2017-03-23 Recovery Day 17

Yesterday I started my post with trying to figure out what days did my road to recovery start, after some some checking, I concluded it must have been the 6 March. I was correct, Dianne check her calendar and notes and came up with the same date. Not that it is important, but It would be nice to know when this is all over and looking back, when was what.

Before providing a summary of today, let me outline my chemo regiment:

  • Carfilzomib via infusion pump
    • Carfilzomib (marketed under the trade name Kyprolis) is an anti-cancer drug acting as a selective proteasome inhibitor. Chemically, it is a tetrapeptide epoxyketone and an analog of epoxomicin. The FDA approved it on 20 July 2012 for use in patients with multiple myeloma.
  • Dexamethasone – 10 pills once a week
    • As an anti-inflammatory medication. Dexamethasone relieves inflammation in various parts of the body. It is used specifically to decrease swelling (edema), associated with tumors of the spine and brain, and to treat eye inflammation. … To treat nausea and vomiting associated with some chemotherapy drugs.
  • Revlimid – 1 pill daily for 21 days, 7 days off
    • Lenalidomide (trade name Revlimid) is a derivative of thalidomide introduced in 2004. It was initially intended as a treatment for multiple myeloma, for which thalidomide is an accepted therapeutic treatment. Lenalidomide has significantly improved overall survival in myeloma. It costs $163,381 per year for the average patient.

Now to my summary, the day did start with a big bang, right at midnight my pain level shoot through the roof. My guess is that it this is due me starting my Revlimid the evening before (day 16). What complicated the problem to get the pain under control was yesterday’s decision to move from Intravenous (IV) medication delivery to By Mouth (BM). The result being I could only get the pill version of Dilaudid every 2 hours, which was not enough to lower the pain.

Things got better around 7:00 when my doctor found out about my problem and agreed to a special dose of Dilaudid intravenously, good for the next 6 hours.

The goal still is to get all my IV medication replaced with BM versions, except for Carfilzomib, so that I can go home. To achieve that goal the day was mostly about pain management, specially finding the correct baseline, keeping nausea, constipation and blood pressure in check.

We will know soon if today’s preparation got us on the right track.