Chemo - Round 2

Chemo is not the hard part.  Its what happens later that gets ugly.

Dar and I got an early start and had breakfast en route.  There was a lot of girl talk and belly laughs.

I checked in, weighed in and blood letted.  I then went into an exam room.   Y took my blood pressure and asked what changes I noted in my body - joint pain in my right hip (walk) and dry nasal cavity (Vaseline on a Q-tip - this sounds especially fun - NOT).  All other systems normal.

Y left the room.  I sat and sat and sat and then I took action.  I stretched my Achilles tendons on each leg by doing ankle turns and lunges.  I did squats.  I paced the room.  I stared out the window and watched freeway traffic.  I paced again.  I opened the door and wandered into the hall.  Dar was at the other end wondering what was going on.  She closed the distance and told me several other individuals had come and gone and was curious what was going on with me.  I did not know but in hindsight I believe they were waiting for blood results.

L, the nurse practitioner, arrived just after Dar so we headed back in.  My blood came out great - everything is normal.  I will only need four shots again.  She realized I hadn't had a MUGA (See below.) so she wanted me to schedule one.  As I write this, I realize I did not do that.  Oops.

Dar and I returned to the chemo lounge where I had earlier scoped my chair for the day.  I chose a window seat with a view of the world and quick access to the snack table.  I liked this position and will attempt to get it for Round 3 as well.

Bag one was hung at 10:30am.  I was high and slurring my words by 10:35am.  As Dar pointed out, she didn't notice the difference.  Bag two arrived at 10:45 or so and the sleepiness washed over me.  Dar left to run errands with a plan to return at 1:30.  I attempted to setup music on my iPad to listen while I slept.  I could not recall my login info for Songza.  I nodded off.  It was a good sleep.  I awoke about 10 minutes before Dar returned.  Today's group was much more chatty so I fit in well.  The last bag finished and we were out of there.

Daily Shots: Chemo kills cancer and white blood cells that protect an individuals immune system.  Its important to boost my white blood cells in the days after chemo so that my immune system is not compromised too severely.  After Round 1, I only needed four shots.  Because my counts were good today, I will only need four rounds this time also. 

Here is where math, insurance, timing and bravery meet in a crazy formula.  Shots administered at the office are considered medical and I have a $20 co-pay.  Shots administered at home are considered pharmaceutical and I have a 30% co-pay with a max payment of $150.  Shots purchased for home come in a ten pack and cost over $5,000 or a $150 pharmaceutical co-pay.  So, using math (don't be afraid), ten shots administered at the office will cost $200.  Economically, shots at home are the better choice.  And because the office is closed on weekends, home is also a better choice for getting daily shots.  The real conundrum is am I brave enough to administer a shot to my belly or arm?  My soul-searched answer is yes.  Tomorrow morning my lead to a different answer. 

MUGA: MUltiple Gated Acquisition scan.  Apparently, there is a chemo drug that can be toxic to the heart muscle.  MUGA allows doctors to determine the left ventricular ejection fraction (LVEF) which is an excellent measure of overall cardiac function.  The ejection fraction is simply the proportion of blood that is expelled from the ventricle with each heart beat.  For instance, if the left ventricle ejects 60% of its blood volume with each beat, the LVEF is 0.6. (A normal LVEF is 0.5 or greater.)  The first one will be my baseline.