The last couple of days my hair hasn't quite its regular self. Kind of dull and flat. I thought it might be the weather or the fact I've been going to bed earlier than usual, but when I tried to pull out a handful of hair yesterday, a lot more came out than I'd ever seen before. Even my wife commented that it looked noticeably thinner than usual. I'll definitely keep an eye on this.
In fact, yesterday was my worst day so far. I got tired very early, and went to bed at noon and stayed there on and off until this morning. The arm that received the gemzar is very sore from my elbow to my fingers, and is swollen and red. I'll keep an eye on this too.
Chemo is a bit like being on a teeter-totter. It's very easy to tip yourself one way or the other. On Thursday I had another guy in my room who was about to have his first session. As the nurse told him the side-effects, and what he could expect in the coming months--in much detail--he almost became ill before the IV was inserted.
This has not been a good weekend. But compared to what many others go though, I still consider myself pretty fortunate.
Sunday, October 29, 2006
Friday, October 27, 2006
The Good, the Bad, and the Ugly
The Good
Yesterday (Gemzar only), was my last treatment in round one. Compared to cisplatin, gemzar is very tolerable--I haven't taken a single anti-nausea pill in a week.
Only two more rounds to go.
The Bad
My veins have grown increasingly shy, and need a lot of poking and prodding and pushing the IV needle around searching for a workable spot. Needless to say, this is painful and requires the ipod volume to be turned up another notch. And gemzar--unlike cisplatin--burns when it goes in. But, it's a short session, and I was in-and-out in an hour.
My platelet count, in one week, has dropped from 187,000 to 77,000. In a normal adult, the platelet count is about 150,000 to 450,000 platelets per microliter of blood. If platelet levels fall below 20,000 per microliter, spontaneous bleeding may occur and is considered a life-threatening risk. That's one of the effects of gemzar, but I was more than a little surprised at how dramatic the drop was. Next week is my week off before the second round, so the numbers should rebound somewhat.
The Ugly
I discovered today that one of the main ingredients in saline IV drips is dihydrogen oxide (also known as dihydrogen monoxide), which has been used for years as an industrial solvent and is a major component in acid rain.
Dihydrogen oxide is composed of hydrogen gas--very explosive--and oxygen--an ingredient in battery acid. It is colorless, odorless, and tasteless. It contributes to "greenhouse effect," is used in nuclear powerplants, as a fire retardant, and may cause severe burns.
After learning this, you can imagine how ill I felt. I went straight to bed and was far too sick for dinner.
Update:
Oops. My wife just informed me that dihydrogen oxide is another word for H20--ordinary water. Suddenly I feel much better.
Yesterday (Gemzar only), was my last treatment in round one. Compared to cisplatin, gemzar is very tolerable--I haven't taken a single anti-nausea pill in a week.
Only two more rounds to go.
The Bad
My veins have grown increasingly shy, and need a lot of poking and prodding and pushing the IV needle around searching for a workable spot. Needless to say, this is painful and requires the ipod volume to be turned up another notch. And gemzar--unlike cisplatin--burns when it goes in. But, it's a short session, and I was in-and-out in an hour.
My platelet count, in one week, has dropped from 187,000 to 77,000. In a normal adult, the platelet count is about 150,000 to 450,000 platelets per microliter of blood. If platelet levels fall below 20,000 per microliter, spontaneous bleeding may occur and is considered a life-threatening risk. That's one of the effects of gemzar, but I was more than a little surprised at how dramatic the drop was. Next week is my week off before the second round, so the numbers should rebound somewhat.
The Ugly
I discovered today that one of the main ingredients in saline IV drips is dihydrogen oxide (also known as dihydrogen monoxide), which has been used for years as an industrial solvent and is a major component in acid rain.
Dihydrogen oxide is composed of hydrogen gas--very explosive--and oxygen--an ingredient in battery acid. It is colorless, odorless, and tasteless. It contributes to "greenhouse effect," is used in nuclear powerplants, as a fire retardant, and may cause severe burns.
After learning this, you can imagine how ill I felt. I went straight to bed and was far too sick for dinner.
Update:
Oops. My wife just informed me that dihydrogen oxide is another word for H20--ordinary water. Suddenly I feel much better.
Thursday, October 19, 2006
Session Two--Round One
This morning was Gemzar only. Not much to report; the session lasted about 45 minutes, start to finish, about like a blood donation without the cookies and prying questions.
I have to say, chemo nurses really seem to be on a higher level than many of the nurses I've dealt with lately. Every one I've had contact with has been pleasant, competent, and empathetic.
Because I've felt pretty good, I've stopped taking compazine. I was warned to be on guard for any waves of nausea and to catch them early, since it's easier to keep nausea at bay rather than try to stop it once it grabs ahold of you. But all-in-all, today was just another day. And that's good.
I have to say, chemo nurses really seem to be on a higher level than many of the nurses I've dealt with lately. Every one I've had contact with has been pleasant, competent, and empathetic.
