Friday, July 16, 2010

Intron A "Interferon Alpha-2b"

After the surgery and treatment in Singapore, now, I am receiving the treatment of Intron A and self-injection for 11 month. The side-effects is making me weak and hair loss. I am exhausted (physically) and have to drink plenty of fluid.

I need to regularly seeing my Oncologist (once every two weeks and blood test done prior to appointment). I had no choice and no alternative for other medication and the only treatment for my malignant melanoma is Intron A (Immunotheraphy).



Intron A® (interferon alfa-2b)

Generic name: Interferon alfa
Other trade name: Roferon-A® (interferon alfa-2a)
Other names: Alpha interferon, IFN-alpha

Intron A and Roferon-A are trade names for Interferon alfa. IFN-alpha and Alpha interferon are other names for Interferon alfa. In some cases, health care professionals may use the trade names Intron A and Roferon-A or other names IFN-alpha and Alpha interferon when referring to the generic drug name Interferon alfa.

Drug type: Intron A is a "biologic response modifier." Intron A is classified as a "cytokine." (For more detail, see "How this drug works" section below).

What Intron A is used for:

  • Approved for use in hairy cell leukemia, malignant melanoma, AIDS-related Kaposi's sarcoma, follicular non-Hodgkin's lymphoma.
  • Other uses: Chronic myelogenous leukemia (CML), renal cell cancer, cervical cancer, carcinoid syndrome, medullary thyroid cancer, multiple myeloma, basal and squamous cell skin cancers, low-grade non-Hodgkin's lymphoma, cutaneous T-cell lymphoma (mycosis fungoides).
  • Blood disorders such as: polycythemia vera, essential thrombocytopenia, thrombocytopenia purpura.

Note: If a drug has been approved for one use, physicians sometimes elect to use this same drug for other problems if they believe it might be helpful.

How Intron A is given:

  • By injection under the skin (subcutaneous, SubQ)
  • By injection through a vein (intravenously, by IV)
  • By injection into a muscle (intramuscular, IM)
  • There is no pill form of interferon alfa
  • Due to differences in dosage, you should not change brands of interferons. Discuss with your doctor or health care professional if there is a problem with supply.
  • The amount of interferon alfa you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer you have. Your doctor will determine your dosage and schedule.

Side effects of Intron A:
Important things to remember about the side effects of Intron A:

  • Most people do not experience all of the side effects listed
  • Side effects are often predictable in terms of their onset and duration
  • Side effects are almost always reversible and will go away after treatment is complete
  • There are many options to help minimize or prevent side effects
  • There is no relationship between the presence or severity of side effects and the effectiveness of the medication.
  • The side effects of interferon alpha and their severity depend on how much of the drug is given. In other words, high doses may produce more severe side effects.

The following side effects are common (occurring in more than 30%) for patients taking Intron A:

  • Early: (occurring after the first few doses)
    • Flu-like syndrome: Fever, chills, generalized aches and pains, headache, poor appetite. (Over time the intensity of these symptoms decreases depending on the dose, how it is given, and the schedule of administration).
  • Later: (occurring beyond one week of therapy)
    • Fatigue
    • Low blood counts. Your white and red blood cells and platelets may temporarily decrease. This can put you at increased risk for infection, anemia and/or bleeding. Decreases are dose dependent.

Nadir: Meaning low point, nadir is the point in time between chemotherapy cycles in which you experience low blood counts.

Onset: 7-10 days
Nadir: 14 days, may be delayed 20-40 days in hairy cell leukemia
Recovery: 21 days

  • Temporary blood test abnormalities: low calcium, high glucose, or high triglyceride levels.
  • Increases in blood tests measuring liver function. These return to normal once treatment is discontinued (see liver problems).
  • Weight loss
  • Hair loss

These are less common side effects (occurring in 10-29%) for patients receiving Intron A:

  • Early: (occurring after the first few doses)
    • Nausea and vomiting (usually mild).
    • Diarrhea (can be severe depending on dosage).
    • Low blood pressure (see blood pressure changes).
  • Later: (occurring beyond one week of therapy)
    • Injection site reaction (redness, pain at site of injection)
    • Cough
    • Depression
    • Dry mouth
    • Skin rash (see skin reactions)
    • Dizziness, vertigo
    • Abdominal pain
    • Irritability (see anxiety)
    • Numbness or tingling of hands or feet
    • Sweating (see skin reactions)
    • Pain
    • Malaise (see flu-like symptoms)
    • Taste changes (metallic taste)
    • Constipation
    • Sore throat (see mouth sores)
    • Insomnia (see sleep disturbances)
    • Itching
    • Confusion, excessive sleepiness, memory loss - may occur at higher doses (see central neurotoxicity).
    • High blood pressure (see blood pressure changes)
    • Swelling of feet and ankles (edema)
    • Dry skin (see skin reactions)
    • Anxiety

Not all side effects are listed above, some that are rare (occurring in less than 10% of patients) are not listed here. However, you should always inform your health care provider if you experience any unusual symptoms.

