Chemo #1 Day 5

Fresh Pizza!

Day 5 passed with nothing special. Steroid dosage was cut in half today, but I didn't feel any real difference. Wednesday I go back in for lab tests and over to cardiology to have a background scan of the heart. They do this as a reference, so later they can do it again and make sure drugs aren't messing with my heart.

I went into work for most of the day today and that went fine - mostly meetings. After work I went and did a little exercise. I've lost about 8 lbs, which is something my doctor has suggested each year during my physical. It is not weight loss from the cancer but rather due to good eating, no beer, no over-eating, cutting back on sweets, and lots of fresh vegetables and fruits. The photo is of a pizza I cooked tonight - eggplant, cheese, roasted garlic and roasted onion. Yum! Anne is now baking a fresh apple pie!

Fresh Apple Pie!

Chemo #1, Day 4

So far I have not had too bad a reaction to the chemo - no nausea, no rash etc. So, that is good news. Four days following the chemo treatment it is an ingestion orgy of various pills: Prednisone, Allopurinel, Emend, Zantac, Bactrim. And Lorazepam and Compazine if needed for nausea. The lorazepam does put me to sleep! Still no alcohol, and we are eating lots of good veggies. I did have my first coffee in a while. On Saturday we made scones, got on the boat and meet Bob and Christy on the lake and tied up our boats. Bob makes a great cappuccino!

Fog rolling on the lake from the marsh

I woke up early on Sunday and watched the fog roll in from the marsh onto the lake (taken with phone camera), as well as watched a Great Blue Heron fish and a hawk sweep in on a missed meal of squirrel.  Early dinner on the boat with Anne and Fred and Wendy (Fred is an old badminton partner). 

Chemo #1

Wednesday, August 24 (one day after our 31st anniversary) was Ack's first chemo treatment. 

We got there at 8 am for blood tests. Then sat around waiting for the lab to work the numbers. My liver was out of whack for a while and while steroids were helping to get numbers within range, the doctors needed to be sure I was near normal. Alas, no, the bilibrubin was 2.7 (reference range is 0.2 - 1.3 mg/dL); it has been holding at around 2.5 for the last few tests (after being at 11.7). So, what that meant was in the R-CHOP treatment, they had to cut back on the H and O to half the full treatment (more on that below).  So, after that was all sorted out....

10:30 We were moved to the chemo-cancer-cubical (a private little room off a hallway and with a window). Meredith, the nurse for the day, started me off on IV of saline solution to hydrate me before they added the strong chemicals.

The pharmacist came in to tell us of all the pills I'll be taking. More than I thought (9, I think?). Some will be taken just on weekends - holiday pills!  I look forward to those.  Some nausea prevention ones that are optional, but I've taken them already just to avoid the problem.

So, R-CHOP stands for the chemicals they give me:
R- rituzimab

C cyclophospamide

H- doxrubicin (there is some historic reason why this is an H instead of a D)

O - oncovin/vincristine

P- prednisone - I take that in pill form for 5 days after the IV, given it is a steroid - then I crash!

Because of liver still not behaving correctly (but no sign of cancer there), H and O are reduced by half. They did not have to reduce R or P dosage.

At 11:20 the nurse started R treatment that would last about 3-4 hours. That is the one that people can have a strong negative reaction to - rash, low blood pressure etc. so they gave that slowly at first. I did not have any reaction to it.

At 3:40 they moved onto the H part (yeah, C came later). They also gave me some pills - anti nausea and things. I also got to suck on an ice cream Popsicle, something about keeping the mouth cold so the 'medicine' would concentrate and that might help prevent mouth sores. This only lasted 10 minutes (I mean, how slowly can you eat a Popsicle?), then she moved on to administering the O and C parts of CHOP. That lasted about 40 minutes. Then they flushed everything with another saline solution. By the time we got home it was close to 6 pm. Dinner at home was fend for yourself - which means I had a great chicken salad sandwich and some of Anne's great Peach Pie (with a few blueberries).

By 8:30 I was fighting to stay awake. In bed early and slept sound, though a bit of the night sweats. In the morning (7 am) I took my suite of pills, then fell asleep on the couch. I woke up after 9 and got to work around 10 am. Stayed at work til about 4:20.  Good energy level and no side effects.

As Anne noted: "It was pretty boring too though the staff were lovely and kind, and his room had a window though not much of a view - just of the beautiful day we were missing."  But we did get to watch the animated movie Tangled - it's all about the horse!

I'm scheduled to go in for the next three Wednesdays: next week for blood tests, the following week for blood tests with a doctor consult, and the third Wed (Sept 14, Eileen's b-day) for the next chemo cycle.  

31 Great Years

Celebrating two prime numbers - our 31st anniversary on the 23rd

We are celebrating our 31st anniversary in a relaxing low-key mode. And it is great! Reading and naps on the couch. Anne is baking a peach pie (maybe with some blueberries). We did some shopping, including chocolates from Gail Ambrosius and a light workout at the gym. Weather was cloudy and rainy, so not much options for outdoor activity anyway. We are getting ready for another day together tomorrow! 

Thanks for all the anniversary well wishes!

Looking back...

