Cycle 3, Week 2, Day 1 Carfilizomib, Dex, Cytoxan, and Day 8/21 Revlimid 10 mg – January 9 2013

Drove to St. Luke’s Hospital in Twin Falls this morning. Left early as I anticipated icy roads through the Craters of the Moon and I was NOT disappointed.

My wbc today are LOW at 2.2 (norms 4.5-11); hemoglobin LOW at 9.6 (norms 12-15); platelets LOW at 76 (norms 140-440); and my absolute neutrophil count (ANC) LOW at 1.16 (norms 1.9-8.8). So, EVERYTHING is low today. Dr. Padavanija wants me to get my blood values checked Friday, 11 Jan 2013 at Lost Rivers Medical Center in Arco. She is anticipating that my values will be too low next Wednesday, 16 Jan 2013 to receive the carfilzomib and cytoxan – so, it might be held. I will still drive to Twin Falls on 16 Jan 2013 to be evaluated.

Surprisingly, I do not feel excessively tired with the hemoglobin of 9.6. I will have to be careful to wear a mask in public places and do good handwashing with an ANC of 1.16.

On a happier note, my comprehensive chem panel indicates normal kidney function with a creatinine of 0.89 (norms 0.53-1.05); BUN 10 (norms 7-17); BUN/CR Ratio 11 (norms 10-20); and GFR > 60 (norms > 60). I knew those abnormal values were from the Zolinza and once it cleared my system – I’ve been fine. My oncologists would argue that the values became normal because the percent of plasma cells in my bone marrow decreased from 60 % to 40%, so my bone marrow could do it’s job more efficiently. 

Pharmacist, Debbie had my prescription of oral Cytoxan for me.

I have to be careful to drink at least 3 liters of water daily now that I’m taking cytoxan 500 mg (that’s 10 – 50 mg tablets) by mouth weekly – all in one dose on Wednesday’s. Cytoxan or cyclophosphamide can cause cystitis of the bladder, so fluids are essential. 

Cytoxan can also cause hair loss. So far, this is only my second dose and I still have my fragile new hair. However, if I lose my hair AGAIN – I’m okay with that.

RN Melisa gave me intravenous Aloxi 0.25mg (anti-nausea) because of the Cytoxan. And, I received 20 mg Dex intravenously along with my carfilzomib (27 metered square dosage).

I worked on my blog while I waited.

I’ll be back tomorrow morning for my 2nd Day dose and then head home in a forecasted snow storm. I’ll just go slow and get home.