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Discussion:
Dave's R-CHOP Experience
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Since I found Cindy's experience (in www.lymphomasurvival.com) so helpful, I thought that others may get something from my experiences (or at least I will get some therapy out of writing about them). Tomorrow I start my 3rd cycle of R-CHOP for DLBCL (Monday: Lab and Doc visit, Tues.: Infusion, Weds.: Neulasta shot, ... then ... deal with it (I am on the 21 day fun plan for a total of 8 treatments).

Recap of the 1st two treatments:
Cycle 1: Had two messenteric masses (10cm and 11cm), with nodes in about 10 other places. Just started some minor night sweats (but I sleep in A/C w/2 fans on me always, so it was somewhat mitigated). However, the abdominal masses had doubled in size in the past 6 months, and were causing me pain. Was very actively practicing TNS (the Natural Solution from the earlier mentioned website), and as I have said I am in real good condition as a VERY strong, and fairly lean 59 yr old (60th birthday 1.5 months away), so I came into this in pretty good shape, physically. In early June, following bad results from a new biopsy and PETscan, I did R-CHOP #1. We had to stop early in the Ritiuxan administration since my mouth started to tighten, and then got itchy in my right side of my face - allergic reaction - IV benedryl and more dexamethasone - then retarted. 1st treatment = 9 hrs. Went home, took a 45 min walk, ate a good dinner, and then took the 30 min bath (note: need bath toys). Read about the Neulasta bone pain in the other site, talked to a breast cancer patient about it, and finally, asked the nurse who gave me the shot (in my arm) whether Claritin was a good idea. She said definitely, and I then asked when ... to which she responded "right now". Funny (actually sad), I had to pull this info from the medical community. It was never offered, but IT WORKED. I took a 24 hr. Claritin readitab every day for 5 days, and experienced NO bone pain. I asked my doc about why he hadn't told me about this, and his response was that it is not approved protocol, and doesn't work for everyone. OK, so let's see from a risk management state: If it doesn't work, then I am out $1 (and keeps my allergies at bay), and have the same 1 week of deep bone pain that I was going to have anyway vs. it works (and no pain - which it did). This is really a no brainer. After the feel good steroids wore off on Weds evening, I had a lot of cramping "dull" pain in my upper abdominal area through Sunday (doc said in my follow-up that this is due to the Vinsristine), then felt like I wanted to crawl out of my skin on Monday. Went back to work on Tuesday for a few part days. Still had, but less abdominal pain, but it always seemed to commence in the mid-afternoon (have no idea why). Never experienced the fatigue that some report (had a CBC on Monday, and levels were fine, except WBC). The last feel good week went well.

Cycle 2: Met with the doc, had more blood work (all good w/good WBC), and he told me that what I experienced in cycle 1 would be similar to cycles 2-4. Then in cycle 5-8 the cummulative effects of the prior cycles would compound with the current treatment. So we did treatment #2. Treatment 2 = 7 hrs. Results: the intesity of the side effects were the same as cycle 1, but they lasted longer. Matter of fact, I am on day 19, and actually had some stomach feelings even yesterday (didn't medicate, but felt them). The cumulative effects that he was talking about have to happen with each treatment, but I am a very astute observer of my body, and clearly noticed this. I guess what he was saying, was that most would notice significant accumulation by treatment 5-8. Still no fatigue. Abdominal pains were a bit worse and lasted longer, so I started Percoset for them (as needed). A bit of chemo brain, or is that just getting old, I am an active working muscian, and the other day, on a song that I play all of the time (Wild Nights by Van Morrison), I forgot the signature opening bass part (fortunately no neuropathy, yet). Took me 2 lines of the intro to the song before I figured it out. I also found that while I was feeling like crap, mentally, if I kept doing things, it helped the day go faster, and kept my mind off of this. In fact on the bad 1st Sat. after treatment, in 100 degree temperature, I went out and re-did my entire garage (moved a freezer and a refrigertor, hung all new shelves, and reorganized everything). On Monday, when I felt like I want to crawl out of my skin, I went out with a bucket and a sponge and got down on my hands and knees and wash the floor of my outside gazebo (just to kill time). I also, have been stopping at Meadows Farms after each oncology visit, and buying plants. I need to see lots of life and color now, and my yard is looking great.

