Chemo Treatment #4 (+ 4 days)

Chemo treatment #4 went well on Monday. Mom and Dad accompanied me for the 10:30am appointment. Prior to leaving for the appointment they gave me a small present - a new HeadBlade shaver.

My New Favorite Toy

It works surprisingly well and takes about half the time as my regular 5-blade razor. I'm on a weekly head shave cycle so it's not too onerous to shave a 24" dome. And once it's clean I am usually donning one of the two cashmere stocking caps my sister Les made for me. They are as comfortable and warm as a stocking cap can be - thanks sis! Another decent side effect is that my beard is not growing nearly as fast so I only need to shave my face every other day.

We arrived on time for the appointment and immediately were into the routine with Dr. Seifter and the Q&A followed by a quick checkout. My blood pressure is normal and weight is down just a few pounds. It's then straight to the Chemo facility. Anna and her son Chris were there so I was glad mom and dad got to meet them. The CBC this morning showed that my white blood cell count was 2900, still where we expect. I forgot to get a copy so I'll get the trend data at the next treatment. It was a fairly busy morning in the unit with 4 patients getting chemo the entire time. We were in the facility for just less than 4 hours and then heading home.

By late afternoon on Monday I was more tired than I remembered from previous treatments. And the metallic taste, tingling tongue, and queasy stomach (am I hungry?) were all back. Time to settle in for a week or so in this mode. And I feel pretty much the same today - tired and tired of the persistent metallic taste. It's been a struggle to get 8 hours of sleep due to work and getting up in the middle of the night. I need to work at getting to bed earlier. As you can tell my humor is dwindling a little with the fatigue. No worries though, Jen reminds me often enough that I'm still a smart ass at home.

I've also updated the Medical Timeline page to include the remainder of my appointments as they are now scheduled. PET/CT #2 is on Wednesday (05-Dec.) and I really hope to see less (fewer and smaller spots) than we saw on the first scan.  March 15 is the last scheduled chemo treatment - can't wait.

Much love to you all.

Round 3: Brack 3, HL Bagel...and Some Thoughts on Being Thankful

Alison asked me yesterday "what's bagel mean?" when I was telling her some college football scores. I simply said "zero". That's how I've referred to a scoreless effort or a shutout for years. So Hodgkin's Lymphoma is still a big ZERO after Round 3. I continue to progress better than anticipated. My general state of being, energy level and appetite are doing really well. 

Due to the Thanksgiving holiday this round has the longest duration (and recovery period) at a total of 17 days. The flip side is Round 4 will last 11 days - just enough time to get back to normal before starting over. Round 3 was punctuated by a business trip to LA that took some getting used to. I had a slight scare for the first time during chemo treatment when my temperature strayed more than a degree outside the high side of my normal range (97.6 ± 0.2) in the middle of my trip. Fortunately I was paying attention and managed to slow down just in time. Since then it has been smoother sailing. My daily scores are below.

Round 3 Scores

This Thanksgiving I have found so much to be thankful for, and have taken pause more than any other time in my life to reflect on how fortunate we are. For my loving and endlessly supportive Jen, Chris, David and Alison I am truly thankful.  For the unconditional love and constant support from my mom, dad, brother, sister and our extended family I am truly thankful.  For our wonderful friends, who are as close to family as a person could imagine, I am truly thankful. For the exceptional care providers who help my family get through each day and week, I am truly thankful. I could go on...

Earlier this morning Jen and I were watching CBS Sunday Morning, one of our favorite weekend "news" programs. The last story on the show this morning was an Opinion piece from Joel Sartore, a National Geographic photographer. Less than a minute into the piece Joel showed a photo from his family gathered around the dinner table. On the left side of the photo was a young man with the same hairstyle that I am currently sporting. I immediately said to Jen "he's fighting cancer." As Joel continued his commentary we learned that his 18-year-old son Cole was diagnosed with Stage 3 Hodgkin's Lymphoma in August of this year. More than any time in my life I truly understood Joel's (and Cole's) perspective. And we soon heard, Cole's fight is in addition to his mom Kathy's ongoing fight because she had a recurrence of breast cancer early this year. As Joel stated at the link below... "Though it may be hard to believe, the Sartore’s are actually thankful."

He continued to talk about how many cancer survivors there are around us. And how fortunate we are at this time in history that medicine has advanced to the point where we can talk in terms of cures. And at the end of the segment I also immediately recognized that 200 ml bottle of red Doxorubicin, aka Adriamycin or the "A" in ABVD chemo regimen, the first chemo drug I get each week that looks like hummingbird food.

