Why I’ve decided to do maintenance therapy

Later this week I start my first round of maintenance therapy treatments. Choosing whether to actually do maintenance infusions was tough for me. I’ve spoken with other lymphoma cancer patients who also struggled with whether to do maintenance infusions. In this post I will briefly write about what maintenance is and why I am choosing to do maintenance.

What is maintenance therapy

Here is what Lymphoma Action ( a great site out of the UK) has to say about maintenance therapy:

Maintenance therapy is sometimes given after initial treatment has put the lymphoma into remission (no evidence of disease). It is used to make the remission last as long as possible by suppressing any lymphoma cells that can’t be detected by scans after the main treatment has finished.

Chemotherapy is sometimes used as maintenance therapy; however, immunotherapy (treatment with antibodies) is the most common type of maintenance therapy for people with lymphoma.

In my research I’ve found many studies that show maintenance therapy does extend remission for a good number of people. One things maintenance therapy does not do however is extend the expected lifespan of lymphoma patients. Basically maintenance therapy extends the time between the bigger treatment options, such as chemotherapy.

Rituximab is the maintenance therapy drug I’ll be using

Currently Rituximab is the standard drug used for maintenance therapy. This drug is a type of immunotherapy, which means it uses antibodies for treatment. In particular Rituximab is a monoclonal antibody. When writing about my chemo regiment R-CHOP I included this explanation of monoclonal antibodies from cancer research UK:

Monoclonal antibodies target proteins on the surface of cells. Rituximab targets a protein known as CD20. CD20 is found on white blood cells called B cells. It is the B cells that are cancerous in the most common type of non-Hodgkin lymphoma.

Rituximab attaches itself to the B cells and marks them. The cells of the immune system recognize the marked cells and kill them.

I still think it is a very cool concept that a persons own immune system can be used to target cancer cells. Technically this is already supposed to happen, but sometimes the immune system just doesn’t attack cancer like it is designed to. Theoretically maintenance therapy will keep the lymphoma at bay if it begins to spread again.

My particular maintenance plan is to have an infusion every eight weeks for the next two years. That is a lot of sessions. Good thing I have my port!

Maintenance therapy sounds like a good thing, but it has a downside

The concept of maintenance therapy sounds like something every lymphoma patient would want to go through. Being able to push another round of chemotherapy farther into the future is a good thing. But maintenance therapy does have its downsides as well. Actually some countries don’t even offer maintenance therapy due to these downsides and the fact it isn’t proven effective for enough people.

One major downside of maintenance therapy is the side-effects of the drugs used. Rituximab is the standard drug used. The Mayo website has a list of dozens of known side-effects from Rituximab. Here is just part of the list, showing only the common side-effects:

  • Black, tarry stools
  • bleeding gums
  • bloating or swelling of the face, arms, hands, lower legs, or feet
  • blood in the urine or stools
  • blurred vision
  • body aches or pain
  • burning or stinging of the skin
  • chest pain
  • chills
  • confusion
  • cough
  • difficulty with breathing
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • drowsiness
  • dry mouth
  • ear congestion
  • fever
  • flushed, dry skin
  • fruit-like breath odor
  • headache
  • hives or welts, itching, rash
  • increased hunger
  • increased thirst
  • increased urination
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals
  • lower back or side pain
  • nausea
  • nervousness
  • noisy breathing
  • pain or tenderness around the eyes and cheekbones
  • painful cold sores or blisters on the lips, nose, eyes, or genitals
  • painful or difficult urination
  • pale skin
  • pinpoint red spots on the skin
  • pounding in the ears
  • seizures
  • slow or fast heartbeat
  • sneezing
  • sore throat
  • sores, ulcers, or white spots in the mouth or on the lips
  • stomach pain
  • stuffy or runny nose
  • sweating
  • swelling of the tongue or throat
  • swollen glands
  • tightness of the chest
  • tingling of the hands or feet
  • troubled breathing with exertion
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • unusual weight gain or loss
  • vomiting

For anyone curious, that was was 52 common side-effects listed. That doesn’t even include the less common side-effects or other possible side-effects which have yet to actually be linked to rituxumab.

I noted above Rituximab was part of my chemo treatment, being the R part of R-CHOP. My very first round of chemo infusion had to be split into two days. The main reason for doing so was because Rituximab had to be injected very slowly the first time to see if I would react badly to the drug. I’ve heard stories from many lymphoma patients that will experience major side-effects such as their throat closing or major nausea. Before even taking Rituximab a dose of Benadryl is given to the patient, and even that is not enough to hold off side-effects for many people.

