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| Nivestim, the culprit that gave me cold sweats, stomach cramps, diarrhoea! |
Here are my experiences with Taxotere (Docetaxel):
Cycle 4 – 23rd September 2016
My morning blood counts were
fine, and thus, the next chemotherapy session proceeded as scheduled. The
pre-medications were given, with the addition of chlorphenamine injection (Piriton)
which made me quite groggy. Piriton injection was given together with
dexamethasone to mitigate any allergy reaction towards docetaxel (Taxotere®)
if any. I was really hoping that Taxotere is going to be better than FEC,
because we are talking about single agent infusion as compared with 3 cytotoxic
drugs at one go!
I requested for Emend even though
my oncologist said I don’t need it! Well, I told him I already felt nauseous before I went for the blood test! Hence, I wasn’t sure if I would be able to
cope with Taxotere without Emend! He relented and said ok! I am totally aware
that this is not right, but at this point of time, I will do anything for not
getting sick! Anything….
Taxotere infusion went well
without any untoward incidents (touch wood!). I was feeling absolutely normal
for the first 3 days and even went for a walk at the Botanicals Garden on Day
3! My energy level was normal and I thought “hmm….taxotere really gonna be a
breeze!” Certainly not wanting to believe what I have read earlier about this
super drug! Luck was not on my side though...my energy
level decreases steadily from Day 4 and remained low until Day 9.
As taxotere will be tough on the white blood cells, 3 Nivestim injections on Day 4, 5 and 6 has to be administered. A kind
senior onconurse taught me how to administer the ready to use syringe on Day 4
at the day ward. It was uneventful but stomach ache and cramps crept in later in the evening which got worse in the next few days.
Day 5 was the worst day I have experienced
so far! Right after I injected Nivestim myself at home, I grew weak, had excessive cold
sweat and lose consciousness for a short while, all within 5 minutes! I was pretty sure I injected the substance into the subcutaneous tissues and not in the peritoneal cavity! gosh!
Like the cartoon character flattened down to a
paper-thin state rolled over by a truck….I have to stay in bed most of the
time since that self-administered injection, feeling really thin and weak like a kitten! Surprisingly, despite all that, my appetite remained the same!
I texted my oncologist about my
condition rather “immediately” wanting to know if I will be in trouble. Luckily there was nothing to worry about and he told me to drop by the clinic the next
day. I literally have to be on the wheelchair as I was too weak to walk to the
clinic! Finally, after waiting for 3 hours, the doctor said, “I think you are
allergic to Nivestim, I guess you don’t need to take the 3rd jab
today, but you have to come over next week so that we can monitor your blood
counts.” For no apparent reason, I turned bright-eyed and bushy-tailed; I stood
up with my wobbly legs and walked down the floors without assistance! Good riddance!
Muscle soreness at
the spine and neck area came in on Day 4 and lasted for a few days, not
too bad as analgesics were not required. I have long suspected that my pain
threshold may be abnormal!
The stomach cramps, dear me, came
in waves, followed a typical pattern, reaching a peak of agony, eases off and
the cycle continued until you pooped! Ok, we are dealing with loose stools here
and this lasted until Day 10! Imodium 3 times a day seemed to control the
cramps, but toilet visits maintained at least twice or thrice a day!
Red spots or petechia were
observed on both of my hands on Day 3. I noticed my face were flushing red on
the same day which lasted for 2-3 days.
Some hairs started to drop by Day
15, slight discoloration on the toe nails were noticed and eyes were slightly
dry and I have to use eye drops occasionally. Skin looked a bit patchy on
certain days but resolved somehow. No mouth sores or ulcers.
The most important change I noted
was that my fasting blood glucose readings went up to 6.5- 7 mmol/L on certain
days. I understood that hyperglycaemia and
glucose intolerance is a known side effect of taxotere, and whether this is transient
or going to affect me permanently, there is still lack of data to conclude
anything at the moment. Anyway, I tried to reduce intake of rice, wheat and
high carb food to manage this side effect.
Some days I felt numbness on my
hands and feet, especially at night, so I took neurobion (Vit B1, B6 and B12)
tablet occasionally, which kind of helped.
Cycle 5 – 14th October 2016
My white cell count was about 5.0
X 103/μL which was surprisingly good despite missing the 3rd
jab last cycle! So, the next Taxotere infusion was given as scheduled. Nothing untoward
happened, luckily. I was feeling normal and even went to a Japanese restaurant for
dinner that night! I knew that was a false sense of security!
This cycle no filgrastim
injection was given. I felt fine throughout the first 3 days, and as expected,
on Day 4, I somehow woke up with muscle and neck sore, but still manageable
without analgesics. Energy went down slightly but I was fine and totally
functional! No stomach ache, no cramps and no sick days! Tiredness was there
but you feel fine after taking a nap. So, now we know which the devil is!
I went for my 1st
blood test after a week (Day 8) and the white cell count was down to 2.0 X 103/μL.
The doctor prescribed a strong antibiotic (Ciprobay) for a week, although I
thought it was unnecessary (I meant….the count was not critical…). As the doc
said, “Better safe than sorry!” I was feeling normal and energetic even though
the counts were low….
Surprisingly, I developed a
delayed “extravasation” (according to the doctor and to my horror!) at the
injection site. Itchiness and tiny blisters appearing on the skin but got slightly
better after I applied a steroid cream. I was later prescribed with Reparil Gel,
which supposedly works best, according to my doc!
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| Redness and blisters appeared a few days after Taxotere injection |
On Day 15 the white cell count turned
out to be 1.9 X 103/μL! That was totally unexpected; the count didn’t
increase a bit! Well, the truth is, taxotere’s nadir period is definitely between
Day 8 to 14 in my case! Sadly, the doc will have to postpone my next cycle if
the blood count did not improve within a week…..
Meanwhile, I have to increase my
protein intake and whatever I could get hold of…..
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