The video of Joel's commentary is not yet up on Joel's website or the CBS website but you can read the transcript here:

http://www.joelsartore.com/were-all-surrounded-by-survivors/

Last but not least, a shameless plug for a book I read last week. Kellie Larsen Murphy, the undisputed queen of white chocolate chip cookies (that she overnights to me during chemo treatments!), is also an up-and-coming author. Kellie is a dear friend since college and just published her first book. A Guilty Mind is a murder mystery with a touch of psychological thriller. It kept me guessing until the last few chapters and was thoroughly enjoyable. It's available through Amazon, Barnes and Noble and via the popular e-book outlets. Happy reading. 

Chemo treatment #4 is tomorrow at 10:30am. Mom and dad are going to accompany me again and I look forward to putting one more treatment in the rear view mirror.

Much love to you all.

Home Sweet Home

I traveled to LA for business this week and it was a challenge at times. Even though I took precautions like wearing a medical face mask on the flights, taking Airborne supplements, and drinking plenty of water, I now know that I got worn out. Both United flights were full and fortunately I didn't notice any coughing or wheezing during the flight. And I don't know what pollen is in air the but my sinuses have also been bothering me for a couple weeks.

With two full days of meetings, dinners in the evening, and hotel beds and pillows that aren't what they used to be, I didn't get the proper rest. I also ran a slight fever for a few hours late yesterday - yes I took my thermometer on the trip. Fortunately a couple Advil, a liter of water, and an hour of rest did the trick. I was able to go out to a fun dinner at a great cafe in Marina Del Ray with Meghan and her college roommate Annalisa. She's the oldest daughter of my good friend Big Murph. With a good meal in me I was able get a reasonable night of sleep.

Lesson learned.

Chemo Treatment #3

It was another very good, full day for lots of reasons... (1) one more dose of chemo moving me closer to being cured, (2) spending time with family, (3) impromptu meals with awesome people both young and closer to my age, and (4) seeing and reconnecting with long time friends.  

Alison and Jen accompanied me today since Alison had a day off from school. We started with her 8:30am physical therapy appointment to improve her arm positions on her swim strokes. Jen and I had coffee and breakfast at Atwater's cafe while we waited for Alison and then all three of us headed over to my 10am chemo appointment not too far away. 

We're into the rhythm now that starts with a quick question and answer session in Dr. Seifter's office, followed by a review of the most recent blood work, and finishing with a checkout in his exam room across the hall. The numbers we are watching continue to be good starting with my blood pressure at 120/70 this morning. The white blood cell count is at 2100 (slightly up from the last CBC of 2000) and remaining in a good place. And I noticed the red blood cell count is actually up slightly from the last CBC. I meant to ask a question about the granulocyte/lymphocyte counts but forgot and will follow-up at Chemo #4, which is on the Monday after Thanksgiving, a little more than two weeks away. My good friend Eileen will also be in for chemo that day so no doubt we'll  be texting each other as chemo buddies.

My most recent CBC is below and the trend data for all prior results is just below that.

CBC on 12-09-12

CBC Trend Data

Five others were in for treatment today. A couple people were there for 3+ hours like me, and the other two came in for short treatments and were gone in under an hour. My treatment ended right around 1:30pm, just after I received a text from one of my most favorite young women, Erin. So this can only mean that it's time for a trip to Miss Shirley's for an awesome late lunch. It's only 10 minutes from the chemo facility and a Southern style diner/restaurant. Jen and Alison are psyched because we try to eat there when we are in this part of town - usually for a swim meet. And it was a chance to have lunch with three incredible college students that we just love.

Erin is the same age as my oldest, Chris. And Erin rousted her older brother Ryan to provide transportation. The two of them are just spectacular, loving individuals who bring a smile or twenty to your face whenever they are around. And Erin was able to bring her roommate Caitlin, who we have come to know as yet another wonderful young woman. All three swim at Loyola University and were available for lunch. And we had such a fun time laughing and eating really good comfort food.

When we got home we were treated to a visit from another long time friend, Gabby who was up from Williamsburg today, in the area on business. Her husband Rick and I are friends and fraternity brothers from way back and it was great to see her. She stopped in for an hour or so and we caught up and shared photos. She's spending the night on the north side of town, here for n overnight stay  to watch her son Sam play in a lacrosse tournament tomorrow.