At the same time I’ve the stories of many patients on maintenance who have developed long-term health issues because of these infusions. The tiredness and beat-down feeling that comes from chemo seems to be extended by many people taking maintenance therapy. Some patients going through maintenance therapy will get sick constantly and appear to have compromised immune systems. I was actually just speaking with someone that had to stop maintenance therapy after two sessions due to their inability to work anymore. Maintenance therapy is not chemo, but it can be just as damaging to the body for many lymphoma patients.

There are other maintenance therapy drugs out there now. Plus, more are currently being developed. So far I haven’t ready about any without major side-effects. It seems to be a matter of finding the maintenance drug with the least side-effects for a particular person.

So why am I doing maintenance

After going through some of the downsides to maintenance therapy it would seem that nobody would willingly choose to go this route. But just like anything in life it is important to weigh the positives and negatives. I won’t go any further into the negatives, since I think the above paragraphs covered some of those well enough. Instead now I would like to focus on the positives.

First, maintenance therapy does help many patients go longer without treatments such as chemo. It is true that not all patients get a longer remission. But enough patients do that I feel it is worth the risk. If maintenance therapy is able to push my next treatment years into the future I find it worth it. By that time it’s possible a cure could be found for lymphoma. Or even if a cure is not found there may be newer and less invasive treatment options available. There have been a lot of advances in the diagnosis and treatment of lymphoma over the last twenty years. I would expect the next twenty years to see advances we can’t even conceive of at this time.

Second, not all patients on maintenance experience major long-term side-effects. Yes, Rituximab is a nasty drug with some very bad side-effects. But not all patients have the same experience. If I find that I am starting to experience some of the side-effects I’ve read about or heard from other lymphoma patients I will simply end maintenance treatments. Once maintenance treatments begin there is nothing that forces anyone to continue maintenance therapy in the future. This is one area of healthcare where we the patients can actually have some control over our treatment.

Finally, the main reason I am choosing to do maintenance therapy is because of my family. I want to be around to help my kids grow. I want to be there for Ashton as he is going through diagnosis for his health issues. I want to go to Lawson’s baseball games and support him as he takes a continued interest in music and starting a rock band. I want to watch Dustin grow as a young man and smile as he makes the same mistakes we all made as young adults. I want to be there with Mindy experiencing this all together. I took a vow that included “until death do us part” and I plan to make that as far off in the future as possible.

Actually when I first mentioned I was questioning whether to have maintenance Mindy gave me “the look” and the looked like she was going to cry. She acted as if I just said I was wondering whether to keep living. That isn’t what I said or meant. But she seemed shocked and almost angry with me because I wasn’t sure if I wanted to do maintenance therapy. That look had a lot to do with my decision to go ahead with maintenance. If there is anything at all I can do to possibly extend time in remission I will do so. Mindy is truly my soulmate and I want to ensure we have as much time together as possible.

Wednesday is the day

This Wednesday is the day scheduled for my first maintenance therapy. I will admit to having a little bit of nervousness about receiving this infusion. But since I made it through R-CHOP mostly OK (I am still very tired and weak two months later) I feel that Rituximab infusions should go OK. I just keep focusing on the fact I am doing this to hopefully extend quality time with my family.

Today’s song – Just Fishin’

Being around for my family is a big reason I am choosing to do maintenance. I think the song Just Fishin’ sums up part of my reasoning very well. This song from Trace Adkins really shows what is important: spending time with family and creating great memories.

Bonus song – Cats in the cradle

The bonus song is one I’m sure everyone knows. Part of the reason I want to do maintenance is so I can do things like play catch with my boys. I look forward to the day when I sit back and think “he’d grown up just like me, my boy was just like me”.

Glad I wore the blue mask during chemo

No, I don’t normally blog with the blue mask on.

It has been almost a month since my last round of chemo. I wore the blue mask for a couple of weeks after the final round of chemo just to make sure I didn’t catch anything. At this point I am very glad I had been doing so. Yesterday I was taken down by a stomach flu bug of some type. The though of having this flu bug while on chemo makes me glad I wore the blue mask!

