Pink for the decision against DOMA

Settling into the routine, at least for the remaining treatments (#4,5,6). I may even be able to learn how to inject myself in the subcutaneous fat, not in the muscle, which has been giving me a small rash, very itchy.
I have Connor for my nurse again this week. He's a big man who can easily get away with wearing a bright pink uniform (boys used to wear pink and girls blue a hundred years ago-even as late as 1918 it was stated in a government publication that pink was best for boys and blue, being a dainty color, best for girls). Nurses don't wear pastel colors anymore? We can hear him talking about going to the Fremont Solstice Parade to another patient.  We can hear everything so I am listening to Pandora except when I want to hear the young handsome doctor (perhaps) with the Eastern European accent.

So I have two more infusions, numbers 5 & 6, and then I get another PET scan to see if there has been progress. If not, I will have two more sessions of Rituxan and maybe get that other drug which is more like chemo in that there are side effects. My only complaint now is the red itchy spots on my tummy from the injections.

It was probably the lettuce

I'm settling into a routine with the third treatment and that's nice. Even comforting. It helped that the weather today was blustery and cool so I wasn't sitting there longing to be outside on my day off. But I had no side effects today. It appears that last week both Steve and I got food poisoning from lunch after treatment. Ha, so it wasn't the Leukine, it was the lettuce!

The routine: ouch goes the needle in my hand or wrist, in goes the Vitamin C, pop two Tylenol and in goes the Benadryl (I didn't even feel drunk from it this time), where is the Rituxan? There it is, saline first, then the monoclonal antibodies, and now I can watch the monitor to see approximately how much longer I have to sit. Today I was alarmed to see the tube turn red after the Vitamin C and the walk down the hall to see Dr Chen: I "bled out" when the bag ended and there was nothing coming in so gravity dictated that something go out. It wouldn't be a problem unless an hour passed and it hardened. You medical people probably understand it a lot better than me but a little saline solution and again it was clear. Except to me.

And two needles of Leukine to take home with me. I can't say I don't have anything planned for my Friday and Saturday nights!

I'm  doing so much better this time around: no side effects so far and I am an hour into the Rituxan. The Vitamin C has been given and I had some minor hand aches where they put the IV.
Maybe I won't even get the chills tonight. I dare to hope. (later: no chills but I did have a bout of stomach ache and diarrhea, which I thought was from the Leukine, but seems to have been food poisoning since both Steve and I felt sick after our late lunch)
I will be giving myself shots of Leukine for the next 3 days, as my insurance pays for "injection benefits".
Dr. Chen felt both of my armpits and could still feel the enlarged node in the left one. He said we might do Treanda  along with the Rituxan if the node doesn't go away or become less prominent. But Treanda usually has more side effects than Rituxan.

I see the traffic on 405 is stopped and I would almost rather be here, relaxing in my LaZ-boy lounger, than out there.

Life causes side effects

Looks like I had all of the typical side effects except for the headache. They told me that the side effects are expected to diminish as you continue the treatment. Is that like when I got my legs waxed in South America and they said it would hurt less the next time (and it didn't)? But next time they will be giving me Vitamin C intravenously (takes an hour) and will that hurt or cause side effects? And the Benadryl (a whopping 25 mg, equivalent to taking 25 pills-note: we got this wrong. It was just the same as taking a normal dose but because it goes in the veins, it effects you more than being mixed with gastric juices) caused arm pain and a feeling of drunkenness (admittedly, not unpleasant). Does anything NOT cause side effects?

Rituxan IV Side Effects

Headache, fever, chills, nausea, heartburn, flushing, weakness, or dizziness may occur. If any of these effects persist or worsen, contact your doctor or pharmacist promptly.

so far, so so

About 1 hour into the first treatment I started feeling pretty sick: sore throat, sore eyes and most of all, a bad stomach ache or acid reflux. So they stopped the Rituxan and gave me some Tums and after a half hour I felt better and was able to eat the Mongolian beef that Steve had gone out to buy for us. Now they have increased the amount they large giving me, from a cautious 25 ml per hour to 125 per hour. Halfway through! 

