Chemo - Cycle 4 - Day 1 - Juicing

He's doing good, so far!  Roberto didn't vomit the entire day!  That means we don't have to worry about him not having enough calories for the day and being dehydrated.  The oncologist moved one of the anti-nausea medications to the first day.  It might have made the difference.

We also got a mini-laugh today because Roberto's nurse's name could be interpreted as a stripper name.  hehehe  Any guesses?  No, it's not Krystal.  Try again.   Is it a fact that nurse's with stripper names help people heal faster???  Stripper nurses?  Wait, I'm taking this in a bad direction.

Anyway, Roberto finally understands the benefits of small portions and hydration despite his usual mode of inhaling all food products.  Yesterday, he went to the Latino grocery store in Woodland to get some special carbonated apple juice that is good for nausea (purportedly).  The icebox we use for infusion weeks is packed with the special apple juice, Powerade and plenty of fruits and yogurts.  Thank goodness for the super Safeway sale on Powerades!

This cycle already feels different from the others.  I feel the optimism returning!  I'm super happy that Roberto is starting the week off well.  I'll just have to ignore his twitchy leg that keeps hitting me. 

Only four more days to go!!! 

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I know that it's the end of the treatment, but I wrote this out a while back and decided that maybe it'll be good to just throw out there.  The stuff below is part of the "Hidden Side" stuff I was writing earlier.  We learned about all the drugs in one day for "Chemo Education."  

There are three main chemotherapy drugs that Roberto gets during his infusion week (the first week of each cycle):  Ifosfamide, Etoposide, and Cisplatin.

Roberto has seminoma with elements of teratoma cells.  Seminoma is a type of testicular cancer and it can occur outside of the testicles; this is what Roberto has.  The good thing about seminoma is that it responds well to chemotherapy drugs. 


Ifosfamide
Good:  Used to treat testicular cancer.
Bad:  Destroys the lining of the bladder

This is the drug that requires Roberto to carry around the fanny pack during the chemo week.  The fanny pack administers the drug Mesna to protect his bladder but it must be given continuously.  Usually Bleomycin is given but it causes lung toxicity.  Since Roberto practically had only one lung at the beginning of chemotherapy, the oncologist replaced the Bleomycin with Ifosfamide. 

Etoposide
Good:  Used to treat testicular cancer.
Bad:  Damages vein tissue.

This is where the advantage of the PICC line is apparent.  Since the PICC line goes almost all the way to the heart, it bypasses the smaller veins and the Etoposide doesn't have a chance to damage them.

Cisplatin
Good:  Used to treat testicular cancer.
Bad:  Damages vein tissue; causes kidney toxicity.

*This* is the drug that induces the most vomiting.  Apparently, most people do not handle Cisplatin well, and I guess Roberto is one of them.  Also, partially to combat kidney toxicity, Roberto gets some saline solution at the start and end of the infusion (so before and after all drugs are administered).  The IV fluid is also part of general hydration for Roberto to help him flush the chemicals out of his body. 

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