The previous two chemotherapy treatments had continued to be rougher and rougher on Karen, but nothing significant happened. Karen did get a small staff infection in an ingrown hair. Arizona Oncology wrote a prescription for some antibiotics, but just to be safe we went down to Mayo clinic to see a doctor there about it. They took a culture and found out it was resistant to quite a few antibiotics, including the one Karen was currently on. It cleared up quickly after changing antibiotics. While, technically, it wasn't MRSA, it was resistant to a sufficient number of antibiotics to flag Karen for MRSA.
Karen doesn't have the energy to go out anywhere most of the time as of late, but even when she does have the energy, the cold sensitivities or other chemo side effects tend to make her want to stay in. If she can get past all that, she is really good about wearing a mask, and we're both really good about washing our hands when we come back from an outing. So we started to wonder where she could have gotten a "hospital bug" from. At her next chemotherapy appointment, Karen pointed out one of the nurses at Arizona Oncology that didn't consistently use gloves. They don't use masks for accessing ports like they do at Mayo, but they deal with so many ports and we hadn't see anyone drop dead from the lack of a mask, so we had gotten use to the idea. But not using gloves was a bit much. They already have everyone crammed into one square room, and since the pumps need to be plugged into the wall, everyone is elbow to elbow against the wall.
Karen also needed another blood transfusion due to low hemoglobin. Arizona Oncology wanted to do a bone marrow biopsy for further investigation. The nurse who brought the news to us followed up with, "Don't worry. It's not as bad as people say it is." Which is the worst thing you can say. First, she's probably never had it done herself, so how would she know? Why should we take her word over others? And second, we had no preconceptions about the procedure, but now we had the most horrible images in our mind. The idea of a bone marrow biopsy was just flat out scarey after that. Karen now had something new to worry about, and worrying about a procedure can be just as tough on you as the pain and discomfort of the procedure itself.
However, with the MRSA scare fresh in our minds, we decided to contact Mayo and have it done there instead. Without encouragement from us, the oncologist we're working with at Mayo said it was unnecessary at this time. So with everything that had been going on, and with our new concerns about Arizona Oncology, we decided to do the remaining 4 treatments at Mayo, despite the hour long drive. The drive is about twice as far as the Mayo location we normally visit, since they don't do Chemotherapy at that location.
We set up an appointment for last Tuesday to get some blood work, meet with the oncologist there, and have chemotherapy. They found, along with the usual low blood cell counts, that Karen's platelets had now dropped as well. In addition to that, she was still having nausea and taking anti-nausea medication, and it had always gone away by the start of her next treatment. The oncologist said her body was telling us it needs a week off.
Karen was glad to have the break, but was unsure if it was a good thing or not. She said she felt like she was suspended from school for doing something wrong, but now gets to stay home and watch TV. Unfortunately, I don't think the week went as well had she had hoped. Mostly because the chemo has been building up in her system, and hitting her so hard; it took almost the whole week to recover to where she would normally be before chemo. She was in a lot more pain than usual, and ended up sleeping most of the time. Still, I think the break was good for her.
We went in back into Mayo today for another attempt at her ninth treatment. Her platelet count was the biggest concern last time, and it had recovered nicely. Her hemoglobin had still dropped a little, but she was healthy enough for chemo.
The oncologist said it's not uncommon for people to only receive 8 treatments of the chemotherapy medication Oxaliplatin when they have stage IV colon cancer. This is to avoid any permanent nerve damage that can occur, especially with future treatments, as such advanced cancer has a way of popping back up again. Since Karen had received HIPEC during surgery, there's a better chance there won't be recurrences, and 12 treatments with Oxaliplatin fit in with that aggressive line of treatment. However, seeing how much it had been effecting Karen, the doctor decided to drop the Oxaliplatin for the remainder of her chemotherapy, leaving her at 8 treatments.
Along with the neuropathy, this drug is also responsible for her cold sensitivity. Karen's issues with cold sensitivity should start to drop off right away, but he said the neuropathy will continue to get worse for a "quite a while." He wouldn't say exactly how long until it starts to get better, but it's going to be one of those things that varies from person to person anyway. At least from now on the remainder of her treatments should be easier on her body, which will be nice after the consistently stronger side effects. He thinks we may even be able to back off some of the nausea medication for the remainder of her treatments. We'll see about that.
Chemotherapy at Mayo is a quite a bit different. And it's not just with the use of masks and gloves. Patients are in a room I can only describe as U shaped. You not only have a good 10 feet between patients, but there are separating walls between units, and yes, your own TV. Much like Arizona Oncology, they have several different flavors of juice, protein drinks, coffee, etc. The only possible down side - if you can even really call it that - is they have no complimentary junk food for the patients here. There are bowls of individually wrapped crackers scattered around, and they have unsweetened apple sauce, fruit bars, granola bars, etc. But the tasty junk food is missing; no more Cheez-Its, M&Ms, and candy bars during chemo. Of course at Arizona Oncology they had a big sign on the snacks saying "FOR PATIENTS ONLY" and here it seems like everyone is trying to give me something.
The delays seem to be about the same as at Arizona Oncology, which is disappointing, but I guess there is an order to things. They don't want to mix the chemotherapy until you get the OK from your doctor - your actual doctor, not an assistant like at Arizona Oncology - and the doctor won't OK you unless you and your blood work look well. So there's delays each step of the way: bloodwork, delay, doctor visit, delay, chemotherapy.
Everything went quite well though, except the nausea was still there and they ended up giving her the anti-nausea medications she usually got despite the hope we'd be able to start cutting back. Hopefully this side effect will fade over the next few treatments as the doctor predicted. We go back in Thursday to have the pump removed. I think we're going to keep getting the home hydration, at least this time around, if for no other reason than to help her clear everything out of her system faster.
