Again With the Scanning

Since my last round of chemo was Cycle 8, and eight is evenly divisible by four, it's once again time to scan.

My appointment is for tomorrow at 8:00 am. Normally, this would be exactly perfect. However, while my oncologist wanted the scan done between Cycles 8 and 9, the radiology center that just three blocks from my house had a five week backlog on appointments. Thus, I have to drive across town at the worst possible time to get scanned at the Bellevue clinic.

Seattle to the Eastside for an 8:00 am appointment. About the only thing worse would be the Eastside to Seattle for an 8:00 am appointment, though it's actually pretty questionable which direction is worse.

This time we're hoping for additional cancer shrinkage, not only because cancer shrinkage is good, but it also might facilitate an early transition to maintenance chemo (i.e., pills) over more infusions. In short, am I still on track to be a "good responder" or am I now on a different path.

We'll see...

Back to the SCCA

So today I had a follow-up visit with the oncologist at the SCCA. It was interesting. A few things I learned:

1. Nothing changes a conversation with an oncologist like the statement, "I'm not doing anymore chemotherapy after 2014." Suddenly, options start falling out of the sky. Who knew, for example, that there's a pill form of one of the chemo agents I'm on? 

2. Apparently, there are "good responders" and "poor responders," the difference being how the person responds to chemo over time. But for a good responder, there's a reasonable expectation that chemo can shift from aggressive, to non-aggressive, to pill forms, to eventually nothing, even with a non-treatable cancer like mine. So far, I am a responder, but they won't be able to say if I'm a good responder until after a few more scans.

3. While I was willing to take the last three cycles as planed, the SCCA oncologist thought that having already done eight, I could reasonably be shifted onto something less antagonistic. So, yay! Of course, this assumes that my next scan -- to be taken on Tuesday -- shows similar signs that I'm a good responder (i.e., continuing reduction in tumor size). But it's nice to think that there's a possibility I could be off the 46 hour pump before the end of the year.

4. I'm still losing weight. Another two pounds since last Wednesday's pre-chemo check in. This despite the fact that my only significant source of calories for the past week have been eggnog lattes. Expensive habit, but at this point one of the few remaining foods that still tastes like food. 

5. No surgery, or other esoteric liver treatments, for me. Too much cancer, too widely dispersed. Chopping out the nasty pieces wouldn't really work, and would in all likelihood result in a relapse o the cancer; and radiation treatments, while potentially curing the cancer, could very well leave me with cirrhosis of the liver. That would be bad, as once my taste buds are back and the weird reaction to iced beverages is gone, I fully intend to have a drink. Probably more than one.

But all in all, things seem more positive today than they did yesterday. But next up, another CT scan on Tuesday to see if all these new options continue to be available or if I'm reclassified as a poor responder. Poor responder would be bad.

Winter Chemotherapy

I used to think I was not a winter person. Now that I'm on chemotherapy, I know I'm not a winter person. Winter weather and chemotherapy don't get along.

Temperatures this past week in Seattle have been decidedly wintery. They're also wreaking havoc with my neuropathy. Most notably, I now seem to have neuropathy in my nose. They didn't mention the possibility that the chemo would affect my nose, but I have to figure that's what it is since I've never experienced this before, not even when I spent winters in Iowa. 

It's very weird not to feel your nose, even when you're touching it. 

I fear it's going to be a long winter.

Smart or Stupid? Only Time Will Tell

Open enrollment ended on Friday and I had to decide whether to stick with Group Health or switch over to Regence. It was basically a choice between inexpensive, convenient health care, that carried with it no attempt to actually cure my cancer, or expensive, inconvenient health care, that might -- emphasis on might -- have something better to offer in terms of treating the cancer.

I went with the complicated, expensive option.

I'm not actually convinced it was the smart choice, but nearly everyone I talk to disagrees. Others seem to have a lot more faith in the local cancer centers than I do.

So I'll finish out the year with Group Health -- and finish out my remaining cycles of chemo -- and then see what SCCA, Swedish, Virginia Mason and any of the other cancer centers in the Regence network have to offer. 

