Chemo # 2, addition of Avastin

I have aready talked about chemo briefly. This time I will go over more details since today I received my second treatment and Avastin was added.

9:00 Arrival at Hôpital Sacré-Coeur (Sacred Heart Hospital). I had my blood work done the day before so I can report my presence immediately to the coordinator of treatment. I saved 45 minutes today this way. She is responsible for preparing, in collaboration with the pharmacy, bags for intaveinous infusion along with the specific protocols that she will give to the nurse in the treatment room.

9:15 The nurse in the treatment room calls me up and I get set-up in a leather armchair the reclining kind. This room contains 4 seats therefore 4 patients at a time.

9:45 The nurse now comes to take care of me. She must remove the bandages covering my transparent piccline then sanitize the region of insertion in the body. She flushes the piccline meaning she introduces a saline solution in the piccline tubing to be sure it is free of obstructions.

9:50 She installs my bag of Avastin (Bevacizumab) said this ten times in a row.
This bag is empty in 90 minutes. I read and listen to the radio at the same time. Josée sits on a small stool beside me. It is not very comfortable for her.

11:30 Avastin is now done. I get Kytril (granisetron) as my next perfusion. It's an anti nausea drug that lasts 24 hours. It is administered in 10 minutes.

11:40 Now the Oxiplatine and Leucovorin (folinic acid). Two bags at the same time for 2 hours. At this point I read half of Lance Armstrong's book. The Oxiplatine is the product that gives me the impression of having the fingertip like a pin cushion. This takes several minutes and then disappears. Then it returns from time to time during the evening and the two days following. My skin is also sensitive to cold for some time but all in all I tolerate pretty well all the poisons they give me.

13:45 Now time for the last part of the protocol FOLFOX (Oxaliplatin + Leucovorin +5 FU) : 5FU or Fluorouracil. This is the one that I have in my bottle during 46 hours. It begins with a bolus infusion over ten minutes and then the nurse installs the bottle on the piccline (see photos).

14:00 I am heading home. Josée took advantage of the time we were at the hospital for a few administrative details (copy of scan on CD, monthly parking packages, etc.). She also brought me lunch. I realise it is a long day for her but I know I could not do it without her present.

The Avastin has now added 90 minutes to the routine. In the third treatment they can make the infusion in 60 minutes and after that in 30 minutes.

Now you know to the minute the unfolding of MY chemo because you must also understand that each case is treated a little differently depending on their situation. Next to me today I had another man who had colon cancer. He was about my age. He had the privilege of having discovered the cancer early enough to be eligible for a radical total colostomy without a bag. He had a different catheter, implanted in the chest like a pacemaker and received preventive chemotherapy or in other words a chemo which ensured that there was no remaining cancer after surgery. His process and medicines was a little different from mine.

Good night!

Finally Some Sun

Not that I am complaining but I admit that the last few days of sun are fully appreciated. The weather was perfect for the garden party at my sister's. I can not eat corn because of its known effect in the colon. Should I say more? I still practiced a visualization exercise while watching the family enjoy their corn on the cob. I closed my eyes and I could se myself with a hot corn on the cob with butter dripping on all sides on which I poured an excessive amount of salt. The late afternoon sun made it glisten like gold. I was turning the corn with my fingers to make sure that the butter had moisten all kernels. I was seeing myself taking a big bite out of this magnificent summer treat. I was so good in my visualization that I was drooling. Yeah right, I was still hungry but still. Bob's spaghetti sauce was excellent and my Ensure (liquid nutrition) plugged the remaining hole in my hunger.

Appointment at the Pain Clinic

Today I went to the pain clinic at Sacre-Coeu, a follow-up appointment. I met Dr. B while during my hospital stay Dr. G was taking care of me. A little waiting but not too bad, time is a changing concept when you have cancer. A review of my case by Dr. B has taught us some new information on my case. At each meeting, we are more precise with our questions and answers are therefore also more accurate ... whenever possible. So I have a new pain killing cocktail as the other one worked very well but contributed to my constipation. They're not major changes but they will perhaps allow me to go do my # 2 without feeling like I just finished a marathon ;) Tomorrow we visit my sister Lilianne and Bob in St-Clet.

What's up with chemo?

Hello, I thought that it would be interesting to explain how I receive chemotherapy. Of course there are variations in each case but I will describe my own situation below. I received my first chemotherapy treatment on Tuesday the 5th. It went well. I had no side effects except being a little bit tired 48 hours after the start of the treatment.
Let me explain treatments: Every two weeks I go to the hospital Sacré-Coeur where I intravenously receive a series of cytotoxic products (which kills the cells, yes, good and bad). The perfusion is done through a catheter installed on the inside of my left arm near the armpit. The catheter is installed for at least 6 months (it is called the Piccline). It consists of a tube of a few millimetres in diameter and about 20 cm long. So it enters my arm and goes through a deep vein almost up to the heart. That is so treatments are distributed to the rest of the body in the most direct and quickest possible way. Back to treatments, the first product injected into the catheter is an anti-nausea drug with a 24 hours effect. It seems to work very well because I did not experience any nausea after the first treatment. Then comes the chemo, the cocktail that I receive is called Folfox-6. It is a mix of three drugs which are regarded as the best of the best for colon cancer today. To this mix will be added another agent, Avastin, in the second round of treatment. Let me explain why later. Folfox is started at the hospital. Two of the three drugs are given to me over a period of about three hours. Then a nurse attaches on my catheter a bottle, they call it the "Biberon" in french (Biberon means a baby bottle in english), it contains the rest of the 5FU agent which must "infused" on a 46 additional hours schedule. I therefore leave the hospital around 13:00 (having begun treatment at 9:00) and for two days I have my bottle in a bag tied around the waist. I look like a tourist with my banana bag but at least I'm mobile. When the bottle is empty, a CLSC nurse comes to my house to unplug it. Why? The catheter installed on my arm is very convenient but it is also a direct opening to the inside of my body that does not offer any protection. Therefore the manipulation of the bottle must be done with a lot of safety and precaution (sterile conditions). Especially since chemotherapy treatments can possibly reduce the effectiveness of my immune system, therefore I must avoid infections at all cost. Once the bottle is removed there is nothing special. I take drugs to control the pain every day but nothing more. This cycle is repeated every two weeks for about 6 months, after which my oncologist will compare the new images of my abdomen to check if my tumors have reduced in size. As far as Avastin goes, one effect of this product is that it prevents scar healing. As I have a big scar on the stomach there needs to be at least a month between any operation and the start of Avastin.

Dr W

We met Dr W today (Marie-Josee is of the opinion that I should not identify docs). It is an oncology surgeon . He came higly recommanded by a friend. Our visit goal was to identify a plan B if I were suffer a complete blockage of my colon. We also wanted to discuss the newest surgical techniques available. Dr W is a charming gentleman. He speaks impeccable french in a soothing and calming manner. He reassured Josée on actions to be taken in case of obstruction without calling it a plan B. He reiterated persuasively that the best scenario is that there is no blockage period. That we kind of knew. Finally, the visit has not provided much more information but at least he has my file and he is ready to come into action whenor if the time comes.