Week 1 to Week 4 - Account of Chemotherapy given for Multiple Myeloma

Each week presented with itself a set of challenges, and for ease of convenience of you all reading this little booklet of mine, I will share the happenings of each week, with details of side effects of medication and the remedies sought and explored in a paragraph-wise manner per week.

Week 1

14th August 2012

First Velcade injection (Dose 2mg) administered through the Vein on Mummy’s hand using a 5ml syringe and post diluting dose with sterile water and a Scalp Vein Set. 

It was our responsibility to get the Velcade Injection in an Ice-Pack, the 5ml Syringe, Sterile Water and the Scalp Vein Set every time we come for the administration of Velcade. H-2 charged us a flat rate of Rs.1000/- in cash for each of the next 16 weeks, whenever we came to him for Velcade administration. H-2 administered the dose in his clinic itself with mummy seated on his right on a patient chair. As he pushed the dose in, he was interacting with other patients seated in front of him or instructing his Attendant to check the reports of the patient. H-2 was a busy man, never waiting a second of his to see patients and make money in the process. His demeanor was ‘straight’, never a smile crossed his terse-looking face. I stood behind Mom, comforting her while holding the lab reports and the bag in which we used to get them. I asked questions I needed to off H-2, he didn’t like me for the questions I asked, I was fearful of his strict personality, but I still battled my fears and asked. This pattern repeated itself week after week, for the next 16 weeks and I have written the key pointers below.

The same day, keeping in mind my Mother’s other blood parameters, H-2 also advised Mummy to take the following medicines regularly:

o   Vitamin B-Complex: multivitamin

o   Orofer: These were Iron supplement tablets to help with Haemoglobin production

o   Storvas: This was to help regulate Blood cholesterol levels, which at that time were on the higher side for Mummy

o   Eltroxin: This was to help Mom with her Hypothyroidism, whose tablets she was already taking for a few years now

o   Pan-D: This was to be taken first thing in the morning as this tablet helps with digestion related issues

o   Zyloric: This tablet was to bring down her abnormally high Uric acid levels

o Acyclovir 400 mg: This was a retroviral drug which Mummy was put on at a precautionary level so as to avoid a disease called “Shingles”, which is a side effect of Velcade intake.

Dexamethasone Intake at Home: 20mg Dexamethasone tablets taken later in the day on 14^th August 2012, orally with water by gulping down 5 tablets of 4mg each of this salt. It was a pain for Mom to open and take 5 tablets, no matter how small and tiny they were.15^th August 2012, at the same time as the day before, Mummy took the next dose of 20mg Dexamethasone

Side effects: A day or 2 days after taking the above-mentioned course of Dexamethasone, Mummy experiences pain in stomach and reports blood in stools.

Note: Every week, a day before visiting H-2 for the next dose of Velcade, we were getting Mummy’s CBC LFT and KFT done. This was being done to monitor her Blood parameters and functionality of Kidney and Liver. 

Week 2

21^st August 2012

Second Velcade injection (Dose 2mg) administered through the Vein on Mummy’s hand using a 5ml syringe and a Scalp Vein Set, same as in Week 1.And much like Week 1, Mummy took 20mg of Dexamethasone tablets on 21st and 22 August 2012, respectively and experienced the same side effects, to which H2 curtly said “live with it”.

Week 3

28th August 2012

Third Velcade injection (Dose 2mg) administered through the Vein on Mummy’s hand using a 5ml syringe and a Scalp Vein Set. And much like Week 1 and Week 2, Mummy took 20mg of Dexamethasone tablets on 28^th and 29^th August 2012, respectively and experienced the same side effects of abdominal pain and blood in stools.

Contrary to H-2 asking us to live with the side effects of Velcade and Dexamethasone, we decided to seek out a solution on our own and decided to find a Gastroenterologist. We decided to visit the OPD clinic of a Gastroenterologist (henceforth named GI-3) in Hospital No. 4 to help seek a cure for the Abdominal Pain that was bothering Mummy no end.

o   Mummy was advised by GI-3 to use Mesacol Suppository for 1 month to heal solitary rectal ulcer detected in Sigmoidoscopy done on 28 July 2012 at Hospital No. 3

o   On the advice of GI-3, we deposited the Rectal Biopsy* slides for review by his Team. (*Rectal biopsy was performed on 27th July 2012 at Hospital No. 3 by GI-1 and whose reports had said that Mummy had Rectal Tuberculosis (Rectal TB) and GI-2 at Hospital No.3 had put my mom on those big and ugly AKT4 Tablets that she was taking every morning since 7^th August 2012

Week 4

5th September 2012

Fourth Velcade injection (Dose 2mg) administered through the Vein on Mummy’s hand using a 5ml syringe and a Scalp Vein Set followed by Dexamethasone 20mg tablets on 5^th and 6^th September 2012, respectively.

Mummy’s abdominal pain worsens

At GI-3’s OPD Clinic on 7^th September 2012: The Doctor asked Mom to begin a 5 day Norflox 400 mg (BD i.e. twice daily) course over the next 5 days to combat stomach pain bothering her soon after taking Dexamethasone tablets as I have mentioned in previous weeks of treatment.

At GI-3’s OPD Clinic on 9^th September 2012, we heard some good news after a long time:

o   Post review of the Rectal Biopsy slides submitted last week, the Doctor/GI-3 said that their review rules out Mummy having Rectal TB and thus, with much relief, Mummy was told to stop taking those AKT4 tablets. What a relief it was!

o   The take-home lesson here is that “Please do get your Biopsy slides reviewed by more hospitals and doctors wherever possible”

o   To help Mom with her abdominal pain, GI-3 also advised that Mummy starts taking Colimax (BD i.e. twice daily) over the next 5 days.