Tuesday, September 25, 2007

Halfway through - some bumps in the road

It is 10 pm, and I am feeling better than I have all day. Actually, I am probably feeling better than I have in days. I hope that I wake up feeling this good tomorrow.

Denial is an interesting thing. I can see now that I was in a bit of denial when this all started. I guess that because the prognosis is fairly positive, I thought "I don't have real cancer". It was like I was just taking the introductory course - the real stuff was for those who were sick, and tired, and got fatigued just standing up from their chair. That wasn't me. Until this week. This past week has been much harder than the first three weeks of treatment. I have been nauseous, tired, and overall just aching. I walk hunched over, and slow - when I can get up at all. I spent the entire weekend in bed. When I took my shower yesterday, I had to get back in bed afterwards because it had taken up all my energy just to shower and dry off.

The hardest thing is that I never know what will make me feel better. My wife and kids see me looking like I am hurting,and ask me if I need anything - YES! I need to FEEL BETTER. Problem is, I have no idea what will accomplish that: do I need a steak sandwich, a glass of water, a heating pad, an ice pack, more pills, what? I honestly have no idea sometimes what I need. So we guess. I usually guess the steak sandwich.

It is also tough to know which aches and pains are normal, and which I need to tell the doctor about. My arms have been hurting for quite a while now, and my neck stared to really hurt over the weekend. When we went into the doctor for my shot today, I decided to mention it, even though I thought I was just being a baby and assumed they would just say to take more Tylenol and deal with it. It was a good thing that I did mention it - as it turns out, the PICC line that had been my savior for the past two weeks has now become my nemesis. It irritated the vein just enough to cause a couple of blood clots, and they had to remove it today. I am now on blood thinners for a while. I was worried that this would interrupt my chemotherapy, and that it might extend my treatments, but the doctor said that for now it should not affect the treatment schedule at all. I just have to stay on the blood thinners for a few months.

As usual, I am trying to stay looking on the bright side. I was a bit worried today as we were discussing what this all meant with the doctor, but it really is nothing more than a small speed bump on the road to recovery. Maybe I am still in denial, but sometimes a little denial can be a healthy thing.

Wednesday, September 19, 2007

Chemo - cycle 2

As expected, I had a fairly good weekend. I was up and around quite a bit, but did run out of energy and still needed some occasional naps. I am now on day 3 of my full week of chemo, and am finding that I am feeling the effects a bit faster than I did the first time around. The last time I had the full week of treatments, I didn't really start feeling the effects until Thursday. This time, I started feeling tired yesterday (Tuesday), and am feeling it much more today. I am already finding it hard to concentrate, and just to take the time to write this is causing me to have to focus more than normal.

I am very glad that I got the PICC line. It has been very nice to just hook me up in the morning without have to get stuck with a needle. My right arm, which hadn't had any needles since just over 3 weeks ago, is finally just about back to normal - yesterday was the first day that I could extend that arm without feeling pain at the elbow. The vein had just hardened up from the I/V, and it was in almost constant dull pain, which would turn to a sharp pain when I extended my arm. The PICC line is taking care of that, as I am now on my third day with no side-effects in the vein that it empties into. I wish they had more fully explained the options before I started, as I would have chosen the PICC line right from the start.

We did have a minor scare last week, when my incision from the orchiectomy started to show some signs of infection. My doctors are very concerned about any type of infection, since my immune system is dramatically effected by the chemotherapy drugs, so we wanted to ensure that there was not a problem here. As it turned out, it was just a couple of stitches working themselves out of my body. I am not sure why they didn't dissolve like they were supposed to - maybe that has something to do with my blood cells working overtime on the cancer, and ignoring the stitches. That is just a guess though - Darn it, Jim, I am an engineer, not a doctor .

In an effort to maintain full disclosure, I need to mention that I had a pretty down day last week. I think this has all finally gotten to me, and I just crashed emotionally. As my kids will attest, I am a fairly emotional individual when it comes to things close to the Spirit, and I tend to get chocked up when talking about spiritual matters. However, it has been a very long time since I just felt like crying for no reason. Last week I had one of those days. It was not from asking "why me", or anything like that - I was just down and depressed about things in general. It passed fairly quickly, and I am back to my normal self now. It was strange to be in such a funk and not know how to get out of it, so I just slept through it.

Overall, I am still doing well physically. I am feeling more nauseous this time, but still have not been sick to my stomach yet. I am more tired this time around than I was last time, but I am still keeping up with work tasks and meetings, and seem to be handling the treatments well. My hair is falling out slowly, but for some reason my eyebrows have not yet been affected. Strange.

I think that is all I have for an update this week. I am expecting the next few days, probably trough the weekend, to be the toughest yet. We'll see if that turns out to be true. I hope I am not setting myself up for a self-fulfilling prophecy, but rather just being the pragmatist that I am.

Thursday, September 13, 2007

Cycle One Wrap-up

One down, two to go. The first 3-week cycle of chemotherapy is now complete. I met with my doctor today, and he said everything is progressing well and on-track. So, I get another good weekend, and then I start on the full regimen again on Monday. Last weekend was pretty good, with each day getting just a little bit better. I don't think I had to take a nap at all this past Monday, which was a first. The doctor said this is one of the tougher cocktails of chemotherapy drugs, and was pleased to hear that I have not been sick at all.

This week has thus far mimicked last week, with the Tuesday shot in the morning, and me sleeping much of Tuesday afternoon and evening. Wednesday was tough, with today just a little better. Again, I spent much of the late afternoon and evening in bed. I have been able to make it into the office a couple of times this week, which is nice because it gets me out of my bedroom.

