Deported

My port is gone, which is wonderful since I am a stomach sleeper and my port made that quite inconvenient.  Getting it taken out got a little interesting.  Readers of this blog know that interesting equals painful.   When my port was put in, I was under general anesthesia.   That means I was asleep-ish, and don’t remember anything about it.   I blacked out in one room, and awoke in another.   I imagine that a trip to Tijauna is much the same way.   When I had my port removed, however, I was under a local anesthesia.   It was in the doctor’s office, and I was awake and talking to him the whole time.   He gave me the local anesthesia by way of a syringe, and started to prep the area.   He made the first incision, and I then realized that I had not gotten enough of the local anesthesia.  Ouch.    He gave me another shot or two, and waited a few minutes for the medicine to work.   He was very apologetic.  Honestly, the shot hurt worse than the incision, but I was quite concerned for the rest of the procedure.  He pulled, sliced, twisted, and cut the port out, cauterized a vein, and sewed me up.  I celebrated by having a Mexican lunch with Malena and a friend.   It was good.

I have taken 14 of my 18 radiation treatments.   I get these every weekday, and I am in the hospital for about 30 minutes each time.  Usually the treatments are in the afternoon, but sometimes I get rescheduled for the morning.   The third treatment was a morning treatment, and took advantage of that by scheduling my port removal immediately after.   Two hospitals in one day.   If that is some sort of record, I don’t want it. 

The radiation is going fairly well,  but I started to come down with some side effects last week.   Six days of the following fun things:

1.  Sore throat

2.  Constant feeling that food is caught in the back of my throat.

3.  Dry mouth.   Like the Sahara in August.

4.  I cannot taste food.

These side effects will persist for weeks after my last treatment, which is Monday.   The worst one is not being able to taste food.   I like food.   I like it so much that I try to eat it several times a day.    But these are the problems of the living.   So I will take them and deal with them. 

I am in the home stretch of my treatment.   I think I have this thing beaten, but it is ‘wait and see’ from here on out.   I will have a PET scan in a couple of months, and quarterly visits to my oncologist.   If nothing shows up after 5 years, I think they will call me cured.  

Take that, cancer!

Another hospital visit

I was not feeling well Tuesday around lunchtime, so I decided to take a nap.   I felt much better afterwards, but decided to take my temperature anyway.  102.6.   Great.    I called Malena at work and told her the news.   She came home and took me to the ER.      When we got to the examination room, my temperature was normal.   The nurse took some blood, and a chest x-ray was taken to make sure my pneumonia was under control.    After hours and hours of waiting, I started to feel warm, so Malena took my temperature again.   102.1.   Right on cue, the doctor comes into to examination room and tells us that we are free to go, nothing is wrong.   Malena convinces him to take my temperature again, and I end up admitted to the hospital, back to the oncology floor, two doors down from my last visit.   All the nurses were glad to see me back, and had a needle party where I think every one of them jabbed me with something, either taking blood or adding chemicals.   At one point my oxygen level got low, so I had to wear the oxygen nose tube/torture device.   Fortunately, I was able to prove that my oxygen levels were fine a few hours later, so I did not have to continue being tortured.   My Oncologist kept me for two nights trying to determine if the antibiotics that I was taking for the pneumonia were causing the fever.   I don’t think that she ever really determined that, but decided that she could not be sure that my chemo did not cause the pneumonia in the first place.   The cytoxan (the C in R-CHOP) has been known to cause pneumonia in rare cases, and she decided that since I was hospitalized twice in two weeks that she was not willing to take the risk of damaging my lungs.   So my last chemo is cancelled.   This will decrease my chances of being cured, but by how much is unknown.   Since I was Stage I,  and the bad lymph node was cut out, I think that I will be OK.  It is out of my hands anyway, so no sense worrying about it.   Radiation simulation is back on for May 19.  

I’m feeling better every day, and I haven’t felt this strong in quite some time.   I’ll be glad when I get to do some things around the house again like cut grass, and whack down some huge weeds that have grown.  I will ask my Oncologist on Thursday when I will be cleared to do these things again.  

