Get your motor running...
Dartmouth-Hitchcock Medical Center is a little more than an hour's drive from my home in Vermont. During that hour a lot can chorus through one's mind. It was while driving up, during one of the most glorious days of the year, for my Aug. 5 chemotherapy "preparatory" meeting, that I blurted out, "I want to live!" Where that came from, and why I needed to yell it out, is anyone's guess. But it reminded me of the winter of 2006 when, only weeks after I'd first found out I had CLL (Chronic Lymphocytic Leukemia), Ron and I had gone with our friends John and Kathy to Park City, Utah; and on the first run our first day we skied a black diamond called Widow Maker -- as I went over the ledge down into the extremely steep, frozen, powdery essence of life I yelled out, "I have leuuukeeeeeeeeemiiiaa!" Yes, I was truly living at that moment, and I still try to live every moment.
After checking in at Dartmouth-Hitchcock and having blood drawn for analysis, I found a barcalounger in which to kick back. I'd brought with me Anticancer/A New Way of Life by David Servan-Schreiber, M.D., Ph.D. -- a book Frank and Anne Wingate had given me a few years back. I started reading it and before long I was asleep. Leukemia saps your strength, and napping can be ever so delightful.
My meeting was with Anna Schaal. We discussed the process of three days of chemo (Aug. 12, 13, 14) followed by three weeks off, and then repeat for from four to eight months, depending upon how my cancer responds to treatment. However (since this is cancer there is always a "however"), they need to assess how the healthy white blood cells (and platelets) are performing two weeks after chemo, so I will return on Aug. 26 for more blood work, which will show how low on the "nadir" curve/graph they went after treatment (how much cancer has been destroyed in my system), which they will then compare to another set of blood analysis taken at the three-week point when I return for the next round of chemo. In essence, I have to be healthy enough to receive chemo; and if not, then we wait longer for the nadir to get back to a healthy state either on its own or through enhancements such as augmenting the quantity of any blood element that may need it. At my age I could have some other things augmented...
We also discussed how the first cycle of three treatments differs from the rest of the cycles. The key to CLL chemotherapy is the Rituxan, which they give sparingly on the first day and not at all on the second day in order to give my body time to react. And if everything goes as planned, i.e., my body accepts Rituxan, then they give me the remaining Rituxan on the third day, which will be administered fully on the first day of all future cycles. Basically, Rituxan will attach itself to my cancerous white blood cells, sending a message to my immune system to attack the cancer cells, which can result in my feeling as if I have the flu: nausea, dizziness, fever, shaking, headache, rash, aches and pains (to name a few side-effects). As I go through this process I'll let you know what I experience. But I'm confident I'll sail right through.
This meeting lasted 2.5 hours, so I will briefly cover the rest of the highlights.
• I've begun taking Allopurinol 300mg daily to protect my kidneys so they can handle all the dead cancer cells once they start flowing through; and there will be loads of them flushed away
• Prescriptions for nausea and anxiety have been provided and filled in anticipation of needing them. I've been told there are no medals for not taking these meds (thank you Catherine Gilmore -- and Anna thanks you, too), so I should look to fend off the nausea before it starts. The anxiety meds are to help me sleep (and deal with any residual Rituxan side-effects). Benadryl and Tylenol have been purchased to arm myself against any potential flu-like symptoms post treatment.
• Elise Busnach, the triage nurse, was introduced so I have a face with a name when, and if, I have to call regarding anything "funky" -- and I was told to call, call, call: Better safe than sorry. Elise and I are going to be BFF which, when I told her, put a huge smile on her face -- I'm already in love with Elise and I have yet to make my first call
• Eating a healthy diet of washed fresh fruit and vegetables is a must; don't eat things like sushi or buffets; stay away from areas where sick people may congregate (I'll wear a mask so they'll stay away from me); stay out of the sun; and I can't work in my garden (which I love to do this time of year -- oh, well)
• My hair may get thin (thinner...); nails rigid; skin dry; soars in mouth
• Purell, Bioteen, Gatorade & Dove are my go-to brand names (maybe I should buy their stock...)
Now for the depressing news (and you thought some of the above was depressing): I begged on hands and knees for 1) a handicap sign to put in my car so I could find a place to park (Dartmouth has a problem with parking) and because I deserve one for having cancer; and 2) for a prescription for medical marijuana now that New England is the Green Belt (I prefer Weed Belt), and it will help me with the nausea and being able to eat. But, alas, neither will be given to me. You'd think having cancer would warrant some benefits -- but no!
Back home that night I picked up Anticancer before bed and read until midnight as I waited for my computer to run a scan for viruses. I have to laugh: Here I have cancer and I stayed up taking care of my virus-infected computer. I love technology.
By the way, my fingers are still tingling from the vincristine, and I'm told they may be for a few more months; but my jaws are almost pain free, my stomach is only mildly rumbling, and my mouth has recovered.
My next visit to Dartmouth will be for my first day of chemo. I'll let you know how it goes, and give you more details around what I was told to expect and what I did experience. But remember, not everyone experiences cancer and treatments in the same way. Until we speak again...
Timing: Chemo beginning Aug. 12 (Rituxan, Cytoxan, Fludara); Aug. 13 (Cytoxan, Fludara); Aug. 14 (Rituxan, Cytoxan, Fludara)
Oh, and Catherine Gilmore, Dr.Sevan-Schreiber, Frank and Anne Wingate, Elise Busnach, and the inventor of the barcalounger have been added to my list of angels here on earth.
Get your motor running...
Postcards From Lebanon: Part 1
Postcards From Lebanon: Part 2
Follow James Stack on Twitter: www.twitter.com/SkygateStack