Week 9 to Week 16 - Account of Chemotherapy given for Multiple Myeloma

Week 9

10th October, 2012

Ninth 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 10^th and 11^th October 2012, respectively.

Deeply troubled by all the stomach related problems Mummy was facing in those days and weeks, on 10^th October 2012, we again visited GI-3 at Hospital No.4 to discuss mom’s issues and he advised her to take Ganoton or Cintapro when faced with acidity/gas problem.

Week 10

17th October, 2012

Tenth 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 17^th and 18^th October 2012, respectively.

Stomach/Abdominal pain related issues continued to trouble Mom.

Week 11

24th October, 2012

Eleventh 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 24^th and 25^th October 2012, respectively.

This time around, post the medication, Mummy complained of severe Pain in lower right back and right hips. We got an MRI Screening of Mummy’s Spine and X-Rays of the Back done on the advice of Orthopedic Doctor O-1 at Hospital No. 4. All reports categorically and thankfully stated that, “no obvious pathology detected”, and on 25 October 2012, O-1, prescribed my mom to take a 7-day course of Ultracet tablet, twice daily course. This course of medication helped and mummy’s pain in the backs and hips, subsided.

Week 12

1st November, 2012

Twelfth 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 1^st and 2^nd November 2012, respectively.

Week 13

8th November, 2012

Thirteenth 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 8^th and 9^th November 2012, respectively.

Abdominal pain continued to bother Mom as it has done every week since this Velcade-Dexamethasone treatment began. Week 12 and Week 13 were no different.

Week 14

15th November, 2012

Fourteenth 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 15^th and 16^th November 2012, respectively.

Mummy contracted Severe Gastrointestinal Infection (GI) on 21^st November 2012, she spent that night vomiting and passing loose stools. I relied on two tablets, named Imodium and Domstal that were written about in the Discharge Summary of Hospital No. 3 where she was admitted in July 2012 to provide her immediate relief on the middle of that night. On 22^nd November 2012, I took Mom to Hospital No. 4 to get her examined by GI-3, whom we trusted. GI-3 put Mom on a 5-day antibiotic course containing the following medicines, I read about all of them on the internet as I was by now, habituated into doing:

o   ORNI-O: BD i.e. Twice daily

o   VSL3: OD i.e. Once daily

o   Colimax: BD i.e. Twice daily

o   Rablet D: BD i.e. Twice daily

o   Imodium: SOS i.e. as required during emergency

Week 15

26th November, 2012

We delayed the 15^th Dose of 2mg Velcade by 3 days till Mummy’s gastrointestinal infection post the 14^th dose intake had subsided and she was comfortable enough.

Fifteenth 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 26^th and 27^th November 2012, respectively.

The 5-day Antibiotic course for Severe GI Infection was repeated by us in the week post 15th dose on GI-3’s advice

To combat her throat infection, she was also put on a twice daily course of Allegra 120mg tablets for 3 days, on the advice of H-2

Week 16

3rd December 2012

Sixteenth and the final 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 3^rd and 4^th December 2012, respectively. Mom and me breathed a sigh of relief and went to the Cafeteria downstairs for our Tea and snacks, it was a customary practice for us both after our weekly ordeal at H-2’s private OPD Clinic at Hospital No. 3; that evening was special for us both, we thought and celebrated as if our bad and tough days were now behind us.

H-2 had asked us to get Mom’s Free Light Chain Assay and Beta2 Microglobulin Tests done again and we did give the samples the next day for testing.

The Chemotherapy Treatment for Multiple Myeloma begins

I tried finding another Hematologist to take Mummy to and zeroed in on another Hematologist at another Hospital. I took Mummy to him and we both found him better than the previous one and the best part was there were no recliners etc., and the medicine dose would be administered at his Private OPD Clinic at Hospital No. 4 by him itself.

Velcade® (Bortezomib), developed by Millennium Pharmaceuticals, Inc., is considered a medical breakthrough. It is the first myeloma treatment approved by the US Food and Drug Administration (FDA) in 2003.

At Hospital No.4, the Hematologist, henceforth named H-2 decided to put my mother on Velcade® -Dexamethasone Treatment for the next 16 weeks, in which once a week through IV (Intravenous route), he will administer 2mg Velcade and then split over two days, Day 1 being the day he administers Velcade and Day 2 being the following day, a 40 mg dose of Dexamethasone (name of the medicine salt) has to be given to her orally, which meant 20mg of Dexamethasone tablets each on Day 1 and Day 2, i.e. 5 tablets of 4mg Decdak tablets-the name of the brand we purchased. 

H-2 gave us contact details of a Pharma dealer who will home deliver Velcade injections to us in an ice pack, we agreed and called that Dealer. It was later I understood that all Doctors receive a commission every time they refer a patient to a Diagnostic Laboratory or Pharma Dealer/Agent.

Measuring the blood level of beta-2 microglobulin, a special protein found in myeloma, provides a useful indicator of the likely course of your disease (prognosis). High levels of beta-2 microglobulin indicate the presence of a large amount of myeloma cells, and / or the presence of kidney damage.

Whereas, Hematologist H-1 at Hospital No.3 had told me that he will put Mummy on Velcade-Dexamethasone and Thalidomide, abbreviated as VDT Treatment. When I asked H-2 about his reasons for excluding Thalidomide from Mummy’s treatment chart, H-2 said that, “Thalidomide is a useless drug, it makes patient feel sleepy all the time and constipated and what not, and that is the reason I don’t put my patients on it”. Point taken by me, I didn’t discuss or deliberate on it further. H-2 also asked me to get Mummy’s beta-2 microglobulin tests done, which we did. 

For the next 16 weeks, every week we visited the Private OPD clinic of H-2 at Hospital No.4, the scenes outside his clinic were the same every time, weak and fragile looking patients seated with anxious caretakers carrying in their hands a bundle of medical reports, all eagerly awaiting their turn! It couldn’t have been more depressing.

Mummy and I faced it, trying to encourage each other and smiling when we could for all that was good.