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Thinking about you and hoping all is well in California!
This is Karen! Marion contacted me about your question…..and Jason’s response it pretty spot-on.
Here is what I emailed Marion:
As far as that question goes, there are many factors that go into chemo dosing.
Gemzar is generally over 30 minutes, Cisplatin anywhere from 2-3 hours rapid bolus infusion, or 6-8 hours. (Plus pre-hydration with 1-2 Liters of normal saline pre-chemo and sometimes more afterwards.) BUT, with chemotherapy the patient’s age, weight, their body surface area (BSA), their labs (hemoglobin/hematocrit, WBCs, absolute neutrophils, etc. are all part of the calculation. Also, with Cisplatin, the serum creatinine, liver and kidney functions, and urine output, come into consideration. So it is a slightly difficult question to answer without all of the information. Also, I don’t know if she is on some sort of clinical trial being that they have orders from MD Anderson. That hospital or trial may have a different protocol than another. (or the patient may have dose modifications based on the above listed criteria, or toxicity issues).
I’m curious if the chemo orders are for 6 hours total including pre-hydration, Gemzar, then Cisplatin? Maybe it’s 30 minutes of Gemzar, 2 hours Cisplatin, 1 hour hydration, I’m not sure.
What I would suggest, is to just ask the nurses that are giving the infusion. Sometimes doctors will say “you will be in the infusion room for “this” many hours”, when in reality, they are there for less time, or more. Ask the nurses how long it takes for the Gemzar and why, how long do you run the pre or post hydration and why, and how long do you infuse the Cisplatin, and why? The nurses are following the doctors orders, but we are also required to have gone through training from ONS and become Chemo/Biotherapy certified, and be tested to hang chemo per the hospital and the Oncology Nursing Society protocols.
Chemotherapy orders are also checked by two chemotherapy pharmacists prior to mixing and again when done mixing, checked by the pharmacist/chemo nurse on receipt of the drug, then checked again with two chemo nurses before hanging the drug. Many checks along the way, and if there were a mistake it will be caught.
The nurses will be able to explain their reasoning….and I’m sure there is a good explanation. I’m sorry if I am not able to give a simple answer! Hopefully this response helps a little though.
In addition, Danna, if you feel any sense of worry or concern over your infusion just let those nurses know. YOU are the one getting the chemotherapy, and YOU should feel comfortable. Ask them a million questions and they should take the time to explain everything. It is their responsibility to do so.
I wish you the best,
(All information is my educated opinion only and not to be used as medical advice. Please consult your prescribing physician).
I did find one of your old posts about tumor fever. I do see it quite often and Tylenol generally does the trick!
Thank you for your kind words too. We are all in this together, and I am glad to help out in any way.
There is also something called tumor fever.
Here is a way too detailed link, but I am fairly certain that it has been discussed on the board here at one time or another. I will look around and see if I can find the old posts for you.
Oh, and I’m sorry to bombard you with questions on your anniversary!!!
I hope that you are able to have an enjoyable night together.
My mother-in-law is another person who received a diagnosis of stage 4 CC with no predisposing factors, or comorbidities.
She was accidentally sprayed with a DDT type mosquito spray in the late 1970s though, which is what she believes caused her CC to appear 30 some years later. I wish we knew why it happened, which is I think, something that many of struggle with.June 2, 2013 at 12:23 am in reply to: Chicago – Join us for dinner (date and time to be determined) #71169
Have a wonderful time at dinner and ASCO!!!!!
I am thinking of you all today, and believing, KNOWING that Lauren is a fighter.
You are all in my prayers.
Congratulations Linda! I learned so much last year working with the RAN group. It was such an amazing program, and a wonderful group of people! Have fun at ASCO!
KarenNovember 17, 2012 at 10:30 pm in reply to: The Oncology Nursing Society Advancing Care Through Science conference #66689
Oh Lainy, no need to feel bad! I hope that you will feel better soon!November 3, 2012 at 12:31 am in reply to: Congratulations: Percy, Patient Represantative to FDA Advisory Commmit #65378
Your NCCN link is very helpful! I will be sure and use it when doing chemotherapy teaching with patients.