Hi Heather,
I just completed three weeks of my RVD and now off the Revlimid (15 mg / day) for a week.
Please refer to my thread ("
K_Shash's RVD induction therapy experience"), where you had posted a comment, too, to see the details of my experience so far. I am posting this to try and specifically address the few concerns:
I have had no side effects specifically attributable to Revlimid. My oncologist advised me that the side effects should not be cumulative (I had asked him specifically).
My biggest problem has been (and today, after the 4th weekly dose of dex and the Velcade shot) the dex, which makes me jittery and my heart starts 'thumping' with the slightest physical activity within about two hours. I could only sleep on the first two nights of dex with the help of Benadryl (Thanks Tracy J).
Also, the first Velcade shot gave me a 'sunburn like' deep pink patch the next day and it was burning and itching. My oncologist told me to use the steroid cream and it helped. However, Multibilly directed me to Dan from Phoenix's post:about the
air bubble technique for subq Velcade injections. The last two weeks the patches, though they did appear, I almost had to look for them. These milder patches were not deep pink like the first one, which was almost glowing, like a sunburn, and these did not burn or itch or bother me during a hot shower. Thanks again Dan and Multibilly.
All these three weeks my stamina and ability to exercise has returned in the same pattern:
- Wednesday (20 mg dex in the morning and Velcade around 2:00 p.m.) - No push ups, squats, or more than few paces of brisk walk. Take 50 mg of Benadryl. Mike B had cautioned me about the side effects of Benadryl and I checked with my oncologist, who OK'ed it for the occasional use.
- Thursday - No strenuous exercise and can walk around 200 yards at a time at about 3.5 miles per hour.
- Friday - Half of the normal exercise (the pounding in my chest warns me immediately) and can walk about 500 yards at a brisk pace.
- Saturday evening - I haven't pushed it, but I walked about a 3 mile round trip without any adverse feeling.
By the 6th and 7th day after the dex and Velcade, I am ready to go play golf, walking and carrying a bag. However, I found out that walking 200 yards at rapid rate got to me after the 4th fairway and I had to quit after half the round. Only riding a cart for me till this induction phase is over.
I only had one bout of diarrhea and I am not sure if it was due to all the veggies that were in a noodle soup that I had a few hours prior to the diarrhea. Two prior nights of pepperoni pizza with some crushed hot red pepper and possibly a bad mushroom in the soup could be to blame, too.
As Sailor Mike wrote, and I have read the same thing: "everyone reacts differently to this RVD treatment."
I think it also depends on the dose levels. My oncologist cut down the 'standard chemo pharmacy dose' of the weekly dex from 40 mg to 20 mg, before he signed the prescriptions. Dr. Santiago in his topic "
Recently Diagnosed with Multiple Myeloma" posted that his 40 mg of dex and 25 mg of Revlimid may have caused him some sugar spike problems, too.
I will have a complete blood panel on Monday and review the progress with my oncologist on Tuesday. I hope the lower levels of Revlimid (which may have avoided any major side effects) have not slowed or compromised the effectiveness of this chemo. I will certainly post the findings on my topic next week.
My physician wife was able to discuss my treatment and the plans for future ASCT with a renowned myeloma (and lymphoma and leukemia) expert just yesterday and found that even 5 mg or 10 mg of dex can be adequate. My understanding is that this steroid is more a catalyst for Velcade and Revlimid to do their job.
One note: I am an 'addicted coffee drinker" and I have 3 or 4 12 oz. (355 ml) mugs of coffee till around noon, every day. I am going to try and quit or reduce the coffee intake, at least for the first two days after dex, and see if that reduces my jitters and the fingers tingling only on the second or third day.
I sincerely hope you can tolerate this therapy well and have a complete remission soon.
K_Shash
But I feel good and am wondering if the hammer is going to drop!
it doesn't show.
), and he does take a pill to help sleep on the days he takes it. Also, he has lowered his dex dose since cycle 1 because it was just too intense for him at the start. He was also incredibly constipated and takes Miralax, Colace and senna to move things along. 