Bald 'n Sassy

Life is for the living. Live simply. Expect less.

A tribute to fellow cancer patient – Anita Seth

Yesterday evening, I was saddened by the news of an ex-colleague and friend, Anita Seth from Mumbai who tragically lost her battle to cancer.  She was a vibrant young lady filled with so much enthusiasm which was reflected both in her personal life and work. When I first met her in my first business meeting in Mumbai, she was open to share about her diagnosis  Acute Lymphoblastic Leukemia (ALL) or in simplistic terms cancer of the blood back in 2003. She successfully tackled the disease was diagnosed to be remission post treatment.

However back in May 2010, her leukemia relapse.  Her doctor’s recommended treatment of 2 intensive sessions of daily chemo lasting 21 days per session.  In addition to the chemo, a bone marrow/stem cell transplant.  From her updated report online, the chemo treatment was progressing well and the bone marrow transplant took place in June 2010.  The specific bone marrow she underwent was called Allogenic Stem Cell Transplant.  The transplant was deemed successful.

Aside from the medical facts Anita was ready to be active once again by slowly getting back into work.  I remembered receiving a text messaging from her wondering if I could offer her some part-time work she could complete from home.  I replied that I would love to help and informed her that I no longer work for the same company we used to work for.  At the particular period, I was about to commence my first session of chemo myself.  I specifically withheld the news from her for the simple reason that she need not worry about me.  I have also received other text messages where she was seeking some financial assistance to pay for her treatment.  As you can imagine, any form of cancer treatments can be very costly.

Anita had a true fighting spirit.  She was aggressive in voicing her opinions and was not shy about this trait. Fighting the disease for the second time wasn’t going to get to her.  She never gave up hope.  I can relate to her fighting spirit and not giving hope. Maybe sharing the same birthday has something to do with it.  I believe that having a fighting sprit, hope coupled with positive attitude are fundamental ingredients in overcoming any disease.  I will be honest to say at times maintaining the fighting spirit and positive when you are suffering the side effects post chemo.

Anita, you were an amazing fighter.  You were a true inspiration to many people.  As a fellow cancer patient, I have learn a lot from you.  You are in a much better place now where you can finally rest.  God bless!

If you wish to read a little more about Anita, click here established by her family.

For the rest of us cancer patients, I encourage to continue to fight!  Don’t give up hope.

Good night from me.  I rallied enough energy to post this after having another round of chemo yesterday.

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Slight change of plans for round 5

Number 5 must be my lucky number.  It is exactly 5 days ago that I had another round of chemo treatment.  However there is a slight change of plans. The morning of the treatment started like any chemo session – a blood test.  I was hoping to have my favourite nurse to draw my precious blood but wasn’t my day.  I am not sure if she was rushed for time.  It was rather painful when she poked me with the needle. I could feel the blood flowing into the tube.  My arm was sore and weak for several hours – this is the first time I have felt any discomfort post a blood test.

So what is the change of plan you might ask.  The cancer marker level in my blood test showed a northward trend – about 10% increase from 56 to 62. This is not what I wanted to see.  My oncologist did not hesitate to advise me that we need to change the chemo drugs.  The plan is to go back using the set of chemo drugs administered last year.  The combo drugs are Carboplatin and Taxotere.  Before we proceeded with the treatment, she gave me an option of changing Taxotere to another drug called Taxol. From what she explained to me, Taxol is within the same class of Taxotere and used to various cancers such as breast and ovarian.  Taxol can be administered either on a weekly basis or every 3 weeks. I just can imagine not having a rest in between each session.  Plus my veins would not be able to recover in time.  I could have opted to insert a catheter but I can’t bring myself to go under the knife once again even if it is for very short duration.  I would be silly enough not to take up the 3 week plan. Mind you it takes around 4 to 4.5 hours to fully administer.   At least I have a longer period to recuperate in between each session.

