At this point, she had had two blood transfusions in order to increase her red blood cell count. It had increased from 3.8 to over 9.0. We weren’t out of the woods, however. Steph still was in the advanced stages of CLL and her WBC, or lymphocytes, were still hovering around 360,000 - 380,000.
I’m not going to get into the details regarding Fludarabine, Cytoxan, and Rituxan...so much information about their M.O. is available online and I don’t want to get too wordy or redundant. I’m sure that if you’re here, you probably know a thing or two about them already.
Steph had been through the shocking diagnosis as well as an intense bone marrow biopsy. This was yet another trial, and, we feared, the most daunting one. The color had come back to her cheeks and appetite had never decreased in voracity and she still had that great attitude. We were worried that those things would change. We had heard horrible things about chemo. She would lose her energy, her appetite...she would feel nauseous and would lose her hair. Out of the three of us sisters, everyone would agree (and I’m not saying this because we extra-love her due to her illness), that she is the most lovely, vibrant, and full of life. The thought of those traits deteriorating killed us.
They would administer the FCR through a PICC line, or Central IV, that was installed in her the day after being admitted. This would make blood draws and intravenous administrations more convenient and painless, as opposed to being stuck in the arm time and again. (I thought the PICC line installation process would be painful and scary, but she said that they gave her a local and she didn’t feel a thing after that.)
With heavy hearts, we stood by her as they administered her first round of chemo. To prepare, the nurse gave her a bunch of pills, consisting of antibiotics and other preventatives to protect her from the toxic side effects of the chemotherapy drugs. Next, she was given a steroid-based anti-nausea medication (whose name I can’t remember) intravenously.
They began with Fludarabine, which would take an hour, and nurses came in frequently to monitor her vitals. Next was Cytoxan, the one with the most fearsome side effects, also administered over the course of an hour. Last was Rituxan, administered over the course of a whopping 4 hours, with even more frequent supervision than the first two.
Her nurse provided her with graham crackers and milk to help ease her stomach in case of nausea. The nausea never came. The only event that occurred was that Steph discovered her love for graham crackers dipped in milk and totally went to town on those suckers. When Dr. B came to visit the next morning, he was flabbergasted by the fact that she didn’t experience any of the common side effects. Also, her lymph nodes and spleen had reduced in size considerably overnight. “How strange!” he blurted out in awe.
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