On surrendering everything to God, my Creator, who has written my path even before I was born.
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Rockin’ 2014
So I stopped blogging for a while after my last chemo. Busy months came after November as most of my time were spent preparing for the holidays in December and my niece’s 7th birthday in January. I was happy that all my cycles were completed in November as I was able to party without my aching bones.
Wearing my shaved head with my husband for the brand new year. Hoping that 2014 will be our year.🎉
My liver was monitored for a while in the latter part of 2013. I was reffered to a gastroenterologist and took medicines to pull down my SGPT/SGOT which was three times the maximum mark. My doctors said that this was expected because of the chemo drugs infused in my body and the medicines I took. I also had my second PET/CT scan which came back negative.
I was born in the Year of the Horse and I’ve been hoping that 2014 will be easy on me. I guess I had a blast as far as January is concerned. Starting it off with very good laboratory results showing normalized stats for my liver. My period came back as well and my OB Oncologist has given me the clearance to proceed with Assisted Reproductive Technology or what they call ART. My hair also started to show up and this was the best part for me! So I took off my head scarf for the first time attending the 7th birthday of my niece, Rhianna, in time for her rockstar princess themed party. From then on, I had the courage to wear my shaved head even in the office and I hope I can carry myself very well.
Bring it on 2014! I believe I have the best luck this time.
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My Last Cycle
My fourth and last cycle was ‘chicken’ (also means ‘easy’ in Filipino). 😊
Chicken or Turkey? In time for Thanksgiving Day, my last cycle was chicken!🐓😊
It was my first time to be admitted in the 9th Floor of St. Luke’s Medical Center Global City. This is where they usually admit chemo patients. Their slots in this floor are usually fully booked. The nurses here are good. It was my first time where the doctor inserted the IV canulla successfully in just one try. I have to thank my nurse, Tonie, who suggested Dra. Cabacunan and she’s not even an anesthesiologist. It was not my first time to meet her as she is Dr. Cornelio’s assistant. I was very happy because I was really worried on this part. I had two blood extractions this time as they were monitoring my liver and bladder. They told me that it was normal because of the drugs I have been taking but I knew I gained a lot of weight after my surgery as this was my heaviest! After my 2D echo and blood tests, Dr. Cornello gave me the R-CHOP regimen I needed. It was very smooth as I was sleeping the whole time. In two weeks, I need to undergo another PET-CT scan to ensure that my cancer has not ‘microscopically’ metastasized and the treatment was working.
Thank you Lord for this day! I’ve been waiting for my last chemo to come and you made it shorter for me (from 6 cycles to 4 cycles). You even made it easier for me – easier than the previous 3 cycles in contrary with what I have been reading that the fourth cycle is the hardest. Thank you for giving me good doctors and nurses. And thank you for giving me my family and friends. They all made it easier for me.❤
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3rd Cycle and Almost There
Done with my 3rd cycle of chemotherapy and I’m almost there…
It’s getting harder and harder but I knew I’m almost there.❤
This round was quite difficult though because of the viral infection that hit my upper respiratory tract the past weeks leading to asthma attack. This was my longest stay in St. Luke’s Medical Center Global City so far, longer than my admission last September when I had my surgery. As expected, they had a hard time inserting canulla into my veins as my veins get more brittle with chemotherapy. This time, they had 6 failed attempts considering that 3 of them were Anesthesiologists. Fortunately, the 7th attempt was a success with a free IVF success story from one of the Anesthesiologist.😊 My Pulmonologist, Dr. Ruth Marie Divinagracia, couldn’t release my clearance to push through with the R-CHOP Regimen until my 5th day in the hospital because of a really bad cough and phlegm. After two years, I was back with my Symbicort – the medication I usually take when having asthma attack. Worse, I was back with nebulizer 3x a day – the last time I used this was when I was 5! I had skin rashes for 3 nights, apparently because I have allergies for antibiotics under Quinolones family, so I was put on steroids to combat my allergies in between treatments.
As expected, my Medical Oncologist Dr. Gerardo Cornelio administered my R-CHOP Regimen to ensure that I won’t have any tissue burn from the toxic drugs infused into my veins. This time, Rituximab was given on my 5th day and the CHOP was given on my 6th day. Fortunately, my chemotherapy went well and smooth. One cycle to go and hopefully I’m done.
I have to thank my husband, my parents in law, and my sister who took turns in looking after me in the hospital. My nurses, aides, and housekeepers for taking care of me and keeping myself and my room clean all the time. My friends who check on me from time to time. My doctors, consultants, anesthesiologists, and pulmonary assistants for helping me with my 3rd cycle. And of course God, for listening to my prayers.🙏
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GnRH Agonist
As expected, my left ovary looked tamer this time. The GnRH Agonist was meant to totally shot it off for at least 6 weeks to lessen the damaging impact of chemotherapy on my remaining ovary.