Actually last Halloween I blogged about my decision to wear the blue mask. At the time I felt the extra precaution of wearing the blue mask was worth attention it drew to me in public. During all six rounds of chemo I was pretty clockwork about using the blue mask and carrying hand sanitizer with me when I ventured out in public. Some chemo patients I’ve spoken with feel the blue mask is worthless. They may be right, but I feel comfortable with my decision to wear the mask. Going through a stomach flu like this during chemo would have been horrible, especially during the last few rounds as chemo got harder on my body.

I know some chemo patients struggle with the decision as to whether the blue mask is necessary. Personally I think it was worthwhile for me to wear the mask, especially since the flu and pertussis (whooping cough) have been going around. Yes I’ve heard some chemo patients say they made it through their treatments with no issues after deciding not to use the mask. But I’ve also heard of chemo patients being hospitalized by things such as the flu virus. In the end though it is up to each person to make their own person risk assessment.

Round six of chemo done, yes I’m still blogging

Last round of R-CHOP chemo done!

It has been a few weeks since I have been able to blog. As I mentioned in my last blog each round of chemo has hit me harder. Round six was no exception to this trend. But I do have good news, I am now done with my R-CHOP chemo! And now that I am past the hump created by my sixth round of chemo I can get back to regular blogging again!

Last week I had my sixth and final round of R-CHOP chemo. The oncologist met with me prior to my round six chemo injection. She had determined based upon the PET scan I had done after round three and other factors that going past six rounds of chemo would not be necessary. I was so happy to hear this news. The fifth round of chemo had really beat me down and the thought of having three more rounds seemed impossible. She did mention however that I would have another PET scan and have to get a bone-marrow biopsy done to ensure the cancer is gone from my bones. If there is still active cancer in my bones she will come up with a plan of action based upon the PET scan and biopsy results. I am more than happy to move on from R-CHOP chemo and possibly on to other treatment options. Although honestly I just hope the R-CHOP kicked the cancer out of my bones and I can just start my two years of maintenance injections.

After the oncologist gave me the good news I had my sixth and final round of R-CHOP chemo. As with the other times receiving chemo I don’t remember much; the Benadryl really did a number on me. Recovery from this round of chemo has been particularly hard on me. For the last week and a half I feel like every part of me has been on the losing side of a boxing match. My energy levels were also at all-time lows. The few times I had to go out and see anyone in public I would use an energy drink and put every bit of energy into seeming normal. Such outings would leave me completely without energy for a day or so. During that time my wonderful boys really stepped up and helped me any way they could. I could not be more proud of them!

Yesterday I finally felt half-way normal. To celebrate I spent the afternoon ice fishing. Again the boys really helped me by getting my stuff out to the ice and helped me bring it back to the house afterwards. I didn’t catch any fish worth keeping, just a dozen or so perch that really weren’t big enough for anything. The lack of catching bigger fish really didn’t bother me though. I was just happy to get out of the house.

Today I feel even better. For the first time in a few weeks I actually feel good enough blog again. I plan to take a trip up north to help move my oldest son. Even though I won’t be much help in actually moving his stuff, I can still drive my pickup to help him out. Hopefully this upward trend can continue! And hopefully I don’t overdo anything; as I really do get tired and wore-out very quickly.

I’ll end this post here. This post was really about getting an update out there about my status. Also I wanted to ensure everyone knew I was still blogging. Actually I have the topics for dozens of blogs ready to go for this year. I just needed to energy to start blogging again. I appreciate the many messages I received during the past few weeks asking if I was OK. It never occurred to me that a lack of blogging by me would even be noticed. Again, thank-you to everyone out there for the support.

Bonus song!

Now that I’m feeling better I can’t get this classic from Robert Earl Keen out of my head.

Each round of chemo gets harder on the body

Last week I had round five of chemo. My blogging has been somewhat lacking since receiving my latest round of infusion drugs. Partly this has been due to my being busy with other projects. But honestly a bigger reason is because I feel just plain beat down. Each round of chemo seems to get harder on the body.

Overall I really can’t complain about the side-effects I’ve had while on chemo. The main side-effects I experience are brain fog, insomnia, and bone pain. I don’t experience debilitating nausea like some on chemo experience. But I have noticed over the last few rounds of chemo that each time I just feel more run down. Of course the lack of sleep may have a lot to do with this run-down feeling.

Over the last few days I’ve been reading the experiences of a lot of cancer patients, especially for those on the chemo regiment I am taking (R-CHOP). I can’t help but think of Forrest Gump when reading through these stories. I can hear him saying something like “Chemo is like a box of chocolates, you never know what you’ll get.” With so many possible side-effects it almost seems that each persons experience with chemo is truly unique. Plus many people on chemo, including myself, appear to have their chemo experience change each round. In my case it appears to get worse each time. But other chemo patients appear to have fewer side-effects with each round.

