scarf he brought me today is gorgeous: black and fuschia with dashes of green.

After the blood transfusion we got to the usual administration of my monthly Zometa® followed by the pre-chemo drugs: Zofran® and Decadron® along with saline. Claudia took care of me today, this typically busy, busy day in the Chao infusion center. After we finished the prep she and another chemo nurse verified the Abraxane® 145 mg and Carboplatin® 200 mg, and Claudia hooked me up first with the Abraxane; all went fine.

Roxy Lovejoy, TAILS volunteer, UCIMC

Roxy Lovejoy, TAILS volunteer, UCIMC

During the middle of all of this I got to meet one of the stars of the infusion center: Roxy, one of the three therapy Bassett hounds. Usually, I miss them because they come on other days, but today was an exception. She came up on the bed with me and right away nestled up for a pet. So adorable. Marianne, her owner, has two other volunteer Bassets in the UCIMC TAILS volunteer program. Her companion, Emma, returned after they left to ask me questions about the visit.

Sometime during this visit Claudia returned to start my Carboplatin infusion. About fifteen minutes into the infusion, after everyone had left and I was just listening to the TV and Marvin was relaxing, my head started feeling hot, and I noticed I was sweating. Simultaneously, I suddenly was so congested I could not breathe through my nose. Marvin, who always notices when anything is awry, says, what’s going on, your face is red and swollen. I figure the chill I had had earlier got better because the room temperature changed; he says that it’s the same as before.

I now am feeling sick all over. He motions to  one of the nursing staff outside my room to come in; she sees me and says, it looks like you’re reacting to the Carboplatin. Magically, Claudia appears with Gaby, one of the techs, who takes my vitals, and there is a flurry of activity. Another nurse rushes in to help. My blood pressure rose to 165/105, pulse hit the 90s, and now I have hives across my shoulders, the redness extends from my face to my shoulders, my lips are tingly, and I am dizzy and retching. They slap an oxygen monitor on my finger, but it registers safe though a little low: 94. They want to give me oxygen, but I say I can do some deep breathing. It happened so fast that, had I been alone, I don’t think I’d have known what to do and I think I would have been scared at the quick progression of symptoms. Everyone acted so fast, though, I was able to concentrate on my breathing to control my nausea (remember, I have a no puke rule) and to improve my oxygen processing. I wanted to sit up, so Marvin stayed close to ensure I wouldn’t fall from the dizziness.

deep breathing to improve oxygen intake and to allay nausea

deep breathing to improve oxygen intake and to allay nausea

During all of this Claudia had also called my hemonc and gave me Benadryl® and something else (I forget) and hovered until she needed to leave briefly; Rochelle took over staying with me. They did not leave me alone, even though Marvin was there. I can’t believe how out of it I felt, but I did not feel scared. They both explained that patients on Carboplatin sometimes have reactions around the fifth or sixth infusion of a cycle. Depending on the reaction they determine whether to administer Carboplatin again: if there is any indication it could progress to anaphylaxis, they do not give it again. In my case they said the tingling in my lips and the hives were precursors to anaphylaxis, so, per Toni, who stopped by, Dr. Mehta said that was the end of my Carboplatin treatment.

Finally, I could tell the drugs started to work because my congestion began to break. The nausea eased, the heat wave began to dissipate, and the face redness and swelling diminished. They kept me until my blood pressure normalized and my symptoms eased. Claudia took blood for an iron panel, and I’ll meet with Dr. Mehta next week to discuss the next wave of treatment in light of today’s highlights.

I could not stay awake after all of that. Kept falling asleep on the way home, and after we got home I slept the entire time until waking up to write. It was a long day: at the infusion from 8:30 am to 4:45 pm. I’m ready for more sleep :). Sweet dreams.

5 6 7 8

We started out with blood tests, because this was my return to chemo following the one-week break. Findings: white blood cells low but still chemo worthy and red blood cells low: time for another transfusion and then chemo. The anemia (RBC 8.7) explained my recent wipe out yesterday.