Now that treatment plan took a detour, the next question I had to ask the doctor is how many rounds would I need to complete.  The answer I received is “Until the cancer markers has stabilized”.

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I am happy to say that the side effects for the new drugs are much easier to manage than the Japanese Campto drug.  No nausea, a slight headache and body aches for a day or two.  Mind you I am still very cautious about my immunity in the first post chemo.  My white blood cells has crept up a little higher but I am not completely out of the woods.

I am looking forward to walking out of the house for some natural Vitamin D tomorrow.  The other happy news is that I can fit in more swimming days in between treatments.

What will the results show today?

It’s Friday and today is round 5 of my chemo treatment. My body is starting to ache from the 2 consecutive days of swimming.  I am proud to that I can swim 40 laps each time. This is my personal best thus far and my minimum number of laps each time I swim.

Ok, swimming aside.  I am little anxious what my blood test results will be later this morning. The results will decide what course of action I will take.  Should there be minimal decrease in the cancer markers, then I may have to revert to using the Carboplatin and Taxotere combination used in my first chemo treatment last year.  If my memory serves me right, my oncologist mentioned that she will change to Taxol instead of Taxotere.  The white blood cells count will be the other indicator closely monitored. Although I feel physically fine, I am susceptible to catching any cold or virus’ very easily plus my body would have a tougher time to fight should I fall ill.  It doesn’t help that my sister and her daughter have not been well over the past week.  I just keep a good distance away when possible.  My brother in law has a sore ankle to add to the woes. So I have been helping out with the cooking and housework. Not a fun household to be in right now.

I am crossing my fingers and toes for a better blood test results.  It is a short post today.  I’ll be leaving shortly to head to the doctor’s.

Round number 4 – checked

Is it me or is timing flying past much faster.  It is exactly one week ago that I successfully completed my 4th chemo treatment.  Phew!  Overall the treatment well but there is a possibility a change in plans.

So here is the story.  As you may have learnt from my earlier posts, there is a blood test that is carried out prior to start of each session to decide how I am responding to the treatment plus the results will raise any concerns in my blood.  For me the key indicators are the cancer markers and white blood cells that I am most worried about.  I like to see a downward trend for the cancer markers and for the white blood cells level increased to a higher level.  As soon as my oncologist sat down with me to review the results for round 4, I was taken aback to see cancer markers increased by 10% from 49.9 to 56.3.  She was just as surprised as I am.  There are two possibilities that could see the markers spike up.

  • Fighting a viral infection.
  • The cancer cells has learnt to adapt to resist drug and mutate to generate new cancer cells.

I have been physically fine and not fallen ill in between treatments. As for the second point, cancer cells are incredibly intelligent to regenerate new cells in a matter of days.  In round 3, I postponed the treatment by 5 days simply because my white blood cells were too low and anemic.  In that short space of time, it is an opportunistic time for the cancer cells to adapt and learn to be resistant. I haven’t researched into this myself nor can I prove it.   Moreover the chemo drugs has  “expiry” date in terms of effectiveness.  In my case, the drug, Campto last for about 17 days or so. Delaying any further could pose further risk and lower the effectiveness.

So what does the above mean for me.  My doctor explained the options available.  First option is to change the chemo drug to the Carboplatin/Taxotere combo used in my first volume of chemo last year.  This means back to one round every 3 weeks and I would need to completed at most 4 rounds.  My white blood cells levels with this drug didn’t drop below the normal range.  Second choice is to use a complete new drug that is prescribed on a weekly dosage.  I am not too keen on this option because my veins would not be able to cope with the weekly poking.  As it is now my veins are under so much stress each time I have chemo plus I only have less than 2 weeks to rest before it all happens again.  In the event I choose to have his intense program, she strongly recommended for me to insert a catheter near my collarbone for much smoother and painless administration.  Oh boy!  Decisions decisions.

