2016-09-15

It Ain't What It Was

One used to hear horror stories about chemo-therapy.  Endless nausea and other side effects that are debilitating.  It is not that such things have disappeared, but they have been substantially reduced.  A month ago, it was determined that the chemo that I had been treated with for the last three years(Revlamid) had stopped working, or in technical terms I had gone 'refractory' to the medication.
So, easy enough to address... move on to the next medication.  Less convenient that the pill that I had been taking, because I now have to show up for a shot once a week and have labs prior to each treatment.  That is workable... more of a PITA, but workable....

Then, after a couple of weeks of getting these shots of different stuff(Valcade) and attempting to adjust to the little quirks that come with this new treatment, the Dr. sits me down and says

Hey, some really cools shit just came through clinical trials and show promise for enhancing the impact of Valcade.  (That is not a quote).

Darzalex, a monoclonal anti-body, combined with Valcade, a targeted proteasome inhibitor, further combined with Dexamethazone, a glucocoroticosteroid, is the cocktail of the hour for those with multiple myloma and for whom other treatments are failing.  Cool!

So, I agree to this protocol (my Dr is cool about such things, ensuring that she explains what she is suggesting, then  giving me all the info I ask for, and letting me decide if I want to pursue the option or not).  The Dr. and team take care of all the arrangements with insurance, the hospital where I get the first treatment, pre-treatment labs, pre-treatment education(of me), the whole she-bang.  I simply show up at the appropriate time and place and all is taken care of, right?.  And guess what,...  it is!

I show up, my car is parked for me by valet service. The front desk knows where to send me, I am checked in within 5 minutes, an orderly shows me to my room within another 5 minutes, and I have met the Dr. and nursing team and support staff within the next hour.  There is a wait for FedEx to show up with the medication until about noon,  In the mean time, I have had a catered breakfast, my internet connection is established, the protocol has been reviewed, pre-meds have been administered through the now installed catheter, vitals have been recorded... etc...  .

Note that this is a fairly new medication, the side-effects are generally known, but not all that familiar as to when and how they show up.  That said, by 13:00, I have received the weekly dose of Valcade (subcutaneous), a pre-treat dose of dexamethazone, some other pre-treats that are supposed to reduced side effects(benadryll)  and the IV of Darzalex is started up.

In about 45 minutes, the side effect hit.  Nothing terrible mind you:  Kind of like an allergy attack. Shortness of breath(minor), watery eyes, runny nose.  They stop the IV drip, and give me some more pre-treatment stuff, cut the IV rate of flow back and start up again after a half an hour.  It works.  My body adjusts quickly to the new anti-bodies.  The side effects go way.  They dial up the delivery rate to 100ml/hr and I spend the next 10 hours slowly getting the Darzalex.

Pretty painless.  And a team of professionals made it that way.  A lot happened behind the scenes for me to be able to sit here and glibly summarize this.  I am fortunate in a lot of ways in this regard.  My wife has a job with insurance that covers the better portion of a lot of expense.  I have an excellent oncology team, and have had since day one.  I have friends and family who are supportive in the way I need them to be.

There are a lot of folks out there who are not this lucky, they are dead, or close to it.  It is that simple.


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