If you're wondering what Leukine is...

Rituxan® plus Leukine® Promising for Low-grade Lymphomas

According to results presented at the 2006 annual Chemotherapy Foundation Symposium, the treatment combination consisting of Rituxan® (rituximab) plus Leukine® (sargramostim, GM-CSF) is effective among patients with low-grade non-Hodgkin’s lymphoma, even among those whose cancer has progressed following prior therapies.

NHL is characterized by the excessive accumulation of atypical (cancerous) lymphocytes. These lymphocytes can crowd the lymph system and suppress the formation and function of other immune and blood cells. (wow, I don't think I've yet read such a clear and simple definition of NHL) NHL is categorized by the type of lymphocyte it involves and by the rate at which the cancer grows. Follicular lymphoma comprises 30% of all NHL diagnoses and is considered a low-grade or indolent lymphoma, which means that it is a slow-growing form of lymphoma.

Rituxan is a targeted therapy that binds to specific components of B-lymphocytes, the most common cancerous cells in NHL. The binding of Rituxan to the B-lymphocytes ultimately causes the destruction of the cancer cells. Rituxan is a commonly used agent in the treatment of various forms of NHL. Researchers continue to evaluate ways to improve anticancer responses to Rituxan.

Leukine is a growth factor, or cytokine, which is an agent that can stimulate the immune system to help fight or prevent infection or disease. It is commonly used among patients with leukemia who are undergoing stem cell transplantation. Leukine is also thought to have properties that improve Rituxan’s cancer-killing effects by stimulating the immune system. Side effects associated with Leukine are generally mild to moderate.

Researchers from France recently conducted a clinical trial to further evaluate Rituxan plus Leukine in the treatment of low-grade lymphomas. This trial included 46 patients, 39 of whom had follicular NHL. Forty patients had received prior therapy and experienced a relapse of their cancer.

• Anticancer responses occurred in 70% of patients with relapsed NHL with in 45% demonstrating a complete disappearance of detectable cancer.
• 100% of the six patients who had not received prior therapies experienced anticancer responses.
• The median progression-free survival for patients who had relapsed NHL was nearly 17 months.

The researchers concluded that the treatment combination consisting of Rituxan and Leukine appears to be a promising approach to the treatment of low-grade NHL, even among those with relapsed disease.
http://cancerconnect.com/

It's not chemo, but...

I will get the first treatment of Rituxan on Thursday. The first treatment (of 6-8) will take about 5 hours because they titrate the medicine to make sure the patient doesn't have allergic responses or other side effects. In the I.V. will also be Vitamin C (I think he said 25 mg.) that they find helps the Rituxan. They will also be giving me "leukine" to help with possible lowering of my WBC which is already low.

I get to pick a curtained off lounge chair or one in a big sunny room where patients do jigsaw puzzles on the table in the middle. I can use their WIFI to access the web. Right now I am watching "Scott & Bailey" about the two female detectives (BBC) and I'm starting season 2 so that is something to look forward to. Perhaps music would be more relaxing though!

I will be getting weekly treatments but they will only take an hour or two after the first week when they know how my body reacts to the medicine.

I feel lucky that Rituxan is now available since it hasn't been on the market for that long. Only three years to wait for Lybrido to go on the market (Viagra for women)!

"Rituxan is one of those drugs that has definitely proven its worth over time. Used in combination with other chemo drugs [and often times alone], it has increased the period of progression free survival (PFS), and the overall survival (OS) for those suffering from leukemia or lymphoma.
But despite being a wonder drug, and not really considered chemotherapy per se, that doesn’t mean it isn’t without its side effects and complications."

http://livingwithmcl.com/2011/03/08/rituxan-its-not-chemo-but/