A bit of detail about the Chemo

I thought I'd add a bit of detail about the chemotherapy itself from my experience. This is a bit more of a nuts and bolts post. You may want to skip it. I'll post a general day-to-day update later.

The drug combination I'm having is, as I mentioned before called ABVD, which are the initials of the 4 drugs. You can find out more by clicking the links:

ABVD : Cancer Research UK

A – Adriamycin (now called doxorubicin)
B – Bleomycin
V – Vinblastine
D – Dacarbazine

I get to sit in a quite soft comfy chair during the whole time, but I can move around a bit if I want to. The stuff from the drip is hanging on a stand with wheels, so I can walk around. I could go to the toilet, after all they are putting quite a bit of liquid in - it has to come out again. But, so far, I've avoided that until after it's finished. The whole room is light and airy, there are 8 chairs for patients in the room, but not all in use at the same time. There are also some (less comfy) chairs for someone to sit with the patients. The room has some quite interesting lighting patterns on the walls, probably for soothing effects. Generally it is fairly quiet in the room.

To start off I put my hands in warm water for about 10 minutes to

try and pump up the veins. The nurse then puts a cannula into a

suitable vein in my arm. A cannula is a small plastic tube that gets put in using a needle, the needle is removed, the end of the tube can then be attached to a drip or syringe to put in drugs or take out blood.

Once the cannula is in I get hooked up to a bag of saline (salt water) which helps to dilute some of the drugs. This just flows in (as do the other drugs from the drip) by natural flow (gravity, liquid pressure ...). There is a pump that is not used for me, but I noticed that other patients do have it running, I guess if they need a large dose.

The first one in is the Vinblastine. This is put up as a bag in parallel to the saline. The nurse hangs around as this goes in in case I start to feel a stinging. This could indicate a leakage into tissues, which they need to sort out quickly. Probably takes a 10 minutes to complete.

Next up I get Bleomycin. This is given via a syringe. This is a bit worrying really, as you expect the speed to be not limited like a normal syringe which has a narrow needle tip, but has a wider open tube. You get the feeling the nurse can force it in too fast. But, so far, it has been okay, they go slowly, and it is probably fairly restricted anyway.

Then it's Doxorubicin. This is also put in by syringe. This one is red in colour. For the first time going to the toilet after having this it comes out a bit red. But nothing to worry about.

The last one is the Dacarbazine. It is also put in via a drip. It needs to be handled carefully as it reacts to light so there is a opaque cover over the drip bag and a coloured tube that it flows down to the cannula. It will also make me senstive to the sun so I need to keep covered up and creamed up. It can be very irritating to the veins so they put it in very slowly with a big dilution of saline. This probably takes about an hour to go in.

Generally the feeling of the drugs going in is a cooling of my arm because mainly because the liquid is at room temperature instead of body temperature for the blood. It is particularly true for the Dacarbazine, maybe because it takes so long. The effect is alleviated somewhat by putting a heat blanket over my arm. But overall the adminstration is not painful.

Once the last drugs have gone in there is a short time of flushing through with saline. Then the real painful bit - taking off the plasters holding the cannula. Removing the tube itself is not painful. Of course all this is replaced by a plaster that I will have to remove myself a few hours later. Once this is done I'm free to go, there's no real check on how I am, but I suppose the nurses would keep an eye out for me fainting or something like that.