Tag Archives: Neupogen

Spooky Things to Come?

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Hi folks! Stine here. Brian went to bed before blogging, and tossed me the keys to the blog again.

Because we had our Halloween party last weekend, it feels like the holiday is over. This whole week has seemed like super-bonus -Halloween-week, because it’s my favorite holiday. That means fun spooky things are definitely to come this weekend as we gear up for trick-or-treaters and the “Running Scared 5K” to benefit the Leukemia and Lymphoma society.

It also means that more seriously spooky things may be ahead as Brian progresses after Wednesday’s chemo treatment. So far, so good; he has just had the anticipated fatigue and easily-controlled nausea/unsettled stomach. As we get into Friday, Saturday and Sunday, we hope that his mouth sores won’t make a major appearance, and his general achey-ness will stay away.

However, in order to avoid a delay in the next chemo treatment like we had last week, they have put him on a medication that will boost his white blood cell count.

I want to take a moment to state how impressed I am with modern medical technology. It is amazing that we, as humans, can recognize, diagnose, and treat cancer, and that we have treatments to ease the side-effects of the treatments. I never cease to be amazed by human ingenuity and expanding medical knowledge. Things that would have killed us just a few years ago are no longer a death sentence, and the treatments are always improving. To those in the medical field – thanks for doing what you do!

As I was saying before that tangent, he will be on a new medication starting tomorrow to boost his white blood cells. Unfortunately, this medication needs to be injected just below the skin, and it causes “bone aches”. We aren’t quite sure what that means, but I guess we’ll find out after we head to the clinic tomorrow to learn how to do the daily injections ourselves at home. I’m glad I decided to accent the red tile in the bathroom instead of ripping it out, because now our “sharp needle receptacle” box will blend right in!

Should I put white trim around it?See? Blends right in!

Shots… but not in the good Las Vegas way

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I mentioned yesterday that this round of chemo has been nothing compared to the first one that we experienced. I’ve had energy and didn’t spend the first two days just sleeping like I did before. I don’t know what the difference has been, but we have a few theories.

Before my first round of chemo I was really sick. My cancer symptoms (cough, fever, fatigue, etc.) were pretty acute and so I was in tough shape both going in and coming out of chemo. So it’s pretty understandable that it was such a rough transition. The other thing that may be contributing to my better health this week is the extra “bonus” third week of recovery that I had due to my low white blood cell count which delayed my next chemo session by one week.

Working theories also include the fact that I was sucking on ice chips during the chemo treatment, the fact that I ate a special smoothie with mouth sore preventing amazing things in it, and/or the manuka honey spoonfulls I ate every few hours in the days after chemo. The mouth sores have definitely been much better after this chemo session than last. (Thanks everyone for their suggestions of these remedies)

Because my white blood cell count was so slow to recover after my initial treatment, my doctor has put me on a new prescription. As Christine mentioned in a previous post, the new medicine comes in the form of an injection that I have to receive daily for the first 5 days after chemo. It’s a sub-cutaneous injection which means that it needs to go in under the skin but not into veins or muscles. That leaves fat, of which I don’t have much. Or at least I don’t have much of it in places that I can reach myself. So it’s Nurse Stine to the rescue!

The pharmacist gave us a quick overview of our supplies (the viles, the syringes, the antiseptic wipes, and the “sharps box” for used needles) but she recommended that we head over to Injections to see if they could give us some further teaching, and indeed they could. One brave technician even let Stine inject her with a saline solution while she talked her through it the first time. I couldn’t believe it!

That just happened.

After injecting saline into a complete stranger (with permission), Stine injected me my with first dose.

I was very brave, so I got stickers afterward:

Superman Stickers

It’s been a few days now of receiving daily injections from Nurse Stine, and I must say that she is doing an amazing job. It’s not something I would want to do have to do to her everyday.

The side effect of these injections? Sore bones. It’s kind of hard to describe what this feels like, but it’s almost like my bones are brittle. There is general discomfort, but when I touch myself anywhere or brush up against something it feels like I have a deep bruise. It’s weird. This side effect is combined with the general muscle pain and soreness from the chemo treatment, so I see lots of Tylenol and many a warm bath in my future this week. Christine has used this an opportunity to reinstate her never-ending campaign for a hot tub.

Things I Will Not Miss – Part I

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Toward the top of the list of things that I will not miss when this is all over would be the Neupogen injections. For 5 days after chemo I have to have a subcutaneous injection of a drug that helps to boost my white blood cell count so it will be high enough for me to safely undergo my next chemo treatment.