Looking back, I went to the chiropractor on July 25, a Monday. My back was bothering me, more of a muscle pain, and I wanted an adjustment before a trip to DC and then the week-long tour with the Teachers of Local Culture. It was during the ToLC tour that I noticed my belly was ‘big’. I figured that is why my back was bothering me, because I needed to lose some weight. But it was shortly after that that my abdomen began to hurt (probably Wed Aug 3.) It sort of felt like being over-overstuffed after a Thanksgiving dinner, and then eating a pumpkin pie. By Friday I was in some pain; and noticed that I couldn’t eat much. The weekend was a great time in Fort Collins at the 30th reunion of the first show of the European Cabaret. I didn’t want to complain about my abdomen, so I just bore with it. By our flight home on Monday I called the doctor to make an appointment while Anne and I were at the airport. They didn’t have one, but said if I called on Tuesday morning after 8 am they might have a cancellation that I could do. They did, and I went. The Doc thought it was just a blocked intestine and that I should take a laxative. Meanwhile, she ordered a soft x-ray of my abdomen to look for blockage and ordered a urine test. She called late on Tuesday to tell me test results, which included some high numbers in some of the liver functions. I requested more tests, she ordered them and said she would call me again on Wed with results. She also set me up with the UW-hospital radiology department (on 8/10) for an abdominal CT, prior to which I had to drink about a quart of fluid – something a full abdomen did not want.. So I went in on Wed morning to give blood, to run more tests. I called at 1 pm requesting to meet with the doctor again as the pain was still getting bad. The nurse said that the doctor was booked, but she would see if there was another doctor available. She called back and said the tests were in and they did have a spot open at 4:30, which I took. The nurse called back a few minutes later and said that there was just a cancellation and if I could come in now that would be great. I thought – cancellation, I don’t think so, they have realized that something serious was up – the CT results were in. Later that meeting, the doctor did say they wanted to look at me and make sure I was not vomiting. They also noticed I was turning a bit yellow – from the liver doing odd things, not from cowardice. The doctors said that the liver had odd numbers and that my liver and spleen where enlarged, and that they wanted to run more tests, and set me up for appointment for Thursday (8/11) at 1030. That was an appointment many weeks ago to have by ‘trigger figure’ looked at, Doc said they wouldn’t be looking at that! It was at that Thursday morning meeting that they first used the C word – cancer. He said it was likely a lymphoma type cancer, some of which are curable.

Here's Ack "visiting the Finger Lakes" when he wasn't feeling well and had just started meds, 8/14.

It is said that once you, as a patient, hear the word cancer, it is all ‘blah, blah, blah’ after that word. But that wasn’t the case for me. I was listening, glad in some way that they knew what it was. I was more listening for him to say if other organs were involved. I went into ‘blah, blah, blah’ land when he used the word ‘good’ and the word ‘cancer’ in the same sentence. “If you are going to get cancer, this is a good one to get.” I wondered how often those two words could appear together. “blah blah blah’ more tests and an appointment with a cancer expert on Friday.

So, then we were set up for an 8:30 am Friday meeting with Dr. Julie Chang. She was asking me questions about my health. And then she stopped, looked quizzically and asked me if I was one of the ‘weather guys’. I said yes, and she replied ‘Oh, a celebrity!’ All that outreach I do is good for something! She explained with lymphoma was and ordered a PET test (for Monday) and a bone marrow test on Tuesday. Results of both tests continued to point to lymphoma. For PET tests they injected me with a slight radioactive material that connected to sugars. Where it ended up was where the cancer cells were residing. The infected sites were all in the abdominal area, which was good news. The bone marrow test they were looking to see if it got into the blood yet. A few, of a thousand, bone marrow cells indicated the presence. And Tuesday (8/16) I got my first order of steroid – prednisone! That reduced the swelling and made me feel a lot better. It also gave me some energy – I washed all the windows and doors – 6 patio doors! That also helped with my liver numbers. For example, bilirubin numbers were 5.1, 6.3 and 11.8 (normal range is 0-1.5). After the steroid it went to 6.5 and 2.5. Other ‘bad liver numbers’ also got better. Liver needs to get back to normal so they can start chemo with a ‘bang!’

So, after a couple of weeks of tests, its official - I have “diffuse large B cell Lymphoma”. Which is a type of cancer. This is a common type of lymphoma, and so they have standard type treatment. I will start chemo on Wednesday morning, a treatment called R-CHOP. I get one treatment every 3 weeks for about 4 months – then it is over. Again, a pretty standard treatment approach that they have used, and with good success rates. I’ve been going to the University of Wisconsin Hospital – which is one of the best hospitals in the country – so that is good news. They also do research on lymphoma, so they are very knowledgeable on latest and greatest treatments.

They wanted to start treatment on Tuesday, but Tuesday is Anne and my 31st wedding anniversary. So, I didn’t want to spend that in a hospital bed. And as I said to the doctor "waiting a day won't kill me", which got her to laugh (and affirm that!). I am sort of looking forward to getting this treatment started, even though it will likely make me tired. This has been going on for about 3 weeks. Steroids have helped the pain for sure!

Oh, the puzzle – a gift from the Holz’s. I started it the first two nights of being on prednisone – where I couldn’t fall asleep until around 3 am. Now we work on it whenever we want – should be done soon.