Why won't this cut stop bleeding?

Pace and I decided to go out to a Saturday night movie date. We haven't done that in a long time. It was a great late show, comfy seats, great sound and a BIG screen. Sometimes home theatres just don't cut it.

So as we are leaving Pace notices a cut on her hand.

"Get it covered." I said and she did.

It is still bleeding on and off for the next day. Considering her imune system is down, open cuts are not desirable.

Then I remember, about the anti-coagulant to keep the veins open, duh! Warfarin has an interesting history. The reason for the beautiful farm scene is that it originally comes from stuff called ensilage (it's an agricultural term in english too.) It has an interesting history as chemical used as an anti-coagulant in humans and as poison for rats.

Treating cancer is a real balancing act between chemicals.

Permenant Hook-Ups, Benefits and Side Effects

Pace gets to wear this non-tunneled catheter till later this summer. It helps them get the FEC Chemo into her. Fluorouracil is particularly hard on the veins, it causes the vein walls to collapse.

So if not for the permanent catheter the nurses would have to try to insert a catheter into Pace numerous times just to administer one chemo treatment. In the last round of treatment they could try with the catheter six times before they got a stable strong vein.

The catheter must be washed every day with a saline solution and an anti-coagulant so that the vein does not close up or that clots don't form causing what's known as "venous-catheter-related thrombosis."

Basically Pace gets to self administer warfarin, brand name "Coumadin", in order to keep blood clots from forming around the catheter. If clots happened and broke loose into the blood stream, she'd have a stroke, and not a TIA.

So Pace cleans the end dangling from her hand, and then injects herself with two different needles filled with either solution.

Then every Friday she goes to the doctor to get the tubing replaced. Only the white Butterfly stays.

Chemeotherapy Round Two - Meet 5FU

Here we go again. After a week off when Pace come up to town and spent time together as a couple. It was a good time to reconnect and rediscover what we both love about each other. Then back to reality.

This treatment is going to be 4 cycles of injections. One cycle every 3 weeks, rather than the weekly cycles of Abraxane. So we should finish up in July.

The oncologist originaly said Pace was going to have 4 cycles of a chemotherapy cocktail called FEC, FLUOROURACIL-EPIRUBICIN-CYCLOPHOSPHAMIDE IV, that's been changed to 5FU which is only the F of FEC. I still want to find out why, as FEC is 3 different families of drugs together, including 5FU.

It seems ironic. The drug is 5FU aka Fluorouracil (flore-our-a-cil) by Mayne Pharma is one of the oldest drugs commonly used for chemotherapy treatment of numerous cancers including breast. Abraxane is on a clinical trial and not available to the general public.

5FU is from the anti-metabolite family of drugs. Anti-metabolites are only slightly different in structure than normal body molecules. However, those differences stop cells from working properly at making and repairing DNA (this is a cool link). Cancer cells are like normal ones in the fact that they can't grow and multiply if the DNA is disabled.

Anti-metabolites masquerade as purine, a protien building block of the A and G components of DNA. As a result Fluorourine replaces purine and stops the normal development and division cells of DNA during the "S" phase of the cell cycle.

Problem is anti-metabolites also stop normal cells from working properly, this results in side effects. Here are the most common:

• Soreness of the mouth
• Difficulty swallowing
• Diarrhea
• Stomach pain
• Low white blood counts
• Low platelet counts
• Anemia
• Sensitive skin (to sun exposure)
• Excessive tear formation from the eyes

Add to that the main side effects for Pace:

• Vomiting
• Exhaustion

We're grateful there are only 4 treatments and that the Abraxane was so effective.

Good night all