Monday, November 28, 2022

Breast Cancer Fight: Chemotherapy - What to Expect

In NUH, they have a patient-nurse buddy system for cancer patients. These "nurse navigators" offer practical and emotional support to cancer patients and their families. 

I met my friendly nurse navigator, Nurse Meera, on Tue 28 Nov, the same day I did the first blood test and echocardiography for my adjuvant chemotherapy and Herceptin jabs treatment plan. We talked for about an hour at the National University Cancer Institute, Singapore {NCIS}. 

Nurse Meera went into the nitty gritty of what I needed to do before, during, and after each chemotherapy cycle... as well as the possible side effects and how to manage them at home.

Basically for each cycle:

A few days before chemo session
  • see Dr Samuel
  • take a blood test to check for complete blood count, as well as kidney and liver health
Day before chemo session
  • take Dexamethasone pills at 8am and 6pm to prevent nausea and vomiting during and after chemotherapy {will be prescribed and collected after the doctor's consultation}     
Day of chemo session
  • take Dexamethasone pill at 6am
  • go for chemo session at the Chemotherapy Centre, NUH Medical Centre, Level 9 at least 30mins before scheduled appointment for vitals screening and for pharmacy to start medicine preparation for chemotherapy and Herceptin jab. Each Chemo Bay has 10 patient cubicles, and each cubicle can house 1-2 patients who receive treatment on a recliner chair. The session will take half a day, or around 4 - 5 hours, excluding 1 - 1.5hrs needed to prep the medicine, and including the extra 30mins needed for scalp cooling before and 1.5hrs after the chemo. I can eat and go to toilet during the session, and to dress warmly as it can get quite cold {blankets are available}. 
  • collect Peglasta syringe from the pharmacist {needs to be refrigerated}
  • take Dexamethasone pill at 6pm
Day after chemo session
  • take Dexamethasone pills at 8am and 6pm to prevent nausea and vomiting during and after chemotherapy 
  • inject myself with Peglasta at least 24 hours after my chemo session ended {up to 36 hours}. Peglasta helps to stimulate the body to produce white blood cells to fight off infections. Side effects include muscle aches and joint pain, swelling, difficulty breathing, fast heartbeat, spleen rupture and kidney injury.... 

I also have to take my temperature daily and if I have a fever, I should not self-medicate. Instead, I need to call Nurse Meera or the NCIS Cancerline if there's a slight fever {37.5 - 37.9°C} or go to A&E if it is 38°C and above. 

During my chemotherapy, I need to avoid raw food, half-cooked or overnight food to prevent food poisoning. No traditional medicines, vitamin supplements or herbal products, and 4 specific fruits - pomelo, pomegranate, grapefruit and starfruit. Other citrus fruits like oranges and lemons are ok. 

Milk and properly washed fresh fruits/vegetables are ok but I should avoid yogurt and cheese as well in case of diarrhea.  

Nurse Meera also debunked some myths like sugar causing cancer to grow. 

In fact, specifically for breast cancer, there is no relation between food intake and breast cancer according to research and I need not avoid sugar completely, just eat in moderation.

The "nurse navigator" system seems like a good idea as I can reach Nurse Meera anytime via text or call on weekdays, 8am - 5pm. It is personalised and direct, and I don't need to jump hoops and go through red tape to talk to a random hospital staff who may not understand my case if I need to find out something quickly regarding my chemo treatment or appointments. Nurse Meera also responds relatively quickly. 

Unfortunately outside of the office hours, I will need to go to A&E for anything urgent as Nurse Meera is unavailable and there is no 24hrs hotline for cancer patients.  

Cancerline - free counselling hotline managed by trained oncology nurses
Tel: +65 9722 0569
Open: 8.30am - 5.30pm {Mon - Fri}
Closed: Weekends and public holidays

Consultation with nurse navigator: FREE 
{probably the only time I can say a NUH medical service is free haha!!}


Follow my breast cancer fight on the blog, Facebook or Instagram {#AiFightsCancer}

Before mastectomy and breast reconstruction surgeries

After mastectomy and breast reconstruction surgeries
Surgical Drains Removal After Mastectomy and Breast Reconstruction 

Adjuvant Chemotherapy and Herceptin Injections

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