The latest Gemzar side effects

I have been steadily feeling better and better since last week's blood transfusion. However, I did notice some additional side effects from the Gemzar which lead me to think this chemo is not quite as tolerable as I hoped.

RASH: Dr G told me to expect a rash on my shins, which showed up briefly as a few large, red spots which were tender to the touch. I had three on my left shin, two on my right. They looked just like spider bites and went away of their own accord over a couple of days.

MOUTH SORES: I developed one sore on the side of my tongue which went away within 24 hours. Now I have two; one on the side of my tongue, but in the back where I can't see it although I can feel it, and the other on the tip of the underside of my tongue. That one is tiny, white, and also tender. I've been gargling with salt water to prevent any infection. So far these are no worse than annoying, and I haven't needed my Magic Mouthwash (xylocaine viscous solution, Zovirax^®(alcohol-free), and Maalox^®, or Mylanta^®).

FATIGUE: This is the kicker. Even after the blood transfusion, I tire easily. Most afternoons I hit the wall around 1 PM and literally collapse on the sofa. Even if I don't sleep, I can't move for an hour or so. If I do nap in the afternoon, then I have trouble sleeping at night. I am trying to do my errands etc. each day in the morning so that I can be home by lunchtime and crash.

This morning I went to Costco, barely made it through the front door with the groceries, shoveled some food into my mouth while standing in front of the refrigerator, and staggered to the couch. I didn't sleep but zoned out quietly with Bobka the dog for an hour or so, then felt refreshed enough to bake an apple pie for Pi Day -- 3.14. (Get it?)

This is my week off chemo and I hope to recover enough to have treatment again next Monday.

Martenitsa

As I wrote in Chestita Baba Marta, when you see a stork (or in our case in the Pacific Northwest, a flowering tree), you stop wearing your martenitsa. Today I was at the local grocery store and noticed so many blooming trees that I had to take off my martenitsa bracelet and hang it from the branch of (I think) a flowering plum tree.

Doesn't it look beautiful? Now we know spring is really on the way.

Transfusion marathon

Yesterday was so LONG.....

I left the house at 10:45 AM for my 11:00 appointment at the Swedish Cancer Institute for a blood transfusion. Just a few blocks from home I realized that something didn't sound right with the car. Sure enough, the front left tire was completely flat. Thank God for cell phones. I called the Cancer Institute to explain I'd be late; called AAA for emergency road service; called my friend G, who was going to hang out with me during the transfusion.

The emergency road service truck arrived in only 20 minutes, barely enough time for me to decide what music to listen to while waiting (I chose Hedwig and The Angry Inch, which is completely fantastic). The technician changed the tire for me and put on the small spare. I drove off to the nearby Les Schwab Tire Center, where they were able to patch my flat tire right away. So I was only an hour late to my transfusion appointment.

By the time I arrived at noon, the Cancer Institute the waiting room was completely full. G met me around 1 PM. Just before she arrived, the charge nurse told me there was a delay in getting the blood and that it wouldn't arrive until 2 PM. G had brought lunch, so we sat in the waiting room enjoying lamb sandwiches from Mediterranean Kitchen. Just as we started a Scrabble game, the nurse called us back to the treatment area.

By 2:30 I was hooked up and getting the first unit of blood. G and I played Scrabble until she had to leave at 3 PM. I finished my book, Sue Fishkoff's Kosher Nation. I leafed through magazines. I played on my iPhone, listened to music, talked on the phone. (Thank God for that toy!) Man, was I bored out of my gourd.

Around 5 PM they switched to the second unit of blood. It turns out that blood units are not standardized by weight or volume, but reflect the amount each donor gives. There is a minimum amount required, but each unit can vary widely from others. So my first unit was about 220 ml, which went in over about two hours, but the second unit was more than 450 ml, and it took almost three hours to transfuse. Plus waiting for it to arrive.

Of course I hadn't planned this would take so long. The hospital cafeteria would have brought me a meal, but they only take cash and I didn't have any on hand. Instead the nurses offered me a sack lunch which had been delivered to the Cancer Institute in the morning. One dry turkey sandwich later, my transfusion ended. I finally left the Cancer Institute at 8:20 PM and was soon walking in our front door.

My back ached from sitting in the chemo chair for eight hours; I had a headache; I was cranky from being so bored for the entire day. But I got a good night's sleep, felt perky enough this morning to walk the dog for 30 minutes, and hope to continue to reap the benefits of the marathon transfusion.

No chemo next Monday!

Seattle's best bagels!

In today's Seattle Times, food critic Nancy Leson wrote a great review of our new favorite bagel place, Eltana.