If it's just wait for the cancer to come back and then stat the chemo back up, I'll know I made the wrong choice. But if someone has something other than chemo to offer up, it'll have been the right one. Or maybe I'm kidding myself, and I'm facing the same situation as the cow.

Guess we'll find out in January. 

A Philosophical Inquiry That Basically Boils Down to Self-Pity

Modern life is missing something.

Those of a Judeo-Christian religious bent will no doubt recall the story of Job, who's living a pretty posh life until God and the Devil place a bet, and poor Job winds up in a pretty miserable state. Job's friends, of course, start asking Job what sin he committed to warrant the treatment he's receiving. 

And then there's the ancient Greeks and Romans. If any of the various mythology-based movies of the last few decades remotely resembles the reality of the day,* then here's another case where bad times basically boiled down to a question of which god the sufferer pissed off, and what sacrifice was necessary to make appeasement. 

Or we can talk karma. Here again we've got a philosophy that argues that crappy things happening are just the universe responding to whatever crappy thing the sufferer did. What goes around comes around and all that.**

And while I'd argue that there's a certain measure of malevolence in suggesting that someone suffering bad times did something to deserve it, I'd also argue that there had to be some comfort in being able to look to the sky, shout "What the hell did I do?," and reasonably expect that there's actually an answer. 

'Cause frankly, I want to know what I did, or who I pissed off, to warrant the year I've had. Increasingly, I'm finding that "random chance" is just a woefully lacking explanation. 


* Yeah, yeah. It's a questionable assumption, particularly when one takes the recent Pompeii into account. 

** It is, of course, interesting that folks seem far more willing to accept that good things happening to them are a function of their good actions than that bad things happening are a function of their bad actions. 

Cycle 8 Round-up

It's official. The chemo cycles are now insurmountable. Used to be I could spend the day getting poisoned, and then go back to work. No longer. This was the second time the chemo has basically laid me out for four days. I wouldn't have thought it possible to sleep for eighteen hours in a day, but at this point once the chemo starts sleep is pretty much all that interests me -- to the tune of about eighteen hours a day.

Twelve over night, plus another six strategically deployed throughout the day. Which doesn't leave a lot of time for updating the blog. Sorry. But at least Saturday had a few hours of sunshine so I was able to spend the my few waking hours driving the Roadster and meeting up with BiL4 and my nephews to see Big Hero 6.

Aside from the overwhelming need for inordinate amounts of sleep, it's been the usual package of side effects: generally feeling lousy; terrible response to even slightly cool beverages (the beer mitten is no longer sufficient); neuropathy (and may I say that sleeping with gloves on is just weird, but it's that or be kept awake by painful fingers); etc., etc., etc.

But now I'm down to just three more cycles. Unfortunately, the idea of just three more cycles used to seem like a reasonably doable number. 

Three doesn't seem very doable now. Hopefully, that will change before next Wednesday.

The Cycle 8 Chemotherapy Liveblog

Today's liveblog will start later than usual as I couldn't get an early appointment with an oncologist. Usually, it's blood draw at 8:00, oncologist at 9:something, and chemo starts before 10:00. Today it will be blood draw at 10:30, oncologist at 11:something, and, if I'm lucky (weird word in this context), chemo will start before noon. 

Which sadly means I won't be pulling the pump on Friday until late in the afternoon. And while it might've meant I could sleep in this morning, the anticipatory side effects are bad enough that I just got up at the usual time. 

All in all, bad luck on the late start. 

So now it's 8:45 and I have about two hours to kill before I have to be at Group Health. At least the late start opens up breakfast options beyond VPC or IHOP. 

As Arnold Schwarzenegger says in nearly every movie he makes, I'll be back...

10:33 am
I'm back. I've been to the infusion center, had the line inserted, blood drawn, and now am waiting for my appointment with the oncologist, scheduled for an hour from now. (Someone here should really work on eliminating the wait times between the phases of a chemo cycle. As a patient, I spend too much time waiting.) It was interesting seeing the infusion center at 10:15 versus 8:15. They get a lot busier as the day goes on. So much so that I fear I may not get my typical semi-private cubicle when it comes time to start chemo. 