If I had to compare the choices, I would opt for number 1. And from past treatments, my white blood cells did not take a huge beating from the drugs.  There is a fine balancing act right now of making sure the drugs are working and still be somewhat strong enough to fight off a cold.

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I am just wondering with the modern medicine today, how come pharmaceutical companies haven’t thought of a wonder pill for white blood cells.

TGIF.  Have a good weekend everyone!

Numero Quattro – a milestone

An active morning for me today. With a sunny day outside I was looking forward heading to the pool to swim some laps.  Each time I swim, I make it a point to swim 30 laps.  This magic number has been my minimum laps for the past 2 months.  I decided to challenge myself and increase to 40 laps.  I am so proud of myself that I did manage to squeeze in the extra 10 laps.  I could see dark clouds looming  each time I lift my head to take a breath. Moments later, the clouds starting to cry. The rain didn’t stop me from continuing with my swim.  I love swimming in the rain.  The rain drops has a soothing effect on the back.  Some may think I am little crazy in the rain.  There were 2 other swimmers who also didn’t let the rain stop them from swimming.  My arms and legs starting to ache now.

Tomorrow will be my 4th round of chemo.  This marks as milestone for me.  I would cross the quarter mark checkpoint.  When I first started this second chapter of chemo, the number 12 is a high number and that it will take 6 months to complete which sounds pretty daunting. As each day treatment passes, I can happily cross each session.

I must admit that I haven’t been doing my stress ball exercise in the last few days.  I hope tomorrow the nurses will not have a major challenge to hunt for a suitable vein.  I like to see this hunting exercise as “game” for the nurses.  I say I make it interesting each time I visit the clinic.

Ok, time to head under the covers and get some shut-eye.  I hope there is some improvement in my white blood cell count in the blood test.  Fingers and toes crossed.

Round 3 – this time it’s for real

Gosh where has the time gone.  One week has zoomed at a blink of an eye. After the wait and see approach and taking iron tablets to address my anemia, it was time to get another blood test done to decide if I am  medically fit to go ahead with round 3.  Aside from the haemoglobin the other key indicator the oncologist is hoping to see some improvements is my white blood cell count.  I kept my fingers crossed while I waited patiently for the results.  In the meantime, I fed my tummy with a nutella and banana sandwich for breakfast.

An hour and half later, the results are back.  There was good and bad news.  First, the good news is that in 5 days, my haemoglobin level increased and fall within the “normal” category.  I was no longer anemic.  The bad news is that my white blood cell count specifically the polymorph level has not changed from last week – this is also known as leukopenia. With low white blood cell count it means that my body is not as strong to fight off any infections. So what does this mean?  My doctor said that I have 2 options.

Option 1:  go ahead with the chemo session with the same dosage but I would have to inject myself with Neupogen, is a man-made form of a protein that stimulates the growth of white blood cells in your body.

Option 2: Wait for another week with the hope that the white blood cells improve.  I did ask if I could eat or do something to help.  Unfortunately, there is very little I can do in this case.  Should I wait a little longer to do chemo, there is a possibility that I may encounter some cramps in my stomach because the cancer cells are working their way into my guts.  Not a pretty picture and nor do I want to wait and see if the pain comes back.

With no other obvious symptoms such as pain or discomfort, there wasn’t anything to prevent me from continuing with the treatment.  Since I am not keen to have any stomach cramps, I chose the first option.  I would rather have the injections.

By now my body is attuned to receive the chemo and most of the common side effects are manageable.  One of my least side effects is the nauseous feeling.  Despite the anti-nauseous medications I am given prior to each chemo session, it still lingers around for 4 to 5 days.  I hate it!  It is having the hangover feelings without the alcohol.  Somehow, I fought the feeling and survived it.

I have officially completed a quarter of my treatment.  Hooray!