I’m looking forward to whacking some weeds.   On to the next phase of the battle.

Waiting to Inhale

Today should be the day after my last chemo treatment.  But it is not.   It is a shame too, since I had some Cinco de Chemo jokes ready to go, but they will be lost forever now - never there to make you laugh.   I will start my tale at the beginning, where most tales start…

Tuesday, April 26th found Malena and me at the Radiation Oncologist’s office where we got some good news.  Instead of 6-8 weeks of daily radiation, I only need 18 treatments!  That is 3 weeks and 3 days!   There was some other news as well.  It is possible that the radiation will destroy a spit gland.  Also, I will not grow any whiskers in the area of radiation.  That’s a shame too, since I wanted to grow mutton chops, like this former president:

We will find out about killing the spit gland when we do the marking and simulation.    Marking and simulation was scheduled for May 19th…

When we left the doctor’s office, I started to feel run down a bit, so I went home and climbed into bed for a few hours.   I awoke and went to the living room where Malena was sitting, and grabbed the temporal scan thermometer to check my temperature.   I did not feel bad, I just did it on a whim.   101.6.   Wow.  Since I was feeling fairly well, I thought that my time in bed under the covers had raised my temperature, and that I would cool off soon.    But the panic flag had already been raised, and arrangements made to keep the kids.   Almost ready to go to the emergency room, my temperature had dropped back to normal after fluctuating most of the previous hour.   We lowered the panic flag and went to bed.

Wednesday, I noticed that if I took a deep breath, I would have an odd sensation in the back of my throat, and would cough.  I placed a call to my Oncologist’s office, and a prescription was called into my pharmacy for a 3 day treatment.

Thursday evening, day 2 of the treatment, my cough got a little worse.

Friday, day 3 of the treatment, I was not improving.  Another call to the Oncologist’s office, another prescription.  

Saturday.   This is where the real fun begins.   I am having difficulty breathing by the afternoon.  I am able to breathe easier if I am on my back, but not upright or on my side.   When I am upright, I can breathe only enough to get a couple of words out at at time.    Malena makes arrangements for the kids, and off to the emergency room we go.   It is packed.   It took 30 minutes just to see the triage nurse!    Being a chemo patient with difficulty breathing does have some priority, and we were in a treatment room within another 20 minutes.   Not bad considering how busy they were.   First into the treatment room was not a nurse,  but the ER doctor.   I guess he thought I needed priority as well.   One CAT scan later, and I was admitted.  It took some time to get the CAT scan, to have someone read it, and to get a room ready on the oncology floor.   We got to my room at 3am Sunday.

Sunday was full of fun.   I had a constant IV drip going into the back of my left hand, electrodes all over my chest, oxygen shooting into my nose, and an  x-ray.  The on-call Oncologist (on-callogist?) came to visit and and told us that he was concerned because pneumonia patients can breathe upright, but not laying down, which is the opposite of my symptoms.  Great.  

Monday I got to see my Oncologist, and she told us differently about the symptoms.   Pneumonia can have my symptoms if it is in the lower part of the lungs.   Another x-ray, antibiotics, constant IV drip, breathing treatments, and oxygen. 

Tuesdays’ x-ray concerned my Oncologist enough to get a pulmonary specialist involved.   His concern was the one of my chemo medications may be causing the pneumonia.   If that is the case, I am done with chemo.  My Oncologist said if I don’t get the fourth treatment, it would lessen my chances of being cured.  

Wednesday was much like the previous days.  Confined to my cell, with time off to walk the halls for exercise.

Thursday had me checking out of the hospital and finally going home.   I have 4 bottles of oxygen here, a concentrator (it takes the air in the house and filters it, and shoot oxygen out through a hose into my nose), a nebulizer for the breathing treatments, and a couple of new prescriptions.