And here is a photo of me learning to make a Montreal-style bagel at Eltana during a recent bon voyage party for Rabbi Borodin, who is taking a short sabbatical. Don't I look like quite the expert!

Transfusion tomorrow

I just got the word that I need to have a blood transfusion tomorrow. My red blood cell count was even lower today than yesterday, so a transfusion is in order.

I did make some delicious chopped liver this morning, and hope that it, plus some spinach soup, will also bring up my red count.

Gemzar dose 2

I did indeed have the second dose of Gemzar yesterday as planned. I've been anemic for at least three weeks and my red blood cell counts were low enough that there was some concern I might need a blood transfusion. Bu Dr G decided I should have treatment anyway.

After the Gemzar finished, the nurse took another blood sample to type and cross in case I need a transfusion today. She left my portacath accessed for the same reason.

I am supposed to go back later this afternoon to get a shot of Neulasta to build more white blood cells. At that point they can all decide if I need the transfusion, and if not, can de-access my port.

I took a nap yesterday afternoon and we went out for a quick dinner. By 9 PM I was in my jammies and starting to feel a slight fever. It continued until about 2 AM but never got above 99.5 degrees F. Of course, I remembered I wasn't supposed to take anything to reduce the fever, to see if it would spike higher, so I couldn't fall asleep. Around 1:45 AM I felt the fever break, but still couldn't sleep. I guess I dozed off around 5 AM and slept off and on until 10 AM, when I finally got up, took a shower, had breakfast and walked the dog.

I'm waiting for a call back from Nurse Jacque so I can report all these symptoms and find out what Dr G wants to do. Meanwhile I will make some chopped liver (gotta get some extra iron!) and maybe take a nap.

Fever

I've run a low-grade, one degree fever three times this week. This morning I called Dr G's office and spoke to Nurse Jacque, who told me to stop taking Tylenol and keep track of my temperature throughout the day. If my temp goes above 100.5, I am to call Dr G's office, even if over the weekend, because someone will need to see me.

My last Tylenol was at 9:30 this morning, and it's now just after 3 PM. My temp is 99.3 degrees F, and I will continue to monitor it into this evening and throughout the weekend.

I don't feel bad, not even a headache. My nose has been a bit runnier than usual these past few days, which may or may not have anything to do with my slightly elevated temperature. (Of course, I was out in the worst weather yesterday, and not really dressed warmly enough: sleet, rain, heavy winds and cold).

I think Dr G worries that the Gemzar may leave me prone to infection. This  potentially serious side effect is what put me in the hospital two years ago after four doses of 5FU. So I will keep track of things and be sure to call his office if needed.

Slowing down on Gemzar?

Last night I ran 100.3 degrees of fever. It was enough for me to notice that I felt weird, take my temperature, down some Tylenol, and hide under the blanket while watching TV. After only a few minutes I began to feel better.

I made it to both meetings today, but came home and CRASHED on the sofa. I didn't think I was that tired, but after quickly eating some lunch, the sofa started calling my name. I slept hard for a couple of hours. I think this is what they mean when they say fatigue is a side effect. I just "hit the wall" and literally could not move any further until I had slept.

Maybe this Gemzar is hitting me harder than I thought. It's possible that I didn't rebound quite as far back to normal after the last dose of Navelbine as I'd hoped. And I'm sure that today's combo of driving rain, high winds, sunshine and cold didn't help either.

Chestita Baba Marta

March 1st is a significant day in the Bulgarian calendar. Each year Bulgarians present to relatives and friends martenitsa - a double red and white tassel signifying health and happiness.

On the first day of March, people in Bulgaria put the martenitsa on their clothes or wrists and wish each other health and happiness with “Chestita Baba Marta” - (”Happy Grandma Marta”). “Marta” comes from the word for March (Mart) in Bulgarian.

Martenitsa are supposed to be worn until the person sees the first stork returning from the South. Then martenitsa are then tied onto a tree branch. The act of giving the martenitsa is in expectation of the near spring season. The “arrival” of the stork indicates that this has happened.

Although we have to go to the zoo in Seattle to see a stork, we can still wish each other "Chestita Baba Marta!"

Gemzar day 2

So far, so good: although I was tired when I woke up, I was able to get out of bed, walk the dog and get to my physical therapy appointment on time. Being with people clearly energizes me; I had a great catch-up with the therapist. On the way home from PT, I stopped at Gran Central Bakery for a loaf of sourdough rye bread and also got Rik a piping hot cinnamon roll, then dropped it off to him on my way home.

I have another meeting this afternoon, but plan to take it easy otherwise. I foresee a nap later today....