I know it's hard to keep track of the treatments I receive, how often each one is administered, etc, so here's a summary:


I have treatment 3 weeks in a row (usually on Monday) and then have one week off.


I feel pretty good the first day after treatment (Tuesday) but I feel the effects by Wednesday and chances are you won't hear from me via e-mail, phone calls or in person that day. I feel better on Thursday but still pretty tired. As an example, I went to the grocery store on a Thursday and ended up coming home without getting what I needed because my legs were tired and I felt light headed. Lesson learned.


About my meds:


Abraxane: This is given every time I have treatment. If you're familiar with chemotherapy for breast cancer, this is the "nonallergic" version of Taxol. It's unusual to get a rash from abraxane but I did, so I probably would have had a significant reaction to Taxol.


Abraxane stops cancer cells from growing and multiplying by changing something inside the cells (and other fast growing cells, like hair -- hence the side effect of hair loss).


The side affects of Abraxane are everything you think of when you hear about chemo: Fatigue, hair loss, nausea (mild for me) and it's probably responsible for my low white cell count (although the Avastin doesn't help). Side effects I've recently noticed are a change in my taste buds (water tastes tinny but I'm living with it) and my fingers and toes feel tingly once in a while. If that gets worse I have a supplement that might help.


Avastin: I receive this every other week. It's considered a bio-therapy, not a chemo therapy. It works like your own immune system but it's made in a lab to specifically attack cancer cells. It cuts off the blood supply to shrink or (if we're lucky) destroy cancer cells. I receive this specifically for my liver because although Abraxane attacks bone and breast tumors pretty well, the liver can be tricky. And it doesn't hurt to have Avastin on board for everything.


Avastin doesn't have many side effects, except for the occasional nose bleed. Some people have blood pressure problems but I'm doing fine.


Zometa: I receive this once a month, the week I don't get Avastin. It strengthens the bone and prevents more bone loss. Even though there are usually only side effects after the first administration, Dr. Kaplan ordered it to be given more slowly because I had such a severe reaction the first time(it usually take 30 minutes but I receive it over 60 minutes). It might not matter and I don't understand why it works that way but I'll stay longer for the peace of mind.


Neulasta/Neupogen: These are the shots I receive. The Neupogen is given 3x a week at home to stimulate the bone marrow to produce new white blood cells and help the weaker blood cells mature. Neulasta does the same thing but it lasts two weeks. You can't have chemo while the neulasta is working so I only get that shot once a month, before my 'break".


Overview:


Week one: Abraxane/Avastin plus 3 neupogen shots given at home during the week


Week two: Abraxane/Zomata plus 3 neupogen shots given at home during the week


Week three: Abraxane/Avastin plus one neulasta shot given in the clinic


Week four: BREAK!!!!!


I'm usually at the clinic 4-5 hours, but it really depends on how long we spend waiting. I get my blood drawn first, those results are sent to the doctor who I see next, then on to the treatment waiting room. I'm usually only in the treatment room 2 hours or so. It's the waiting that takes so long!


Hope that was helpful.