Luis and I went in for our second round of Chemo today, and things went pretty smooth. I was done with Chemo around 1pm… it’s nearly 6pm now, and I’m still feeling quite well.  Here’s the day’s run down:

 

MORNING

We had an early call time. Our appointment was for 9:30am, but we’ve found that they take us back almost immediately upon arrival. So we aimed for and arrived at the oncologist’s office before 9am.

I’ve fallen in love with the frozen quiche from Trader Joe’s. So before departing, that’s what we had for breakfast this morning. If you haven’t tried them, you should. I prefer the broccoli to spinach, but both are quite good. And they are only like $3.

In related diet news, I’ve decided that I am “off diet” for the duration of chemo. Just going to eat what tastes good for a few months, supplemented by some food recommended for treatment (salmon and seafood heavy, certain fruits & veggies).  Luckily, I generally tend to eat healthy without thinking too much about it. But I am giving in to my sweet tooth a bit more often. And I’m okay with that.

I packed up my chemo bag in my new “Merv Beats Cancer” tote bag. The new mini-chess set, a book of sudoku, snacks, blanket.

 

PRE-CHEMO

True to form, Dr. Stevens’ office took us back to get started right when we arrived, even though we were over 30 minutes early for our appointment. I suspect this is because we don’t actually require any of Dr. Stevens’ time. We are wholly served by the nurses on staff, all of whom have been incredibly nice and helpful; they are each the types of people that make you truly believe they really come to work each day enthusiastic about helping people.

Vital Signs: first up, they take my vitals. My weight was the same as two weeks ago, and my blood pressure and temperature were both perfect. This is good news, since my home blood pressure machine seems to think I have high blood pressure, and all of my at-home thermometers seem to think my body temperature hovers between 94 & 95 degrees…  So, in short, all good here!

 

WHITE BLOOD CELLS

Here’s where we ran into problems…

My White Blood Cells (WBCs) have fallen low. Like, really low, and that can be a problem.

First, they had to receive special permission from Dr. Stevens in order to administer chemo. I was in the range where they sometimes might decide to not give chemo.  Luckily for me, Dr. Stevens was referred to as an ‘aggressive’ oncologist and rarely defers chemo, and he decided to move forward with today’s treatment as planned.

Here’s the read out of my CBC. I’ve highlighted the two important numbers here.

WBC – As you can see, my WBC count is a 2.32.  This is well below the accepted range of between 4.5 – 11.0.

NEUT – As it was explained to me, the NEUTs are my “baby WBCs in the making” or the ones that are in the queue to become healthy WBC to replenish the supply. But as you can see, I don’t have a lot of NEUTs getting ready for the call of duty!  The accepted range is between 2.0 and 8.8; the test showed my level at an extremely low 0.17.

So… what does this mean?

It means I am extremely susceptible to infections. If I get a fever over 100.5° then I have to call the doctor right away. Infections during chemo can be life threatening and can escalate quickly. That’s all a bit unsettling.

I am under strict orders to minimize activities which put me in crowds of people, at least for the next two weeks.  The example the nurse gave was to avoid doing things like going to the grocery store.  She rolled her eyes when I asked if I could fly on a plane.  I decided at the point not to ask about hanging out in Las Vegas casinos for a few days this weekend.

So on the (strong) advice of the oncologist, I’ve gone ahead and cancelled (canceled?) my Las Vegas trip this weekend for the National Handicapping Championship, even though I’m physically feeling 100% fine. Honestly, I’m devastated. I was really looking forward to the trip. I’ve planned a swanky party for our clients and prospective clients in the Penthouse Suite of the Treasure Island which I now will not be able to attend (my job is hard); I know it’s in extremely capable hands, though. I’m also disappointed that I won’t get to see the dozens of folks in the horse racing industry that I otherwise rarely get a chance to see.  But I suppose my health is more important; NHC will be there again next year. Gotta stay healthy and kill the cancer right now.

I also can’t be around people who are sick or might be sick.

Platelets – The one bit of good news is that my platelets are doing good and well within normal range! These can also get out of whack with the chemo treatment, but they seem to be doing well so far.

Daily Shots – For the moment, they are not signing me up for daily shots. The most common are called Neupogen and there is also something called Neulasta. But basically, they are shots that I would have to get (every day – in the stomach!) which would help recover my WBC & NEUT counts.  We’ll reevaluate after my next appointment on February 7.

So yea… the blood tests were a bummer… but we did move onto chemo.