10:51 am
It appears the chemotherapy weight loss program has started to kick in. I'm down 10 pounds over last time (214). Pretty sweet. Now if only there were a chemotherapy muscle-building program to go with it. Oh well. Skinny and mushy is still better than fat and mushy.

11:16 am
Apparently we're still waiting on the lab results before I'm cleared for chemo. Saw the oncologist without the lab results, and she's cleared me to proceed contingent on the lab work. So we wait for the lab work.

12:18 pm
Still waiting for the drugs to appear, though the labs are done. This time I won't be getting Avastin, since one of the tests showed I have too much protein in my urine. Not sure why that's a problem, but the medical providers think it is and I'll just defer to their judgement. They also told me to drink more water, but that may be more difficult as I'm not a fan of water and particularly not lukewarm water.

12:33 pm
Drugs are here, less Avastin. So we're off to the races.

12:56 pm
I'm tired and have a headache. 

2:24 pm
I'm still tired, and still have a headache. But the infusion is almost done, and then it'll be the pump hook-up and I'll be done. So unless something striking happens in the next fifteen or twenty minutes, this is probably it for the liveblog. 

But who knows? Maybe the line will come out and we'll have an orange alert or something. 

Though probably not...

How Can This Be a Thing?

I know I'm repeating myself, but anticipatory side effects. How can this be a thing?

Tomorrow is Cycle 8, and I can totally understand feeling crappy tomorrow. But why on earth am I feeling crappy today? So crappy, in fact, that I had to leave work at noon to come home and sleep for five hours. How is this a thing?

What could possibly prompt your body (or worthless mind) to decide that since I'm going to feel bad tomorrow, I may as well get a head start and just start feeling lousy today. What the hell? There are enough bad days with chemo, when you're actually on chemo, why do you need to feel lousy on the days that you're as far from chemo as you can get?

Stooopid. And annoying. I've got better things to do with my time than feel horrible for no reason. 

But here I am, feeling horrible for no reason. Yay!

May She Rest In Peace

If you're at all engaged in popular culture, you've probably heard about Brittany Maynard, the 29-year-old woman who was diagnosed with some horrible form of terminal cancer and so moved with her husband to Oregon so she could legally take advantage of Oregon's assisted suicide laws and end her life on her own terms.  

Apparently she died on Saturday. 

And all I can say is, rest in peace. Twenty-nine is way too young to be handed a cancerous death sentence, and who am I to question the choices someone in that position makes -- whether it's to sign up for any and all treatments available, sit back and wait for the cancer to do its thing, or head to Oregon and cut it off at pass. They're all equally terrible options which no 29-year-old should have to choose between.

And as someone facing their own terminal cancer diagnosis, if certainly less urgent than Ms. Maynard's, I'm impressed by her ability to face the fact that she was going to die, and actively and engagingly respond to it. Based on my own experience, and what I've heard and read about, this seems a fairly rare trait. We all know we're going to die, but few seem to want to accept that fact, even when all the evidence suggests that it's going to happen fairly soon.* 

So, here's to Brittany Maynard and her family and friends. I hope her decision gave them all more peace than any of the other available options might have done.


* Personally, I'd be willing to be bet that the thought going through the minds of most people facing a firing squad is not "I'm about to die" but "maybe all their guns will jam."

Beer Mitten...with Shark

At risk of turning my cancer blog into an alcohol blog, I just wanted to share this very cool beer mitten I got from a friend at work. I'm sure it's designed to keep the beer inside cold, but it also works very well to keep the fingers on the outside warm -- or at least warm enough not to have the neuropathy kick it. 

And it's got a shark going through a tube on it. I'm not sure why it has a tube-traversing shark -- I don't typically associate beer with sharks -- but the shark seem does seem cheery and festive, so what the heck. 

So woohoo! for the beer mitten, and here's to the Pacifico inside it. Pacifico was my Mum's brand, so whenever I drink it I think of her. And while part of me is very glad she's not around to worry about the current state of my life, another part really wishes she were here. She'd no doubt have useful commentary on all of this crap.