I have an appointment next week with the pulmonary specialist to see if I am improving.   I am, since I can breathe now.  I have learned a valuable lesson in all of this:  Do not go to a hospital and expect to get any rest.   I had people in and out of my room every hour or so checking blood pressure, oxygen levels, the electrodes on my chest, or giving me handfuls of pills.   So I didn’t get much rest.   Neither did Malena – she stayed with me every night but one, when my father stayed so Malena could get my oldest son ready for a band competition. 

My final chemo treatment is  tentatively scheduled for May 19th, which means I will need to reschedule the appointment with the Radiation Oncologist.

Stay tuned…

Fear

You have good days, and bad days during chemotherapy.   My bad days come about two days after stopping the steroids, and these low points get lower and lower.   Generally, this is something that I can handle, but there was something that happened Thursday that really had me down.    I was researching chemo-brain.    It is a real condition, although according to an article on foxnews.com, it wasn’t given any credibility until 2004.    That was enough to set me off, but I will save that tirade for another day.

Chemo-brain affects your cognitive abilities.   Some people report that it is as if they are in a fog the whole time, or that they lose items, have some memory loss, and can’t focus.    For me, there is a focus issue, in that focusing my attention for long periods on a particular item is difficult, but the largest issue is my inability to multitask.   Since I am in the computer field, this is a big deal.    I normally administer several disparate computer systems, and must do this simultaneously.   Right now, I can’t.  

As I was researching chemo-brain, I wanted to know when it would go away, when I would have my faculties back.    Answers varied from months to years.  And then fatigue and low emotional state took over and whispered into my brain:  ‘It may never come back.’    That thought had me the most frightened of the entire ordeal.    My wife, God bless her, recognized what was happening and suggested I take an Ativan.    This is prescribed for anti-nausea, but it is also an anti-anxiety drug with sleep aid benefits.   I am better now, but it was a frightening few hours.    We’ll be better prepared for the low point after my final round of chemo, which is May 5.   I won’t get that low again.   And if my abilities don’t come back, I’ll just add that to the list of things I have to deal with.  

As for the rest of the time, I took one anti-nausea pill for nausea, and my taste went bland for 4-5 days.    So in that regard, it has been easier.  However, I am far more tired through this round than I was the previous treatments.    This is expected, but I don’t think I could have prepared my self for it.   

Better late than never

I know it has been quite some time since my last post, but there really hasn’t been much to report.   And that is a very good thing.    I took anti-nausea medication for 3 days.   I lost my sense of taste for 4 or 5 days.   The biggest issue, and the one that kept me from updating the blog, was fatigue.   Around 2 or 3 o’clock every afternoon I started to feel drained.   By dinner time, my communicative skills devolved into grunts and pointing like some kind of bald neanderthal.  

Speaking of bald, I haven’t quite lost all of the hair on my head.   Only 98% of it.   And now I need a haircut.   It is a very odd sight.   That 2% Marine Corps hair is hanging in there, and will not let go without a fight.   I am very proud of it.  I have some pictures of me before and after the hair loss so you can see how it has changed me.

Before:

 

And after:

I don’t think the change is too bad, and when I wear a hat it is barely noticeable. 

I am posting now from the chemo chair at the Bruno Cancer Center,  taking round 3 of 4 chemo treatments.   I hope that this treatment goes as well as the last, and I will try to do a better job of keeping you informed, even if there is nothing to report.   Be warned though, if I am as tired after this treatment as I was after the last, you will get a post that will read as if The Hulk wrote it:  Hulk tired.   Hulk eat.   Hulk need sleep!

I can’t say enough good things about the folks here at the Bruno Cancer Center.   They are top notch.   God bless every one of them for what they do.