When to contact your doctor or health care provider:

Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:

  • Shortness of breath, chest pain, rapid heart beat
  • Depressed or have any thoughts of hurting yourself or others

The following symptoms require medical attention, but are not emergency situations. Contact your health care provider within 24 hours of noticing any of the following:

  • Diarrhea (more than 4 to 6 episodes in a 24-hour period)
  • Nausea that interferes with eating and is not relieved by prescribed medications
  • Vomiting (more than 4 to 5 episodes within a 24-hour period)
  • Unusual bleeding or bruising
  • Black or tarry stools, or blood in your stools or urine
  • Extreme fatigue (unable to perform self-care activities)
  • Persistent fever (fever lasting/occurring beyond expected timeframe for dose and schedule).
  • Anxiety, changes in thinking or mood, confusion, difficulty concentrating or trouble sleeping.
  • Swelling of the feet or ankles, sudden weight gain

Always inform your health care provider if you experience any unusual symptoms.

Precautions:

  • Before starting interferon alpha treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.). Do not take aspirin, products containing aspirin unless your doctor specifically permits this.
  • Do not receive any kind of immunization or vaccination without your doctor's approval while taking interferon alpha.
  • Due to differences in dosage, you should not change brands of interferons. Discuss with your doctor or health care professional if there is a problem with supply.
  • Interferon alfa may cause patients to develop mood or behavioral problems. Make sure to tell your doctor if you are being treated for a mental illness or had treatment in the past for any mental illness, including depression and suicidal behavior. You should also tell your doctor if you have ever been addicted to drugs or alcohol.
  • Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category C (use in pregnancy only when benefit to the mother outweighs risk to the fetus).
  • For both men and women: Do not conceive a child (get pregnant) while taking interferon alfa. Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
  • Do not breast feed while taking this medication.

Self-care tips:

  • Drink at least two to three quarts of fluid every 24 hours (unless you are instructed otherwise), to keep yourself well hydrated throughout therapy.
  • Wash your hands often.
  • You may be at risk of infection so try to avoid crowds or people with colds or not feeling well, and report fever or any other signs of infection immediately to your health care provider.
  • For flu-like symptoms, keep warm with blankets and drink plenty of liquids. There are medications that can help reduce the discomfort caused by chills.
  • Acetaminophen or ibuprophen may help relieve discomfort from fever, headache and/or generalized aches and pains. However, be sure to talk with your doctor before taking it.
  • To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.
  • Avoid sun exposure. Wear SPF 15 (or higher) sunblock and protective clothing.
  • In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.
  • You may experience drowsiness or dizziness; avoid driving or engaging in tasks that require alertness until your response to this drug is known.
  • Conserve energy, try to get plenty of rest.
  • Maintain good nutrition.
  • If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

Monitoring and testing:

  • You will be checked regularly by your healthcare professional while you are taking interferon alfa, to monitor side effects and check your response to therapy. Periodic blood work to monitor your complete blood count (CBC) as well as the function of other organs (such as your kidneys and liver) will also be ordered by your doctor.
  • Your thyroid gland may also be affected by this medication. Your healthcare professional may order a blood test periodically to assess your thyroid function.

How Intron A works:
Interferon alfa belongs to the category of therapies called biologic response modifiers (BRM), also called immunotherapy. This is a type of treatment that mobilizes the body's immune system to fight cancer. The therapy mainly consists of stimulating the immune system to help it do its job more effectively.

Interferon alfa is part of a family of proteins called cytokines. Cytokines act primarily by communicating between the various cells of the body's immune system.

Interferon alfa interacts with receptors on the surface of cells. There are several ways that interferon alfa fights cancer; directly by interfering with the cancer cells ability to divide, and indirectly by modifying the bodies response to the cancer cells.

http://www.chemocare.com/bio/intron_a.asp

Tuesday, July 13, 2010

Teratak Anna Abadi

Dulu, saya memang peminat Anna Abadi dan sering mengikuti blog beliau ketika dia masih hidup. Design graphic blog dia best sangat... di sertakan dengan musik background yang lembut. Tetapi Tuhan lebih mengasihi dia dan dia telah di panggil dan kembali kepada-Nya pada waktu umur dia berumur 29 tahun (26 Dec 2006).