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Not quite ready for Round 3

Today is my scheduled day for the 3rd round of chemo but it just didn’t happen.  The reason lies within my blood.  Yes, my blood test result is the determining factor if I my body can cope with chemo.  In my case the 2 key criteria that was the show stopper are my haemoglobin and total white cell count.

My oncologist asked if I am including red meats or other good sources of iron.  Since my last hospital visit and based on dietitian’s advice, I have kept to a low fibre diet.  Mind you I have consumed more fish and white meats like chicken and pork.  I only eat red meats maybe once in a fortnight.  I do take iron supplements on a daily basis but it seems that it is not enough.  My doctor says that I should be consuming at least 200mg of iron per day.  I just checked the over the counter iron supplement and the real dosage of iron is 18mg plus 10mg of iron in my multi vitamins .  In total I am only consuming 14% of the recommended daily intake – yikes.  Here I am thinking that other iron in the natural foods that I take should be enough.  I guess not.  This is not the first time I have been told that I am iron deficient. Hence, I self prescribed to take store-bought iron tablets.  As of today, my doctor has prescribed higher dosage of iron tablets to take over the next few days to boost my levels.  Of course the alternative is to eat more red meats like beef and liver.  Isn’t that a great reason to go out and eat a thick slice of delicious prime roast.. Ha!

As for the total white cell count, it was one particular cell called polymorphs that was particularly low.  Based on my understanding it is this polymorphs in your body that fights any infections or bacteria.  The blood test indicated that it is below the normal range.  If my doctor proceeded with the chemo, she has to administer a lower dosage of the drug which means less effective to kill the cancer cells.  It also means that I maybe more susceptible to catching infection post chemo.  The doctor strongly suggested that to postpone the treatment a few days after taking the prescribed iron tablets.

This is the first time in my chemo treatment plan where I had to wait for a few days till my body is ready.  I rather be safe and have the drug work effectively. Wednesday, 13 July is the D Day.  My body will be ready then.

Round 2 of chemo put to rest

Today is the first day in five days that I have fully regained my energy. I must say in comparison to the first round, the second round was a little better.  Even from the time I stepped into the clinic, the usual tasks of drawing blood before the actual chemo was good.  I had my favorite nurse from the pathology lab to do it. This time, my oncologist ordered a full blood test to show the platelets, red, white blood count etc.  That means I have to wait at least an hour before the results are ready.  A good time for me to have home-made egg and cheese sandwich for breakfast.  Breakfast of champions I say! ha!

When the results were in and the overall results indicated that it was ok with the exception of my low white and red cells.  From what I understood of this particular drug I am trying, it would not have a huge impact on my immune system.  But of course anything can happen.  Overall I felt pretty good and didn’t meet anyone with virus or colds.  The other indicator that I am always keen to see are the CEA markers.  Comparing to the previous blood work, there is no change in terms of absolute numbers.  It is good from the perspective that it has not increased.  On the hand, it hasn’t decreased.  My oncologist says that it will decrease after 3rd or 4th session of chemo.  Cross my fingers as downward trend is the way to go.

I was sharing with the doctor some of the side effects that I had from the first round.  I mentioned that the headache is rather strong and lingers on for at least 4 to 5 days.  Even taking ordinary Panadol tablets to relief the pain didn’t help. The doctor asked if I had the same discomfort from the very first time I had chemo. She concluded that it is likely the anti nausea tablets that I take prior to the start of each chemo was the underlying cause of the headache.  The meds are great to control the nausea but not so good with headache.  My doctor did ask me if I wanted to try alternative medication.  However, there is a “but” in the sentence.  The alternative could reduce the headache but it doesn’t control the anti nausea very well.  Hmmm… so there is no magic pill???  Meds to help with nausea that comes with headache or lesser headache but feeling nauseous.  Choices, choices??  Nausea vs headache – not a great choice if you ask me.  I opted for the meds that controls the nausea.  I can tolerate the headache.   Given the headache is a real pain in the butt, my oncologist prescribed a much stronger paracetamol to handle it.  Phew!  there is light at the end of the tunnel.

