Wednesday, January 30, 2013

Second ABVD Cycle

Not much fanfare here. Second chemo session went off without a hitch.  A tiny bit of nausea this time around, similar to that feeling that sticks with you a few hours after a serious spinning ride at an amusement park.  The fatigue has been less this time, probably because chemo was not immediately preceded by a flu shot this time around.  Sunday evening through Tuesday after chemo is still the worst time though.  Wednesday truly is hump day but I'm going to try to get back on the ice tonight. I didn't have any issues with hockey last week but that was almost 2 full weeks after the first chemo session.

I'll take the next chemo cycle over at Providence because they have a much nicer infusion center. I can get my own little cubby instead of sitting there staring at everyone else and comparing IV stand size.

No hair loss yet but this the week it's supposed to happen. Can't wait!

Tuesday, January 29, 2013

$15,000 Shot

That is not a typo. I got my first treatment-related insurance statement last night and...WOW! A single shot that took 30-seconds to administer: $15,000.  My annual deductible and nearly all of my out-of-pocket max taken out by a single is that even possible? Seriously, it must be made with bits of real panther. Let's just hope it works more than 60% of the time.

Even better, it's not even related to the main chemo treatment. It's the day-after shot that's designed to boost my immune system and help keep me from getting sick while I'm on chemo. I can't wait to see what a chemo session gets billed at. I can't imagine going through this without insurance. Can you say total financial ruin? Thankfully, I have a very "reasonable" annual out-of-pocket max which will kick in after just a single treatment session.  Funny how I used to stress over deductibles...cancer don't care 'bout no deductibles!

Wednesday, January 16, 2013

I Pooped 3X Today!

That's right...that which I have always taken for granted has become cause for a minor celebration. I think I have turned the corner on the chemo-coma that I slipped into on Sunday night.  Aside from the incessant hiccups, the day after chemo wasn't bad but I crashed pretty hard Sunday.  Work on Monday was a haze of lethargy and apathy and Tuesday wasn't much better as the energy went up slightly but "chemo cramps" were introduced.

Things seem much better today which is good as we leave for Arizona in the AM to do a bit of mountain biking. I really have no idea how that is going to work out but we've had it scheduled for a long time and I guess we'll see what I can make out of it.

Saturday, January 12, 2013

On the Lighter Side

First night after of chemo was fairly uneventful. The only side effect so far has been some general fatigue which is to be expected, especially since I got a flu shot an hour before I started chemo, and a bit of a fever scare last night. I was having trouble sleeping and sweating in bed even though I ditched all the covers. I was getting a little nervous (fevers while on chemo are trouble) but it turned out the heat was just left turned up when we went to bed. False alarm.

Hey, I said "lighter side"...what gives?

Ok so the lighter amusing anecdote from my Conoco on-boarding process. Post offer acceptance, there were a number of forms and procedures that needed to be completed and verified prior to becoming an official employee of Conoco Phillips. One of these checklist items was the drug-screening. No problem, pretty standard for any new job. Almost.

I showed up at the testing facility just before they closed because they're only open until 5 on weeknights, I was still working, and I only had to pee in a cup and be on my way, right?  WRONG! Turns out I was slated for the hair test which heretofore I had suspected was only an urban legend. Not so, my friend! As anyone who has seen me since I graduated from college knows, I keep my hair fairly short but for this particular test, they needed to get a 90-day history which requires hairs at least an inch long or a large volume shorter hairs.  The options I was given were to shave: most(?) of my head, one leg, or both armpits. I could only assume the tester was joking because what guy has hair that long these days?  Not many, surely there must be another solution here. Nope. So I had to go back into the testing room and this poor woman had to shave my armpits with electric clippers onto a sheet of paper from the printer and then "collect it" and jam it into foil collection packets. Those things are kid of spring/wiry and they ended up everywhere. Absurd! She kept apologizing (I'd find out why not too much later) but I felt like I was the one who should be apologizing. It seemed like she sure got the short end of the stick on that gig. 

Then I got home and for the next several days "enjoyed" that prickly, itching sensation as your hair oh-so-slowly grows back in and the extreme irritation that you experience when that is occurring in a high chafing zone. I gained a new respect for the effort that women who shave must maintain to avoid that uncomfortableness. You can't stop once you stings!

Friday, January 11, 2013

ABVD Treatment 1 - Not so bad

....has been delayed from 9 until Noon today because apparently my oncologist's office is either unfamiliar with the concept of linear scheduling or it never occurred to them that "Chemo training" should occur prior to the application of chemo, not in the middle of it.  Stay tuned...
 So that's all you got?  That wasn't so baZZZzzzzzzzzz...........

Wuh-wha...Hey you kids! Get off my lawn!  Now where was I...oh yeah. Aside from the fact that I was the youngest person in the chemo treatement room (room of about 10 recliners, full house), it really wasn't that unpleasant.

Prior to beginning the treament session, I received my "chemo teaching" (odd verb masquerading as a noun) and got most of my questions answered. The training session was with the Weapons of Mass Cellular Destruction (WMCD) doctor and he confirmed the my oncologist was indeed being overly positive about the side effects I will be experiencing, as I suspected. These WMCDs will cause my hair to fall out, without a doubt, sometime between treatment 2 and 3.  The other side effects I am guaranteed to experience are fatigue which will peak 2 to 3 days after my treatment sessions (Sun-Tues) and a severly suppressed immune system, particularly 7-10 days after a treatment session.  For the coming week, that window falls right on our AZ mountain biking trip.  Outstanding!