Today, a week after my latest round of chemo, I actually feel pretty good. It does make me wonder what round six of chemo will be like for me in two weeks. Theoretically that could be my last round of chemo, which at this point I wonder how worn down I will feel after that round. I guess I’ll find out in two weeks.

My port mostly worked for round 5 of chemo

Last week I blogged about the catheter connected to my port being retracted. The surgeon didn’t think this would be an issue for receiving my chemo infusion. Yesterday had I round 5 of my chemo infusion and the port worked fine for receiving drugs from the IV, but not for taking blood draws. In this post I will share that story.

The chemo appointment started as it normally does. One of the nurses accessed my port by connecting a needle contraption through my skin into the port. She then proceeded to flush the port, which the surgeon said might actually undo the retraction. The port flushed fine and there didn’t seem to be any resistance. That was good. But then the nurse went to take a blood draw from the port and she was unable to get anything to return. Her and another nurse tried multiple flushes, I think around eight or so. For some of those tries they had me move my neck into different positions to see if that would help. Nothing made a difference. The flush would go through the catheter fine, but no blood would come back when trying to get a blood sample. After speaking to the surgeon over the phone, the nurse said we would get an x-ray to see what was going on with the catheter now.

As a recap this is the picture previously posted to recreate what my x-ray looked about a month and a half ago. In this picture the catheter is correctly going from the port, up to the neck and down through my jugular, and stopping just outside of the heart.

port

This next picture is how the port looked about a week and a half ago. Looking at this picture is shows the catheter being retracted into a loop. The end of the catheter is also further away from the heart due to the loop.

portretracted

Finally, here is a recreation of the x-ray from yesterday. The loop is gone, but now the catheter is in a J shape in the jugular.

portretractedj

After viewing the x-ray I received a visit from the surgeon. He believed flushing the port must have caused the end of the catheter to straighten out. But it was not strong enough to completely extend the catheter. Since the catheter is still in the jugular and not in a smaller vein, the surgeon decided it was OK to proceed on to chemo with the catheter as it is. He noted the blood draw would have to be done on my arm. He also did a couple of flushes to ensure there was no resistance. He also verified blood draws were not possible. At the end of his visit he said we would look at this again in a few weeks after round 6 of chemo is done. After that he would be comfortable fixing the catheter, since I will hopefully be done with chemo treatments. My PET scan after the sixth round will decide if I have to go a full eight treatments. But my PET scan after round three looked good, so I hopeful the next PET scan will show no active cancer in my bones. If I have to go a full eight rounds I’ll speak with the surgeon to see what the plan will be then.

After the surgeon left, a tech from the lab came to take my blood. As usual my numbers were looking good. Each round of chemo my blood numbers have looked good and recovered well from the previous round of chemo.

Finally it was time to receive the drugs through my port. The saline bag flowed fine. Then the antibiotics were put through the IV and they ran fine. All of the drugs the nurse put in through the IV flowed fine.

Hopefully the catheter will be fine for round six of chemo, which happens to be scheduled for the day after Christmas. Fluids flowing from the port to the jugular are working good. The only problem right now is that the port cannot be used to do blood draws. Basically my ports catheter is acting as a check valve. Of all the problems one can have with a catheter or port this one isn’t so bad. But it is something that will eventually have to be dealt with. After I’m done with chemo I’ll have two years of rituximab maintenance infusions.

The second PET scan looked good!

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Kicking the cancer into remission means being able to spend more time with my boys and I am better able to take care of Ashton on the days he cannot walk!

Last Wednesday I had my second PET scan done to see how well my first three rounds chemo has been working at pushing the lymphoma back. Friday of last week I posted about the scanxiety of waiting for those results. Luckily over the weekend the notes about the scan had been released and it appeared to be good news. Yesterday during my scheduled round of chemo I had an appointment with my oncologist so I could actually see the scan images and get her take on the scan notes. Overall I will say it is great news!

 

The original PET scan reminded me of a fireworks display show. This scan looked nothing like that. Previously I had what appeared to be dozens of lymph nodes from neck to groin lit up with cancerous activity. This time there were no lymph nodes showing any activity. In the first scan my spleen was very over-sized and most of was showing cancerous activity. This time my spleen was almost down to a normal size and showed no cancerous activity. One of my lungs showed quite a bit of cancerous activity. With this scan there was no presence of cancerous activity. I was ecstatic to see this dramatic change.

