It is my second week on this cancer-killing drug, brand name Calquence, generic acalabrutinib, 100 milligrams taken every 12 hours. Doctors and patients often refer to it as "acala".
The first week was complicated due to a flu vaccine received the day prior to starting this medication. I have never had an adverse reaction to any vaccine, but can only speculate that the combination of the high dose given to people over the age of 65 and starting to take a BTK inhibitor might have triggered the symptoms that started on the third day. I got the flu shot on a Monday afternoon, started taking these pills on Tuesday evening, and on Thursday started to feel a little off. Something did not feel right, but it was vague...mild discomfort all over and by Friday morning it was a level of sluggishness I have never experienced as far back as I can remember. It felt overwhelming to even consider the idea of getting up! But I had to get up, and quickly, because the feeling of nausea quickly turned into an uncontainable urge to regurgitate and I barely made it to the toilet. For the rest of the day, I struggled to keep water down and even after a few sips, swallowed several minutes apart, my digestive system said, "Nope."
I called and left a message for the oncology pharmacist, reporting the symptom as instructed, and she soon returned my call and told me to pause taking acala and prescribed Zofran, an anti-nausea pill. Unfortunately, I was too weak to drive and could think of no one able to go to the pharmacy for me, and same-day delivery was not an option. I had to wait until my husband could pick up the prescription on his way home from work.
I share this as a recommendation to others who may be planning to start CLL treatment with this drug or another BTKi often prescribed as first-line treatment, Brukinsa (zanubrutinib)... if you are in need of a vaccine, get it done a week or two before starting this drug. We cannot be certain that it was the combination that triggered my flu-like symptoms, but it's awfully coincidental and probable.
Pausing a few days, taking the anti-nausea med, rehydrating and getting my body nourished restored me to my new normal and I began taking acala again the following Monday. It is Saturday as I write this and I have had no problems at all. I have been able to enjoy my morning swims and healthy foods and even some homemade treats. No nausea whatsoever.
As others who have walked this path before me have informed me, a mild headache is common, but it disappears with a cup of coffee (a little caffeine). Today the headache was barely noticeable. Seems my body is adjusting to this cancer-killing process.
Starting in November, I will be prescribed the second drug in this two-year regimen: Venclaxta (venetoclax). This will be started on a low dose and gradually increased, with weekly blood tests to monitor my body's tolerance. This drug scares me a little due to the higher risks[1] involved. I feel a bit anxious about it and do my best to stay focused on the present, to nurture a state of calmness and minimize stressors.
Speaking of calmness, I discovered this fantastic video on HBO MAX. It is categorized as a documentary, but it is unlike any documentary I have ever seen. It is magical, mesmerizing, and yes, very calming! The trailer really does not do it justice. I find myself wanting to tell everyone to watch it! Each episode is a different topic and features a different narrator. Check it out! ❤
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[1] URL: https://www.drugs.com/venetoclax.html#warnings
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