Thursday, October 4, 2007

Chemo #6, Doing It My Way

My blood counts were good today, so I got my chemo. But I got only one of the side effect drugs instead of the seven my doctor had been giving me. And I got a slightly higher dose of Herceptin than I used to get, and a higher dose of Navelbine (chemo) than I got in Sydney.

All in all, I think I’ve taken into consideration the advice and methods of my doctor, the doctor and nurse in Sydney, and the information I’ve read on the Internet and come up with my own customized treatment for myself. I feel good about that. Of course, it could turn out my dosage is all wrong and I’ll develop horrible side effects, in which case I’ll be rather annoyed with myself. But for now, I think I’ve come up with the best treatment tailored for me. And, as my doctor admits, we’re all pretty much just guessing anyway.

Tomorrow, I go back for a G-CSF (Neupogen, Gran, Filgrastim) shot, which will boost my white blood cell count. Chemotherapy kills white blood cells so the body sometimes needs some help replacing them after chemo. Until now, my doctor has been giving me the G-CSF shot the day before my chemo if my blood counts were too low, which is what happened yesterday. But now we’re going to take a prophylactic, or preventive approach and I’ll get a shot the day after chemo, to prepare my white blood cells for my next chemo.

It was my decision to have the G-CSF shot the day after chemo. My doctor gives the shot on the same day as the chemo because she believes an American study that shows no difference in efficacy whether the shot is given the day of or the day after. But it seems to me that chemo would kill off the new white blood cells injected in the G-CSF shot if they’re given at the same time. My reasoning is that these blood cells would have less chance of getting killed by the chemo if they were not injected straight away.

I might have a faulty understanding of how this works, but in the absence of any counter-argument or clarification from my doctor (other than one American study), I’m going to go with what makes sense to me. Luckily, my doctor has no problem letting me decide to do it my way, even though she does it another way. I think she trusts that I’m informed enough to make this decision, given that there is no solid evidence that one way is better than the other. I’m thankful that my doctor doesn’t let ego get in the way of letting me do it my way.

I still don’t feel any side effects, and it was quite nice to walk out of the chemo clinic feeling alert and energetic. I ran more than ten kilometers tonight – my all-time longest run. I’m training for a 10K women’s run in three weeks’ time, plus another one for the Singapore Marathon in December. I won’t be running the marathon, just the 10K event. I hope to work up to a marathon by next year. It seems a pretty common thing – people who get cancer want to run a marathon. There’s the obvious symbolism, of course. But for me, I don’t have a lot of things on my list of “Things to do before I die”. Finishing a marathon seems like an easy one to put on the list. Besides, it shows optimism. It presumes I’ll still be alive next December.

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