Observations (post 2nd cycle): Down 20 lbs. abdominal area is much smaller, my beard ended up in the wash cloth about 2 weeks ago, the lump in my neck is gone, drinking lots of ice water (went to a club last night to hear a friend's band and drank ... you got it ... ice water - saving lots of money on drinking alcohol). SO ... this is definitely working. Had good workouts this week, and even though I have missed a lot of workouts, I can still bench 3-45 lb plates on each side of the bar. I'll keep doing what I can.

Cycle 3: Today, starts cycle #3 (infusion on Tuesday). I am apprehensive, but know that this will be one more treatment down out of the 6 I still have coming. I'll get through it.

Just thought that someone coming "down my pathway" may get some value out of this. At least was good for me to write it.

_________________
Stage 3A, Grade 1 fNHL (Dx 10/21/11 W&W for 6 mos). DLBCL w/10 & 11cm messenteric masses (Dx 5/12 w/new biopsy & PET scan). Starting R-CHOP on 6/5/12. 59 yrs. lifetime involvement in bodybuilding w/strong heart (hope it stays that way).
Posted on 07/16/12, 07:29 am
30 Replies | Most Recent Add Your Reply
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Reply #1 - 07/16/12  3:45pm
" Dave good job explaining what you are going through. I will start my chemo on July 30, and 31. I am getting Rituxan and Treanda for my treatment. Finally got my mind wrapped around this that I need to do treatment. I still don't have any symptoms and really feel good. Not looking forward to the treatments, but will be glad to get started and get them over with. I am also in pretty good health.....Don't take a any medication except for synthyroid. Had graves disease 36 years ago and had ratioactive iodine to destroy my thyroid and have been very healthy ever since. So a little nervous about starting the chemo...

Will be thinking about you on Tuesday and will be saying a prayer that this one will be easier.... "
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Reply #2 - 07/17/12  12:22am
" So glad to get your update Dave. Sounds like you are tolerating it okay and keeping a positive mental picture. It also sounds like you have some incredible energy. I'm glad that is working for you. I have my fingers crossed for you tomorrow. I hope you continue to do well. Look at the bright side. You no longer have to shave! And one more after this one, and you are half done! That is a big milestone.

Hang in there and please keep sharing your stories. I think we all like hearing how you are doing...and learning from your brave adventure in chemo. "
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Reply #3 - 07/17/12  6:57am
" Funny, I don't feel so brave. Just the patient, waiting to hear what to do next. I know that each person's experience is somewhat different, but based on all my readings, I am just trying (praying) to minimize the side effects, and get through this in one piece. I leave in an hour to start cycle 3. The doc gave me oxycodone to get through the stomach pains from the Vincristine, and I have Lorazepam & Lunesta to sleep with, so I think that my med arsenal is fully stocked going into this. Nevertheless, the fun commences again, today. Thanks for all of your support. "
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Reply #4 - 07/19/12  6:14pm
" Thinking of you and glad you are doing ok!! "
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Reply #5 - 08/03/12  7:49am
" Dave, you are doing so good. I had R-CHOP for six sessions, once every three weeks. My fatigue was so bad, I didn't do anything for most of those three weeks.
You seem to be handling it all a whole lot better than I did. I'm impressed and happy for you. "
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Reply #6 - 08/06/12  7:55am
" Cindy, It has not been a "walk in the park". Not a lot of fatigue. If anything, I have been very "wired". But the oxycodone has helped to take "the edge" off of that. On my way to get my labs and meet with the doc, prior to treatment #4 (tomorrow). Later today, I will try to post my treatment 3 experiences. "
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Reply #7 - 08/07/12  7:29am
" Well, here we go again. This morning, R-CHOP treatment #4 (of 8). My blood work came up good again at my pre-treatment doc visit, yesterday. He seemed to be very happy when he felt my abdominal area (as in he could hardly feel the huge masses that we started out with). When he came in he looked at me and said that I didn’t look happy. He was right (in a sense). I am thrilled with the fact that this is clearly working, and honestly, I am probably doing better than most going through this. BUT, even though I constantly get comments on how good I am looking (trimmer than I’ve been in years {down 23 lbs.}, and without the greyish beard {lost to the chemo} I am looking younger, too), this is NOT a “walk in the park”.

