Chemo treatment 2.6 down and salt in the wounds...

It hasn't been any easy week since the last post and that is why you haven't seen some updates. I have had to battle through some excessive sleepiness during the day leaving me exhausted and ready for bed in the evenings. Even on nights I would get a decent amount of sleep. I guess with the impending change of seasons and increase in allergens in the air, my body can feel it a little more acutely with being on all the meds I am on. I have been trying a stronger dose of tryptophan and that might be adding to it. This is a pretty good sleep aid, I find it to be better than Lunesta.

To add to it. Monday night I went to bed with an inflamed wisdom tooth. Yes, I still have one and its showing its ugly head at the wrong time. It has been pretty sore all week causing me to have to take 800 mg Ibuprofens, which lower my blood platelets - not good. At one point, I hit it with the toothbrush and it started bleeding pretty good. I went to bed with that flavorful blood taste in my mouth! So now I have one big sore to add to the plethora of little sores from the chemo. And, Dr. Chen does not want me doing any major dental work while on chemo. While as I write this, the tooth has greatly improved, Dr. Chen did give me a prescription to an antibiotic to be on the safe side.

Finally, I had to wake up to Dana Reeve dying on Tuesday morning. I followed her battle as well as I could since she was diagnosed a month before me. I have been craving a little more information as to how she could have quickly turned for the worse and passed on from the complications. If I recall correctly, and I can't find any sources on the internet, I thought she was diagnosed with stage 3 Non-small cell lung cancer, although I don't think I ever new what subtype. It was said she was doing both chemo and radiation so that does confirm she was at stage 3. While I have stage 4 NSCLC, my subtype is adenocarcinoma of the right lung primary. This is a disease more common to female smokers. Since Dana was not a smoker, it could be possible that she didn't have adenocarcinoma. Of the 4 subtypes, adenocarcinoma is the middle aggressive form. There is more aggressive forms of NSCLC and maybe that is what Dana was dealing with. With her youth, stage of cancer, and amazing strength and positive outlook she had tending to her late husband, I thought she was a good candidate to beat this disease and so I looked to her for a little inspiration. Sadly, we see just how bad this disease really is. I guess one positive result of her unfortunate death is the day of press dedicated to Lung Cancer education and awareness. The main message that got out all day was that you don't have to be a smoker to get it. About 10-15% of the nearly 200,000 Americans to be diagnosed with Lung Cancer are not smokers and half of those diagnosed had quit smoking years ago. But, there is about 2-3% of us who are under 50 and non-smokers. I guess I represent the 1-2% under 40, lucky me. But I guess if its a rarity for a person like me to get the disease in the first place and its rare to survive this disease, maybe I can keep the rarity going! While I crave more info related to Dana's death, it is irrelevant to my personal battle with the disease. I guess I would like to know if she was hit with pneumonia or some other infection and it got her. Or, maybe I just feel pretty bad for the Reeve family and the ordeal they have been through. Seems unfair that she was a beautiful angel to her husband only to be struck by what I see as the devil's poison. Life just has a way of being unfair at times. But this is the life we have so we must enjoy it every minute of everyday. The unfairness only reminds us just how precious and delicate it really is. You can live the richest, purest, and loving life and still be struck by tragedy. However, the flip side is you can live as an asshole not once stopping to enjoy life or smell a rose, more likely to step on them, and live a long miserable existence. It really is your choice. My heart goes out to the Reeve family and I still draw strength and inspiration from Dana's battle. I continue the fight for her and all other cancer patients in the world.

So enough of the salt and onto the sugar. Since I was so sleepy on Tuesday and reeling from Dana's death, I called into the clinic and talked to Krystina about how I was feeling and the sore tooth. She felt it was probably the allergies hitting harder on me this year with my immune system being lowered from the chemo. She said she got by chest x-rays back and things were looking much improved from the last chest x-ray done last November when I head to check in to Swedish with the chest pains. See the November 23rd post to remember. She said that they had the meeting of the minds that morning and my case was reviewed. Dr. Chen had reported that they could see marked improvement. I was glad to hear that Dr. Chen, Dr. Chue, Krystina and the Naturalpaths get together and discuss patient cases. I always thought doctors would get together and discuss cases and pick each others heads, such as we do at the office amongst the project managers from time to time. So it was good to hear and confirm its not just a one man show. I bet Krystina makes a point to get her 2-bits in! So Krystina and I finished the phone call with her telling me it was good to call in and if I felt the need, to stop in at any time for a check up.

Before I went to the clinic on Thursday, I stopped in to see Dr. Sodhi and get him caught up. He clearly didn't look to good and was obviously burdened by the recent death of his young son. He was still very professional and concerned about me, but I could read his pain on his face. I know it will take time for him to heal. I got him updated on everything and he said I was looking real good. I felt that meant a lot more since its been a month from the last time I saw him. He said the color in my skin looked great, he said he could see some weight gain, and my pulse has been stronger the last time he could remember. I told him about the x-ray and the recent echocardiogram. While the x-ray showed improvements from the last time, I didn't get the results yet for the echo. But when the tech was doing the ultrasound, I could see on the screen less black space meaning less fluid build up. But ultimately, I don't have a trained eye for those things but it did add to my optimism. Dr. Sodhi said to keep it up and that I was headed in the right direction. I finished off our appointment telling him how sorry I was for his loss and my heart is with him and his family. He squeezed my hand with a smile and thanked me.