Because I've felt pretty good, I've stopped taking compazine. I was warned to be on guard for any waves of nausea and to catch them early, since it's easier to keep nausea at bay rather than try to stop it once it grabs ahold of you. But all-in-all, today was just another day. And that's good.
Wednesday, October 18, 2006
The Price of Admission
I'm sure you remember the classic Pogo cartoon--"We have met the enemy, and he is us."
That's a bit like what going through chemotherapy is. We can be our own worst enemy. From my own experience, and that's all I have, my nausea -threshold is something that I can both raise and lower with certain thoughts. If I just imagine drinking another Readi-Cat 2 pina-colada, I can literally feel the waves of nausea beginning. If I concentrate on the beginning flicker of illness, I can feel it grow and crest. In fact, I can make this happen a dozen time before lunch.
And it's hard not to concentrate on how you're feeling. I find myself struggling to not put every sensation under my mental magnifying glass--but, I'm also finding that it's something I can control by not focusing on it.
I know this isn't easy, and is perhaps even counter-intuitive. For many months I didn't pay attention to what my body was telling me, and my cancer may have spread because of it. But we can choose what we think about, and to the best of my ability I'm choosing to not magnify and exaggerate every new or different sensation--even those that aren't pleasant--into something that can make me sick.
I'm not naive enough to believe that I can control all this, or that I won't get legitimately ill, but all I have to do is get through the next three months.
I can do this standing on my head.
And this is your price of admission. Along with what's really going on with my chemo, you have to read what I think is going on. I hope it helps.
That's a bit like what going through chemotherapy is. We can be our own worst enemy. From my own experience, and that's all I have, my nausea -threshold is something that I can both raise and lower with certain thoughts. If I just imagine drinking another Readi-Cat 2 pina-colada, I can literally feel the waves of nausea beginning. If I concentrate on the beginning flicker of illness, I can feel it grow and crest. In fact, I can make this happen a dozen time before lunch.
And it's hard not to concentrate on how you're feeling. I find myself struggling to not put every sensation under my mental magnifying glass--but, I'm also finding that it's something I can control by not focusing on it.
I know this isn't easy, and is perhaps even counter-intuitive. For many months I didn't pay attention to what my body was telling me, and my cancer may have spread because of it. But we can choose what we think about, and to the best of my ability I'm choosing to not magnify and exaggerate every new or different sensation--even those that aren't pleasant--into something that can make me sick.
I'm not naive enough to believe that I can control all this, or that I won't get legitimately ill, but all I have to do is get through the next three months.
I can do this standing on my head.
And this is your price of admission. Along with what's really going on with my chemo, you have to read what I think is going on. I hope it helps.
Friday, October 13, 2006
Session One--Round One
We arrived at the clinic yesterday at 8am, and I was welcomed with another of Edna Wilholtz's Readi-Cat 2 pina-coladas, which as I grow more accustomed to them taste a bit like a pina-colada mixed with Elmer's Glue.
The CT scans were clear, so that was a relief.
The actual chemo session lasted about four-and-a-half hours, since Cispaltin needs a lot of saline solution to dilute the evilness. They begin with some anti-nausea drugs before the Cisplatin and Gemzar, and quite honestly, except for the sheer boredom of sitting there, it was no worse than a morning spent with English-as-a-second-language DMV workers.Perhaps even better, since chemo nurses are very nice.
Only one part of the treatment was a bit unpleasant. Towards the end of the IV drip, they infused the solution with something called Lasix, which is a powerful diuretic. I was warned that I would probably have to urinate about every ten minutes. Well, since people who have had a radical Cystectomy do not necessarily feel the same urgency that we did before, this can be a problem, especially if there is only one bathroom for the whole chemo section. Plus, the nurse wasn't exaggerating--I've never had to pee so much in my life. She finally brought me a portable urinal, which not only worked fine, but had measurement printed right on it, so I didn't have to use one of my wife's cooking measuring cups to satisfy my curiosity about my flow and volume. The first wave was twelve ounces in a very very short time--not bad.
I was sent home with two prescriptions, compazine for anti-nausea and ativan (which helps with sleep).
The entire day wasn't bad at all. Much better than what I expected. I had some pizza and went to bed.
In the interest of honestly, however, this morning was less than perfect. I had one wave of nausea and threw up a couple of times, but it passed in about ten minutes. After than I felt a bit tired, but fine. I worked all day without any incidents.
I'm certainly not predicting that this is as bad as it's going to get, but for me, right now, 2:45pm, Friday, Pacific Standard Time 2006, this certainly seem doable.
My next session is October 19, and is Gemzar only--which goes very quickly; about half an hour.
The CT scans were clear, so that was a relief.
The actual chemo session lasted about four-and-a-half hours, since Cispaltin needs a lot of saline solution to dilute the evilness. They begin with some anti-nausea drugs before the Cisplatin and Gemzar, and quite honestly, except for the sheer boredom of sitting there, it was no worse than a morning spent with English-as-a-second-language DMV workers.Perhaps even better, since chemo nurses are very nice.
