First Cycle I was admitted on Monday for pre-chemo preps.

They said the drugs they'll be giving me will have some toxicity effects such as pulmonary fibrosis and renal failure, the first two days as in-patient was spent waiting for the completion of Lung Function Test and 24 hour Creatinine clearance. Upon completion of the investigations, Dr.yong said that Bleomycin, one of the drugs have not arrived yet. To complete dosage, I need to be infused with 7 pines of different kinds of drugs and fluids, for 10 hours continuous per day, for three days. Since it was already Wednesday, he decided to allow discharge first, because on weekends, he is unavailable to do the chemo even if the drug arrived tomorrow. He is the only person authorized to do it. So I was to be re-admitted on Monday for the chemo. Admitted again the next Monday for chemo. Drug arrived in the evening, so they decided to start the chemo drugs the next morning. Umi slept in the hospital surau. She was anxious of my first response to the chemo drugs. Who would know right? I was so far the first patient in gynae oncology ward in Ampang, undergoing this BEP regime. A rare case indeed, though throughout Dr.Yong's practice in Malaysia, he met several. First day of chemo. First step was hydration. I was infused with a pine of Normal Saline + 1g KCL and a pine of Dextrose saline + Magnesium Sulphate, each pine for one hour. The reason is because they want to compensate the expected loss of these ions due to the administration of the next drugs. Next in line are three drugs administered in boluses. They are Furosemide (Lasix), dexamethasone, and ganisetron. Can you guess what they are for? Furosemide protects my kidneys by acting as a diuretic and avoids the harmful chemo drug, Etoposide that is nephrotoxic from being trapped in my kidneys and cause harm. For the other two drugs, they are powerful anti-emetics, avoiding me from experiencing hyperemesis ( extreme vomitting) due to the effect of Cisplatin, one of the most emetogenic platinum-based chemo drug that is going enter my body later. Hm, I was not feeling anything weird, except that when Dr.Yong was giving that bolus of dexamethasone, I felt a prickly feeling at certain areas. Same feeling was felt from the second time. It must have been some reaction to the dexamethasone. Next step is the infusion of Etoposide, the first chemo drug. It is mixed with a pine of _____ and infused for two hours. Then it is followed by ____ ml of Mannitol for ____, another diuretic, to enhance the protection of my kidneys. Next was infusion of Cisplatin. This particular drug is infused by mixing it with one pine of _____ and administered within four hours. Finally, they end the day with hydration. (Infused with a pine of Normal Saline + 1g KCL and a pine of Dextrose saline + Magnesium Sulphate, each pine for one hour) However, The IM bleomycin is given on the first day and every other Tuesday. The injection that I once dreaded because of some internet article saying that it is a very

painful injection, turns out to be not that painful. Almost painless, haha. It was just a mild discomfort that I can tolerate. Dr.Yong said, he added some Lignocaine to minimize the pain. Alhamdulillah. Second day, some feeling of nausea developed. But tolerable still.