Day 83 - Maintenance Chemotherapy Administration Month 1 Week 1 December 5 2011

After my blood  values were back, we were escorted to the infusion center. I was weighed and measured for height. My weight has crept up to 151 pounds (but, I did have heavier clothing on since it was only 10 degrees outside) and my height is steady at 5' 2 1/4 ".


We waited in the recliner area for the nurse to hang the Decadron and Normal Saline which was scheduled to run over 15 minutes.

Then, I should have gotten my quick intravenous push Velcade (1.7 mg dose based on 1mg/metered squared), but I asked if they were going to give me Aloxi (long acting intravenous anti-nausea medication) along with my Velcade. That question really delayed things since they do not pre-mediate with ANY anti-nausea medication for Velcade/Decadron. When I was receiving my induction chemotherapy from Dr. Moore at Front Range Cancer Center in Ft. Collins, Colorado, it was their protocol to always give the Aloxi with the Velcade/Decadron, so that is what I was used to.


The nurse explained that my insurance might not pay for the Aloxi, but I told her they paid for it in Ft. Collins. They offered me Kytril (anti-nausea) or Zofran (anti-nausea) and then went on to explain that patients receiving Velcade/Decadron do no need ANY anti-nausea medication. So, I decided to fore go the medications for anti-nausea, but they did send me home with Zofran tablet if I started to feel badly on our long drive back to Greeley, Colorado in rush hour traffic. More later on if my decision to go without anti-nausea medication was good idea or no.

My wonderful caregiver sister had a bit of a melt-down on Day 83. What should have taken 1 1/2 hours took 3 hours and then add the 1.25 hour drive each way and we were pretty much gone all afternoon into the evening. Good thing Jani wasn't wearing a mask like I had to for all that time - or, I think she would have gone ballistic.

Our drive home was a chilly one - temperature dipped to Minus 1, but was mostly 2 above as we drove from Aurora, Colorado to Greeley, Colorado.

Day 83 - Maintenance Chemotherapy Begins Month 1 Week 1 - December 5 2011

In 10 degree temperatures with clear skies, Jani drove me to the University of Colorado Hospital (UCH) and I had my blood drawn via my Bard Power Port (I always put Emla Cream over the site on my right chest wall 1 hour before each access) prior to the maintenance chemotherapy administration. My hemoglobin remains normal at 12.8 (norms 12.1-16.3), my platelets remain normal at 206 (norms 150-400), and my white blood cell count went down from 12/1/2011from 5.1 to 3.9, which is only slightly abnormally low (norms 4-11.1)

My Lactate Dehydrogenase Blood Test continues normal at 145 (norms 98-192)

 My liver enzyme tests, Alanine Aminotransferase and Aspartate Aminotranserase which had been high when I first started the Fragmin (blood thinner) injections have decreased to 43 for Alanine (norms 0-47) and 28 for Aspartate (norms 0-47).

 My blood phospherous level has been increased since 11/9/2011 and was down from 5.7 on 12/1/2011 to 4.6 today, 12/5/2011 (norms 2.7 - 4.5). I'm not sure what this means.

 In addition to these blood tests, they draw and report the total CBC with Differential, Comprehensive Metabolic Panel, Magnesium, and Uric Acid. All of those values were normal today.

After the blood draw, my baby sister, Jani, and I sat in a waiting room for the infusion center for more than an hour. They need more comfortable chairs.

Day 83 - Maintenance Chemotherapy Plans - December 5 2011

I started my Maintenance Chemotherapy today at UCH. My Maintenance Chemotherapy schedule will be:

• Velcade intravenously (1mg/metered squared dosage) and Decadron intravenously (20 mg) to be administered once a week for Month 1 (Dec 2011) and OFF for Month 2 (Jan 2012) and Month 3 (Feb 2012) and back on once a week for Month 4 (Mar 2012), off for Month 5 (Apr 2012), off for Month 6 (May 2012), and back on for Month 7 (June 2012), etc, etc. etc for at least the next 2-3 years.
• Revlimid by mouth (10 mg) 14 days on and 14 days off each month for the next 2-3 years
• Zometa (bone building medicine) intravenously once a month