After an unusual 1-hour power nap  (unusual due to the anti-sleep effect of the corticosteroids coursing through my veins) we were off to dinner for a casual Italian meal at Luna Bella with John and Elaine. I work for John and it's just refreshing to be able to enjoy some quality time outside of the office with both of them. Another very good meal accompanied by great conversation. And one of things I am learning is to not over eat on chemo day. So far so good.

One of the many upsides to this slight diversion in my life is the amount of time I get to spend  more time than the usual with my family and friends. The depth of personal character of both close and extended friends continues to amaze me. From Deno's solidarity head shave this week (complete with photos on Facebook), to a quick call from Cheryle, to the usual emails or texts from the same core group asking how chemo day is going, to the weekly emails and calls just letting me know of the thoughts and prayers flowing my way, to Ellen's tips and advice that are making my treatments easier to adapt to (nice tat Ellen!), to the weekly chemo comparison with Eileen and Mitch, to random work email from a cancer survivor who appreciated a smile from me on the elevator and offered some good advice, to the comments from people I don't even know (thanks Kay and Steve)...the outpouring of love continues to amaze me.

My love to you all.

Round 2: Brack - 2, HL - 0

I'm really happy with how things are progressing. Round 2 has been very similar to Round 1 but a little better. I'm getting used to the rhythm and learning that, among other things, the occasional feelings of slight nausea are actually hunger pains. I have tweaked my scoring system since Round 1 to be less subjective and more data driven based on 7 factors: Sleep Quality, Hours of Sleep, Level of Activity, Meals/Appetite, Stomach Feeling/Nausea, Internal Systems, and Body Temperature. Each day I start with a score of 100 and deduct points based on less than optimal scores in each of the 7 areas. The pattern so far is that most of the first week is the "down time" in the cycle and the second week is back to normal. 

Scores for Rounds 1 and 2

I also had my second Pulmonary Function test today at the JHU Hospital Outpatient Center. While some of my trend data actually increased, the main value we're watching is my DLCO/VA. That dropped by 8% from my initial baseline on 28-Sep. It went from 108.5% of predicted value to 99.6% of predicted value. I will review these results with Dr. Seifter on Friday.

Chemo #3 is the day after tomorrow on Friday, 09-Nov. Alison has the day off and she and Jen are going to go along for the ride.

Out With The Old...

As planned, David shaved my head today. He's quite the barber. The continual shedding this week got old in a hurry. There's nothing like waking up multiple times in the middle of the night with a hairy (shag) pillow that's tickling your ears or nose.

It's a true November day outside today and I definitely notice the insulating effect my hair used to have. In my opinion the dome is not as bad as I imagined. Here's a few photos from the fun:

Before

During

After

Chemo Treatment #2 (+ One week)

Round Two is going well at the midway point, slightly better than Round 1. We’re getting a little smarter each week at figuring out how I’m responding and what to do as a result. And just as Dr. Seifter said it would happen, my hair started to fall out, little by little, on the day before Halloween…18 days after chemo started. Depending on how it progresses over the next couple days, or when I just get tired of seeing it fall out, we might just have a family head shaving party this weekend. I’ll post a picture or two when I join Big Murph, Wrigs, MO, Ritty, and others in the closely cropped hair club.

As far as my other reactions to chemo, here are a few so far. The metallic taste starts a day or two after chemo and lasts for as many as 5 days. It makes everything taste different, some things are worse than others. An occasional mouth-coating film accompanies the metallic taste and it makes most food and drink textures appear creamy. There's a few ways to minimize this, a quick olive oil rinse being a good way (thanks Rick). By day 4 I’m just tired of plain water although a little fresh lemon or lime juice does help (thanks Eileen). Fortunately lemonade tastes great all the time so we have plenty on hand (thanks Ellen). When the metallic taste fades, everything goes back to normal. During this same period there is the occasional queasiness but nothing serious so far. My appetite is still decent so I’m happy about that. One of the ways I’m measuring my daily score is by the number of Tums that are required on a given day. Although I’m not craving sweets as much (I know some of you will find that incredulous) ice cream still tastes great. And there is no desire for an adult beverage in the first week or so after chemo, oh well. Lastly, it feels good to stay active and my energy level is still high but I do get tired and need more sleep on really active days. 

I'm always reminded of those who are facing a tougher challenge than me. My sister-in-law Twila is back in Ohio to care for her mom Janet who is doing her best to beat Multiple Myeloma. She was released from the hospital yesterday and is back at home thankfully. And our good friend Danielle is back in Florida caring for her mom who has been in the hospital for several weeks now. She's just trying to heal from multiple internal surgeries but her body is not cooperating yet. Be strong and know that we love you all very much.