Meeting with Dr. Patel

Here is a list of potential side effects from cisplatin (alternatively, cis-diamminedichloroplatinum), the chemotherapy drug I am on, edited from Wikipedia:

• Nephrotoxicity (kidney damage) is a major concern. The dose is reduced when the patient's creatinine clearance (a measure of renal function) is reduced. Adequate hydration and diuresis is used to prevent renal damage...Nephrotoxicity is a dose-limiting side effect.
• Neurotoxicity (nerve damage) can be anticipated by performing nerve conduction studies before and after treatment.
• Nausea and vomiting: cisplatin is one of the most emetogenic chemotherapy agents, but this symptom is managed with prophylactic antiemetics in combination with corticosteroids. 
• Ototoxicity (hearing loss): unfortunately there is at present no effective treatment to prevent this side effect, which may be severe.  
• Electrolyte disturbance: Cisplatin can cause hypomagnesaemia [magnesium], hypokalaemia [potassium] and hypocalcaemia [calcium]. 
• Myelotoxicity: This agent can also cause profound bone marrow suppression.

As you can see, it isn't necessarily associated with hair loss, as Dr. Patel told us today. That was a  surprise, showing again how cancers are different, chemos are different, treatments are different. We got some fairly good news from Dr. Patel. (Here's a picture of him by the way, which does not do justice to how cute and excellent and communicative he is!) He said my immune function is not seriously low.

My magnesium & calcium counts are high, and my kidney function is very good, and I haven't had any of the other side effects from the chemo except nausea. My blood counts (white blood cells etc) have gone down a lot but are still within healthy range. I think I said somewhere that my dosage of the chemotherapy drug is low - he said today that it isn't low. It's the maximum dosage for when it's combined with radiation. (When it's not combined, it's a higher dosage given less often.)

He also gave me a prescription for vicodin, which is delightful. I forgot to say about the HDR treatment that they (necessarily) punctured my bladder. Also, after the treatment is over, especially if the tumor is eliminated, I may end up with a tumor-sized hole inside me. Hopefully, it will heal on its own, but could take several months. These ideas don't bother me nearly as much as they did the first time I heard them.

Another thing we talked about is the post-treatment timeline. I guess I had this idea that on date x, I would know what my situation is. But it doesn't seem to work like that. After a month I get a CT scan, after 3 months I get a PET scan. Then there will be a lot more info...but still it all seems somewhat...provisional. It's a See What Happens kind of situation...