October 25, 2024
We had a call this morning to go over the protocol and side effects of the upcoming chemo. Like before, David will receive Dexamethasone and Akyenzeo prior to each chemo IV in an effort to minimize the nausea and other side effects. He will also take the Dex for three days following the treatment. The nurse said the first day of the cycle, David will receive both the carboplatin and etoposide (VP-16) (around 3 hours). On day 2 and 3, he will receive just the etoposide (around 2 hours). At least we won’t be there for 7 straight hours like before. She explained they would monitor blood work closely as both of these meds would cause a drop in RBC and platelets. Not great news since his RBC is already low from these past months. This will make him even more tired and low platelets make you more susceptible to bruising. Nausea is a big side effect of these and she suggested peppermint, ginger, and avoiding spicy, greasy foods. Our old friends constipation and diarrhea may drop by along with lack of appetite. More neuropathy is expected (he still has some in his feet and fingers from last Fall) but there won’t be the cold sensitivity with these drugs. He may experience a metallic taste in his mouth from the carboplatin and she suggested some people find eating with plastic cutlery and drinking from only a glass to be helpful. He will be tired, and I cannot imagine him being more tired than he already is. The etoposide will cause hair loss more so that he saw with the last chemo. And yes. Hair loss does bother men too. She said it will start to come out around 10 days after the start of treatment and will start to return around 4-6 weeks after treatment ends. She suggested gentle shampoo (baby shampoo) and sunscreen will be even more important as his skin will be more sensitive. His mouth will most likely develop sores or ulcers. Also this was not something he had to be concerned with last time. She suggested a very soft toothbrush and non-alcohol mouthwash. We will be back to washing his clothes and towels separately and flushing the toilet twice with the lid closed for 48 hours following each last treatment day. Any fever over 100.5 and we are to call them immediately even after hours. Gloves to clean up any bodily fluids careful of the depleted immune system. She gave us the dates for the next treatments and that wrapped up our chemo education.
It was a nice day, so we decided to put all that in the back of our mind, shut the laptop, went and picked up some lunch, and went to sit at the The Bluff by the Flint River for a picnic.