So, last cycle, I thought I had worried myself into chest pains. Turns out that may not be true. This cycle I was calm, and things were going well, until the late afternoon of Day 2, where more chest pains arrived. I called the oncologist, and back to the ER. They weren't as bad as last time, and stopped on the way to the hospital. The ER doc said my EKG was mostly normal, but the EKG from two weeks earlier still had him concerned. He doesn't understand why the cardiologist didn't do a heart catheter two weeks ago. So, I spend the night in the hospital for observation, and met with a different cardiologist in the morning, who said he agreed based on the EKG from two weeks ealier, I should have a catheter, so I went down to the cath lab, and got that procedure. I will say that was an interesting experience, with very minimal pain and very low invasive. It was kinda like getting a big IV in my wrist (they almost never do this in the groin any more, as was standard a few years earlier), and taking a lot of images. Took all of about 20 minutes once the procedure started. Result: Again, all clear. The techs were giving me high fives as I rolled out of the procedure room.
My oncologist is doing two things
- Switching from FOLFOX protocol to CAPOX. Essentially I'm switching from 5FU 46 hour IV pump, to CAPecitabine pills for 14 days. It's essentially the same medicine, just trickled in more slowly, and taken in pill form. The hope is it will be better tolerated from a chest pain perspective. The CAPOX cycle is 3 weeks instead of two. Pills for 14 days, then 7 days off. I still get the OXaliplatin infusion on day 1, so I'm still sitting at the hospital for half day with IVs, but I at least don't leave with that stupid pump hooked into my chest.
- She's sending me to a cardiologist who works with her frequently on the cardiac side effects of these drugs. It turns out these drugs can have these kinds of issues with a small percentage of patients. I'm seeing that guy on May 11. The obvious question is: Is this chest pain just an annoying side effect, or is this damaging my heart? Are there things I can be doing prophylactically, to avoid this in upcoming cycles.
Other Side Effects
I have to admit, other than then chest pain/ER trips/cardiology tests, the first two cycles have been well tolerated. Details below:
- Cold sensitivity - This cycle was more intense, and lasted longer. As I write this on Day 10 of the cycle, I'm still having very minimal cold sensitivity symptoms. Last cycle it was all gone by day 5.
- Gastrointestinal Symptoms - No nausea, no vomiting, but my appetite went away around day 3-4, and recovered slowly day 5. One 3 hour episode of diarrhea, that's it.
- Fatigue/Malaise - I would say similar to last cycle, I definitely lost energy, and took until day 6 or 7 to get mostly recoverd. As I sit here on Day 10, I'm back to normal for sure.
Next week is a visit to the cardiologist for more questions and investigation on Monday, then Tuesday, starting cycle 3. Here's hoping for no ER visits, and a well tolerated cycle. The CAPecitabine can have some different side effects (more diarrhea, rash/blistering on hands/feet), but hopefully that can go well.
Fingers crossed.
Want even more details? Check my daily chemo symptom log in the sidebar.