Cycle 3, Day 1 (Chemo)

Teresa started her third chemo cycle on Tuesday, November 21. 

Day 1 is always a short day (give or take, if things start on time), so we only took snacks with us.

It wasn’t a short day.

We got started right on time, and went back to the office visit much faster than usual. This time we met with FNP Kelley Mayden (she’s awesome) instead of T’s oncologist.

We got a lot of good questions answered (ex: her tumor is not estrogen or progesterone receptive so she shouldn’t need any aromatase inhibitors (AI) for it). 

T told her that the iron supplement made her a little nauseated, so we were told that now that they could tell T’s insurance that T had “tried and failed” with the supplement, she should be able to get approved for IV iron. They could probably set that up for either same-day or the following Tuesday, depending on how T’s bloodwork came back.

It wasn’t good. When T was severely anemic, pre-surgery, her hemoglobin was 7.7. Tuesday it was 7.2.  We were sent to the ER that night in August for an emergency blood transfusion, where they gave her 1 unit.

After chemo, which they rushed through as fast as possible, given that the drip times can’t be changed, we went down to BRMC’s infusion center, so Teresa could have a full blood transfusion instead of just IV iron.

She received 2 units. It took about 3 1/2 hours.

We’d been planning to return to Roanoke on Tuesday, but everything ran so late, we waited until Wednesday so we wouldn’t get caught in rush hour traffic. 

Her hematocrit was also very low. And her RBC was low. However, most of the numbers on her metabolic panel were good. 

We’ll find out with next week’s bloodwork if she needs another transfusion or if she can just have IV iron.

Her nurse on Tuesday told us that anemia is one of the most common and long-term effects of chemo. It kills off RBC and WBC. She receives the neulasta shot to stimulate WBC, which is working well. 

Besides transfusions, we don’t know yet what they’ll do to keep her RBC, hemoglobin, etc, levels up where they should be. 

Her next CT scan will be December 5, and hopefully we’ll get the results from that ASAP. This is the scan which will tell us how well the chemo regimen is working. We’re thinking good thoughts for the very best result possible!

So, schedule:
Cycle 3, Day 8 (chemo) will fall on 11/28.

CT scan, 12/5

Cycle 4, Day 1 (chemo) – 12/12*
Cycle 4, Day 8 (chemo) – 12/19
Week off – 12/26 – 1/2 (So, hopefully, no holiday travel!)

* Assuming the CT results do not change anything.

Also, if you all remember from several posts ago, we were told that the Neulasta generally bills at (before insurance) $16,000. That was apparently a low estimate. Or maybe it’s for the shot and not the OnPro body injector. Either way, the Neulasta she gets bills at $21,634.00. For ONE injection. And that doesn’t count the actual device. That’s another $148.

Docetaxel comes in at just under $7500. Gemcitabine at $2021. That doesn’t include the cost of administering them. 

IV Zantac costs a lot more than the pill form! Sodium Chloride solution is pretty pricey too, given how many they’ve used so far. 

And that’s just for October’s treatments. 

Still waiting on the “your part owed” bill, which hasn’t show up in our Wellmont app or in the mail yet.

All this aside, Teresa is feeling good enough to cook our Thanksgiving dinner (with breaks, of course!). 🙂

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