Strength

The breathing tube remains in place, not that anyone is very happy about it.  Adele succeed in removing the tube yesterday so nurses made the choice to restrain her arms just enough so she was unable to pull it out again.  She has been heavily sedated with the hopes of making her more comfortable while the tube is in.  However, when she is not sleeping or heavily medicated she has been able to give her thoughts a voice with a simple pen and pad of paper. 

Adele has also developed anemia which is most likely due to the chemotherapy.  This is a very common side effect of chemotherapy.  Anemia (also known as "low blood" or "iron poor blood") is defined as a decrease in the number of red blood cells or hemoglobin, making it difficult for the blood to carry oxygen to body tissues.  Anemia is usually defined as a hemoglobin less than 13.5 grams/100 ml in men, and less than 12 grams/100 ml in women.  Adele was given some medication to help with the anemia.  Below is some additional information on symptoms and treatments of anemia.

Symptoms you may experience with anemia include:

• Fatigue
• Lack of energy
• Lightheadedness or dizziness, especially when sitting up rapidly, or standing
• Shortness of breath
• Headaches
• A pale appearance
• Rapid heart rate or palpitations
• Chest pain

Treatment of Chemotherapy Induced Anemia

Most of the time, mild anemia can be dealt with by simply altering your lifestyle a bit and waiting for your body to make more red blood cells. Insufficient rest, standing up rapidly, or drinking beverages with caffeine or alcohol can worsen your symptoms. At other times, especially if your red blood cell count is very low, or you are experiencing symptoms, your doctor may recommend treatment.
Options for treatment include:

• Transfusion –- The fastest way to increase red blood cells is with a blood transfusion. Side effects can include a fever and chills, and the small risk of having a blood transfusion reaction or contracting an infectious disease such as hepatitis.
• Iron supplements (oral or IV) -– Oral or intravenous iron might be recommended. Iron taken orally can cause stomach discomfort. Common side effects of intravenous iron are a transient feeling of flushing, a metallic taste, headaches, and joint or muscle aches a few days after treatment. Occasionally, iron injections can cause allergic reactions that can be serious.
• Medications to stimulate formation of red blood cells -– Medications are sometimes used (often along with intravenous iron) to stimulate production of red blood cells in your body. There is currently a lot of controversy about this treatment, and your oncologist will discuss the benefits and possible risks if this is recommended. These medications include Epoetin alfa (Epogen, Procrit) and
• Darbepoetin alfa (Aranesp).

 Worry does not empty tomorrow of its sorrows; it empties today of its strength.                                                      
                               Corrie Ten Boom