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the symptom gets worse.<br />
The generic for Zofram anti-nausea drug was not approved by by our Medicare Part D<br />
provider. $21.95 for 8 pills. An advisor at Dr Flam's office, Patty, who was very helpfull,<br />
established my right to coverage under Medicare Part B as I am having "in-office<br />
chemotherapy". This reduced the price to $7.30. Out of interest, she called Winton's<br />
Pharmacy in Fresno and got a quote of $1200 for 100 non-generic Zofram. What a<br />
racket.<br />
Tomorrow should be a repeat of today, and then a brief visit Saturday for a subcutaneous<br />
shot of Neulasta.<br />
Symptom to expect as a result of the Solucortef: Insomnia.<br />
Symptom to expect as a result of Chemotherapy: Fatigue.<br />
What a combination. Fatigue but insomnia. Can't stay awake, can't fall asleep.<br />
So far it is a draw, as I fell asleep <strong>with</strong>out difficulty, but my old man prostate woke me up<br />
after about 3,5 hours and then it was very difficult to get back to sleep,<br />
Stay tuned for updates.<br />
Posted by David Shuster at 06:42PM (-07:00)<br />
Update Five Days After Cisplatin<br />
Monday, May 02, 2011<br />
It is Monday, May 2, 2011. On Friday, I had the third session of chemotherapy <strong>with</strong> VP16,<br />
along <strong>with</strong> all the other medications they routinely give. This went off <strong>with</strong>out incident<br />
except that they wanted me to have labs drawn, and made me wait for the lab tech to<br />
draw the blood when I could have been starting the chemo. It makes no sense to stick a<br />
vein when the port is going to be used the same time for chemo. On days when there is<br />
no chemo, get the labs from a vein. On days when there is chemo, get the labs from the<br />
port. This resulted in a half hour delay in getting started, no big deal.<br />
On Saturday, I went for my shot of Pelfilgrastim (Neulasta), a drug which stimulates the<br />
growth of healthy white blood cells. The shot is given into the subcutaneous tissues. I<br />
took mine in the left arm. There is a 30% incidence of bone pain from this drug but I had<br />
no symptoms.<br />
Neulasta Link<br />
On Wednesday, I have an appointment <strong>with</strong> Dr Flam. The following Wednesday, again,<br />
and the second round of chemo will begin May 17.<br />
I am feeling fairly well at this time. The spasms in my chest have reduced. Could this<br />
mean the chemo is working? I am more fatigued than I am used to, going to bed at 10:00<br />
PM instead of close to midnight. I am having some constipation <strong>with</strong>out significant<br />
discomfort, and waking every 2 hours to void. I suspect this may be due to the Zofram,<br />
which I stopped this morning as I am not at all nauseated.<br />
Zofran Link<br />
The surgical site in the abdomen and the port insertion site have healed well.<br />
I a trying to resume some activities, going to the bridge club today and tomorrow<br />
morning, driving, walking the dog and watching the inept San Francisco Giants blow<br />
baseball games.<br />
I hope to post a follow-up after my visit <strong>with</strong> Dr Flam.<br />
I thank the so many people who have offered their prayers and encouragement.<br />
Posted by David Shuster at 07:34PM (-07:00)<br />
<strong>My</strong> <strong>Battle</strong> <strong>with</strong> <strong>Merkel</strong> <strong>Cell</strong> <strong>Cancer</strong><br />
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