Did my third chemo session today. In general, things went really well. Heart, bp, temp, Pete the Port all doing well. Some small issues as well - my WBCs are low and we talked about giving me a medication that boosts WBC production. The down side is that there's some anecdotal evidence that it can boost Bleomycin induced pulmonary problems. So far now, we're holding off on that. Going to be careful not to hang out around sick people, wash my hands a ton, stay away from (more) road rash. The other minor negative is that it seems like my port is having a small negative effect on venous blood flow in my left arm. My arm's slightly swollen at times and is a little pinker than my right arm. So I'm going to tweak my bike setup to get some pressure off my arms when I ride and also stay out of the pool to avoid more stress on the port line. Both issues could become serious but for now things seem very manageable. More good news is that my tumors have shrunk some more. And in general I'm in pretty good health, all things considered.
In about 3 1/2 weeks we're going to do a PET/CT scan. The hope is at this point that there will be no metabolic activity suggesting growth of cancer cells. We'll see - crossing my fingers on that one! I asked the dr. about the value of doing this, since there is some slight negative to getting more radiation. He said that it can affect the treatment course. If there's no cancer activity, that would suggest a more complete remission and that might indicate a bi-modal treatment that include localized radiation. It seems counter intuitive that the better your diagnose the more stuff you have done to you. I think the logic here is that if your cancer is pretty localized and responds well to the chemo they can really up your long term survival rates with radiation. If they see the cancer being less responsive or still being widespread, it indicates that your odds of getting a recurrence don't go down, because you may get a recurrence from cells not in the areas you radiate. And since the radiation does have negative side effects (can increase your chances of getting other cancers down the road), at some point the survival graphs cross and radiation isn't a net positive. So all those decisions are down the road a bit.
I also asked the dr. about my reduced aerobic capacity when I work out. He indicated that it probably wasn't an organic specific issue (so not due to the Adriamycin or Bleomycin). It might be due to a reduced hemoglobin count (less ability to get O2 to my blood cells) but that in general the chemo introduces a systemic "malaise" to your body. Basically, the chemo isn't good for you. Does a great job of killing cancer cells but your body in general is assaulted. This is why for some people they just totally crater. For me, it's been a lot more manageable but I've definitely noticed a toll in terms of my ability to work out hard. He also said that it probably would plateau and wouldn't get a lot worse than where I am now. That was really great news. If I can stick to this level of energy through the summer I will be really happy. I also got clearance to do push ups so now I have at least one upper body exercise I can do. And 6-8 weeks after I finish the chemo I should get the effects completely out of my system. Can't wait for that milestone!!!
So into the infusion room for the chemo. I talked to the nurse about a range of things I could do to keep my GI track moving in the few days after chemo. Well, the more interested I got in the topic the louder my voice got (go figure) so pretty soon the whole room was getting a blow by blow description of my efforts to get stuff to come of the bottom half of my plumbing. The funny thing was that almost every body there had the same experience. "Yup, been there, done that!" people would chime in. So we all got a good bonding moment over the joys of not being able to take a dump. Ah, the life of a chemo patient!
Also got to check in with the woman we visited with two weeks ago. She definitely looked better - more energy, a little spark in her eye. Her tumors are also shrinking which was great news. She had some good questions for Susan (Beryl has breast cancer) so it was great to see Susan be able to talk about different treatment options and the decisions that were right for her. One thing that Beryl said was that didn't have any remorse about the whole experience. It had opened her eyes to lifestyle decisions, things she wanted to do with her life. I thought this was pretty enlightened view. My knee jerk response was "hell, yeah! I have remorse. I have remorse that this damned thing happened to me and I would sure like to learn my life lessons in a much less dangerous class room!" But it is what it is, and as sensei Susan says, "the only way out is through". Wise words from my wing-woman!
So now for some fun photos from our session today. I was in a pretty good mood given the news about the tumor shrinkage and all, and that my port was working ok, so I had to celebrate with a little pole dance with my infusion pole. This is undoubtedly not what most people think about when they hear the phrase "pole dance" but it's all I got. Trex-in with the pole (private joke for the family) :
And another picture with my wing-woman bringin' a little attitude:
And here I am raiding the bagel stash. Not quite sure what's going on with the tongue thing - readers will have to fill in the blank on that one:
After I got home, I realized that I had a safety issue to resolve! Don't want to get any more road rash, so I obviously need new mountain bike tires! Here's what I was currently riding:
Ok, one last slightly gross note. Despite the best efforts of the censor, I did get a chance to take a pic of my adriamycin induced pee. Sadly the pink didn't come out too well (bad color correction on my phone camera's software, I guess). And, it's been rated not blog-appropriate. So if you see me in person and want the viewing, I'm more than happy to oblige :)
And a brief update on the workout front - although the quality of my work outs has gone down, I am getting in a reasonable amount of exercise. 3 mile run Friday, 10 mile bike ride Saturday, 30 mile ride Sunday, 7 mile road ride and 14 mile mtn bike ride today. So the body is definitely still able to get out and move around, which is really a huge boost to my mental and physical well being.
So that's it for the 3rd session. Some stuff to work through (low WBCs, some port induced arm swelling) but in general a really good day. Off to bed now (hoping I don't have too much acid reflux!). Thanks again for following the blog - it feels good to be able to blurt about my cancer and have people care enough to read about it!!!