Hi Adis,
I'm sorry to hear about your kidney problems
, but am very happy to see that you seem very organized and knowledgeable about starting cytoxan and about what the treatment entails! 
Going to a sperm bank before you start treatment is a wise decision. Cytoxan may or may not empair your fertility and there are a lot of factors that play a role in this: age, duration of treatment, dosage used etc but since one never knows if their fertility will be affected or not going to a sperm bank ensures that you can have a family later in life whatever happens.
Re the side-effects: Yes drinking lots of fluids especially during the first 24 hours after an infusion is very important in helping flush cytoxan out of your system. There is a med called Mesna that is often given together with cytoxan (right before or right after depending on the protocol used) and that helps protect one's bladder from the possible toxic effects cytoxan may have on it. You might wish to discuss the possibility of receiving mesna with your doctors if it's not already on the "schedule" for you.
My rheumy and kidney doc always told me to drink a lot of cranberry juice between infusions and right after cytoxan too; cranberry juice being one of the things that help protect the bladder against UTIs and other nasty things. Again this might be something you could discuss with your docs as I don't know if cranberry juice would be ok with your nephritis or not.
After a cytoxan infusion you may also have some nausea, but you will get anti-nausea meds both intravenously in the hospital and in tablet form to take home. I was usually nauseous for 3-4 days each time, but I took zofran (anti-nausea med) and was ok. During those 3-4 days after an infusion I had frequent, small meals of "light" (slightly bland) food too so as not to cause further stomach upset. This varies greatly though with some people having very little or no nausea at all after infusions!
Lupus nephritis is usually very responsive to meds and iv pred can help a great deal. Also cellcept is one of the most effective meds used to control lupus nephritis, with some studies showing that it can control nephritis as well as cytoxan. Calculating one's cytoxan dose is fairly easy business, it's just a matter of calculating one's body surface area (this is done using your height and weight) and just deciding what protocol will be used (high dose vs low dose and monthly infusions vs fourthnightly ones). It may be that your doctors are waiting to see whether cellcept will bring your nephritis under control (cellcept starts working about a month after you start taking it) before putting you on cytoxan...?
I haven't heard about the stronger dose protocol (the three month one), but I have been through the standard protocol with high dose cytoxan and then some and while I cannot advise you which intravenous protocol you should or shouldn't follow I will say that before you take oral cytoxan if in the end that is the med it comes down to, please discuss it in detail with your docs as oral cytoxan can be particularly toxic. Again I cannot tell you what to do about it, it's just I've been advised against oral cytoxan many times by my doctors.
Re the not being excited about this, I think it would be rather worrying if you were excited about it! No one is excited about cytoxan and I, for one reacted with a lot more apprehension (even a slight panic and mayhem!) at the idea of monthly chemo than you seem to have at the moment...!
Cytoxan though is what rheumatologists often call "the big guns" and for some people can be incredibly successful in bringing their disease activity under control...!
Do share any questions you may have about protocols and treatment options with your doctor so that together you can make an informed decision about a course of action!
Hope whichever protocol you follow helps you loads!!! :bigsmile:
Zoi
I'm sorry to hear about your kidney problems
Going to a sperm bank before you start treatment is a wise decision. Cytoxan may or may not empair your fertility and there are a lot of factors that play a role in this: age, duration of treatment, dosage used etc but since one never knows if their fertility will be affected or not going to a sperm bank ensures that you can have a family later in life whatever happens.
Re the side-effects: Yes drinking lots of fluids especially during the first 24 hours after an infusion is very important in helping flush cytoxan out of your system. There is a med called Mesna that is often given together with cytoxan (right before or right after depending on the protocol used) and that helps protect one's bladder from the possible toxic effects cytoxan may have on it. You might wish to discuss the possibility of receiving mesna with your doctors if it's not already on the "schedule" for you.
My rheumy and kidney doc always told me to drink a lot of cranberry juice between infusions and right after cytoxan too; cranberry juice being one of the things that help protect the bladder against UTIs and other nasty things. Again this might be something you could discuss with your docs as I don't know if cranberry juice would be ok with your nephritis or not.
After a cytoxan infusion you may also have some nausea, but you will get anti-nausea meds both intravenously in the hospital and in tablet form to take home. I was usually nauseous for 3-4 days each time, but I took zofran (anti-nausea med) and was ok. During those 3-4 days after an infusion I had frequent, small meals of "light" (slightly bland) food too so as not to cause further stomach upset. This varies greatly though with some people having very little or no nausea at all after infusions!
Lupus nephritis is usually very responsive to meds and iv pred can help a great deal. Also cellcept is one of the most effective meds used to control lupus nephritis, with some studies showing that it can control nephritis as well as cytoxan. Calculating one's cytoxan dose is fairly easy business, it's just a matter of calculating one's body surface area (this is done using your height and weight) and just deciding what protocol will be used (high dose vs low dose and monthly infusions vs fourthnightly ones). It may be that your doctors are waiting to see whether cellcept will bring your nephritis under control (cellcept starts working about a month after you start taking it) before putting you on cytoxan...?
I haven't heard about the stronger dose protocol (the three month one), but I have been through the standard protocol with high dose cytoxan and then some and while I cannot advise you which intravenous protocol you should or shouldn't follow I will say that before you take oral cytoxan if in the end that is the med it comes down to, please discuss it in detail with your docs as oral cytoxan can be particularly toxic. Again I cannot tell you what to do about it, it's just I've been advised against oral cytoxan many times by my doctors.
Re the not being excited about this, I think it would be rather worrying if you were excited about it! No one is excited about cytoxan and I, for one reacted with a lot more apprehension (even a slight panic and mayhem!) at the idea of monthly chemo than you seem to have at the moment...!
Cytoxan though is what rheumatologists often call "the big guns" and for some people can be incredibly successful in bringing their disease activity under control...!
Do share any questions you may have about protocols and treatment options with your doctor so that together you can make an informed decision about a course of action!
Hope whichever protocol you follow helps you loads!!! :bigsmile:
Zoi