It really is a full-time job keeping track of the medicines you need to take at home, especially in the three days after chemo but also beyond.
I have even more medicines to take after this latest session than I’ve had previously. Blame the cough and the cold and the red eyes I’ve had.
So on Day 1 after chemo (we’re now on Day 3), I wake up and the first thing I do is take domperidone to guard against nausea and vomiting. This should be taken 20-30 minutes before food. So I’ve got to remember to actually have some food 20-30 minutes later. Then with or after food, I take dexamethasone, the steroid, also against nausea and vomiting. At some point, with or without food, I also need to take azithromycin, an antibiotic, to guard against chest infection.
While I’m at it, I need to get the antibiotic (chloramphenicol) drops from the fridge to prevent any bacterial eye infection from developing. If I ask him nicely, my husband will get them for me and will bring them upstairs with the banana that constitutes the food for the dexamethasone. I must have asked him particularly nicely this morning as he arranged everything into a nice smiley face on the pillow while I was in the loo. A bit like the chocolates they leave for you in posh hotels.
I take domperidone three times a day on Days 1, 2 & 3 or longer if needed (one tablet per dose); I take dexamethasone twice a day, also on Days 1, 2 & 3 (two tablets per dose and the second dose needs to be taken not too late in the day or I don’t get to sleep that night); azithromycin I need to take once a day for the next two weeks (one tablet per dose); and the chloramphenicol drops I’ll take four times a day for the next week.
Also on Day 1, there’s the all-important lipegfilgrastim injection that stimulates your bone marrow to boost white blood cell production*. That has to be kept in the fridge and taken out an hour before I inject it, and I need to inject it 24 hours after the previous day’s chemo session ended.
Even with the very helpful checklist the hospital pharmacist has prepared for you, you still have to be on the ball.
On top of all that, I use an anti-dry mouth mouthwash at least four times a day every day. And finally, there are the nail drops that are meant to stop your nails getting brittle (too late, I fear) and breaking that I’ve to massage into my finger and toe nails 2-3 times a day, every day.
I think that’s it.
By the way, I’m feeling well today. That is a very good thing as in a fit of madness we have allowed our older son, who’ll be 17 on Monday (how did that happen?), to have a party in the house tonight. I will report back in due course.
*Today’s biology lesson… Chemotherapy can make the bone marrow temporarily less efficient at producing all blood cells including neutrophils. Neutrophils are the most common type of white blood cells and they play an important role in helping the body fight off infection. If your neutrophil count falls below the normal range, as a result of chemo, for example, you have neutropenia. When you are neutropenic, you are much more likely to develop an infection and that infection can make you much more unwell than it would normally. That’s where the injection comes in, stimulating the bone marrow to boost white blood cell – and so neutrophil – production. For the numbers geeks among you, an average-size adult has a blood volume of around 4.5 – 5.5 litres and the normal range or count for neutrophils is 2.5 – 7.5 billion per litre of blood. Now how many of you knew that?