Had my second dose of chemo this morning. Pretty smooth sailing with a few small wavelets. Wavelet #1 is that my white blood cell count is down. This is a pretty common side effect of this chemo therapy. My oncologist has put me on a prophylactic antibiotic to keep me from getting an infection in my port. Wavelet #2 is that my port is in fact trying to erupt out of my skin. Apparently Pete watched too many Sigourney Weaver flicks and is trying to come out and party. The result of this is that the skin over my port has gotten stretched pretty thin. This raises the risk that I could get an infection by the port site. As another precaution, we've decided I shouldn't swim for a couple of weeks to keep from rolling the port around too much in my upper chest. My oncologist did also notice the road rash (I wore shorts so I could ride my bike to chemo). He's a pretty casual guy but did mention that I should be really careful about getting dirt out of any cuts I could get. As a result of this conversation Susan has put me on a 1 strike and your out plan wrt mountain biking injuries. So I've got to get pretty conservative on the bike or I'll lose my biking privileges.If my WBCs are too low next time they may give me a dose of a medicine that will boost my WBCs. The down side of this is that there is some anecdotal evidence that this can raise the risk (10-20%?) of getting a pulmonary reaction to the Bleomycin. So again, it's all about trade offs. If they back off on the Bleo there's a reduced efficacy of the treatment. So my oncologist's plan (which I agree with) is to get the first 4 chemo sessions at full strength, on schedule and deal with depressed WBCs as necessary. I'm going to do my best to avoid any situations where I could be at risk for infection and then just take a day at a time. We also talked about my GI tract slowing down a bit - apparently both the chemo (Velban) and the anti-nausea drugs can cause some constipation (different mechanisms but same outcome). I've been eating granola and high roughage cereal to combat that so again, although a minor drag it's certainly been manageable so far. It's really funny to interact with these oncologists - they've seen it all before and what is a big deal to you they take as totally everyday events. Yup, that symptom is because of A, that symptom is because of B, let's do C and D, you're fine, go get healthy! I guess this is preferable to a situation where you present them with symptoms that are weird, troubling and not easily diagnosed. So I'm happy to stick with my pedestrian symptoms and have them be bored with all my reports of things that have gone on in the last two weeks.
But let's focus on the big, good news. My tumors are definitely shrinking!!! I had one in my throat area that was about 4.8 cm long 2 weeks ago and it's now about 2 cm long. A bit of that may be from post surgical swelling going away but some of it is definitely the tumors getting smaller. And I have 2 more in my neck that have gotten smaller. So that's basically fantastic news. I'm a bit bummed about the swimming but maybe the port will settle down in my chest and I can get back into the pool in a month or so.
We then went in to get the infusion of chemo. The place was pretty backed up so it was kind of a long session. I was sitting next to a women who was getting chemo for breast cancer. She'd had a pretty rough road so far - 10 chemo sessions to date, super exhausted, spending 20 hours/day horizontal on the couch/bed sleeping, couldn't work, lost ALL her hair (including eyebrow hair), skinny as a rail. Sort of your classic, chemo-as-concentration-camp-victim look. She promptly nicknamed me "chia-pet" after seeing how much hair I have. Our heart went out to her - with Susan having gone through breast cancer and my cancer we're obviously super sensitive to other folks going through a similar journey. The good news for this woman was that on Friday she'd had a sonogram and her main tumor had gone down 75% in size. And she had switched over to another type of chemo which was leaving her with a bit more energy. We talked about nutrition, thinking positively about the port (she's had lots of problems with hers and was thinking of it as a malevolent entity that had invaded her body. I told her she should name it and think of it as a tool that will help her get better. She was toying with calling hers Paula which also has good alliteration :). I hope that my positive energy and enthusiasm helped cheer her up a bit. She's got some hard work in front of her, more chemo and then some type of surgery to get after her tumor(s). I'll probably see her in two weeks and I'm hoping that she can put on a bit of weight and get back some energy. Her goal is to be able to ride her bike about 2 miles to/from her local grocery store. I didn't tell her that I rode my bike 50 miles this weekend in two different rides. But I sure was feeling lucking that at least so far, my energy level has been excellent. Trust me, there is nothing like sitting in that room for a few hours to make you feel compassion for other people with this illness and to be thankful for the positive things going on in your life.
Pete did great in his role as chemo delivery mechanism. I had one brief period where the pump was kind of screwed up and I was back flowing blood up into the line. This may sound gross but after you've been hooked up to these various machines a few times it all becomes pretty pedestrian. The chemo nurse came by and fixed things up so other than losing about 15 minutes of time with a non functional pump it was no problem.
Here's a picture of me showing chemo session #2 in progress:
Just like in the 1st session, I also peed a bit of pink urine from the Adriamycin. I was going to post a picture of my work in this area but the censors have clamped down on that. So you'll just have to use your imagination for that visual :) And it's pretty crazy to think how quickly this stuff goes through you. I had the Adriamycin and within an hour it had gone through me and was showing up in my urine. Crazy stuff...
I'm going for a walk in a bit just to keep things moving; mountain bike is in the shop for a couple of days so I will give my skin a couple of days of healing before I risk any more full contact riding!