As expected, my hair has started to fall out this week. Of course, my head is already bald, but we are now finding hair from all over my body falling out in the bed, in the shower, on the bathroom floor, etc. It is strange - I can run my hand over my arm, and several little hairs will just fall out. I can understand how unsettling it would be if I still had hair on my head.

I am truly humbled by the wonderful service of my great neighbors. Before all this started, Debbie and I (mostly Debbie) had been spending quite a bit of time in our yard, trying to get our landscaping in this year. We had completed the front yard, but the backyard still needed quite a bit of work, and Debbie had been out there by herself ever since I started my treatments.

Our caring neighbors took notice, and for the past two days we have had neighbors in our yard digging, raking, setting sprinkler heads, etc. What an outpouring of love and support. We don't feel worthy of such service, and are humbled greatly by it. It reminds me of the quote from Thomas S. Monson: "In the New Testament we learn that it is impossible to take a right attitude toward Christ without taking an unselfish attitude toward men." We have seen such Christlike service and giving from our neighbors, family and friends.

Although I would never desire to be a cancer patient, it has been such a blessing in our lives already - just for us to see such unselfish service from those we love. It certainly makes it all more bearable.

Thursday, September 6, 2007

Week 2 of 9

They tell me that it takes 48 hours for the chemotherapy drugs to be completely expelled from my system. If that is accurate, then I am now drug free for the first time in 11 days, and it will be 6 more days until my next injection. I suppose that these next few days I will be feeling the effects of my body trying to replace the blood cells that have been used up over the past week, rather than the direct effects of the drugs themselves.

Today is a good day - very different than yesterday, when I barely made it out of bed all day. Today I am out of bed, and actually got out of the house for an hour or so. My legs told me it was time to sit down again, but I am not as fatigued as I have been. I have not yet found any rhythm or cycle to the fatigue, other than the fact that I haven't had two good days in a row yet. Some days I can move around, and even attend to some normal activities (like going into the office), others I can barely walk from the bed to the bathroom before I have to lay down for a few minutes. I was definitely overly optimistic regarding my ability to maintain normal activities, but overall it has not been as bad as it could have been. Still no sickness, other than some overall aches throughout my body.

We had one scare this past week. It was about 1 am or so Sunday morning when I awoke with my body completely soaked in sweat. I felt very hot, and thought I had a fever. They had told us that a fever of just 101 would be an emergency situation for me, as the drugs reduce my immune systems' ability to function, so I awoke Debbie so she could check it out. Luckily, she said my skin felt cold rather than hot, and it turned out that I didn't have a fever at all. She still called the doctor, who said that hot flashes from the medication are not uncommon. He said if it didn't pass in a half hour or so that we should go to the emergency room. It passed, and all was well again.

Both of my arms are black and blue and swollen. They ache, and have even hurt enough to wake me up in the night if I move them wrong in my sleep. I can still tell which vein the IV was pushed into, as they are still sore. Since we now know that my veins won't take the IV for more than two days before causing pain, I have requested a PIC line, which they will install on Tuesday before my next injection. This is a line that will be inserted into my fore-arm, close to the elbow I think, and they will thread it up my arm and into my chest, where it will empty into a larger vein. This will stay in place for the remainder of my treatments, and will be the source for all IVs, injections and blood work. The other option was a porta-cath, but that had to be surgically implanted in the chest, and seemed like overkill for just 6 more weeks.

I am starting to recognize the signs my body gives me. I can tell when my body is planning to shut down, and how long it will be until it happens. It usually starts in my legs, then 15 - 30 minutes later I feel it in my head. After that, I have about 45 minutes or so before I had better be in my bed. It is as though my body decides it is time for a "troop surge" against the cancer cells, and starts depleting the blood from my legs for this purpose. Debbie tells me that the body will naturally re-route blood from the less-critical areas of the body (such as the extremities), which explains why it starts in my legs. Why it goes next to my brain is anyone's guess (insert your own joke here...).

It does seem as though my mind has been getting clearer these past few days, and I almost feel back to my normal self today. I hope that these next 6 days are more like today than yesterday...

Saturday, September 1, 2007

Week one of Treatment

It is 4:30 Saturday afternoon, and I finally have enough energy to sit up and type for a few minutes. I have completed my first week of chemotherapy. It could have been worse - I never did get nauseous. I suspect that is due to the saltines and strawberry fig newtons that I kept eating, as well as keeping water by my bed all the time. I never did have to take the "emergency" medication that they prescribed for me, which I consider a blessing.

Things certainly took a downturn on Thursday. I found it hard to open my eyes on Thursday. I couldn't necessarily sleep, but I just couldn't keep my eyes open. Friday I bounced back a bit, and although I was fatigued, I was lucid and able to participate in a good meeting at work.

Today is a different story. My legs feel like rubber, and my throat is very sore. My stomach feels like I have been doing sit ups. It hurts to swallow - I have had a lot of ice cream today (which is unusual for me, as I really don't eat many sweets). Some things are starting to taste different - I couldn't tell the difference between a Diet Coke and a Sprite. My head feels fuzzy - I find it difficult to concentrate. This is especially frustrating, as I can't read or study anything since I can't focus my brain. Since I don't have the strength to get out of bed, and I can't concentrate, I find myself simply staring at the ceiling for periods of time. Very weird.

The toughest thing for me is that I am listening to BYUs opening football game while laying in my bed, rather than sitting in my normal seats in the stadium watching it (at least we are winning...). My boys didn't have to miss out, though - with the help of some good neighbors and family we got them to the stadium. It has been inspirational to watch family and friends provide such support - everyone is doing something to help - bringing dinner, sending gifts, cards, e-mails, prayers, thoughts. I truly believe that having such a good support system has also been critical to making this week better than it could have been. Things certainly could have been much worse this week.