In keeping with his tradition, Marvin went to the cafeteria and the gift shop and returned with our favorite breakfast burritos. I was starving this morning and gobbled mine up in no time. The scarf he brought me today is gorgeous: black and fuschia with dashes of green.

After the blood transfusion we got to the usual administration of my monthly Zometa® followed by the pre-chemo drugs: Zofran® and Decadron® along with saline. Claudia took care of me today, this typically busy, busy day in the Chao infusion center. After we finished the prep she and another chemo nurse verified the Abraxane® 145 mg and Carboplatin® 200 mg, and Claudia hooked me up first with the Abraxane; all went fine.

Roxy Lovejoy, TAILS volunteer, UCIMC

Roxy Lovejoy, TAILS volunteer, UCIMC

During the middle of all of this I got to meet one of the stars of the infusion center: Roxy, one of the three therapy Bassett hounds. Usually, I miss them because they come on other days, but today was an exception. She came up on the bed with me and right away nestled up for a pet. So adorable. Marianne, her owner, has two other volunteer Bassets in the UCIMC TAILS volunteer program. Her companion, Emma, returned after they left to ask me questions about the visit.

Sometime during this visit Claudia returned to start my Carboplatin infusion. About fifteen minutes into the infusion, after everyone had left and I was just listening to the TV and Marvin was relaxing, my head started feeling hot, and I noticed I was sweating. Simultaneously, I suddenly was so congested I could not breathe through my nose. Marvin, who always notices when anything is awry, says, what’s going on, your face is red and swollen. I figure the chill I had had earlier got better because the room temperature changed; he says that it’s the same as before.

I now am feeling sick all over. He motions to  one of the nursing staff outside my room to come in; she sees me and says, it looks like you’re reacting to the Carboplatin. Magically, Claudia appears with Gaby, one of the techs, who takes my vitals, and there is a flurry of activity. Another nurse rushes in to help. My blood pressure rose to 165/105, pulse hit the 90s, and now I have hives across my shoulders, the redness extends from my face to my shoulders, my lips are tingly, and I am dizzy and retching. They slap an oxygen monitor on my finger, but it registers safe though a little low: 94. They want to give me oxygen, but I say I can do some deep breathing. It happened so fast that, had I been alone, I don’t think I’d have known what to do and I think I would have been scared at the quick progression of symptoms. Everyone acted so fast, though, I was able to concentrate on my breathing to control my nausea (remember, I have a no puke rule) and to improve my oxygen processing. I wanted to sit up, so Marvin stayed close to ensure I wouldn’t fall from the dizziness.

deep breathing to improve oxygen intake and to allay nausea

deep breathing to improve oxygen intake and to allay nausea

During all of this Claudia had also called my hemonc and gave me Benadryl® and something else (I forget) and hovered until she needed to leave briefly; Rochelle took over staying with me. They did not leave me alone, even though Marvin was there. I can’t believe how out of it I felt, but I did not feel scared. They both explained that patients on Carboplatin sometimes have reactions around the fifth or sixth infusion of a cycle. Depending on the reaction they determine whether to administer Carboplatin again: if there is any indication it could progress to anaphylaxis, they do not give it again. In my case they said the tingling in my lips and the hives were precursors to anaphylaxis, so, per Toni, who stopped by, Dr. Mehta said that was the end of my Carboplatin treatment.

Finally, I could tell the drugs started to work because my congestion began to break. The nausea eased, the heat wave began to dissipate, and the face redness and swelling diminished. They kept me until my blood pressure normalized and my symptoms eased. Claudia took blood for an iron panel, and I’ll meet with Dr. Mehta next week to discuss the next wave of treatment in light of today’s highlights.

I could not stay awake after all of that. Kept falling asleep on the way home, and after we got home I slept the entire time until waking up to write. It was a long day: at the infusion from 8:30 am to 4:45 pm. I’m ready for more sleep :). Sweet dreams.

5 6 7 8

You are very brave … I think I would have freaked out.

That was a very long day and a bit too exciting … hope you got some good rest.

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