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No hospitilization for this five-day session of chemo...and no new PICC line, either. Toward the end of the week, the nurses were running out of veins that weren't burned out by the chemo. After the third day's chemo, the cumulative effects of the chemo were hitting me again, but this time, I was at the ECCC, where the nurses gave me IV Ativan instead of PO. Instant relief...at least for a while.... Same was true for the remaining two days.
13Mar: Dr. Hsiang (Harvey) wanted me to get two labs done (i.e., get more blood drawn), since the latest he had was very old. When he mentioned what he wanted, I reminded him that he had had me get those done two weeks ago, and should have the results by now. He found them, and was VERY pleased with the numbers. Most of what he said was medical stuff with, to make it worse, a Chinese accent. There was one thing he said, though, that I understood: the numbers mean that the cancer is NOT [emphasis his] resistant to chemotherapy.
14Mar: I got one of the nurses to give me an explanation in plain, layman's English, along with the numbers that Dr. Hsiang was so excited about.
The two blood indicators he was looking at are alpha-fetoprotein (αFP) and human chorionic gonadotropin (βHCG). If they're going up, it's bad...down is good...sharply down is very good, and is exactly what the doctors want to see.
Here are the numbers that Dr. Hsiang was looking at:
| Time | αFP | βHCG |
| Initial | 407.0 | 7451.0 |
| 09Feb06 | 608.0 | 3033.0 |
| 01Mar06 | 19.3 | 35.0 |
Note the rather drastic drop in both numbers. This is not an absolute indicator, i.e., it doesn't automatically mean that the tumors are going away, but it is an extremely good sign.....
15Mar: After chemo, as I was leaving (nausea once again being a pain in my backside as the IV Ativan wasn't doing its magic as well by that point), I saw Dr. Chang. He asked how I was doing, and I told him I wasn't feeling so great, but that given the numbers on the previous labs, I'd take the nausea, weakness, and generally sick feeling any day. He agreed, and as I was starting to head toward the lobby door again, he mentioned that he'd seen the latest chest X-ray, and that the tumors were almost gone.
Helping dad and Joey with some gardening type stuff (pruning grape vines, to be exact)...but didn't put real shoes on—still wearing slippers. Some heavy green thing falls out of the truck and lands right on the toe next to my pinky toe on the right foot. I won't repeat my words at the time....
RBC count is low yet again...still not low enough for another transfusion, but this time, Dr. Chang instructed the nurses to give me Procrit. If I heard correctly, I'll be getting it every week now until the last round of chemo is over...but I'm not sure I did hear that correctly. We'll see.
Chemo (Bleomycin only). Phlebitis in veins in both arms from last week's chemo session (more of the "my arms are on fire" bit). Dr. Chang orders blood cultures to check for infection. He also orders X-rays of my right foot. After the X-ray, after saying that it looks normal enough to me, I'm (unofficially) told that no, it is NOT a normal X-ray, and that I need to stay off of my feet...but that the real word will have to come from the doctor.
The nurses then get the difficult part: finding a vein that they can use.... Actually, I think I had the harder part, because I had to keep getting IV needles (whatever) stuck in me.
News for today: my fever is really trying to push near the limit...but it hasn't made it there yet, and I intend to do what I can to prevent it from getting there. As for my toe, I got the word today: it's broken, stay off of it as much as possible. Beyond that, there's nothing anyone can do.
Only one tiny bit of news for today: I got a call this afternoon from the ECCC—Dr. Chang made an appointment for me for next Friday (31Mar06) with a doctor (orthopedic type) in Niceville for my foot. He wants me to pick up the X-rays from Tuesday when I go in for chemo next week and take them with me.
My question: WHY? What's the point? If there's nothing anyone can do, and there's no sign of infection, or anything like that, why bother?
Non-cancer related news for today...but what the hell.... I've been annoyed by Windows' lack of something like Unix's procmail(1) (a free and very powerful e-mail filter available for Unix in source form), as I designed JStrack to use procmail (or a similar filter) to process incoming e-mail from the WX-ATLAN distribution list to handle NHC/TPC products and pass them to JStrack's filter, which then extracts the data for JStrack's tracker portion of the code. Unfortunately, for Windows users, there's no such utility (despite constant claims from Windows "experts"—you know, the ones with pieces of paper that say they know what they're talking about, even if they don't—in various flame wars that "anything that can be done in Unix can be done in Windows, and done better and easier"). I've even asked said self-proclaimed experts, and the best reply they could offer, after my explanation of exactly why I needed such a utility, was always along the lines of, "why would you want to do that?" Idiots.
Anyways, I'll step down from the soap box for a moment and continue with my not-so-brilliant revelation (I say not-so-brilliant because it should have been far more obvious). Right now, Windows users are forced to use the FTP kludge that I hacked together. Unfortunately, if the NHC/TPC FTP site is down, busy, or just being cranky, that script doesn't do much good...and I couldn't even begin to tell you how many times I've gotten e-mail about how the script isn't working, only to find that it's another case of the NHC site not accepting the connection, etc..... In some cases, I've gotten the same e-mail from the same user over and over again.
Ok, so what's this great idea? Simple enough..... Use tcllib's pop3 library and hack together a quick POP3 client for windows...one that won't mind piping a copy of JStrack e-mail to JStrack's filter for processing (and one that can run in the background, etc.). Yes, I could compile an existing POP3 client using cygwin and gcc, but that would require users to install cygwin...and some may not want to (some seem to like the Windows interface...strange). Anyways, it should be fairly simple...then the user just sets up a POP3 account specifically for WX-ATLAN advisories, and the rest takes care of itself. The FTP script then becomes just a backup for when WX-ATLAN is down...as it should be.