During this treatment cycle, the predominant issue was that I was “wired” from day 2 through day 18. Kind of like I drank 14 cups of coffee at the same time. Not fun. The oxycodone helped to take some of the edge off of the wiredness, but not all. Minimal abdominal pain this cycle. I did go to beach on day 5 - 12 {but, I can’t really drink or go in the sun, so not much to do there}. I did get a couple of workouts in at the local YMCA (felt good with the first set), and read a book. The night I got back I played a gig. The problem is that I look very healthy to others, but not from my side (having to live in my body). So I wasn’t very sociable and a bit snappy. Again not fun. I told my main music group that after the gig on 8/18 I am going to go on a leave of absence until the chemo is over. Don’t want to, but I need to. Don’t think that I need to be out in bars with smokers, and sick people, until 3AM at this point.

While I was at the beach, I got a call from my case manager from Blue Cross (insurance) who asked me if she could do anything for me. First, I said no, then I said, you know there are 2 things that you can do: 1) order me a new body, and 2) turn the clock ahead to November (treatment #8 is on Oct. 30th). She laughed, but I was serious. But, I did get the hoop earring to go with the no hair “Mr. Clean” look.

This past weekend I promoted the a pro-qualifier drug free bodybuilding and figure event. I large endeavor when I don’t have this “stuff”. But, I assembled a good team to assist me, in case I “went down”, and pulled it off. I need to do less (but this was on the calendar last year, so ...). It went well, but I am soooo happy to be on the other side of it. Talking to a bunch of carb depleted competitors while I was wired form this past cycle was very tough. Then you get the call from a competitor who announces at the beginning of her call that “I’m the one who called you 3 other times”. Let’s see, if 70 athletes make 3 calls each, we’re talking about 209 more calls than I wanted to talk on.

I asked the oncology nurse about the wired feeling. He said that everyone has different experiences with chemo, but he really hasn’t had a lot of that kind of complaint. Anyone else have this experience. The doc seemed to feel that it was a positive thing (it’s sign that things are working. Okay, but still not fun).

So here we go again. Thanks for letting me go on about all this. "
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Reply #8 - 08/07/12  10:44am
" Thanks again Dave for sharing your experiences with us. I think you are doing amazing! But I do know what you mean about not feeling as "me". One of the weird things about cancer sometimes is you can't always tell someone has it. I guess that is good and bad. Good because you can go around and avoid the "pity" stares but bad because people have no idea you are fighting for your life.

I've not done RChop so I don't know about the wired feeling. Hopefully others will. I do know the "p" is Prednisone. I wonder if that is doing it to you? I know it can.

It is fantastic you are able to still do the things you wanted/committed to do. You are probably right to stop the band thing. The smokers and sick people are bad for you right now. Maybe you can find people to jam with in a smaller, healther setting? I know your music is important. I also think it is important to try to do the things we enjoy while in chemo.

Hang in there. I hope today goes well for you. You are half way done!!! "
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Reply #9 - 08/07/12  12:41pm
" Greetings from the infusion area. The Rituxan is just about finishe (3.5 . Typing on my phone is tough w/the Benadryl.
DAVE "
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Reply #10 - 08/07/12  3:16pm
" That is great Dave. Is it getting faster? I know when I used to get Rituxan, it took 6-7 hours for me but that was my only treatment so maybe I got more or something. Who knows. I used to always laugh about the Benedryl. It made my mind junk for a few hours. I thought I would read, watch movies, or even work during my infusions but my mind was turned off. I felt like I could read the same magazine each week and not even know it because of the Benedryl.

Hang in there. Sounds like today's infusion is almost done! "

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