My Battle with Merkel Cell Cancer

This is the best photo I could find of the port itself from the Bard website. There are two
wells into which the drugs can be injected. Each is delivered through a separate lumen in
the catheter to the Superior Vena Cava. The ports are strong enough to take a pressure
injection for contrast enhanced CT. Supposedly, the port does not degrade CT or MRI
images.
I am feeling quite good. There is mild discomfort at the incisions controlled well by Extra
Strength Tylenol, a drug which I rarely take as it usually does not work for me. I prefer
Advil but they want me to stay off it for now.
I hope to be feeling well enough tomorrow to post my experience with the first day of
chemo.
Posted by David Shuster at 12:18PM (-07:00)
Chemotherapy. Day 1
Wednesday, April 27, 2011
I arrive at The hematology Oncology office almost promptly at 8:03.
I sign in and sit and wait. Apparently Wednesday is the busiest day and they have added
Dr Rao to the practice and he brings 125 patients.
After about 25 minutes, they call me to the lab. I refuse to submit to more labs because
Dr Flam ordered the labs at St Agnes to be done Monday, just 2 days earlier, after a
discussion which went something like this.
Dr Flam: You'll need labs before the Chemo. I could just get them here or at St Agnes
since you'll probably need labs before they place the port.
Me: OK, let's get them at St Agnes.
Dr Flam: OK. I'll write the order.
And he did.
However, the labs are not immediately available, not having been filed in my chart.
Dr Flam: We can get them from the computer.
Nurse: The computer is down.
They did find my labs and my Hemoglobin is creeping up towards the normal range, at
11.8 from I think 11.1 three weeks earlier.
So they will draw blood from the port for serum iron and iron binding capacity.
9:00 AM. After a brief examination, I am sent to the small room for my Chemo. There are
about 5 LazyBoy chairs down one side of the room. I grab the only vacant one. There are
four sofabeds with elevated knee support on the other side of the room, all empty but
soon to fill up. To my left are two very large bathrooms with folding doors. I decide they
are not very private and will be used only in an emergency.
A very experienced nurse named Bill checks my port. He accesses it using a special
needle called a Huber needle which has a 90 degree bend and tapes easily to the skin.
Before inserting the needle, he numbs the skin with Ethylene Chloride spray, and I don't
feel the needle. They draw my blood and begin treatment.
I am given Aloxi 0.25 mg bolus,
Next was Emend, 150 mg.
I am pre-hydrated with 500 cc of normal saline to which potassium chloride (KCl) and
magnesium sulfate (MgSO4).
Sorry, I don't know the doses.
At about 10:30, they bring in the big gun. Cis Platinum 170 mg with 40 mg KCl, 12 mg of
MgSO4
and 20 mg of Lasix. Lasix is a drug which increases urine production. It is used to prevent
nephrotoxicity. (Kidney damage). 10 mg of decadron is also given. It is basically IV
cortisone. This is in about 3000 cc of fluid, I think normal saline.
My Battle with Merkel Cell Cancer
67