After the third round

Several hours after the infusion of Irinotecan incredible nausea and vomiting began. It lasted for 7 days. A persistent cough seemed to creep in and finally I landed in the hospital for 30 hours for hydration and antibiotics. I will have to say that the stay in the hospital was pleasant and seeing friends was helpful for healing. I would not go anywhere else but Baptist Health Richmond. My office staff remains loyal and the very best of friends, at the risk of sounding too emotional, I love them so much! I have Cancer so I can act silly and get away with it!

During these difficult times of experiencing side effects many questions from friends and colleagues arose concerning the medications given to relieve the symptoms. Let me start with the preparation of infusion. The nurses prepare the port for infusion then hydrate with normal saline. A combination of antiemetic medications IV are given: Aloxi, Emend, 0.5 mg of ativan and 12mg of dexamethasone.

Steroid

The steroid has many mechanisms but Ill concentrate on several. N/V is a major concern, however, its mechanism is not fully understood. An effect on prostaglandin release and it's subsequent effect on the brain is thought to be the desired effect. One can expect to feel a subjective sense of well being but anxiety and mood changes are also to follow. This steroid in combination with the other anti- emetics can surely bring about diarrheal episodes.

A list of side effects:

- proximal muscle weakness

- Cataract formation

- Hyperglycemia

- adrenal suppresion

-Lethargy

-Weight gain

- Insomnia

Cannabis

Cannabis contains 60 different types of cannabinoids. 2 oral agents approved by FDA are in the market place. Dronabinol and Nabilone a third is under investigation, Sativex (a buccal spray).

Limited conclusions from recent studies about its efficacy can be drawn. the standard of therapy are the previously mentioned agents - 5-HT3 receptor antagonist.

A list of side effects:

- Euphoris

- dizzyness

- dysphoria

- hallucinations

- hypotension

E. L. Doctorow stated, "writing a book is like driving a car at night. You never see further than your headlights, but you can make the whole trip that way". That philosophy applies to life as well. The headlights on my car shine 350 feet, but even with that much light, I can travel all the way to California. I need to see only enough light to get moving.

Psalms 97, 9-12  O lord, you are supreme over all the earth; you are exalted far above all gods.

                           You who love the Lord, hate evil! He protects the                      lives of His people and rescues   

                            them from the power of the wicked.

                            Light shines on the godly and joy on those whose                     hearts are right

                            May all who are godly rejoice in the Lord    

Thank you for reading this blog, I pray that God will give immeasurable blessings to you and your loved ones.

In Peace, Strength and Courage always,

Bo Morris