Another unexpected nugget is that every Sat after a treatment session, I have to to the hospital to get another injection of neugypeugygeugy that will stimulate my bone marrow to produce more blood cells to reduce the immunosuppresive side effects of the chemo. Drugs to treat drugs to treat drugs. This puts a bit of a whole (that one's for you, Tim/Cindy) in my plan to get treatments on Fridays and have the rest of the weekend Scot(ch)-free.

Thursday, January 10, 2013

Seriously Pissed

The worst part of this so far has been by far, dealing with all the insurance bullshit. It amazes me how these people will confirm a "fact" or tell you're they're going to do something, give you a reference number and then be either completely wrong or never do anything. Over and over and over yet again. And I haven't even started chemo yet. Awesome.

I think I've moved on from denial to the angry monkee stage. I can deal with the 4-6 months of minor to significant discomfort (depending on who you talk to). It's the possible complications down the road from all these toxic chemo drugs that has me pissed. I'm a pretty health guy: get a lot of exercise to stay in shape, cognizant of the perils of high fructose corn syrup and MSG (shut up Sean), no drug use and, I have no choice but to have massive amounts of poison injected into me.  That pisses me off. I've got my doctor over here telling me "It won't be that bad. You won't be that tired, probably won't lose your hair"...  How do you know?  You want some chemo, my friend?  No on both counts. It affects everyone differently and the majority of the people DO lose there hair and DO feel completely wiped out.

I can't wait until tomorrow when I get to sit in a chair for 4 hours while they subject my cellular population to WMD. Until then, I guess I'll just have to get a hug from Julie and go play some hockey tonight. Maybe have a beer. /rant

...Oh and get a flu shot because when I asked about that, they told me "Absolutely!"  THEN WHY THE HELL DIDN'T YOU MENTION THAT WITHOUT ME SUGGESTING IT????????????

Tuesday, January 8, 2013

Diagnosis and Treatment Plan

Finally, after nearly 2 months since starting the investigative process, we have a (nearly) final diagnosis as well as a treatment plan and schedule.

In reviewing the PET scan, it was determined that the lymphoma has not spread to any lymph nodes outside of the ones we'd already observed (neck and chest) or any organs.  This firmly cements me in Stage II and without any consistent "B" symptoms (large tumors, night sweats, nodal pain, weight loss) leads to a very positive prognosis. The only outlier is the bone marrow test results, which should come in later this week. Given that it has not spread anywhere else, we do not expect anything to turn up in the marrow.

Obviously we are much relieved and as happy as can be expected with the diagnosis: Total CRAP but at least not a baby diaper filled with indian food.

I will be starting chemo treatment on Friday which will consist of 4 to 6 cycles of ABVD chemo. Each chemo cycle treatment will consist two long 2-4 hour chemo sessions which have been conveniently scheduled to coincide with my off-Fridays at Conoco. It appears that Thursday night hockey has been spared. {yay!}

Side effects: This has been updated since the "chemo teaching". I will be losing my hair and I can be expected to experience significant fatigue, especially 2-3 days after the application of each chemo. Additionally, my immune system will be severely compromised, primarily during days 7-10 after application of each chemo.  There are host of additional side effects that may present themselves but we won't know those until the show up.
Beers on me this week because after Friday, drinking not so much. Doctor said I can still have a couple of beers a week but not really more than one a sitting. Certainly no Beer and Barleywine Festival for me this year.

Saturday, January 5, 2013

Human Pincushion

You hear people use the term "human pincushion" all the time to the point that it seems overused but sorry, that's what I'm starting to feel like right now. The best part is, it's only just beginning.  Fun new year for me so far:

Weds: Got my chemo port surgically implanted. The port is so they can inject the chemo drugs directly into my jugular rather than tapping the veins in my are each time.  That's right...jugular.  The rational behind this is that the chemo drugs are very hard on the veins and if they go into the jugular, they get distributed much faster.  Or so I'm told.  Anyway, this port, about the size of 5 dimes stacked, was implanted in my chest, just below my collarbone. It has a flexible rubber tube running out the top (but still under the skin) that is somehow spliced into the jugular in my neck. So I've got this weird bump on my chest and the line is plainly visible under the skin. Franken-monkee. Julie wants to know what happens if the line somehow comes unanchored from the vein. I have no answer for this.

The procedure was quick and painless, I spent more time in pre/post op then in the operating room. In addition to the incision in my chest, they told me there'd be a "puncture" in my neck but the end result is a knot of skin bound up in a stitch or two.  Looks like a hack job, definitely bigger than advertised. The whole region itches like crazy and I can't take a shower for 3 days...awesome.

Thurs: A little pain, a little itching, full day of work.

Fri: Bone marrow biopsy! The last test they need to perform before treatment. This one involves sticking a large gauge "horse" needle in my ass and into the hip bone to withdraw some bone marrow and a bit of bone. Outstanding! This one was not as painful as advertised but was pretty humiliating. Due to new/visiting personnel, there was a lot of misscommunication in the prep for the coring of my butt that resulted in at least half of the oncologist's office walking in on my bare ass waving in the breeze. I was seriously concerned that they were going to have to stick me a couple of times and almost walked out. I think my favorite moment was when the nurse described the procedure and said "you'll pull your pants down a little and the doctor will just get in there and get after it". I lost it when she said that but she somehow failed to see the humor. They said I'd be pretty sore for a few days but I've had much worse from falling on my butt playing far.