Yet another vein deciding it likes phlebitis...this one is on the back of my left hand (another spot they've had to use for IVs for chemo). This is getting very annoying (not to mention painful).
Funny thing happened last night...I woke up, it was cold—the fire had died down. So, I grabbed a log out of the bucket and put it on the fire. Now, apparently there's a trick to this that, not having lived around a fireplace before, I don't know...because it immediately set off the smoke detector. I was not amused (but I am now...).
Yep, more chemo today...and I have no idea (nor do I dare think about) where they're going to find a vein they can use.... More later, if there's anything more to type....
a) Weight Gain...Not Happening (good news!)
Ok, here's the story for today.... First, weigh-in, blood pressure and temperature, and the usual stabbing of one finger for a CBC (complete blood count—that's where they measure the levels for red and white blood cells, platelets, and all of the related stuff—I get a printout of the results a few minutes later). This is part of the standard routine...I only mention all of that because the first bit, weigh-in, confirms, yet again, that I've avoided one of the potential side effects of the chemo: weight gain. Weight gain and weight loss are both potential side effects—but generally at a very unhealthy rate, as I saw during the first week of chemo.
During the first week of chemo, I lost about 10–15 pounds in less than a week...not a healthy weight loss...but once the chemo was over, I returned to the weight I started out at the day I originally went to the hospital, and have continued to stay at EXACTLY that weight (except that the original number was at home, without clothes, and the numbers now are with clothes, but that's not going to be very significant in this case, given how light the clothes in question are).
b) Finding a Vein
For the Anzimet IV (for nausea), they found a vein on the back of my right hand. When that IV finished, in the short time it took for the nurse to get ready to flush the line and get it ready for the Bleomycin (basically, grab a syringe pre-loaded with saline), the blood around the IV site clotted up, and she couldn't even flush it. So...she had to find a new site, which ended up on the back of my right wrist. Two IVs that took about 15 minutes each, and it took two IV sites to get it done.... Next week is going to suck, particularly when one considers that I'm running out of useful veins.
c) Overall Effects (today)
As for effects from today's chemo (so far—some effects from Bleo don't hit for a while), no nausea to speak of, but it did basically wipe me out.... It's not cold tonight, but I am (no fever)...and I'm flat out tired. Zero energy. And given that I keep drifting off as I type this, it's time to quit typing and call it a night.
d) More Tests
Dr. Hsiang wants another round of tests for αFP and βHCG. So, one day early next week, after chemo, I get to head over to the outpatient side of the main hospital and get more blood drawn. All of the vampires will get to be happy next week....
Well, as usual, today is THE DAY AFTER.... And the Bleo is having its way with my system. I got up this morning an hour later than usual, and with barely enough energy to get out of "bed" (a recliner in the living room is my "bed"—sleeps nicely, too!). Got up, made coffee, got online for a bit (well, ok, an hour or two—you can't do anything fast over a dial-up Internet connection), and after that, started feeling really cold again (again, no fever—just anemia and other side-effects of the chemo). So I laid down on the couch with two heavy blankets over me, and proceeded to fall asleep again. Wake up later, re-heat my coffee, and fall back to sleep. Repeat...a few times. I finally actually got moving around noon...but only to a certain degree, with very little energy. My coffee had been nuked a few too many times, so I dumped it and poured a Monster(tm) instead. ;-}
But even if I do sleep completely through the bad days after chemo, I'm just following one of the suggestions from the nurses, so I'm not going to get too upset about it!
Funny note: my dad's wife, Karen, just turned on the satellite radio, and started with what sounds like progressive metal (need to hear more to be sure). Dad left the room...Karen turned up the volume. :-) Nope, not a prog. station—just rock....and not even very good rock (after the first song).
Not much going on today.... I got insurance for my truck and bought a few pepper plants—habanero, tabasco, cayenne, etc...but they didn't have any Thai peppers, and my prik ki nu and Thai piquins didn't survive the winter. :-(
I have that appointment with the orthopedic guy for my broken toe tomorrow morning...oh joy. At least I can get him to look at my knee while I'm there and make the trip worthwhile.... And then next week...oh, there's a fun one...we begin round four of chemo...another five day ambush on the veins in my arms. At least they're finally starting to recover from the last round....
What a complete waste of time, other than getting Thai food (yes, of course I got it Thai hot) from Thai Saree (my favorite Thai place), that is.... The doctor looked at my toe, wrapped it, and gave me some kind of shoe that's supposed to keep it from moving so it'll heal right. The shoe is already history...and the wrap isn't going to last much longer, either. Both are (well, is/was) a royal pain in the ass.... Oh, and as far as looking at my knee...this guy apparently only knows feet and ankles...so I have to see one of the other doctors for my knee. He did at least check it out enough to confirm that it needed to be seen (he told me what the damage he suspected was called, and even though I can't even remember it, much less pronounce it or spell it, I do remember that, based on what I read on the Internet (but didn't save a copy of—DOH!), that's what I suspected, too.
Oh, one other good thing: at Thai Saree, I got some variety of Thai prik (not sure which one, but it looks like prik ki nu...but then again, so do lots of other varieties of Thai pepper), so I'll be starting some seeds in peat either this afternoon or tomorrow.....
It's about five minutes...if that...since I typed the above...the wrap that the doctor put on my toe is now history, too. It may have been more uncomfortable than that blasted shoe....