CHEMO INFUSION 6 IS FINISHED - I THINK IT'S DONE!!!

Hi, I've been absent.  I've been SUPER tired.  

I had my seemingly last chemo treatment on Thursday, 2/2 with the pre-meds (steroids), a bag of bendamustine and a large bag of rituxan;  then on Friday, 2/3 with the pre-meds and my LAST bag of bendamustine!!!  

Just to remind you, bendamustine is considered a chemotherapy drug.   It is related to mustard gas:  The nitrogen mustards are cytotoxic chemotherapy agents similar to mustard gas. Although their common use is medicinal, in principle these compounds can also be deployed as chemical warfare agents. 

During World War II nitrogen mustards were studied at the Yale School of Medicine by Alfred Gilman and Louis Goodman, and classified human clinical trials of nitrogen mustards for the treatment of lymphoma started in December 1942.  Also during World War II, an incident during the air raid on Bari, Italy, led to the release of mustard gas that affected several hundred soldiers and civilians. Medical examination of the survivors showed a decreased number of lymphocytes. After World War II was over, the Bari incident and the Yale group's studies eventually converged prompting a search for other similar compounds. Due to its use in previous studies, the nitrogen mustard known as "HN2" became the first chemotherapy drug mustine.

Common adverse reactions are typical for the class of nitrogen mustards, and include nausea, fatigue, vomiting, diarrhea, fever, constipation, loss of appetite, cough, headache, unintentional weight loss, difficulty breathing, rashes, and stomatitis, as well as immunosuppression, anemia, and low platelet counts. Notably, this drug has a low incidence of hair loss (alopecia) unlike most other chemotherapy drugs.  (Yes, I did not lose my hair!!)

The irony here is that I used to work out at the Umatilla Chemical Depot in Hermiston, OR, where our mission was to destroy these chemicals, including Mustard Gas (some type of mustine compound), VX Nerve Agent and Sarin Gas.  The "Weapons of Mass Destruction" were here in plain sight, not lurking in Iraq.  Umatilla Chemical Depot  

Rituxan  is not considered a chemotherapy drug;  it is a type of antibody therapy that can be used alone or with chemotherapy. It works in different ways to find and attack the cells where cancer starts. It targets and attaches to the CD20 protein found on the surface of blood cells with cancer and some healthy blood cells. Once attached to the CD20 protein, rituxan helps my own immune system destroy the cancer cells (i.e immunotherapy vs. chemotherapy) and/or by destroying the cancer cells directly.  However, it can also harm healthy cells in your body. (what-is-rituxan)
  
So, I will have my PET scan on 2/16 (the radioactive one for which I'm not supposed to think before, and the scan lights up in pretty colors) to determine if the cancer is in remission.  I meet with my oncologist on 2/23 to go over the results.  If the lymph node "tumors" have diminished and I am in remission, chemo is done (for now - this cancer frequently and randomly pops out of remission).  If not, I will continue chemo.  But Dr. Lufkin is pretty sure it is in remission, based upon the CT scan done the end of November 2016.  Good news!

I will start my 2 years of Rituxan infusions every 2 months as soon as my surgery is completed and I am in recovery for that.  I have a meeting with my surgeon, Dr. Jordana Gaumond, (who will hopefully fix my surgical hernia) on 2/21 to discuss the surgery and maybe schedule it for sometime in March or April.   It will be major surgery including an 8" vertical incision in my abdomen (the emergency laparotomy last February 2016 was a 5" incision), a 10" x 10" (or so) alloderm mesh and 4 or so bone or muscle anchors to hold to mesh in place.  I've been told the anchors will cause pain for 3-6 months - fun summer ahead!! 

She's estimating I will be in the hospital 7 - 10 days.  Yay!   When I had my previous surgery, it was emergency, so I had no way to anticipate what was to come.  Now, I know.  And the anticipation is not fun.  

This link has a pretty accurate picture of before and after:  Abdominal Wall Reconstruction  I'm not sure why the last photo (side view of repair) is pictured inside a styrofoam cup, but it is what it is.  I'll leave it as a link, in case you are squeamish re: all this stuff.  I have had to get over being squeamish.  


These are weird times.  For a multitude of reasons.   Be well.