So I got over to the clinic with time to spare and found myself having to park on the street again. This time a couple of blocks away in a 3-hour zone. I gave a little prayer to the parking enforcement gods and left. It was a cold and blustery day so the walk sucked. I got into the clinic and it was a little busy. My boss John was coming into join me so I asked George if he could get me a private room so we can do a little work. So I took my seat in the waiting room and waited...and waited...and waited. About 1:45 PM, Dr. Chen walked through and said there you are! He was a little put off and snapped at Jess the receptionist that my appointment was at 1:15 and I needed to be hooked up and going. Jess said George just took a lunch and Dr. Chen said get Rebecca then. So a minute later, Rebecca called me for vitals. My bp was up at 134/84, pusle was 88 bpm, blood O2 was 98%, and weight was up to 201 lbs. I was then escorted to my private room. Jessica soon came in and jacked me in, took a blood sample and hooked up my IV to start the sodium/sugar water solution. She later came back with zometa. We talked a little about Avastin getting approved for lung cancer and the expected dramatic cost increase. That was a source of contention with Jessica and she let her liberal side flare. I guess Genentech is a sore spot with the nurses. I guess they are the first one's to hear it from the patients when drug costs and copays go up. In the meantime, the drug reps come in and leave hundreds of free samples. As they say in the DARE program to kids, the first one is always free and then they get you hooked! So I asked if a good marijuana grower recently stopped by to drop off some free samples. We had a good laugh and frustrations went away.

Dr. Chen came in soon after and plopped down my thickening file and we got busy. He said the x-ray was looking impressive and said that it was compared to the x-ray taken last November. He wanted me to remind him all the events that led up to that last x-ray and when the heart fluid was drained. I told him the heart fluid was drained in mid-September. I had a couple of echocardiograms and within a couple of weeks could see the fluid building back up. By the time of the November x-ray, I was about three-quarters back to what it was orginally at the time of the draining. It peaked around late December according to an echo and interpretation with Dr. Olsen. Dr. Sytman confirmed right before Christmas. Neither wanted to drain it again until complications with the heart and lungs can be confirmed. Since the first of the year, things have been improving with regard to the chest pressure and heart palpitations. Dr. Chen said the x-ray showed a much smaller heart sack volume and less "ghosting" in the right lung. The "ghosting" is merely a guess as to what it could be. It might be fluid or mucus buildup, the pleural effusion, or possibly the main tumor. When you look at it, it looks like a cirrus cloud drifting in the lung void, here is more cirrus clouds over Mt Rainier while we are at it. This is an x-ray of a severe right pleural effusion that was similar to what I was dealing with last September, it looks like a large cumulus cloud sitting in the lower lobe. It was why I was on oxygen for a week, but a simple water pill cleared it up. Anyway, Dr. Chen hadn't received the results of the echo yet and called in George to start tracking that down. Dr. Chen then told me that my insurance rejected paying for next weeks PET/CT scan. He said he just dictated a letter and sent it off to them. I asked him if its something they only want to pay for a couple times a year and he said they should expect to cover it every 3 months since that is the standard progress check interval. He said they tend to always reject it in favor of pushing just doing a CT scan so he always has to go back to them and tell them why the CT scan is not effective. For some reason, my tumor(s) don't show up on the CT. Furthermore, the PET gives the standardized uptake value (SUV) scores which are a better prognosis tool. I am scheduled to get this done Friday, March 17th. Hopefully my insurance approves and we can get on with it. Dr. Chen did his exam and said things are still looking and sounding good. He seemed more animated then usual. I was thinking it might be the meeting of the minds on Tuesday giving him thoughts and ideas to act on today. Maybe there was also a sense of urgency since Dana Reeve also died on Tuesday and there are similarities between both of our diseases and non-smoking backgrounds. We finished our conversation in time for Jessica to hit me with the benadryl. Of course, that is also when my boss John comes in.

Soon after the benadryl, I got started on the chemo. John and I talked about the chemo and premeds and he asked Jessica a lot of questions. That was good, I was trying to review a few things Amanda emailed over from the office. John and I then discussed work related items for a while and it became a good talk. We have had some ups and downs lately and it was good to both vent and put heads together to figure things out. However, we didn't get long to talk as Darin interrupted us for my acupuncture appoinment. John came with me and watched as I laid on my stomach and Darin filled me up with needles from neck to lower back, following my spine. John said I looked like a pin cushion and I told him it felt great. Darin did say I have a higher pain threshold then many of the patients. I clearly and wickedly enjoy this! John said he might have to give it a try. Honestly though, I am not sure if its really a higher pain threshold or that it brings quick relief to the aches and pains. I wanted Darin to work on my back because the lesions on my spine were flaring up the last couple of days. At times, it would get pretty achy. Since the acupunture, I haven't felt a thing. In fact, as Darin was adding needles, I started losing the ache feeling and we had a hard time finding some sore spots I knew where there. But, Darin is good, he would use a little accupressure and eventually find those tender areas, then poke it! After getting filled up with needles, John headed out to beat the afternoon commutte home. I laid there another 20 minutes with the needles in me and the last of the chemo dripping into my veins. Darin came back and pulled the needles and it took me a while to move after being so relaxed. Finally, I got back to my room and Jessica came in to unhook me. Amanda had been calling while I was loaded with needles and I needed to get back to her. She had sent me another item to review so I stayed there in my room until 6 PM finishing up my review so I could get it back to her so that she can get home at a decent hour. Thank goodness the clinic offers free wifi internet.

When I left the clinic, there was snow mixed into the rain. It was cold and I had to walk that couple of blocks back. The parking enforcement gods once again answered my prayer so there was no tickets on my windshield...