The cancerous activity was not all gone. My bones still show activity in them. But that cancerous activity is greatly diminished from what it was. The oncologist says it is normal for the bones to take longer. She did say she is happy with the progress made on the bones, even if it is not as far along to being in remission as the rest of the cancer is. I guess bones take a lot longer to heal.

In the notes from the imagine expert it was noted that I have sinusitis. I was given a Z-Pack prescription to take care of this. Despite my best efforts to keep germs and bacteria away, I must have picked up a cold from somewhere. Luckily it isn’t anything too serious. I actually already figured I had something going on with my sinuses for the last week or two due to a stuffed/runny nose and coughing. But part of me thought it was just a side-effect from a chemo drug or fall allergies. Actually I wonder if fall allergies lowered my immune system even lower so I was able to catch some sort of cold.

I just finished my fourth round of chemo today. After six rounds I will have another PET scan done to see if I can stop there or have to go the full eight rounds. I am really hoping I only have to do six rounds. This chemo stuff is very hard on the body and mind. If things go right my final round of chemo will fall on the day after Christmas. That should make for a happy holiday season.

PS. You may have noticed I said I spoke with my Oncologist on the day I was scheduled to have chemo. My chemo was postponed a day due to the hood used by the pharmacist while mixing chemo was broke down on Tuesday for a time. It was repaired and I did chemo today (Wednesday) with no problems. I don’t blame the pharmacist for not wanting to mix chemo chemicals without proper ventilation, this stuff is very toxic!

Fall allergies while on chemo

Cleaning up Yard during AutumnEarlier this week I noted there wouldn’t be any real post that day due to not feeling very well and my brain fog being too thick. For the last few days it has been hard to put thoughts together and breathing has been very hard. Luckily today I seem to be back to normal and believe it was in fact fall allergies which took me down for the last few days.

One thing I love about our home is that we have a lot of old trees surrounding the house. Of course that also means a lot of leaves. Sunday of this week was a very nice day. It was slightly cool, but there was no wind at all. This was perfect for one last time to clean the leaves in the yard. I spent a few hours in the afternoon with my leaf-blower and hauled a full pickup load of leaves to the dump site. Not only did I feel that something was accomplished by removing all the leaves, I also got some good exercise in.

It didn’t occur to me at the time to worry about my fall allergies. I am already taking Claritin every day. I partially take Claritin to combat fall allergies; and partially to combat the side-effects of certain drugs I am taking; more specifically Claritin helps battle the side-effects of Neulasta and Xgeva. Even though Claritin does a fine job of keeping fall allergies at bay, it does have its limits. I apparently found those limits by using a leaf blower to shoot a lot of allergens into the air.

I didn’t exactly have my normal fall allergy symptoms. Typically during fall I get a runny nose, my sinuses feel plugged, and my head feels like it is going to explode. This time I had a little bit of a runny nose, but I don’t believe my sinuses were clogged at all. My head didn’t feel like it was going to explode either. Instead I had a harder time breathing and I just felt “off”. Additionally my brain fog seemed to really get thick. I just couldn’t put any thoughts together at all. Finally today, four days later, I feel almost back to normal (well the new normal for me being on chemo).

This morning I was in contact with another cancer patient going through chemo. She has a similar experience when doing yard work. To combat this she has to take a shower immediately after doing any yard work and ensure she doesn’t come in contact with the clothes she was wearing again until after they have been washed. Additionally if she has done something like raking she will put the blue mask on. That day I did not take a shower until the evening. Now I know to do that right away.

Now that there is a light layer of snow on the ground hopefully fall allergies won’t be an issue. Furthermore, if my treatments go right I hopefully won’t be on chemo come spring when I have to worry about allergies again. Either way I now know my body definitely reacts differently to fall allergies than it used to. I guess it’s just one more thing to watch out for while on chemo.

The blue mask

SONY DSCIt is Halloween today! This is a day where a lot of kids and adults wear masks to pretend they are someone or something else. In the past my wife and I have held Halloween parties and dressed up in couples costumes (my favorite was me as a gunslinger and her as a barmaid). Between my being on chemo and us traveling to get our youngest son seen by a specialist, no costumes or parties are happening this year. Even so I will be wearing a mask this year, it just happens to be the mask I wear every time I go out now that I am on chemo. In this post I will blog briefly about the blue mask.

