little troubles

I have been prescribed a low dose combination of Pomalyst 2mg, 300mg Cytoxan and 20mg Dexa, which has been reduced to 12mg after the 3rd cycle, each cycle being 4weeks. The rest of 1 week within the 4 allows for the body to recover and hopefully for the blood count to remain normal. 

I am so very thankful to the Lord for the excellent results of the 1st and 2nd cycles, m-band dropped significantly. Thankful to Prof C for proposing a low dose treatment protocol that is effective. I'll have to complete 6 cycles of this and praying that the results remain good. 

Over the months, as one goes through one cycle onto the next, the toxicity to the body increases. Knowing what these side effects are, I try to manage them. I have switched from taking Pomalyst in the morning to the night, as taking in the morning, meant a sense of sleepiness and brain fog throughout the day. Paul reminded that Pomalyst, a 3rd generation Thalidomide, its original purpose in the early days, was used to help pregnant women to sleep. 

After I switched from morning to night, I experienced an extremely bad bout of constipation and had to SOS help from my Dr, as well as GP. Secondarily, it exacerbated an old-time problem of haemorrhoids. That is double troubles over 2 weeks. Now I have to carefully manage my gastrointestinal system with 2 additional medications. Must be thankful that such side effects can be resolved and managed. 

Nevertheless this is the reality of being on any cancer treatment, even a lose dose regiment can give "little troubles". I see these as minor compared to serious side effects of high dose treatment which causes high raging fever - cytokine release syndrome. In immunology, CRS is a form of systemic inflammatory response to immunotherapy drugs, more aggressively than it should; symptoms of fever, nausea, fatigue and body aches. Recently, a dear sister had an ulcer in her stomach that caused contents to leak out to the peritoneum cavity, requiring emergency surgery. That is "big troubles". 

I recalled an occasion, 18 years ago, while hospitalised, I experienced severe stomach pains in the middle of the night, the haematologist Dr had to call for a gastrointestinal Dr to attend to me. Some of the dangers of these immunotherpy and chemotherapy include intestinal blockages etc. Thankfully the medical care in Singapore is excellent and our Drs are experienced and are alert of signs of pains and complications. 

I don't take for granted that I have gone through this before and more experienced; this second time round, I will definitely still exercise care and be in tune to the effects on my body; respond timely and seek help from the Drs and nurses when needed. 

I'm on my 4th cycle. By God's grace to complete the remaining cycles, uneventfully.