I will deal with these in reverse order.
I have had some pain in my jaw, principally the left hand side, on and off for most of my treatment. As I have probably said, it is never really a good idea to read all the side effects of the drugs that are given as it is at best depressing and at worst incredibly alarming. The bone strengthener that I am given, Zometa, has a bizarre side effect of destroying the jaw bone. Whilst enjoying my French sojourn I finally worked out why my jaw was hurting or at least what was happening. Basically my lower jaw was gradually creeping forward meaning that my back teeth weren't coming together and my front teeth were coming together in a very annoying manner. Yawning was painful and I would get terrible cramping around my lower left jaw. Although, with a little bit of massaging, this alleviated the pain and my jaw kind of went back to where it should be. At my pre-assessment I mentioned all of this to the nurse and she took note. On the day of my treatment I mentioned it again and much consulting of the consultant took place. The upshot was it was unlikely to be osteonecrosis more likely an increase of calcium. It was decided not to give me Zometa this time round. I have had it every 3 weeks for about 11 rounds. Apparently, it should be given every 4 weeks, so I am well covered. Suffice it to say that even with the jaw pain my ability to talk and eat was not impaired in any way. No surprise there then! Well a week on and the pain has completely gone and my jaw is back to normal. As to whether I will continue with Zometa in the future I don't know.
My new drug, Kadcyla, has the most delightful side effect of constipation. Not only is this easier to spell than diarrhoea, it also means that for the first time in about 8 months I do not have to plan my life around where the nearest loo is. Also, I didn't realise how much of my time has been spent sitting on the loo. I have so much free time and my nights are far less disturbed. The judicious use of psyllium husks has made everything trot along nicely.
A week ago I had my first round of Kadcyla. My appointment was for 9.30am. Surprise, surprise my drugs didn't come up from the pharmacy until 11am. I have absolutely no idea what the hospital pharmacy do or how they are organised, or if they are organised. They must know what drugs are needed and when. I appreciate that most of the drugs used in the chemotherapy unit cannot be made up too far in advance as they have a very limited shelf life, but what is the point of having a 9.30am appointment if nothing happens for and hour and a half! The nurse decided once it had arrived that perhaps, given half of what I was about to be given is Herceptin, to which I am allergic, I should be given my usual premeds of Piriton and hydrocortisone, which he could have given me in the intervening 90 minutes. The first dose has to be given over 90 minutes and then I have to sit for an hour or so to see if anything interesting happens. Well nothing interesting happened so I went home.
The following few days I suffered from a slight headache which got progressively worse as the day wore on and my teeth and jaw ached as well. Both of these were easily dealt with by taking my preferred painkiller of co-codamol. The fatigue I had is totally different from previously as it responds well to an afternoon snooze. Overall, Kadcyla seems eminently do-able. I can only hope that the chemicals are doing their stuff and killing the cancer cells.