Since I’ve started chemo I tend to stay out of public as much as possible. My immune system gets trashed by the drugs I’m taking and I have to do everything I can to reduce the risk of catching any viruses or diseases. Of course that doesn’t stop me from going to events my kids are participating in. When I do go out I wear the blue mask.

Wearing the blue mask and being bald definitely makes me stand out. I’ve noticed everyone looking at me while trying to make it seem as if they aren’t looking at me. That really doesn’t bother me. The best is the times I have to go into the school for my youngest sons. When going through the elementary there are some younger children who say hi to me and ask if I am a doctor. That always gives me a smile.

I’ve been in contact with other chemo patients that don’t wear the blue mask. Some of them believe the blue mask does very little or they don’t want attention drawn to them. Personally I think the extra precaution is warranted, especially since it is such an easy step to take in order to protect myself. Actually there has been a lot of cases of pertussis (whooping cough) going around at the schools. I really don’t want whooping cough while my immune system is compromised. So I will continue to wear my blue mask when out in public.

Tonight I will be around my little nieces. While they are dressed in their costumes I will be dressed in mine: a surgeon! I guess I am dressing up for Halloween after all.

My wife thought chemo went differently yesterday

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The wife fretting over me.

Yesterday I blogged about my third round of chemo. Overall I felt it went well, even with my blood pressure dropping quite a bit. My wife Mind however remembers yesterday differently. In this post I will briefly blog about how she though this round of chemo went.

 

First off Mindy agrees that my blood pressure was dropping. But she doesn’t see it as being no big deal. In fact her and one of the nurses were worried a bit because my blood pressure was dropping much quicker than it had the previous two rounds of chemo. My initial blood pressure was 130/68. It was 99/52 the last time it was checked. Telling her this is a known possible side-effect doesn’t make Mindy feel any better. It is just one of the things my poor wife has to worry about while I am on chemo.

Another thing other thing Mindy worried about yesterday was my dizziness. During this round dizziness seemed to be a larger side effect that it had been in the past. Even if I got up slowly to go the bathroom I would experience some dizziness. Mindy said it looked like I was about to fall over and I was very unsteady walking to and from the bathroom. I really think she wishes I would have called the nurse. But I couldn’t see calling a nurse for doing something so simple as walking to the bathroom. Mindy might have been right though…

Finally Mindy mentioned I was not sleeping as hard as I had during the previous two rounds of chemo. The Benadryl definitely knocked me out. But this time she said I would keep sitting forward in my chair and it would look like I was about to tip forward out of said chair. I don’t recall doing this. But I expect I was doing so because my back pain has been getting worse over the last few weeks. The shot I take to rebuild my bone marrow probably has something to do with my back pain getting worse. Sometimes the shots of pain I get are debilitating. But it doesn’t last long at high levels of pain and usually settles down to about a six on my pain scale. Mindy was definitely worried about this happening during chemo and me possibly falling forward onto my face.

I’ve said it before that chemo is hard on my body. It is also hard on my psyche at times. But I think in some ways Mindy is under much more mental stress due to my cancer than I am. It doesn’t help matters that we have a son with medical problem just as bad if not worse than my own. Hopefully I can find a way to reduce some of the stress on Mindy. She really has been a large reason I have coped so well with cancer so well.

Low blood pressure during chemo

22376520Today I had my third round of chemo. By this point I don’t even fret about chemo days anymore. One of the first drugs they shoot me up with is Benadryl, which knocks me out for the next few hours. The only chemo day side-effect which is somewhat troubling is my blood pressure getting low.

My blood pressure was 130/68 at the begging of this mornings appointment. As each IV bag was given to me the blood pressure would be checked. After taking the first IV R CHOP drug (I believe it was the rituximab) my blood pressure dropped. It dropped even further after the other three chemo drugs. At the end  of chemo my blood pressure was 99/52. My bottom number technically fell into low blood range since it is under 60. The nurse was concerned about this. But my blood pressure did this the last two rounds of chemo as well. I’ll just take it easy for the next couple of days for my body to recover from the chemo drugs.

In researching R CHOP blood pressure problems I’ve noticed this is a somewhat common side-effect. My advice to others on chemo is to not be overly worried about blood pressure drops as long as the nurse is continuing to monitor the decline. But just like anything if the low blood pressure continues after going home I would definitely call the doctor! The low blood pressure may not be an immediate concern, but it could turn into a very bad situation if allowed to get out of control.