Yesterday, I was back in Dr. Eileen Manalo’s clinic. My left ovary looked tamer as expected because of the Mercilon tablet which Dr. Efren Domingo prescribed me to take. This contraceptive pill was meant to protect my left ovary from chemotherapy. The surgery and chemotherapy could expedite the rate of egg loss in my ovary and as the number of follicle declines to low levels, I could enter early menopause. Because my lining was still thick, I was scheduled to receive the GnRH Agonist shot Decapeptyl from Dr. Manalo’s clinic. It was meant to totally shot off my left ovary for 6 weeks to lessen the damaging impact of chemotherapy on my left ovary.
A GnRH Agonist binds to pituitary receptors, prompting an immediate hormone suppression. It is believed that when suppressed, follicles are more resistant because they remain in an inactive state. Furthermore, suppression results in a reduction in ovarian blood flow, and therefore the chemotherapeutic agents do not reach the ovary in high concentrations. Finally, GnRH agonists may have direct ovarian effects that could limit the toxic effect of chemotherapy. Each of these mechanisms might explain the potential benefits of adjuvant GnRH agonist treatment. (medscape.com)
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Food for the Soul #3
I know that this will end really soon.🙏 In my life, I’ve just realized that I always work hard for whatever my heart desires and I don’t easily give up whenever I fail. Thank you Lord for giving me all the strength and courage to move on. I may be learning from this journey the hardest way I could possibly imagine but I love you for being with me all the time.❤
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My PET-CT Scan and R-CHOP
After 3 weeks, I was back last Sunday afternoon at 16th Floor of SLMC Global City for my next chemotherapy. This time, nurses already knew me especially Sam, Marlon and Ana who did a good job in facilitating my treatments. I was scheduled for a series of tests this time – I had the blood extraction, ECG, and 2D Echo last Sunday and PET-CT scan last Monday. My Medical Oncologist, Dr. Gerardo Cornelio, visited me almost everyday. He broke the good news that all my tests results were fine and he could possibly reduce my chemotherapy to 4 cycles from 6 cycles as long as I wouldn’t be having any infections.
My PET-CT scan experience was not painful but a bit uncomfortable because of the position. Last photo below was a quick and funny shot with my husband Jorel – I guess this would temporarily replace our dream of having that documented shot inside a delivery room. Maybe not a milestone, but this would remind us of a remarkable journey.
It was my first time to undergo a PET-CT scan which was requested to assess my response to therapy. An integrated PET-CT scan combines images from a positron emission tomography (PET) scan and a computed tomography (CT) scan that have been performed at the same time using the same machine. Because a CT scan provides detailed pictures of tissues and organs inside the body, while a PET scan reveals any abnormal activity that might be going on there, combining these scans creates a more complete image than either test can offer alone (cancer.net). Initially, I was given a small room where they did check my sugar level after 4 hours of fasting. Then they infused a small amount of a radioactive glucose into my vein. The IV port on my left hand collapsed so they needed to transfer it on my right arm where they normally use for blood extraction. The nurses said that my veins get thinner with chemotherapy so its already expected that it gets harder to insert the ports in my veins. The radioactive substance that was infused in my veins are then absorbed more by cancer cells since they use more energy than healthy cells. After an hour, I was put inside a Philips Gemini TF 64 PET-CT scanner where images were subsequently acquired at 19 bed positions (90 seconds per bed position from head to mid-thigh, and 20 seconds per bed position from mid-thigh to feet). A contrast medium or a special dye was also injected into my vein to provide a more enhanced detail in the images. I was asked to lie with my arms above my head which was quite uncomfortable but not painful. From time to time, a voice inside the machine would tell me to ‘hold my breath’, ‘don’t swallow’, ‘don’t move’, and ‘relax’. After more than twelve hours, I got the review from the radiologist and Dr. Cornelio said that it was good news.
My new concoction for my next chemotherapy – the R-CHOP Regimen. Since I’m positive to CD20, adding Rituximab can treat my B-cell Non-Hodgkins Lymphoma.
Moving forward, Dr. Cornelio administered my next treatment – the R-CHOP Regimen. He added Rituximab in my usual CHOP Regimen. Rituximab was a very expensive drug but it made the B-cell Non Hodgkins Lymphoma more curable than Hodgkins. It is a monoclonical antibody that is used for treating Non-Hodgkins B-cell Lymphoma that have CD20 receptors on their surface. It took me almost 3 hours to consume this drug since it has to be given in a very slow drip. Meanwhile, Dr. Cornelio also made some variations in my CHOP treatment. He decreased the dosage of Oncovine and changed Hydroxy Doxorubicine to Epirubicine to lessen the toxicity. This time, they did not come in bags but through syringe because of a small dosage. Dr. Cornelio, himself, gave these to me.
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Day 20 and Beyond
Top Photos: These justify turning on my “selfie” mode.😍 Coping up with hair loss is a test of courage and optimism especially in women. Below Photo: Waiting for my Medical Oncologist outside of the Outpatient Oncology Section of St. Luke’s Medical Center Global City. Inside this room, I saw people of varying ages battling different types of cancer.
