More Chemo and a Shot

On Friday January 30^th we did another infusion of chemotherapy.  The bloodwork was good enough to get the full amount of each of the two drugs, plus of course the hydration bag that includes electrolytes and the anti-nausea drugs.  The process from the time of accessing the port to completion and removal of the port access takes about five hours.  It seemed a little faster this time, but it was probably in my imagination.

Over this time, I typically sit in a comfortable recliner, although once in a while they put me in a bed.  (They assure us that it is all randomly done.)  I prefer the chair but the bed is more private if the doctor comes.  The recliners are in what they call a pod and there are 4 chairs per pod and eight total pods in the infusion clinic.  So there are 30 to 40 people getting infusion at a time counting the beds.  I use my smartphone to access the internet looking at the news, read e-mail, take a nap, eat something that we brought or maybe something that Kath gets from the cafeteria upstairs.  Kath always accompanies me and sometimes goes to the library or to the pharmacy to get prescription refills.

The infusion nurses are always very careful to verify that the bags of medicine are the ones issued to me by the pharmacy.  I repeat my name and birthdate lots of times—every time a bag is changed—and they match my wristband to the barcode on the bag with scanners.  I appreciate the thoroughness, but it gets a little annoying sometimes.

As long as the chemo keeps working, this routine will be repeated—two Fridays doing infusion and then two Fridays off.  I look forward to the breaks which I am just now starting again.  The infusions seem to bring on the "cancer fatigue."  I know I have talked about that before, but I probably haven't explained it very well.  Here's a definition I found from the Cleveland Clinic:

Fatigue can be confused with tiredness.  Everyone gets tired.  In fact, it is an expected feeling after certain activities or at the end of the day.  Usually, we know why we're tired and a good night's sleep will solve the problem.  Fatigue is less precise, less cause-and-effect.  Fatigue is a daily lack of energy; an unusual or excessive whole-body tiredness, not relieved by sleep.  It can be acute (lasting a month of less) or chronic (lasting from 1 month to 6 months or longer).  Fatigue can have a profound negative impact on a person's ability to function and quality of life.  Cancer-related fatigue (CRF - sometimes simply called "cancer fatigue") is one of the most common side effects of cancer and its treatments.  It is often described as "paralyzing."  Usually, it comes on suddenly, does not result from activity or exertion, and is not relieved by rest of sleep.  It may not end -- even when treatment is complete.

On Saturday afternoon, we made another trip to the Huntsman Clinic to get a shot.  The shot is “neulasta” and helps stimulate the bone marrow to produce more white blood cells.  I have been typically on the low side in this blood test and it has reduced the chemo dosage at times, so we’re trying to elevate the white blood cells so I can continue with treatment.  So far I don't feel any significant negative side effects from the shot, which is a relief.

The procedure for the shot is short; it took longer to walk from the car to the clinic than it took to take vitals and get the shot.  But the insurance company demands that it done at the hospital if they are to pay for this several thousand dollar injection.

Speaking of insurance, I am covered through my New Mexico retirement.  I looked at the insurance summary the other day and it paid well over $200K in 2014, so it has been a real blessing through all this testing, surgeries, scanning and chemotherapy.  This is not a cheap kind of medical problem, so my advice to all of you is two-fold: take care of your health to prevent all you can, and keep your insurance.

I continue to appreciate all of your thoughts, visits, e-mails, text messages, prayers, etc.  I have an amazing support system that helps me keep a more positive attitude.  Yes, of course there are some brief times when I think of how bad this is and might become, but those are rare.  I just keep thinking of all the support, and because of that I can and will be part of that small percentage that beats this type of cancer.  Thanks again.

Good News

Back on January 16th, we did the periodic bloodwork and CT scan to see how things are progressing.  During the chemo infusion on the 23rd, we saw the doctor and got the results.  The CT scan showed smaller lesions and fewer of them and the blood maker was down.  This means that the chemo is still working.  The doctor said that he doesn't often see these kinds of positive results after the preliminary rounds of chemo, so we will be continuing with more chemo until it is no longer working.  We will also put off the clinical trial of immunology until at least summer.

Because my white blood counts continue to be low, we will also try an injection of neulasta the day after chemo.  This means another trip to the Huntsman Center since the insurance requires that it be administered at the clinic before they will pay. These injections sometimes cause some "bone pain", but there are no reactions in others so I am hoping that it is pretty uneventful for me.

I also saw the primary care doctor earlier this week regarding the diabetes.  After looking at results of the A1C test, he said I could again reduce the frequent glucose testing to a couple of times per week.  Things are well controlled by the pills and by self regulating the amount of carbohydrates that I eat.  I am blessed that this is easing, as I feel like I have enough to worry about without the constant reminder of testing and insulin injections.

The oncologist continues to emphasize the three "A's"--  Appetite, Activity and Attitude.  Keep all three of these in good shape and the outcomes will be better.  I continue to struggle with the activity part.  The chemo fatigue is hard to keep motivated to overcome, but I try.  Your thoughts and prayers are an important part of keeping the "attitude" on a positive note.  Thanks for all you do.  It's kind of amazing to think of all those praying for me and sending good thoughts.  I'll continue to do my best.  Thanks again.

The Whole Enchilada

Yesterday was another chemotherapy infusion at the Huntsman Cancer Institute.  After we checked in at 7:00 am, we were escorted to a bed located in one of the separate rooms of the Infusion Center.  We had been advised in the beginning that this could occur, but after numerous infusions in the various chairs it felt like a surprise.  They assured us that it was just a random choice and nothing to worry about.  After doing it this way today, I prefer a reclining chair.

The port was accessed without any problem and when the bloodwork results came back, it showed the blood counts being in normal range and I could take the full prescribed chemo drugs.  That was the first time that happened in several months.  I guess forgoing one of the chemo drugs last week resulted in my blood being back to strong enough for chemo.  So I got the whole enchilada today instead of a "less than full strength dosage."  The downside is that after being home just a few hours, I could already tell that the "chemo fatigue" will be a little worse this time.  Guess everything has its trade-offs.

Also saw the oncologist yesterday and reported the usual things: no pain, no swelling of hands and feet, just fatigue.  We scheduled the next CT scan in a couple of weeks.  We'll go over the results of the scan when I see him again at the end of the month.  He did say that the latest blood marker test was down from the previous test again, but it is hard to say it is really a trend with so few data points.

In summary, I am doing as well as expected.  Lots of that is due to my awesome support system.  Thanks for making it easier to stay positive.  I know that all the thoughts, prayers, e-mails, phone calls, text messages really help.  I really appreciate it.  Love you.