 

CHEMO

There’s really nothing much to say about the actual administration of today’s chemo… it went just about exactly as the first treatment.

That IV they stick in your arm for chemo is a real bitch! I’m a pretty big boy about needle sticks, even if I don’t like to watch it happen — and I’ve been stuck dozens of times in the last two months. This one HURTS! But it only hurts for about a minute while until they have finished collecting blood and take the needle out, leaving in the softer IV tube.

The order switched up a bit… I did the B & the V first (the clear syringe injections), and then the A (the red one that makes me pee red), followed by the D (the drip which takes 60 minutes to finish).

I did have some trouble with my tubes today… They used my right (dominant) arm today instead of my left arm like last time.  This made it tricky to do anything for the several hours I was hooked up.  And late in the process the machine stopped twice due to ‘kinks’ in the tube, likely due to me trying to play chess and cards.  If I can, I’ll try to request my left arm next time, if it’s all going to the same place.

My nurse today was very knowledgeable about the treatment and gave us some good pointers. She was also able to explain my WBC test very well.  Again, I really like everyone I have come into contact with in Dr. Stevens’ office.  She also wrote me a prescription for 60 of the post-chemo steroid pills, so hopefully I don’t need another refill and don’t have to do another co-pay for those.

Luis and I played chess and rummy. I know it goes without saying, but I won both games or chess and the game of rummy – quite dominantly, if I do say so myself. Luis also taught me how to play dominos; I don’t think I’m into it that game he taught me, though; the ways in which I prefer to enjoy dominos are either 1) put many of them in a long row and then knock them down, or 2) call them to order delivery of thick crust, sausage & pepperoni.

We live streamed a little bit on Facebook Live. I tried to stretch it out a bit longer to give people a chance to join, but I just run out of things to say! Plus, you all know how shy I can be. Anyways, that has been a special request from Mom, and I can’t say no to Mom!

Also, the most painful part of chemo has been ripping the tape off the IV after treatment and pulling all the hair out of my arms! Immediately after this blog, I am shaving my arms!!

 

MUGA SCAN

This came as a surprise, or at least something which hadn’t previously been mentioned. They’ve scheduled me for a MUGA Scan, which has to do with my heart. Here’s a pithy explanation I found using a Google search from Heart.com:

A MUGA scan is a test using a radioactive tracer (called a radionuclide) and a special camera to take pictures of your heart as it pumps blood. The test measures how well your heart pumps with every heartbeat.
CLICK HERE for more information.

This is a routine test for all patients undergoing the ABVD treatment. There is nothing that happened which caused specific concern, it’s just routine.  I just hadn’t been told about it, so it came as a surprise.

Anyways, the test is tomorrow at 1pm ET. I really need to do a bit more research on what to expect, but hopefully it’s easy.  I can’t decide whether to fly solo or ask someone to come with me; Luis is working from Columbus tomorrow. I hate to bother anyone for something which might be pretty trivial.

Will report on this test tomorrow. Don’t know how long it takes to get results.

 

POST TREATMENT

After we left treatment, we went across the street to get Senor Iguanas. I got the lunchtime steak fajitas.  I know what you’re thinking: “Merv!!! After last treatment you went to Qdoba and got the 3-Cheese Nachos and triggered your Acid Reflux for a week! What are you thinking!? Don’t you learn!?”

I can’t help it!! I love Mexican food! It’s my favorite! And I deserve a treat after chemo!! Besides, my acid reflux has been extremely well behaved since I started taking the daily off-brand Pepcid pills.  And more besides, I like to live dangerously.

Dad came over to drop off my steroid pills, and also picked up some of our laundry.  Mom is going to stop by tomorrow and give the house a good deep clean – especially important now considering my depleted immune system!

It’s about 6:45pm and I’m still feeling fine. I don’t have an appetite just yet, but I’m not feeling nauseous or tired. If anything, my mind just feels a little hazy, but nothing serious.  I do feel a little amped up on the steroids…  They pump me full of steroids before chemo, and also I took steroid pills about an hour ago. I’m worried that I could be looking at a sleepless night.

I’ll be sure to report tomorrow night following the MUGA Scan and on how I am feeling!

 

Next Appointments:

Tomorrow @ 1pm:  MUGA Scan @ Norton’s outpatient.

Tuesday, 2/7 @ 10:40am:  Chemo Treatment #3 & Dr. Stevens consultation

 

Much Love,

Merv