Went in for my fourth chemo treatment yesterday. This time there was no drama, they got me in pretty dang fast, and everything went smoothly and surprisingly quickly. Even the chemo nurse was a fast talker! Unfortunately for you, my dear reader, that means no stories about Vern or Cooter, and no new denizens to add to the fun. Just the usual efficient, friendly, attentive ministrations of the Carbone staff.
Dr. Leal was in a chirpy, upbeat mood. I think the sudden vast improvement in the local weather has everyone feeling good this week. I am certainly feeling it! My numbers looked pretty good, due to the 25% dose reduction initiated last cycle. My red blood cell counts are a tad low, but not dangerously so, so they consider me slightly anemic. That goes a long way toward explaining my relative lack of energy and tendency to get winded after, say, marching a couple of laundry loads up the stairs and changing the bedding. There still may be a cancer component to that symptom, but anemia would account for a lot of it too. This should resolve itself slowly as I recover from this treatment and my body can begin to produce blood cells more normally again.
I will be driving in yet again for my 7 Neupogen shots beginning next week. I actually don’t mind doing so, as it kind of breaks up the day, and I use it as a chance to do errands and stop for little snacks along the way. Day 10 will bring a CBC test, which will hopefully show decent neutrophil levels and give me the information I need to not freak out about getting a fever so much. My temp tends to rise a bit in the evening and then begin to drop back again when it gets late. I watch it like a hawk starting about Day 8 and all through that weekend, which is when my vulnerability to infections is highest. It is apparently a common effect of chemo, and causes this day-10 dip in lots of people’s immune systems.
After that, I’ll have the final CT scan in four weeks instead of the usual three, as Dr. Leal will be out of town. Fine by me; it’ll be a longer break from appointments, and will give the meds that much longer to do whatever they’re gonna. I predict the results will be the usual mixed bag of good/not so good. The likelyhood is that the scan will show minor improvements and, hopefully, nothing new. But, as my study coordinator Martha said, the way I feel is the primary indicator, and I maintain that all this chemo HAS helped me noticeably and significantly. That’s my story and I’m sticking to it.
After all this is concluded, I guess I’ll get another lengthy break so my body can recover. Time to live life, enjoy Spring and Summer, and work on going up a pant size again! At some point, I think they’ll want another scan to see where things are a few month out. I don’t know what further options there are – perhaps more chemo at some point. I tend to tolerate it well enough, and I think it has been helpful. Perhaps more radiation if they think I can tolerate the scarring I experienced last time. I know they are concerned about the cumulative effects of all this, so I can’t say how eager they would be to inflict it on me again.
The concept of head/brain irradiation is still out there as a preventative measure to counter small-cell cancer’s tendency to spread up to the brain. That prospect is still daunting to me, as it carries potential memory and cognitive effects with it. All my head MRIs since last Spring have come out clean, meaning that they have been unable to detect any cancer there. That doesn’t necessarily mean there IS no cancer lurking, just that it hasn’t reached a detectable level. Yet. So they’ve back-burnered that issue in favor of the more pressing (literally) issue of the mass around my heart and wind pipe area. That and general symptom amelioration have been the primary goals so far.
I have to confess, perhaps for the first time here, that I have already experienced moments of inexplicable memory glitches. They have been rare so far, and I mostly notice them while playing shows. I come to a song or a section of a song that I know I know well, and the music I need is just not there at that moment. It’s weird and disconcerting, to say the least. I don’t think it’s a sleep issue, because I’ve always been a hopeless night-owl and am used to functioning on 6-7 hours of sleep. It could be simple aging, although, as far as I know, memory and cognition have never been issues in our family. It’s pretty mild as these things go, but I note it for posterity. Probably, it’s just a weird glitch. Dunno, we’ll have to wait and see.
For now, I’m happy to be concluding this round of chemo. All in all, I have tolerated it quite well, it has helped me in many noticeable ways, and has been altogether worth the trouble. I’m very much looking forward to enjoying 2015 in a way I was not quite able to do last year. I still maintain a positive outlook each day, and I am so very thankful for my generous and loving family, my awesome group of friends, and mostly my wife, without whom this whole story would be very different, and not for the better. I don’t, and can’t, know where the road I’m on is heading. That information is unavailable to the mortal man. But the scenery around me is beautiful, the air smells good in my nostrils, and the path is leading me over a lovely hilltop, past which I’m still eager to see what lies beyond.