CHEMO: peripheral or portacath?

leslie :-D · Aug 21, 2004

thank you susan.

already on the 2nd treatment, it's gone from tolerable to intolerable, just like that. we'll get through it.

i SO appreciate everyone's support.

peace to all....leslie xo

jemb · Aug 21, 2004

Just wanting you to know that I am thinking about you and Lisa.

We always tell our patients to take Tylenol before going to bed the night after a neupogen injection. Seems to help with the middle of the night pain.

Is she getting Neulasta or a series of Neupogen injections? Our patients are taught to give themselves Neupogen. It eliminates the need for that extra trip to the clinic, plus gives a little more time control to the patient, since some prefer to take it in the evening just before they go to bed.

Many of our patients also gain weight while on chemo and report cravings. Others report complete loss of appetite.

I'm concerned about your sister's nausea control, or lack thereof. What is she taking? What premeds is she given at the clinic? The extra hydration she will be getting should help, but sounds like she needs more effective antiemetics. She doesn't have to be so nauseated!

leslie :-D · Aug 25, 2004

lisa's nausea is under better control now, thank goodness.

jemb, she's on a series of neupogen injections the day after chemo rx's.

i will bring it up to her about she or dh doing the injections themselves.

i wanted to bring up a coping/defense mechansim that i haven't heard before from a cancer patient.

as i mentioned, lisa shaved her head completely on saturday, 8/21 since she was losing it in clumps.

she already has a wig but has been steadily building up a notable wardrobe of scarves and hats.

on sun 8/22 i went over to her house to physically remove the hair from her house since she didn't want to part with it (per the request of her dh).

after i assessed lisa on why it was so important for her to hang on to her shaved hair, she then agreed with getting rid of it.

on mon 8/23 when she called me at noc, she was telling me about 2 more hats she bought. and she asked me about the scarves i'm supposed to be sewing for her (which i hadn't even started).

i told her that i'll have them done before she comes back from vacation on 8/29.

she was then quiet on the phone.

i then insensitively told her "in the grand scheme of things, scarves would not be high on your priority list".

she quickly responded with "considering the grand scheme of things, i think i'd rather focus on the scarves".

her response hit me very hard.

so from now on, whenever i think a patient is obsessing on something that i don't understand, i am submitting here on this board, a different and powerful perspective.

i finished sewing lisa's scarves tonight.

leslie

jemb · Aug 25, 2004

(((((((Leslie)))))))

memesusan · Aug 25, 2004

Ahhh...Leslie, the scarves are such a wonderful story for you to share; it's a perfect illustration of how even with the best of intentions and love, I cannot know exactly how things are inside another person until they tell me. We are all beginners in this same sense. It's not required to be a perfectly empathic support person or not to have your own feelings (like exasperation! sometimes)--it's only required to stay present/awake to what is happening...does this make sense?

[Regarding self-injection of neupogen, sometimes people's insurance will only cover the drug under certain administration conditions (ie, office or infusion ctr) at least here in NC.]

FranEMTnurse, CNA, LPN, EMT-I · Aug 28, 2004

Leslie,

I just finished reading this entire thread. It has given me a lot more insight about what both of you are going through. She sounds like a fighter all the way, and that's a very good thing. I think on the other hand, it is taking an emotional toll on her sis. But you are such a blessing to her. No sister could love another as much as you love Lisa.

XOXO

leslie :-D · Aug 28, 2004

Leslie,
No sister could love another as much as you love Lisa.
XOXO

no question about it, fran.

God knows how deeply I love her.

Energizer Bunny · Aug 28, 2004

Leslie..I didn't even know this thread was here and was wondering how everyone was keeping updated with you and Lisa! Last night I had this dream about someone making a quilt. It was a woman and I was helping her. Very odd....there is much more to it, but it's not necessary to post here. Think it means anything here?

You know that you and Lisa are always in my prayers and thoughts and on this day (your b-day) I am sending you all my love and respect and strength that I have!

Love you........more than you know chickie!

xoxoxox

Ted · Sep 7, 2004

Thank you for the updates. (I'm just getting around to reading them. :imbar )

Again. . . warm thoughts to Lisa as she continues her treatment.

Ted

chemoqueen, BSN, RN · Oct 3, 2004

A port is the way to go. Those agents can be given PIV, but it is risky--for the patient and the nurse. New standard of care for younger pt c breast ca is a q2wk schedule. It's called dose densing. We do it alot in our office. Just be sure that she receives a growth factor for wbc such as neulasta 24 hrs after tx to prevent neutropenia.--Phyllis

my sister starts chemo on 8/4. she is scheduled to have a portacath implanted on 7/28, per the recommendation of her chemo oncologist.
today her surgeon was having her sign the informed consent. she urged lisa to speak w/onc nurses to see if peripheral tx would be feasible.
i am against it, knowing that lisa's going to be on 3 potent chemo agents and its' vesicant properties. i understand her surgeon is just doing her job but i've encouraged my sister to also get the portacath, as her tx will be up to 9 mos.
my question being, can one realistically administer cytoxan, taxol and adriamycin in a peripheral line w/o increased risks or adverse reactions????
also when my sister had her aspiration/needle/bx, the needle literally went in one area and out through the other....so she is now petrified of needles, since it was so painful and traumatic. any input would be most helpful.
thanks very much,
leslie

debRN0417 · Oct 3, 2004

thank you cindy. your input was very helpful.
i just got off the phone with her....she had her 2nd treatment today. and she also started losing her hair this morning in the shower.
she got an epogen injection today and will go for the neupogen one tomorrow.
she sounded like crap tonight.
i think a lot of it is losing her hair.
but lisa is determined to go to work tomorrow and friday, then will be on vacation for 2 weeks.
they warned her that she'll wake up tonight around 2-3am and feel like hell.
it sounds like these nurses have this whole regimen down to an art.
i personally find it extremely helpful.
but then again, i'm not going through it.
i personally don't like surprises; lisa loves surprises.
cancer is never a pleasant surprise.
it's kind of taken the joy out of her love for the unexpected.
we'll get her back soon enough.
they say it's God's will.
hmmph.

Please continue to "journal" the things that are happening. When my mother became ill with cancer, I began a journal of all my thoughts, feelings and everything that happened. It helped me through it. I can now sit and read through those months and though some parts are so hard to re-live, there are so many other wonderful things that bring me comfort to this day. I pray for healing for your sister, and for strength for you and your family as you take this journey with her.

debbie