Notes from June 24 1st Chemo – Chemo and rules

PICCline

Question1: Blood pressure question – bp not a concern for a short time
Get a thermometer to take temperature and track fever

Question 2: “The cough”
Antacid will help for the cough, but best to get swelling to go down
Right now will get worse when the radiology happens
Going to be a hard time but a short time
The “PICC line”
Infusion line can get clotted or get infection – if see redness at site, redness, swelling, pain – not much discomfort
Cleaning and flushing do that here
Will have in for a while – as long as need to for chemo – some people have in for 6 months at a time
Small tube, won’t interfere with radiotherapy
When and how are treatments going to progress?

Timing of the treatments – nurses will fix

Discomfort – burning, stinging in secretions – going to be caused by radiotherapy – in a couple of weeks and  radiotherapy finished 3 weeks from Monday
Chemotherapy taking place over three days for the drip, a pump bottle must be worn around the waist for 5 days.
Cycle of chemo every 3 weeks (or 4 weeks, depending) aiming for 6 cycles
So, 18 weeks from today – cycle done
Then 2 weeks after, fit for travel – so second week of November before fit for travel
Not ignoring the liver and lymph nodes – that’s what the chemo is for, it is a cell type
Let radiotherapist know of pain and discomfort

Anti-nausea drugs will be given to Paul today along with steroids

Oral drugs given as well, along with a Zolfan prescription

Given Metoclorpramide (APO) tablest, 10 mg 50 – one to two tabs four times a day for nausea and vomiting
Dexmethsone one tablet in morning day of chemotherapy

Sustagen for sustanence may be required

Paul will lose weight
Sometimes people can’t manage fluids at home – so come in and can get drips – not anticipating for Paul, but have ways to manage

How big is the tumour?

7 centimeters long – not sure how thick – probably just a centimeter thick
Is the swelling around it that is causing the problem – it’s irritation

Often people have a bit of swelling initially, then goes down

Questions for nurses in chemo ward

Slant pillows? Good for acid reflux? FORGOT TO ASK
What are the drugs?
First steroid
Then anti nausea
Then magnesium
Cisplatin – by drip into the vein, will take 3 hours
Fluorouracil – by pump through the veins, continuous for 4 days

 

 

PICC line Dressing changes and cleaned once a week – 9am, not sure what day
What do we have to know/do?

Tuesday 30 June do bloods at CliniPath prior to Wednesday meeting with Oncologist

15 July – next round of chemo

Big W – $20 for bottle bag that fits around the waist

Shower gaiters for arms/PICC line
Shower bag for bottle
Keep pump below the heart
Runs under a pressure valve – heat and cold affect marginally
Piccline and Elastometric Infusor
Don’t raise arms above your head
The routine today same every three weeks. Blood test before. Day 1, see doctor, if all okay, do the chemo
Day 1 – every three weeks, first day is Day 1
C1D1Cycle 1 Day 1
Side effects
Firs-t 48 hours after end of chemo – nausea and vomiting, sense of smell and taste is going to be blown to hell, going to have problems with swallowing.
7-10 days  – bone marrow affected, blood counts go the lowest. Need to watch white cells(immunity), red cells (will need transfusion) and platelets (clotting) Nothing we can do about it. Supplements meh. Wash hands frequently. Nausea will be gone by then. Nausea will improve Day 5 on.
7-10 days. If shivering shaking – feeling unwell, flu, diarrea. Take temperature. If over 38, ring up straight away. If concerned, take temp.
In a couple of weeks, could start moulting heavily. Hair grows back.

If feel unwell outside of these side effects – shivery, hot and cold, flu-like symptoms – TAKE TEMPERATURE. If close to 38 C, go to hospital.

Will get admitted to hospital, iv drip for a few days.

Gastrostop for diarrhea. IF lasts for 24 hours, call.

May get watery eyes, bathe with warm water. Skin will get sun sensitve.
Go for walks, gentle walks. If tire badly, let them know. May need transfusion.

Use moisturuiser.

 Cysplatin can cause ringing in ears or hearing issues, let dr know on next visit.

On both – numbness and tingling in hands and feet. Let dr know.

 If feeling unwell, if people have infections and colds – don’t go out.  Otherwise – get yourself out there.
Cautions

When urinate, close lid before flushing.

Disposable Fluorouracil container. Wrap well and throw out.

If get Fluorouracil on clothes or bedclothes – wash right away in warm, soapy water.
Don’t have intimate relations – will be secreting poison.
Pre-emptive measures

Take Panadol for pain.

Paul should have FluVax.

Hands and feet and skin – moisturiser.
Kidneys  – drink lots of fluid.

Nausea tablets – take regardless of how you feel. Do pre-emptive. 2 x four times a day for first to days, if still feeling sick half an hour – take the good stuff. But – if tomorrow feeling sick in teh morning, come in and they will give in drip on Thursday and Friday

Numbers to call on back of the cardboard appointment card
Want you to have as comfortable a life as possible.
Night time best time take the Zolfran(?)
Drugs upon drugs and side effects

If vomiting, call them

Tablets – can give fidgets. If does – let them know and they will change. But radiotherapy will give Motilium. If Metoclopramide doesn’t work, take Motlium.

Steroid – don’t take until after chemo – just the two days, with breakfast – Dy 4 and 5. Helps with side effects of the chemo.

 

High energy, high protein food – smoothies, soups, Sustagen, fortified drinks – may have to put in a tube

Sore throat and mouth – soft toothbrush, rinse with salt and water

BioTene – mouthwash, toothpaste and toothgel – can get from chemist

If mouth and throat really sore – then ring Calvary for more aggressive treatment for the side effects
Nexium is what the GP gave for gastric reflex and that’s fine — it will get worse
Chest pain – if it happens go straight to emergency dept
Royal Adelaide – closest emergency room,
Once raidotherapy, milk will cause lots of phlegm. Milk might not be the best.

 

Here’s the kicker after all of this advice and instruction (and I quote)

“You rule chemo, chemo doesn’t rule you.”

2014-04-25 21.10.07

I think Buster’s face in this photo pretty much mirrors my expression when the nurse said this. Oh really?

 

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