Only one part of the treatment was a bit unpleasant. Towards the end of the IV drip, they infused the solution with something called Lasix, which is a powerful diuretic. I was warned that I would probably have to urinate about every ten minutes. Well, since people who have had a radical Cystectomy do not necessarily feel the same urgency that we did before, this can be a problem, especially if there is only one bathroom for the whole chemo section. Plus, the nurse wasn't exaggerating--I've never had to pee so much in my life. She finally brought me a portable urinal, which not only worked fine, but had measurement printed right on it, so I didn't have to use one of my wife's cooking measuring cups to satisfy my curiosity about my flow and volume. The first wave was twelve ounces in a very very short time--not bad.
I was sent home with two prescriptions, compazine for anti-nausea and ativan (which helps with sleep).
The entire day wasn't bad at all. Much better than what I expected. I had some pizza and went to bed.
In the interest of honestly, however, this morning was less than perfect. I had one wave of nausea and threw up a couple of times, but it passed in about ten minutes. After than I felt a bit tired, but fine. I worked all day without any incidents.
I'm certainly not predicting that this is as bad as it's going to get, but for me, right now, 2:45pm, Friday, Pacific Standard Time 2006, this certainly seem doable.
My next session is October 19, and is Gemzar only--which goes very quickly; about half an hour.
Wednesday, October 11, 2006
The Night Before
I told my wife I could do this standing on my head. Now we'll see.
A little background. I turned 50 in September, and was diagnosed with T3a N+M0 bladder cancer in May, 2006. Because my cancer was both invasive and aggressive, my urologist recommended that I have surgery at USC Norris Cancer Center. My surgeon was Dr. John Stein. In that regard, I couldn't be more fortunate. Dr. Stein is one of the leading BC surgeons in the world, and my surgery (on June 23, 2006) went very well.
In fact, three months after the surgery, I feel terrific. Looking at me, you'd never know anything was wrong, and indeed, most of the time I almost forget I had surgery at all--my bladder, prostate, two feet of intestine, and 85 lymph nodes would probably be disappointed that they aren't missed too badly, but it was either them or me. They lost. My pathology report, however, indicated that the cancer had spread to one of my lymph nodes, so three rounds of chemo were indicated. Both Dr. Stein and my local oncologist agreed on gemcitabine (Gemzar) and cisplatin.
I was pretty apprehensive about the chemo before meeting with my oncologist, but really, it doesn't sound as awful as I'd dreaded. I'm generally an optimistic person, and perhaps I'm being a bit naive, but I'm not as fearful about this as I was just last week. I'm going to bring my ipod, turn it on, let the nurse find a vein, and listen to music for four hours. I can do this standing on my head.
That's the plan.
Tomorrow is the day. I'm keeping my fingers crossed.
Update: Since I'm having CT scans and x-rays right before the chemo begins, I just drank a bottle of something called Readi-Cat 2, no, not a new kitty litter, but a barium solution that tastes a bit like a virgin pina-colada served by Edna Wilholtz at the Boise Rotary Club's annual Luau night. A bit of rum would make it more palatable.
A little background. I turned 50 in September, and was diagnosed with T3a N+M0 bladder cancer in May, 2006. Because my cancer was both invasive and aggressive, my urologist recommended that I have surgery at USC Norris Cancer Center. My surgeon was Dr. John Stein. In that regard, I couldn't be more fortunate. Dr. Stein is one of the leading BC surgeons in the world, and my surgery (on June 23, 2006) went very well.
In fact, three months after the surgery, I feel terrific. Looking at me, you'd never know anything was wrong, and indeed, most of the time I almost forget I had surgery at all--my bladder, prostate, two feet of intestine, and 85 lymph nodes would probably be disappointed that they aren't missed too badly, but it was either them or me. They lost. My pathology report, however, indicated that the cancer had spread to one of my lymph nodes, so three rounds of chemo were indicated. Both Dr. Stein and my local oncologist agreed on gemcitabine (Gemzar) and cisplatin.
I was pretty apprehensive about the chemo before meeting with my oncologist, but really, it doesn't sound as awful as I'd dreaded. I'm generally an optimistic person, and perhaps I'm being a bit naive, but I'm not as fearful about this as I was just last week. I'm going to bring my ipod, turn it on, let the nurse find a vein, and listen to music for four hours. I can do this standing on my head.
That's the plan.
Tomorrow is the day. I'm keeping my fingers crossed.
Update: Since I'm having CT scans and x-rays right before the chemo begins, I just drank a bottle of something called Readi-Cat 2, no, not a new kitty litter, but a barium solution that tastes a bit like a virgin pina-colada served by Edna Wilholtz at the Boise Rotary Club's annual Luau night. A bit of rum would make it more palatable.
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