My Adventures in Gemcitabine Induction Therapy: Week 1
Last updated: May 2023
Tomorrow I begin 6 weeks of intravesical chemotherapy induction with gemcitabine. I am feeling less anxious than I did two weeks ago. After all, I have been too busy planning for the blessed event.
Preparing for the gemcitabine induction therapy
First, I waited for the telehealth follow-up with my urologist. I was delighted to tell her that my bladder was healing nicely without a catheter in place. The post-surgery irritation and hematuria had cleared up and I felt no pain or spasms.
"Let's get you scheduled for gemcitabine induction into the bladder in two weeks," the doctor said. And once I had confirmed all six treatment dates, I knew it was official.
The second challenge was getting to UW Urology at Seattle Cancer Care Alliance. Minus gridlock, I live 45 minutes away. However, I haven't made that drive for years because interstate traffic is a nightmare.
The last thing I need is to attempt it when I don't feel well. But these days rides to medical appointments have become necessary. My insurance provider only offers such a program to Medicare members. And rideshares are too expensive. So, as of tonight, I am still working on securing transportation.
On my way to the first treatment
Meanwhile, I decided to drive my (2001 Nissan Altima) jalopy to the first appointment today. I picked up a friend who agreed to ride along and we headed north on I-5 from Tacoma.
GPS estimated a 52-minute trip to UW Urology at Seattle Cancer Care Alliance. But that ETA changed when a fatal accident slowed traffic to a crawl. Our trip was delayed by more than an hour, so I missed my 8:00 check-in.
My friend helped me call to alert clinic staff that I'd be about 20 minutes late. But we were further delayed by two more road hazards, including shoes strewn across the highway.
Eventually, I could no longer hold my bladder and took the nearest exit to find a restroom. Unfortunately, south Seattle business owners had no compassion for my urinary issue. One offered a "sorry, out of order sign" on the door. But thank God for disposable underwear. They saved the day... And my pants.
"You made it!" said the receptionist
We arrived an hour past check-in and a few minutes past my appointment time. I checked in while my friend parked the car. Surprisingly enough, I had plenty of fluid to spare for a urine sample.
Then after waiting for half an hour, I was told that the gemcitabine was still en route from another location. It would take at least another hour before delivery.
"We could have swung by and picked it up on our way," my friend joked. I agree. We laughed because one more diversion would have been par for the course.
We have chemo... Can you hold it?
I was finally ushered in for my 9:00 treatment at 10:30.
Right away, I was given the option to leave once the chemo was instilled. However, I chose to stay in case something went wrong. I also chose to lie on the bed rather than walk around.
About 15 minutes in, a good amount of the chemo leaked from the catheter plug. A hanging drainage bag with tubing was attached to slow the outflow from my bladder. It seemed to work until a bit more chemo leaked out in the last 5 minutes.
Finally, the nurse tried draining the chemo through the catheter tube, but nothing came out. She removed the catheter, thinking the bladder was empty. But the rest of the chemo gushed out while she was giving me after-treatment instructions. Needless to say, we each had much cleaning up to do when all was done.
Gemcitabine induction therapy: Is that how it's supposed to go?
In the aftermath of my first induction treatment, I am not quite sure whether it went well or not. I was late. My bladder spilled over. The chemo arrived late. I failed to hold it in.
With all the glitches, I wonder if it was the nurse's first time, too. But I am glad I remained in the clinic where I could be monitored throughout the process.
The good news is that, so far, it has been painless. I am feeling no bladder irritation at the end of the day. However, the nurse shared that some patients' symptoms increase with each treatment. I sincerely hope that isn't the case with my future adventures in induction therapy. Here's to progress!
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