Today is Day 20 post chemo. I guess Dr. Efren Domingo did a good job in preparing me on this day when I will totally lose my hair. True enough, I have started to feel my hair falling out slowly on my fingers since Sunday night (Day 13) until yesterday when I’ve finally decided to chop everything off since I couldn’t comb my hair anymore because it falls out with the comb. I had been a bit uneasy and uncomfortable the past days seeing hair strands on my pillow in the morning and having a hard time taking a bath and keeping the washroom clean without hair strands on the floor and at times on the wall. Indeed, coping up with hair loss is quite difficult and fearsome but I think I have done a fairly good job in controlling its psychological impact on me. Going to work this week has helped me a lot in diverting my attention and sharing good laughter with my colleagues at work has helped me feel the comfort of living a normal life despite of these chemo side effects that have been creeping inside me from time to time. I have to thank my sister for helping me in getting rid of my hair totally and for encouraging me to face this fear of seeing myself bald at the mirror and eventually be comfortable in wearing my naked head.
Moving forward, I have finally met my Medical Oncologist Dr. Gerardo Cornelio in the Outpatient Oncology Section of St. Luke’s Medical Center Global City. A medical oncologist specializes in treating cancer with chemotherapy or other medications. He has explained to me that my next treatment will be the R-CHOP Regimen. This another concuction will help lymphoma with a B-cell origin significantly with the addition of the monoclonical antibody Rituximab. He said that I can possibly have fever and chills during chemotherapy because of the Rituximab but he has also decreased the dosage of CHOP. Lastly, I will undergo a series of tests such as PET-CT Scan, 2DEcho/ECG, CBC, BUN, Creatinine, LDH, Uric Acid, Na, K, ALT, AST before my second chemotherapy.
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Medical Junta
Yesterday, I received a call from Dr. Efren Domingo’s clinic asking me to see him today. Quite confusing though – what could have happened since I last saw him a day ago as I didn’t even have a pending laboratory results anyway? So I proceeded to see him and became his first patient on a Saturday morning.
Dr. Domingo told me that he conducted a ‘medical junta’ after my consultation last Thursday. In the medical junta, he gathered 4 oncologists in different specialization to discuss my disease. Because of its rarity in nature, he called a Medical Oncologist, a Surgical Oncologist, a Hematologist-Oncologist, and an Immunologist-Oncologist. Their conclusion was to put me first under active surveillance of a Medical Oncologist. A Medical Oncologist specializes in treating cancer with chemotherapy. The purpose of putting me under active surveillance was to see whether the condition progresses which would enable us to know what kind of threat my disease poses and they could make a better decision how urgently the treatment would be needed. I would learn more about my treatments on Friday as I was scheduled to meet my Medical Oncologist. For now, Dr. Domingo said that the important thing was that I’m tumor free (from surgery) and I had the initial CHOP treatment for my Lymphoma. He will continue to monitor me as my Gynecologic Oncologist with Dra. Manalo as my Infertility OB.
To close the medical junta, they needed to inform the patient to avoid confusions. He said there were times the patient was needed to participate in the junta. I guess more heads are better than one so this was really no big deal to me. Being closely monitored by specialists and having it documented were good news as well.
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Post Chemo Check Up
Today, I’m on my Day 12 post chemo. I have started to feel the side effects the past days, with Day 6 and Day 7 being the most dreadful. It has not been consistent though. At one point, back pains are digging my back to bed but I’m alright the next day. I always wake up in the middle of the night because of frequent urination and there are discomfort from my pelvic and abdominal area from time to time. My OB Oncologist Dr. Efren Domingo said that these are normal side effects from the treatment – specifically from the Prednisone steroids and Adriamycin (the red chemical) – and there’s no indication yet for him to lower the dosage.
A simple cyst from my left ovary. Dra. Manalo said that it’s better for us to be extra paranoid this time. We’ve both seen how aggressive these cysts could grow with my Diffuse Large B-cell Lymphoma.
My meds are also down to five from fifteen tablets a day. I am done with the steroids and anti-sickness drugs and all that are left are the multi vitamins, iron, and the oral contraceptives. My platelets have also dropped almost half of the count from my initial complete blood count but Dr. Domingo has given me the assurance that everything is fine. I’m also a bit anxious because my OB Infertility Dra. Eileen Manalo, has seen a simple cyst from my left ovary last week. I guess it’s better for us to be extra paranoid this time because we’ve both seen how aggressive these cysts can grow with my diffuse large B-cell lymphoma. But Dr. Efren Domingo has given me the assurance that these are just normal follicles from my left ovary. I guess that interpretation from the eyes of an OB Oncologist can pacify me enough. He has also said that the oral contraceptive is putting my left ovary and uterus to sleep so the pain and discomfort from my pelvic area are all coming from my chemo treatment. It has been my first time to get an ultrasound from a male doctor and I should say that it’s not too awkward after all. He’s in fact more careful and gentle not to mention a more ‘high-tech’ ultrasound – his transducer probe is just connected and powered by a Macbook and the images will just be sent directly to my email. I am impressed.
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My Teal Life 