"Take one tablet, wait half an hour, take a different tablet, wait half an hour, eat breakfast." How much of that timing is essential? Is there any flexibility? Or is "half an hour" an exact time on which my life depends?
Doctors -- like other experts -- know what they mean. Often they know it so well that they forget that the patient may not also know what the doctor means.
"Allow enough time for tablet A to start working, then take tablet B." Aha! that almost makes sense! Did the doctor intend to be so clear?!
I've been trying to work out the best timing for my chemo tablets. A timing that works for me and that also allows the drugs to work... So:
I set the alarm for 4am. If it rings, Deb has instructions to poke me because I have overslept. I wake up sometime between 3am and 4am, reset the alarm (for Deb) to six, get up to swallow pills.
First pill is Kytril, swallow that quickly. My chemo tablets cause me to vomit, Kytril is anti-vomit. When DrT finally said, "Allow enough time for the Kytril to start working," it made sense: Let the Kytril sit in my stomach -- starting its anti-vomit magic -- before I swallow the next, vomit-inducing drug.
The next drug is Temozolomide. Its main function is to slow the growth of cancerous tumours. Its secondary function is to make me sick. (Its third function is to make me tired.)
How long is the Kytril effective? If I wait too long, will it have released its death grip on the contents of my stomach? If I wait more than the specified half hour between Kytril and Temo, will I vomit? The chemist suggested a *one hour* delay... I wait at least half an hour but no more than one hour.
Perhaps DrT knows how long Kytril is effective. Perhaps it is a few hours. Perhaps if she told me, I could be more relaxed in my timing. Perhaps I over-analyse.
I decide that the time between drugs will be the time it takes to finish this blog post. Somewhere between 30 and 60 minutes. That will get me back to bed before four o'clock. To get some sleep before breakfast.
Why all this 3am, 4am messing about?
After some quizzing, DrT admitted that Temo should be taken on an empty stomach. At a point "between meals" when my stomach contains very little food. And -- I guess -- I wait at least half an hour before breakfast so that -- if I do vomit after breakfast -- the Temo has had time to be absorbed.
Or does the Temo simply stop working as soon as I eat my next meal?
DrT may know the answer. If I knew the answer then I could adjust the timing to better suit myself.
Perhaps it's best to just blindly follow doctor's orders.
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There, Temo swallowed. fyi:
I took 140mg of Temo each and every day for seven weeks, along with radiation treatment. No nausea, no vomiting.
Now I'm on five days of Temo followed by the rest of four weeks on none. First cycle was 300mg of Temo, double the previous daily dose. Then up to 400mg each day of the five-day cycle. This is definitely enough to make me sick! The Kytril prevents me from being sick. Though there is a lingering feeling of... tension... uncertainty... in my stomach. Nothing serious.
Kytril takes a grip on the food in my stomach, so I do not vomit. The grip is so tight... that I get constipated. Morning & evening I take Macrovic to counter constipation. The allowed dose of Macrovic is one to eight sachets (it's a powder, to be dissolved in water) each day. It seems to work... I started on four sachets a day, now I'm reducing to two. (It works very effectively.)
Three of five days into this Temo cycle and the balance seems okay. At least the Macrovic has no further side effects!
So far this week I'm feeling fine... As long as I can sleep for eight hours at night and another four hours during the day.
So far, so good :-)
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While on the topic of Macrovic... it does have a side-effect. A *positive* side-effect!
In my previous life -- pre-cancer -- my drug-taking was limited to a couple of headache tablets every three or four years. Now I am a regular druggie. And I have been having chafing -- or the feeling of chafing -- in my bum.
It *feels* like chafing. The same feeling that I would get after a long and sweaty run. To be countered with Vaseline before the run. Due to its location, I can't see it. And no, I have not asked Deb to see if my bum is red and raw and chafing. I just rub on Vaseline.
This new "chafing" started with my chemo treatment. It comes and goes. Usually after (trying to be polite) after "number twos". Of which there are plenty, as I fight to balance the constipation.
This week has been the usual toilet regime, as the Temo tries to constipate and the Macrovic fights back. And yet... there is no feeling of "chafing"!
Not that I'm complaining! I'm just wondering... Did the Temo manufacturers add chili to earlier batches of the drug? Does the Macrovic include Vaseline? Am I too bum focussed?
Well, constipation and diarrhea are what I have. No pain, no other suffering, no sudden fits of psychotic insanity (as far as I know).
I take what I have. And blog it.
Dr Nick Lethbridge / Consulting Dexitroboper
... Agamedes Consulting / Problems ? Solved
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"You're only young once but you can stay immature forever" … per Ginger Meggs
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As you should
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