A busy week indeed ...

I'm going to start this entry with some really GOOD news.  We were at hospital on Thursday and Friday last week for appointments to see both Dr. Corey Lau and Dr. Steven Kao.  These are the two Doctors who are looking after Alex and their level of care, knowledge and approach make us so grateful that they are looking after him. 

On Friday when Alex checked in at the main desk, one of their jobs is to weigh him and note it in his charts.  And after his weight losses in the past, we were thrilled to see that HE HAS PUT ON WEIGHT!  Alex did wonder if this was because he had his wallet in his back pocket  ...  ???

It was great to get some good news though.  This was offset with the results of the recent scans.  It seems that the initial effects of the current chemo treatment were not ongoing and that new lesions were appearing.  So a new regime of chemotherapy was required. 

It seems we had the trifecta and so this week we had 3 treatments.

The first was booked for Monday, at Strathfield Private Hospital.  This was a "new" hospital for us so we've broadened our hospital horizons.  Part of the reason Alex has been feeling so unwell is that his lung has been filling with fluid.  This is a direct result of the cancer.  After discussing the options with both Corey and Steven it was decided to drain the fluid from the lung.  This should make Alex's breathing easier and will also give the new chemotherapy a better chance of working well.  Over time, his lung will most probably start to fill again with fluid but it makes sense to start with it as clear as possible. 

This seemed a daunting procedure, but Alex said it was the most painless procedure he's had.  There were scans done to determine the best place for the local anaesthetic

and then a needle was inserted.  This was attached to a syringe and following the images on the screen, the needle was moved around so the Doctor could draw out the liquid and it was pumped into a bag.

In total there was 600ml of liquid drained from Alex's lung.  We were assured that this was not considered a very large amount but it was easy to understand why having this amount of unwanted fluid would make life uncomfortable. 

The doctor left to move to the next patient and left us with Joanne, the nurse who had been setting everything up and doing the scans.  My mind was focused on the bag of liquid and I was quite surprised when Joanne said she was finishing up soon and was worried she would forget her chicken livers and post-it notes that were in the corner  ...   ???

It turns out that she teaches nursing at one of the Sydney Universities and that afternoon the student nurses were starting to study biopsies.

On Tuesday morning we were back at RPA very early for Alex's second treatment this week - another blood transfusion.  His red cells had fallen to extremely low levels - 'normal' people have levels between 110-120 and Alex's had dropped to 72.  This was even lower than it was a few weeks ago when he had his first transfusion, and so this time he was being given 6 units.

At 8am we were back in the chemo suite to start the transfusion.  This would take several hours, so fortified with the obligatory coffee and a few episodes of  'Sons of Anarchy' Alex was set.

There were several bags required, and the process was relatively painless. 

Liquid gold looks like this

So with clear lungs and healthy blood levels, Alex was ready to head back to the chemo suite today - Thursday - for chemo.  The new chemo is Docetaxel and this is also given every 3rd week, again by a drip into a vein.  This is a much stronger drug than Alex had previously been given.  It also has more potential side effects, but the main one is that Alex will most likely lose his hair.  One of the other major side effects is nausea and vomiting.

Alex chose his favourite chair, and Dipin was the main nurse looking after him today.  Dipin had looked after Alex for a few of his previous chemo treatments and so the conversation continued from the last time.  First they gave Alex a bag of Dexmethsone and allowed enough time for this to be absorbed - this helps fight the nausea.  Alex's dose of Dex is always increased the days around chemo, and for the Docetaxel our normal chemo doses were already doubled.

 

When they were ready the Docetaxel was started and this time, the nurses stayed with Alex for the first 15 minutes.  This is the critical time - if a patient is going to have an adverse reaction, it apparently is almost immediate.  Thankfully Alex had no problems (of course!) and for the next couple of hours, he was again settled into what is becoming his routine

Yep - coffee, something sweet (today it was a triple chocolate Belgian cookie) and a few episodes of one of his favourite TV shows - this was after he had read the now shrunk Sydney Morning Herald - the time it takes to read it now has also shrunk.

The major difference though soon became apparent with this new drug.  Dipin came out with a very large travelling cosmetic bag, and this was provided by the drug company.  It was like getting a sample bag from the Royal Easter Show - a soft toothbrush, toothpaste, mouthwash, digital thermometer, a tube of hand cream (not as good as Lanolin Beauty!), gloves and a bottle of Intensive Nail Hardener.  When Alex questioned the nail polish, Dipin said that it would be a good idea to use it because one of the potential side effects of the drug is brittle nails.  If Alex does use it, I promise to let you know and will gladly provide photographic evidence ...

The gloves were used - Dipin had removed Alex's shoes and had made sure the chair was extended, so Alex's feet were raised.  He then came out with a pair of slippers and mittens - except they were chilled.  It was like putting your feet and hands into an ice pack.  Hence the gloves on first.  The idea behind these was that the cold will shrink the veins and blood vessels in his hands and feet and so the blood circulation will be much slower.  Since the chemo drug is carried in the blood, it will be more concentrated on the rest of Alex's body and will therefore be far more effective fighting the tumours.

He looked like an explorer, ready to head off with Tim Jarvis should he decide to once again recreate Ernest Shakleton's antarctic survival journey

Thankfully Alex did not have any adverse reactions at all to the chemo, and he surprised Dipin and the other nurses by saying that he was hungry when the treatment had finished and he would be heading out for something to eat.

When we left the hospital, a sky signwriter had just started and we could see the first two letters

We hoped that he was not advertising for one of the drug companies - our first thought was 'Dexmethsone' and we wondered if he would just shorten it to Dex, as we call it.  We didn't have time to wait and see - lunch at one of our favourite cafes beckoned.

We headed off to Little Treasures in Petersham to share a lunch

A delicious reward.