Mary Jo Update #17 - Derby Week: Chemo Cocktails and "Peeing In The Hat"

We were at the hospital at 7:30am this morning for Mary Jo's first day of chemo before her stem cell transplant on Monday, May 6th. This is called the conditioning phase. We also got the results of Respiratory Viral Panel Test and the PET Scan that were ran yesterday. The result of both was negative which indicates that see has none of the 20 respiratory infections known to man, and that her Mantle Cell Lymphoma is still in remission.

 The chemo cocktails for the next four days are etoposide and cytoxan. The side effects are about the same for both. Other than Cytoxan being the one that causes the loss of hair. Here's a list of the side effects:

Cytoxan Side Effects

Get emergency medical help if you have any of these signs of an allergic reaction while taking cyclophosphamide (the active ingredient contained in Cytoxan) hives; difficjult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• blood in your urine or stools, pain or burning when you urinate;
• pale skin, feeling light-headed, rapid heart rate, trouble concentrating;
• sudden chest pain or discomfort, wheezing, dry cough or hack, feeling short of breath on exertion;
• fever, chills, body aches, flu symptoms, sores in your mouth and throat;
• easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;
• extreme thirst with headache, vomiting, and weakness;
• jaundice (yellowing of the skin or eyes); or
• severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common side effects may include:

• nausea, loss of appetite, stomach pain or upset, diarrhea;
• temporary hair loss;
• a wound that will not heal;
• missed menstrual periods;
• changes in skin color; or
• changes in nails.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

Some of the side effects are controlled by giving the patient other drugs to counteract the effects of the chemo drugs. They will giving Mary Jo about 16 liters of fluids (16 bags) over the next 4 days to protect her kidneys from damage. She spent a lot of time in the bathroom today. It was kind of comical because there two other people who also began their first day of chemo today, too.

Everything going in or out for the next four days must be measured. In the stem cell clinic the nurses keep the measurements on a scoresheet. When we are in the apartment away from the clinic Mary Jo has to do the measuring by writing down the amount every time she drinks something, and writing down how much every time she pees. To accomplish the measuring part, ladies "pee into the hat". The hat could be a Derby hat if you put a brim, some ribbon, flowers and a horse or two on it. Of course, gentlemen pee into a measuring cup.

When you pump this much liquid into a person they can easily become bloated, and it throws off the body's chemistry. The levels of things like sodium and potassium can be affected. It also causes the blood pressure to rise dramatically, so they have to monitor those fluids carefully. If Mary Jo doesn't pee enough, they will give her lasix which is a diuretic which will REALLY makes her pee a lot.

Living in the apartment is great for going to and from the hospital. We just walk across the pedway shown in the picture above. The pedway crosses over 21st Ave. S. to the 5th level of the medical center's Central Garage. There are actually five different parking garages serving the medical center. I found out that those STAT Flight helicopters that I was hearing last night don't land on the parking garage roof. They actually land on the Children's Hospital roof. Here's a video. A pretty impressive helicopter for saving lives.




After the treatment Mary Jo and I walked to a CVS drug store a few blocks from the apartment for a prescription she needed. We cut across part of Vanderbilt's campus which is right next to the apartments. The campus is beautiful nearly every building has large columns in the front. They are getting ready for the commencement activities next week.

Tomorrow more cytoxan, etoposide and "peeing in the hat."



It was a pretty tiring day for My Girl.