Christine has been giving me these injections for 5 months now and I don’t think I’ve made a single one of them easy for her. I complain, I protest, I whine. She’s really pretty incredible to put up with me as I work to come up with new excuses every night as to why I don’t need my shot. And I do feel bad about the many, many times I’ve blamed her, or accused her of enjoying the process of stabbing me with a needle, just to possibly make her feel bad and let me get out of it. She’s resilient though and it’s never worked.

So, for 5 days after chemo we go through the motions. The drug comes in individual vials that have to be kept in the fridge so we take it out at least an hour before giving it me so it can warm up, cold injections are very painful. About an hour or so after its been sitting on the counter we start to bicker about whether or not its time for me take my shot. She is in the “pro-shot” camp, and I am firmly in the “anti-shot” party. She quickly grows tired of this game and will eventually wander upstairs to the bathroom to start preparing the shot.

She gets a syringe, opens it up and draws the contents of the now room temperature vile into the syringe.  At this point, her tone changes and I know that I can no longer avoid the invitable. With my tail between legs I go up to the bathroom and accept my fate.

Throughout the week we work our way through a series of 4 injection sites. The back of each arm, and fatty area around my hips (or love-handles if you will). After a discussion about where the shot is going tonight she uses an alcohol swab to sterilize the area and then she pushes the syringe in. Before pushing in the plunger and injecting the medication she has to pull back on the plunger to check for blood return. By this she is just to double checking that she isn’t injecting it into a vein, as apparently that would be bad. Assuming all is well, she pushes it in.

Sometimes it hurts, sometimes it doesn’t. it’s about half and half. Even after several months we can’t really seem to figure out why sometimes the injection is painless and sometimes it really hurts when its going in. Not the needle, its pretty small, but the actually injection of the medication. At any rate, it happens, the needle comes out and I get a little bandaid put on the injection site. Then I’m done for another day.

As many of you already know, Christine is amazing. I don’t know how I would handle having to give her a shot everyday and she handles it like a champ. I’m not an easy person to deal with it comes to something like this, something that I don’t want to do, and I HAVE NOT made it easy for her. Its just one of the many reasons why I love her.

2 more shots for this round. Then 3 more rounds of chemo… so 17 more injections… though maybe I won’t have to do the shots after my last chemo appointment, so it may only be 12!

Either way, it’s too many. I’m certainly not going to miss the shots.

One less thing “needling” at Brian

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Stine here. Tuesday night marked a momentous occasion in the Lange house, as Brian had his last neupogen shot! Back in early February, he talked about how this is one thing he will absolutely not miss.

In October, we were given the large sharps box by the pharmacist, because he needed one shot per day for 5 days after each chemo session. He will have had 12 rounds of chemo when it’s all done, and he didn’t have shots after the first, and he won’t have any after the last. By Brian’s calculations (because I’m not so good with math), he had 50 shots:

Sorry I couldn't get a "sharper" picture. =)

That’s a lot of shots. It feels like it was more than 50, simply because it was spread out over such a long period of time. I feel like it was years ago when I was given a tutorial by the kind nurse.

You can see the syringes through the plastic, with my thumb as a reference for size. That's a lot of shots poor Brian had to put up with.

Tuesday night was a happy night in our house as we put the last needle in the sharps box. One more thing checked off the list, and just one more chemo session left to go! I’m glad I get to stop being a “prick” by forcing the sick guy with cancer to get shots he doesn’t like. For someone who doesn’t work in the medical profession, it’s an interesting skill to have. But I’ll be happy if I never have to give another shot again. =)

Last Blood Draw

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Every two weeks, on the day before chemo, I go in for a blood draw. Today is the last one!

Yes, it’s possible that I may have to go in again before we see the doctor in two weeks, but still, it feels like a milestone.

One of the cool things about getting results online is that I can see all of the results going back. There is even a function to make a graph:

The first point on the graph was the blood draw that I had after my first meeting with Dr. Dodge, September 13th. That was he uttered the words that I’ll never forget “I don’t see any reason to sugar coat this: I believe you non-Hodgkin’s Lymphoma” (HA! Joke was on him, he was WRONG it was Hodgkin’s!). Before leaving the office he sent me for a blood draw, my white blood cell (WBC) count was 13.2, the “standard range” for WBC’s is between 4.0 – 10.7. (fun fact: the numbers are in K/ul which I believe stands for “Thousand per Unit”)

The second point on the graph was the blood draw that I had before my first chemo and it came in at a respectable 10.7. Then, well, you can see for yourself how I reacted to my first chemo treatment, 2 weeks later I my WBC had RECOVERED all the way back up to 1.5.

From then on I began taking the injections, and you can see from the chart that from then on my WBC generally hovered around the low end of what a normal count should be.

The shots SUCKED. I hated having to do them. But they worked.

Anyway, I just thought the graph was neat. It’s one way to have documented the journey.

OH, and Happy Anniversary to my parents. 37 years!