Di atas permintaan beliau sendiri:

Pesanan anna…tutuplah hompej anna. ..tutuplah blog anna…tutuplah Teratak dan segala-gala perkara yg melibatkan anna di internet. Buanglah semua gambar-gambar anna yg tersimpan di chamber rahsia yg hanya diketahui teman-teman rapat. Buanglah puisi-puisi anna kerana anna tidak mahu kawan-kawan anna bersedih dgn apa yg anna tinggal. Hilangkan semua jejak anna di alam maya yang tidak bertepi ini. Mereka tahu password anna. Password anna hanya satu utk semua perkara. Anna tidak pernah mengubahnya sejak pertama kali anna mengenali apa itu password di alam maya. Password itu tetap sama dan ada makna tersendiri. Mereka adalah kawan-kawan anna yang anna percayai dan anna tahu mereka tidak akan mengecewakan permintaan anna.

Anna tidak mahu website anna tergantung-gantung di maya selepas ketiadaan anna. Anna telah banyak melihat website dan blog yang ditinggalkan sepi oleh pemiliknya yang sudah kembali kepada Tuhannya. Dan tahun ini saja sudah ada 2 teman blog anna yg deceased. Salah satunya blog teman blogger anna, misznana yg telah kembali ke rahmatullah. Blognya tergantung begitu saja tanpa ada sesiapa menutupnya.

http://sukns.blogspot.com/2009/03/teratak-anna-abadi.html

Saturday, July 10, 2010

My Workplace

Recently, the Outpatient Psychiatry Services in RIPAS Hospital had been moved to new place. That is the place where I work. I like the environment here, although quite busy and stressful sometimes, but I do enjoy my work so much. This place is still inside the compound of RIPAS Hospital but next to the Specialist Clinic Building.

Working in the new environment is quite different and tiring but I know this is only temporary and the period of transition... from old system to a new system. The doctors do not have their own room here... we are lacking of rooms for the doctor to sit and consult the patient. For the Outpatient services, there are only 4 rooms for the doctors (including the room of our HOD).

This is the outside environment where I work and spend most of my time...

Sunday, July 4, 2010

Hidup rajawali

Kehidupan

Kadang.. hidup ini sangat unik... Tapi Penulis hidupku sudah menulis dan mengarangkan semua ini... aku tak bisa lari dari semua ini. Aku cuma bisa menjalani aja...

Dulu ada orang berkata kepadaku begini: ... "kalau lapar, makan... kalau sakit, berubat..." hidup cuma simple dan ga se-complicated.... Tapi aku sendiri merasakan.. hidup bukan cuma itu saja... Tapi orang itu juga telah pergi dari hidupku buat selamanya... Mungkin hidupnya cuma sesimple itu makanya dia katakan kepadaku.

Suatu saat dulu... aku tidak pernah menghargai orang yang ada di sekelilingku... sehinggalah mereka menghilang dan pergi dari hidupku satu demi satu. Ternyata hidup ini tidak ada yang kekal... semuanya sementara... Kesihatan, kekayaan, kecantikan, percintaan... semuanya bersifat sementara...

Sudah lama aku tidak mengarang dan menulis... Dulu, aku sering menulis dan mengarang tapi kerana kesibukan, aku hampir melupakan hobiku ini. Semenjak aku mendapat Penyakit Kanker ganas ini, aku semakin menghargai hidup ini dan membuatku banyak berfikir. Aku tidak pernah kalah dengan penyakit kanker ini... walaupun aku sudah di operasi 3 kali sejak dulu dan sekarang masih lagi sibuk berubat.. Kerana dari awal lagi, aku udah tau kehidupan ini tidak akan selamanya.

Dulu, ada seseorang yang sangat menyakitkan dan mengecewakan hatiku.. tapi aku sangat berterima kasih kepadanya kerana membuatku sedar kerana dalam kehidupan ini, kita tidak boleh menyandarkan kepada manusia... Manusia bisa berubah-rubah. Dan kata cinta semuanya adalah dusta. Aku cuma berharap dan berdoa kepada Tuhan agar Dia tidak membalas apa yang telah dia lakukan kepadaku...

Aku ingin seperti rajawali.. semakin badai menerpa ... dia terbang semakin tinggi dan tidak pernah mengenal erti berputus asa.
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