The first week of intense chemotherapy involves 2 drugs in what is called the HIDAC-3 protocol . The aim of this two-pronged attack is to remove all the cancerous blood cells from your body. However, these chemo drugs cannot distinguish between the good blood cells and the bad and so both are eliminated by the chemotherapy.
In order to keep you alive until your bone marrow starts producing blood cells again, the doctors need to top up the red blood cells and the platelets . Otherwise, with limited red blood cells, you cannot transport oxygen around the body leading to hypoxic-type symptoms (think of the benefits Lance Armstrong gained from additional red blood cells). Platelets stop you from bleeding to death from things as simple as a blood-nose.
One of the major effects of the first week of chemotherapy is your neutrophil count drops to zero. Neutrophils are a subset of your total White Blood Cells and are your first line of immune defence.
After the week of Chemo you then enter what is called the neutropenic stage. This lasts until the bone marrow has produced enough neutrophils to get back in the normal range again. During the neutropenic phase you are highly susceptible to viruses, bacteria and other infectious agents. This is why isolation and hygiene during this period is so important.
During the neutropenic phase I will be getting a new drug flown in from America ( more on this later).
The medical team also start injections of G-CSF – a compound which stimulates the bone marrow to start generating blood cells. This is injected just under the skin on my stomach once a day.
The aim of the G-CSF is to kick start the blood cell production system again, hopefully the good white blood cells will out-number the nasty cancerous blasts. There is some uncertainty as to how quickly the good white blood cells will reproduce and whether they will be able to compete effectively against the cancerous ones.
During the neutropenic phase, the so called ‘chemo brain’ cuts in. I also regularly experience high body temperatures with associated hallucinations during limited periods of sleep.
The doctors aim to support you as best as possible throughout this neutropenic phase, knowing that each day will be a rollercoaster of emotions and wellbeing – with a constant risk of infection. For me, it is one day at a time, making the most of the energy and positive vibe that I receive from all my great friends and family. Stay tuned for more.
(it’s important not to take yourself too seriously, no matter how bad you’re feeling)