Brrrr. That was a chilling experience. I just pulled off the last cold cap for the day at 10.30pm and am currently thawing … 18 total cold caps, each starting out around -32ºC, administered continuously at 20 to 30 minute intervals over the course of 8 hours.
I spent this morning running around town taking care of last minute errands. The first stop was at at a commercial gas supplier, where I bought 100 pounds of dry ice at a 50% discount, created just for us cancer patients using cold caps (of which I’m the 3rd). Next, I picked up some extra food including popsicles to keep my mouth cold during chemo to help ward off mouth sores. Afterwards, I headed off to buy Aleve to take prior to wearing cold caps to prevent headaches. This seemed to have worked as desired.
Just before I reached the house, I stopped to select Mighty Aphrodite at the library to watch during the infusion. The movie was a bust since not only could I not hear terribly well through the cold cap, but I also couldn’t use ear or headphones because the cap was in the way. We tried watching with subtitles, but gave up when we realized we’d have to change caps soon (and then every 30 minutes). It’s just as well. A mere 5 minutes into the movie, I could already discern subtitles were sub-par in conveying Woody Allen humor.
We had first arrived at the infusion clinic at 1.45, around 30 minutes early. I took a nap in the waiting room while Earl sat next to me. In the clinic, we hurriedly cut moleskin to protect my forehead, and protected my ears and chin with more padding. Earl put the first cap on as the nurse started my IV with a 90 minute infusion of Herceptin. We watched carefully for any adverse reactions to the Herceptin. Fortunately, as those did not materialize, I should be able to breeze through subsequent Herceptin infusions in just 30 minutes. With that completed, the nurse ran a 15 minute course of Pepcid, Benadryl, and Decadron, the first to prevent stomach upset and the latter two to prevent nausea and allergic reactions to the Taxol.
By the time I started the Taxol, I had worn the cold caps for close to 2 hours. Each cap change was done as quickly as possible to prevent my scalp from warming up. The first 2 minutes of wearing each cap were intensely cold, and the remaining 18 minutes (for the 1st two caps) or 28 minutes (for all remaining caps) were comparatively comfortable because by then my scalp was numb from the cold. As each cap cooled my head, my body temperature dropped and I worked to stay warm. I was already wearing socks, sneakers, long yoga pants, a long sleeved cotton shirt, and a fleece jacket. The nurse had piled warmed cotton blankets on top of me, and I added a fleece blanket on top of that. I stayed comfortable for the most part, but did shiver for a good portion of the afternoon, thus might use an electric blanket next time.
After the Taxol was finished, Earl changed a cap at the clinic, and we raced out of the building over to our car and drove home as quickly as possible to return home before the end of the 30 minute window. Earl changed the next cap in the car on our driveway before we headed into the house to unpack the day’s gear and finish out 3.5 more hours of cold caps.
I haven’t noticed any side effects yet. Taxol can and probably will accumulate with each treatment, so although I feel fine now, I might worsen after a few treatments. Currently, my scalp feels a little overstimulated and cool to touch. The moleskin was difficult to remove and ended up pulling out a little hair and leaving adhesive residue on my forehead. Although it functioned otherwise perfectly, I might find a moleskin substitute for the next treatment. The padding at the chin and over my ears proved effective in preventing frostbite.
Yes, the first 2 minutes of each cap were uncomfortable, but I think I can handle the process. Hopefully Earl can, too. It was quite a long day of hard work for him schlepping two huge 90 pound coolers to the infusion clinic, removing solid frozen cold caps, kneading, measuring, and systematically fitting readied cold caps to my head. All the while I was crankily pestering him to do it this way, do it that way, in a manner guaranteed to make the criticized party cranky, too.
The nurse instructed me to take two medications to prevent nausea tonight and tomorrow night (Compazine) and for the next couple of mornings (Zofran). The Compazine, which I have already taken for the evening, also causes sleepiness and seems to be taking effect. I had read and heard that the Decadron/Dexamethasone steroid which I received through IV could cause sleep problems, but I predict that when I walk upstairs in a few minutes and lay my head down on a hair pampering satin encased pillow (thanks, David L!), I will submit to slumber easily.
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