Saturday, February 16, 2013


Gore Bay, ON - Summer 2006
So let us continue with the Chemo 101.  There is so much to learn about blood cells.  It is quite amazing how our bodies function and continue to function despite chemotherapy and other harsh treatments.  Human beings really are quite incredible.  We now know that chemo kills fast dividing cells and in the process it also ends up killing fast dividing healthy normal cells.  This includes blood cells produced in the bone marrow.

Ready for some more info?  Again, keep in mind that this is just what I learned and in no way do I profess to be giving medical advice.  Here we go...

Bone Marrow Suppression
Bone marrow makes red and white blood cells and platelets.  White blood cells protect the body against infection and red blood cells provide the body with oxygen.  Platelets are what help your blood to clot to stop bleeding.  The job of the white blood cells is to attack different viruses, bacteria and allergens in your body.

White Blood Cells / Neutrophils
The most common kind of white blood cells are the neutrophils.  I didn’t know it at the time but I was to become very familiar with the importance of neutrophils.  They protect you from bacterial infection and the level of neutrophils in your body can be significantly lowered by chemotherapy.  This causes a high risk for infection because you basically have a limited ability to fight against infection.  It is not always possible to prevent infection but it can be helped by frequent hand washing, good oral hygiene, avoiding people that are sick, and staying away from litter boxes, bird cages and that sort of thing.  A good thing to avoid at anytime anyway I think.  We have a dog so chemo got me off “poop pick-up duty” for awhile.  (I had to find the perks where I could.)

Red Blood Cells
These can also drop due to chemo and it is usually a slow and gradual drop that can cause you to become anemic.  This means you could suffer weakness, tiredness, dizziness, headaches and shortness of breath.

Low Platelets
If your blood as unable to clot as it usually does, you can have nose bleeds, gums could bleed, blood could show up in your urine, and/or small red spots might be seen on your skin.  You need to be careful brushing and flossing your teeth, be careful with sharp objects (like we wouldn’t already be doing that anyway) and also keep an eye on bruising and other bumps and scrapes.
British Columbia - Summer 2006

Ready for more?  How about some side effects?  These are numerous and depend on the type of treatment and on each person.  Everyone reacts differently.  The most common side effects can be managed fairly easily but others are more difficult.

  • Hair loss is the most obvious and visible change for most people.  It can start as early as 2 to 3 weeks after the first treatment.
  • Mouth sores are also quite common with certain medications so we were told to try to get in to see a dentist prior to starting treatment.  Thankfully I had just seen the dentist so I was covered on that front.  Of course you have to avoid certain foods that might cause irritation as well as alcohol, tobacco, mouthwashes, etc.
  • Nausea and vomiting is another big side effect that can be assisted with anti-nausea medications, eating small meals and drinking lots of water.
  • The other two common side effects are at opposite ends of the spectrum as one is constipation and the other is diarrhea.  Again, these really aren’t the most pleasant things to experience or to talk about but can really cause major discomfort.
  • Sex drive can be reduced and your hormonal system can go completely out of whack.  Not only is sexual desire affected by the treatment but the other side effects really don’t sound like they’d leave you feeling particularly sexy either.
  • Fatigue is probably the most common side effect.  In order to prevent this or to relieve it we were recommended to take short rest periods for about 20 to 30 minutes each.  Oddly the one thing that can help the fatigue is exercise.  Light physical activity can boost your energy levels.  Allowing friends and family to help you and prioritizing the things you need to get done are good places to start.  Do what you need to do but also within your limits.
  • Photo sensitivity is something to really watch out for.  You can burn really quickly while in the sun so using a sunscreen of SPF 30 or more and covering up while outside are good preventative measures.  I was glad the summer was just finishing because I love being outside and it would have been difficult to stay in the house all the time.  I can’t imagine sitting outside all covered up either.  Again, an upside.
  • Other 911 things to watch for are anemia, memory loss, menopause, neuropathy (hands and feet), back pain, bleeding, chest pain, shortness of breath, swelling of legs or arms, and again – fever.
Whew!  Got it?

Finally, at the end of the teaching session, we were all assigned a Patient Designated Nurse (PDN) that we could call during office hours if we had any weird side effects going on that we needed to ask about.  This was reassuring to know that there was a direct link if it was needed.  After hours of course we could always go to Emergency.

So, that was a very informative session right?  Now we are all up to speed on the ins and outs of chemo.  Does that mean I was ready to get on with treatment #1?  Well I was as ready as I could be I suppose.  Two more days to go.

Bad Blood - Neil Sedaka

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