Happy with the prescription, it was time to start the chemo.  I have been a good patient by exercising my veins with my stress ball.  For round 2, I chose to be poked on my right hand.  The nurse was quite happy to see that my veins decided to co-operate.  It didn’t take her long to find a good vein and poke me.  Yes, it did hurt from the initial poke until it needle went in deeper.  Although the needle was successfully inserted, it can’t be declared that it is ok to start the drip.  There is always a saline test to make sure my veins are ready to accept the real drug.  I can happily report my veins passed the test and ready to administer the drug.  It may sound so boring to what I just described but each step has its purpose.

A few days after the chemo, I noticed that my hand developed a bruise from where I was poked.  It has happen before from past sessions.  It looks like someone has taken a light green crayon and shaded around the needle hole.  Yes, I am delicate and have sensitive skin.

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Ok, that’s my round 2 of chemo.  10 more sessions to go!

It’s that time again

At the blink of the eye and it is 2 weeks ago that I started round 1 of chemo. I have been awake since 6.30am and taking my time to get ready.  Pottering the kitchen preparing my simple egg and cheese sandwich for breakfast later.

There are 2 essential items that I must bring with me to each chemo session.  First is my red heart-shaped stress ball to squeeze each time I get poked by a needle.  This is the same stress ball I use to “exercise” my veins. The second most important item is my iPad.  It takes 2 hours to administer the drug and what a better way to occupy my time by either reading a book or catch up on my favorite TV series.  Most likely I will do the latter.  At the moment I am watching the last few episodes of Criminal Minds (Season 6)  – one of the great psychological crime shows.  My niece loves the show too but her primary reason is because she likes the actor Shemar Moore.  She finds Shemar “so cute” and I kinda have to agree with her. The second series that was highly recommended by friends is Flash Forward.  I have only watched the first episode and I do like the story line.

It’s 9am.  Time to sign off for now and leave the house for the doctor’s.

Let’s get physical for cancer patients

It such a great feeling when the rush of endorphins is released into the body. Other than day-to-day walking and pilates , it has been over 4 months since I did some form of regular physical exercise.  I broke the spell and decided to start swimming again.  Over the last 2 days, I eased my way and swam some laps.  Boy, it has been too long and I loved my time. Today, my arms are sore and I don’t mind it one bit. I am not the greatest swimmer nor am I training for the next Olympics.  I take my time in between strokes and I even stop for a minute every few laps before continuing. Swimming relaxes me, clear my thoughts and purely focusing my strokes.  The other benefits is that it helps strengthen my lower back and help me to cope better with side effects of chemo.

Fatigue is a very common side effect of chemo.  For me, this is one side effect that hits me quite hard.  For cancer patients, it is encouraged to include some light exercise like walking to help battle the fatigue, it boosts physical functions, and just makes the quality of life a little better.  There is an abundance of reports encouraging cancer patients to avoid inactivity. What a better way to get some natural Vitamin D by taking a walk around the park with family or friends. I know it is tough even on better days to muster enough energy and get yourself moving. The key message is to listen to your body. As a former gym rat who did squats with at least 100 pounds weight and ran 5km quite comfortable, I had to change my overall workout.  I tried to do a light jog after completing my first batch of chemo.  I couldn’t jog comfortably without feeling some aches in my knee-joint. I know that the chemo drugs had some impact on m physiological functions. Hence, swimming is the best workout for me.  Pilates is my other favorite workout.  It helps to build my core muscles and a perfect way to do some strength workout without the heavy weights.

Having said the above, the mantra of exercise and eating right to prevent or reduce the risks of cancer has been over publicized .  I have yet to come across any campaigns whereby medical professions encouraging cancer patients to exercise during and after treatments.  Why is that? I need to dig into this topic further.

Time to get some shut-eye.  Tomorrow is chemo round 2.

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