Cue

Saturday, March 19, after doing some light yardwork after sunset, I decided to take a shower.  I washed my hair last, because that is just the way it is done, and looked down at the drain.   A handful of my hair lay upon the drain.  Malena  told me that my new nickname will be ‘Cue’.   I hope that she means Cueball, and not cuecard, or q-tip.   That would be awkward.
This is no big deal to me, just an annoyance in my battle.   My hair loss may be frightening to others though, as I just do not have a head made for baldness.   To compare, I have some of the greatest bald heads in movie history:
Yul Brynner, image from The King and I (why is your head higher than mine?):

Telly Savalas of Kojak fame (Who loves ya, baby!):

Patrick Stewart of Star Trek The Next Generation (Make it so!):

Unfortunately, my noggin is more closely shaped to Worf:

Although our hue is different, the skull structure is quite similar.
Seriously though, this is not a big deal for me.   It is a HUGE deal for others that go through this, especially women.    Fortunately, there is something you may be able to do to help, and it is painless to you and your bank account.    Get a haircut.   If you can do without at least 7 or 8 inches of hair, you can donate it to be made into wigs for chemo patients (PS – your hair will grow back!).
Here are a few places where you can look into these programs:
Locks of Love
Wigs for Kids
Pantene
and a google search:
Google

Yesterday, I did my second of four rounds of chemo.    I was able to take the medicines as fast as they could administer them, which is very good.  There were two nurses in the room, wearing their blue nitrile gloves and attending to the patients.   So there they were, two by two, hands of blue, administering life saving medications.   They are wonderful people.   I noticed when I left that I was substantially more tired than after the first treatment.   It may be due to the lack of good sleep over the past few days, but it is something that we will watch.    I didn’t sleep at all last night, even with the help of Atavan, so Malena and I decided that we would work from home.   I really didn’t trust myself to drive.    I did go over to the Bruno Cancer Center at 1:00 to get my follow up shot of Neulasta, but it was a quick trip and I felt a bit more together.  
This is a race, and I am in the lead.   Cancer will lose.

Timing

 

Tuesday started off great.   I felt better than I had since my first chemo treatment, and I was ready to face a beautiful day.  By the end of the day, things had gotten interesting.   And if you have been reading my blog, you know that interesting means painful.   At 5:00 pm, my abdomen started to feel uncomfortable.   I went on a three mile walk with my wife at 6:00 pm, and by the end of the walk I was in pain.   I tried to eat, and I tried to suck it up and endure, but could not.   At 1:30 am Wednesday, I knew that this agonizing pain was not a simple gastro-intestinal issue, but a problem with my appendix.  I was nauseated and had a fever.  Malena took me to the emergency room, which was thankfully not busy, and we were immediately taken to an examination room.   I was given a saline IV, and some dilaudid for the pain, and had a CAT scan scheduled.   The dilaudid only took the edge off of the pain – it went from agonizing to ‘this still hurts!’.  After my CAT scan, the pain started to intesify again, so I was given more dilaudid.   The doctor arrives in my examination room and tells Malena and me that my appendix is fine, that I am having cramps.   Cramps?  Really?  If cramps can hurt that bad, they need a new name, like hyperpain muscle flexion or something.   The doctor gave me a new prescription to add to my growing collection, and sent us home.   We stopped to get the prescription filled, and arrived home just before 7:00 am.   It was a long night to say the least.   We tried to sleep, but an endless parade of phone calls and people banging at the door prevented any type of meaningful rest.  At 2:30 pm Wednesday, the hospital calls back to tell us a second radiologist looked at the scan and determined that it may have been my appendix after all.  The really weird thing is that this scenario played out almost exactly as it had in 2008.   Big pain, emergency room, not your appendix, oops - yes it was.   Different hospitals, for those wondering.   I am not in pain now, just a bit tender in my abdomen from the ‘cramps’.   I called my oncologist’s office on Wednesday to fill them in, and so they could decide whether or not to schedule an appendectomy.   I haven’t heard back from them, so I am guessing that since I am not in pain, we will delay the appendectomy until after chemo.    If I have my appendix removed now, I will have to completely heal before I can resume chemo.   On the other hand, if my appendix ruptures while my immune system is compromised from the chemo, things could get exciting.  I think a ruptured appendix is unlikely, and that cancer is my most pressing problem since I am not currently in agonizing pain.   But, I will do whatever my oncologist wants me to do in regard to my appendix.  My second chemo treatment is scheduled for Thursday, March 24th.  Hopefully, my blood counts will be good and my appendix and I can proceed with the chemo.