• Nathira Salim

Reaction to Taxol

Welcome back to my blog!

About nearly 24 hours ago, I was due for my 6th chemo (2nd Paclitaxel) session at the cancer centre. As usual, I gave my blood, went out for lunch and was an hour early for the chemo. After being called in and all other formalities completed, such as confirming my name and ID number, and getting comfy in my chemo chair, and my veins prodded for the cannula, the anti allergy drug was administered followed by the saline flush. The moment the anti allergy drug was in, I was lightheaded, so I proceeded to switch my mobile and doze off.

After a while ( I was lightheaded so, I did not note the time) the nurse confirmed that she's now starting to administer the Paclitaxel (Taxol). I said ok and went back to doze. Then maybe an hour later, she replaced the first bottle and started up on the second and confirmed the same to me and after I nodded my confirmation, she left.

I think it might have been around 15-20 mins later, I felt this huge heat radiating around my neck and shoulders. I immediately opened my eyes, like they do in horror movies. I couldn't breathe as well. My lower back was in excruciating pain. I realised in my own mind, I am getting the well known allergy reaction.

The remote control to call for the nurses was just next to me, I have the nurses walking around in front of me as well. None of them had their eyes on me, so I pressed the red button. But somehow, the beeper didn't go through. I had to press it thrice and harder when the beeper went off and then the nurses looked at me. I think I must have looked one kind, for all three of them ran over to me. I whispered as loud as I could - "I can't breathe".

I pause here for a moment.

This is actually an allergic reaction against the paclitaxel. The detailed allergic reaction can be seen here. I have read about this and I was prepared for this. But then, what happened was that the moment my chest tightened, I closed my eyes real tight and I was in darkness for a brief few seconds taking stock of my body. I know my back was hurting and my neck and shoulders were getting hotter. But when my chest was tightening, I noticed I couldn't breathe well. I was grasping for air. And like a stupid dumb dumb, I panicked. I was in a room full of nurses and doctors, and I panicked. "Oh my God! Am I dying today?" was my first thought when I opened my eyes and I started crying. Like flood wall of tears was coming right out of me. I couldn't control it and honestly speaking I felt better crying than holding it all inside of me.

So - back to the story. The nurses saw me and my crying state of mess, and immediately did a few things at once.

  1. They closed the curtains around me.

  2. They stopped the chemo.

  3. They called out " REACTION! REACTION" as loud as they could for the whole room to hear.

  4. The doctor on duty at the room ran over to me and took note of my vitals on the monitor and my physical state of mess

  5. The main nurse calmed me down and asked in detail what was wrong.

  6. I was given oxygen immediately.

  7. My ECG was taken to figure out if my heart was ok - in the next few minutes.

  8. The doctor on duty called my chemo doctor and explained the situation.

  9. My chemo doc sent one of her team docs to check on me and was on the scene like 15 mins later.

By then, and I mean when number 1 to 7 was all done, the main nurse calmed me down, patted my back and told me not to worry and wiped my tears away. Then she explained that I was having an allergic reaction and this happens to people. Usually it might happen like after a few sessions later or on the first session itself. I am having it on my 2nd session, and she told me not to worry. She offered me warm water to calm me down, and I was like already clearly embarrassed that I cried, I declined saying I bought my own bottled water.

When number 8 happened, I was calm and steady.

Actually before the Reaction, my oxygen reading was at 100% - I can see that cos that damn monitor was on my left, When I was grasping for air - the oxygen reading was at 70%. When the main nurse asked the other nurses for my baseline pressure reading, they didn't know on the spot. But according to the doctor on duty, it all looked normal. The chemo docs's sub came around and asked me a few questions and I repeated the same thing. These two docs went on discussing about this.

I was able to overhear the conversation the doctor on duty had with a couple of nurses and my chemo doc before she came over. He reported ( the doctor on duty I mean) that my readings on the monitor - the blood pressure, the heart beat and the oxygen were all normal. There was no anomaly at all - but he could see that the patient (me) was clearly distressed. And that after the oxygen was given and the chemo halted, she (me) was ok again.

I have 11 more cycles of paclitaxel and its all weekly session. I am already distressed on my 2nd session. So the doctors were concerned about it. My chemo duration was set for 2 hours. I think they have a maths formula for pumping the drug in me like 600mg in 2 hours at a particular rate. So the chemo sub doctor came over and explained the new workaround. She said she will administer more anti allergic drug, and start on the chemo again - but this time, the dose will be lower and longer, meaning, I will have to be there for the next 3 hours and it was already 4.45pm. I said ok. They wanted to see if this might work.

So they started with the anti allergic drug, I became light headed and rested my eyes, and soon after they confirmed they started the chemo. I nodded my confirmation. This time, I was ready. I was in darkness, focused on monitoring any slight changes coming in. 20 mins later it came. The heat started radiating around my neck again. I waited a while to see if it goes, but it didn't. This time I was able to breath, no back pain, no other effects, I opened my eyes and called for the nurse and told her. My neck's burning.

This time, both the doctors, and the main nurse stopped my chemo and gave me more anti allergic drug and let me rest while they discussed on the next action plan.

Then the chemo sub doc came over and explained that she will discuss this with my actual chemo doc on what to do next. Maybe they will see if I need to be on a longer duration instead of 2 hours and again if it does not work, change my treatment plan. I will know about this when I meet the doctor next she said. And she left.

My main nurse came over and also explained, She said since its already late ( 5.30pm), she will let me rest since I just had 3rd dose of the anti allergic drug. She asked me to come back three days later and at eight am to start on the chemo drug. This time it will be 4-5 hours and I may need to be in bed or something, I didn't catch that actually. But she said lets try again this time with very low dose going in me. And let's hope it works.

I am not sure what happens if this doesn't work then.

As I was looking over the internet for more help, it's noted from this site that patients with weekly Paclitaxel treatment were 27% more likely to be alive and free from breast cancer 5 years after diagnosis compared to those who received standard taxol treatment of three weekly.

So if I am going to keep having allergic reactions and am thrown out from the treatment, will I die before my son's O level? What a bummer.

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