*WARNING: Starting today, my story becomes a bit more graphic. I wish I could report that things were less awful but they weren't. This is what my cancer treatment looked like in its purest form.*
As the Ara-C (7-day chemo) continued to drip, its effects started kicking in... rapidly!
Background and a little Ara-C Science
Ara-C, also known as Cytarabine, is primarily used to treat acute leukemias and non-Hodgkin lymphomas. It was first created in 1959 at the UC Berkley, and approved by the FDA ten years later. Since that point it has been used in induction therapy of white blood cell cancers (like AML). As you may recall from biology class, cells have to duplicate their DNA in order to duplicate themselves and make more cells (does mitosis sound familiar?).
Ara-C works by interfering with this process, specifically by halting the creation of new DNA. Because my cancer cells were dividing rapidly and were going through this process of DNA creation much more than other cells in my body, Ara-C could have a large impact on the cancer cells while not destroying the rest of my body. HOWEVER, Ara-C still affected the other cells in my body.
Due to the mechanism that Ara-C used to fight my cancer cells, it had the largest effect on the other rapidly dividing cells in my body - most notably, my GI tract. Once the Ara-C started affecting my GI tract, I immediately felt the effects in the form of unimaginable nausea and vomiting.
The Morning
The morning was tough; I was really nauseous. My dad spent the entire morning next to my bed as I did nothing but dry heave bloody mucous. As you may remember, I was still taking Allopurinol to prevent Tumor Lysis Syndrome and kidney damage, or rather, I was still supposed to be taking Allopurinol. Unfortunately, Allopurinol is administered as a pill. I did try to take it- honestly; however, my failed attempt only resulted in severe gagging and more dry heaving.
Shortly thereafter, my nurse infused Benadryl through my Broviac. Although I felt absolutely awful, there was a 30 second period between when the Benadryl kicked-in and before I fell asleep that I felt borderline euphoric! Intravenous Benadryl was my new favorite thing. In the moment before I fell asleep I thought, "finally, some relief."
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| What too many cancer kids look like. Borrowed from Super Skyler. |
The Afternoon
Unfortunately, the Benadryl wore off and when I awoke I was overcome with nausea followed by more dry heaving. I couldn't move without dry heaving. My goal became to lay as still as possible. It was the beginning of a stretch of days when the lights would only be turned on for physician exams. The TV in my room had to remain at an almost inaudible volume or else it triggered more retching.
Trips to the bathroom were a nightmare. I tried to have as little extraneous movement as possible while trying to pee and return to my bed as quickly as possible; a feat that is challenging to accomplish when you're still getting used to the tubes coming out of your chest that are hooked up to a machine- a machine that has to be unplugged and follow you to the bathroom. My poor parents had the responsibility of rapidly unplugging my pump while helping me out of bed, ensuring that I didn't step on/roll over/pull out my tubes, and grabbing 'barf bucket' in the event that something went awry. They couldn't act as if they were trying to move quickly because that would inexplicably make me feel nauseous but they definitely couldn't move slowly or else the wrath of a sick, 12 year old Hilary was unleashed.
Speaking of unleashing the wrath of Hilary, the nurses came in every two hours, around the clock, to get my vital signs. It goes without saying, that the only thing keeping me from losing it was the steady stream of anti-nausea meds.
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| To give you an idea of what a pump looks like for a cancer patient. Borrowed from Team Matthew.org. |
More Antiemetics - score!
My nurses came to the rescue again, as they hooked up a bag of Zofran. Zofran is an antiemetic (anti-nausea med) used to help CINV or Chemo Induced Nausea and Vomiting. What I didn't fully comprehend at the time, was that I was getting Zofran because I was about to get another type of chemotherapy with the known side effect of nausea. After the Zofran was done infusing, I was given Daunorubicin.
Daunorubicin
Daunorubicin, like Ara-C, was first created in the 1950's. It was one of the first anticancer compounds created by isolating soil microbes, in this case the microbe was Streptomyces peucetius. Daunomycin fun fact (if that's possible): the "Dauno" comes from the name of a pre-Roman tribe that once occupied the region of Italy where the compound was created and the "rubicin" comes from the red pigment produced by the new strain of Streptomyces peucetius.
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| Yep. The stuff is actually bright red. |
More importantly, Daunorubicin works to stop cancer in much of the same way as Ara-C; although it uses a different method of altering the process, Daunorubicin also stops DNA replication, which halts the rapidly dividing cancer cells.
The Night
The night offered a small relief (only one episode of dry heaving in four hours), which was largely attributable to the wonders of antiemetics.
My goal for this blog is to raise awareness, support, and donations for ongoing cancer research. Please make a donation today to support this cause.
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