The Beginning of Chemo
A quick recap on the happenings of my previous blog post was that the second opinion of the pathology report turned out to be Burkitt Lymphoma, which is more aggressive in nature.
There was no point crying over spilt milk. No matter whether the diagnosis was Diffused B-Cell Lymphoma or Burkitt Lymphoma, both are cancers! There’s a Malay saying that goes “malang tidak berbau”, which literally means “bad luck has no smell”. As blunt as it sounds, it is true to life.
Initially we were frightened by the word “chemo” and the reactions the hematologists (blood specialists) portrayed. My current hematologist convinced me that this disease is curable, bringing up the example of “Lee Hsien Loong The Great” our current Singapore prime minister whose lymphoma has since gone into remission after a string of successful chemotherapies. He is indeed an idol for all lymphoma patients!
Since there was no way to avoid the true fact, I had to forcefully accept and face my destiny with dignity throughout the chemotherapy treatments .The possible side effects of the treatment regime are the usual nausea , tiredness, mouth ulcers, diarrhea and lowered blood counts. Decreased white blood cell count increases infection risk while decreased platelet count increases risk of bleeding.
9th July 2014 marks my first day of chemotherapy. The names of my chemotherapy agents remain etched into my brain. They were divided into two blocks – Block A and Block B, whereby:
Block A consists of, Ifosfamide, vincristine, methotrexate, VM26, cytarabine
Block B consists of cyclophosphamide, vincristine, methothrexate, adriamycin
The two distinctive colors of the chemo drips are the bloody red adriamycin, or commonly known as the “Red Devil” and the bright yellow methotrexate, which will never slip from my memory.
The six chemo cycles started off with Block B, following the sequence of B-A-B-A-B-A, with both blocks alternating every three weekly. Both supplemented with the antidote – folinic acid to reduce the side effects, dexamethasone for anti-inflammatory and intrathecal methotrexate through a procedure called lumbar puncture (poking a needle directly into the spinal canal at the back of your body for the infusion of the chemo drug). Each cycle would require a 5-day hospitalization stay.
The frequency of my visit and the number of days I had been in the hospital strengthened my relationship with all the onco nurses in Sime Darby Medical Centre. I was seen to be the cheerful and happy-go-lucky young girl who was there just for holiday stays. After day-in-day out of the hospital for nearly 4-5 months, generally, I have noticed significant differences among Malay, Indian and Chinese nurses.
Malay – very caring, always concern about your condition every now and then
Indian – very friendly bunch of people whom I can always tease and joke with
Chinese – fast and efficient. Tend to speak lesser but do things faster
All in all, every single one of them is amazing! Thank you my angels for having me under your care!
Due to my lowered immune system, I have to follow a very strict diet and amend my lifestyle. No raw food, meaning no salad, no filtered water, no sunny-side up eggs in my American breakfast, drinking water must be boiled, no seafood, everything must be fully cooked and hygiene must be a priority. Also, only fruits with thick skin are allowable with skins all peeled and washed with boiled water, which means my used to be favorite berries – strawberries, blueberries, mulberries, whatever berries are strictly prohibited! Crowded places are definitely a no-no for me and it is advisable for me to wear a surgical mask every time I leave home to prevent any infection.
A few days after my first chemo cycle, I decided to shorten my hair as I was being told to do so.
The third week from the treatment, I started losing my hair. If I pulled gently, a significant clump of hair would come out in my fingers. At the beginning I was perfectly fine with the concept of not having hair but the latitude of hair falling was just too depressing. I couldn’t control tears rolling down my cheek during the initial stage of hair loss. Imagine when you unintendedly, delicately brush your hair, clumps of hair just fall off like that. My shower place was filled with fallen hair everytime i bathe and my hair dryer would just blow my hair away, messing up the room. As a result, my hair became shorter and more sparse, the scalp became more visible, and I finally decided to trim off the remnants of my hair until finally there is no hair left at all.
The typical reaction to chemo that one would describe would be losing appetite, mouth ulcers, nausea, diarrhea but I did not portray any of those side effects at all throughout my six cycles of chemotherapy journey. Everyone who knows about my condition then and even my doctor were so impressed with how well I was tolerating the high-dose chemo treatment. Perhaps the antidote – folinic acid was indeed very effective on me. To top that up, I even increased 5-6 kgs during the entire chemotherapy sessions, which was undoubtedly remarkable! Usually for my kind of high dose chemotherapy, that is not the case, I was just fortunate to be one of those luckier ones.