Today was supposed to be Treatment #11...in fact I went in to the Oncology clinic this past Friday prior to the long weekend to get my bloodwork done to determine whether I would even have treatment today. My Oncologist had warned me in our meeting to discuss my CT scan a week ago that treatment may be delayed in light of the drop in platelets from my previous bloodwork. However, the bloodwork from this past Friday came back quite positive. Platelets had rebounded to 91 (100 is the threshold for treatment but in light of there being only two treatments left there was good chance that we would push on with levels just below the threshold) and neutrophils were 2.05 (1.5 is the lowest threshold for treatment so I should have been fine with this count). The nursing team told me to come in Tuesday (today) and prepare for treatment.
My sister, Jodie, who lives in Guelph made arrangements to take today off and come down to TO to accompany me at treatment. She had never joined me previously and with three young girls and a husband at home it was a considerable gesture to arrange to be my Onc buddy for this treatment. We headed for the hospital for my appointment time of 11am and I asked the receptionist if I was still required to do bloodwork today since I had had it done on Friday and she confirmed that Dr. Lingas (my Oncologist) considered the three day long weekend enough of a timeframe to warrant me having my bloodwork analyzed today. So...another bloodletting and wait in the waiting room that was packed, busy since the clinic was closed yesterday on Thanksgiving Monday. Jodie and I had a good conversation about the process...about the usual routine for treatment. Then, one of the nurses, Michiko, came in to the waiting room and sat down beside us to talk about the bloodwork. As soon as she sat down beside me I knew the news wasn't good - you see, if you are cleared for treatment the nurses simply come to the door of the waiting room and call you into the treatment room. And the news isn't good.
My platelets have dropped to a dangerous count of 59. This was a significant drop over the weekend and represents the lowest they have ever been since treatments began in May. Of more importance this level means I now suffer from chemotherapy induced thrombocytopenia. This condition makes me at a significant risk for bleeding as the clotting factor in my blood has been compromised. It isn't quite at the dangerous level for internal bleeding but the downward trend is alarming and needs to be monitored. (http://www.chemotherapy.com/side_effects/platelet/managing_platelet_count.html) It also might be why I have been so friggin' fatigued inside my bones - basically I have no strength. None. Nada. And no stamina. Climbing stairs is almost embarrassing for this once physically fit male. My hips ache, my knees and legs have no energy or strength. I sometimes even have to grab the banister to pull myself up - when noone is looking of course.
My neutrophils dropped to 1.88. This is above the lowest threshold for treatment but represents a significant drop in three days even after a round of Neupogen injections the week previous which are meant to stimulate my bone marrow to produce neutrophils. So the downward trend is alarming and makes me immune compromised...at risk for infection, fever, illnesses that would otherwise be warded off in healthy individuals but unfortunately can pose a serious threat to cancer patients like me whose immune systems are compromised. A simple fever or infection is an Emergency room visit. Admittedly I have been seriously fortunate all things considered for the course of treatments...I haven't yet succombed to any flu, fever, sickness in the 5 months of chemo on top of the side effects of the therapy.
What does it all mean? Well it means that I was not well enough to continue treatments today. In fact, Dr. Lingas has requested a delay of an entire week for the next treatment. Damn. I am trying really really hard to focus on something positive but it is tough to do so. I guess I feel very fortunate that my Oncologist insisted on doing bloodwork today even after having it done on Friday and that she is putting my safety and health at the forefront. Delays in chemo treatments are crappy. Ironically we cancer patients want to get through these treatments according to the prescribed schedule for maximum efficacy - the protocols are designed with a schedule that sets dosing and cycles of treatment to maximize/optimize their results. My attitude from day one has been let's go....full dose...manage the side effects as best as can be but stick with full dose to optimize the results. Kill the beast...do their job.
So I will cling to the positive that my safety is top priority and accept that treatment #11 will have to wait another week. That means that my last treatment will be at minimum October 30 and possibly not until the first week of November. Victoria's due date is November 27. With treatments going into November we are both sad, anxious, desperate for the end of the treatment cycle. I soooooo badly want...no...need to be stronger and feeling better than I have been when the baby arrives. I have no idea how long it may take for me to recover from these treatments...I would imagine some side effects will take much much longer to resolve themselves if they indeed do such as the peripheral neuropathy, mucositis, fatigue. And now to add to the list my fingers are a complete mess...I mean they are a disaster...it is painful for me just to type this blog post. The nails are disintegrating and my fingertips are constantly in nerve pain. My chemo coach, Aunt Diana, has "warned" me about this possible side effect and it has now come into effect full force in the past month.
It is what it is. Treatment #11 will have to wait a week....but then there is just one left after that. The end. No more chemo.
So in tribute to my friend and fellow battler, Barb...BRING IT ON.
My sister, Jodie, who lives in Guelph made arrangements to take today off and come down to TO to accompany me at treatment. She had never joined me previously and with three young girls and a husband at home it was a considerable gesture to arrange to be my Onc buddy for this treatment. We headed for the hospital for my appointment time of 11am and I asked the receptionist if I was still required to do bloodwork today since I had had it done on Friday and she confirmed that Dr. Lingas (my Oncologist) considered the three day long weekend enough of a timeframe to warrant me having my bloodwork analyzed today. So...another bloodletting and wait in the waiting room that was packed, busy since the clinic was closed yesterday on Thanksgiving Monday. Jodie and I had a good conversation about the process...about the usual routine for treatment. Then, one of the nurses, Michiko, came in to the waiting room and sat down beside us to talk about the bloodwork. As soon as she sat down beside me I knew the news wasn't good - you see, if you are cleared for treatment the nurses simply come to the door of the waiting room and call you into the treatment room. And the news isn't good.
My platelets have dropped to a dangerous count of 59. This was a significant drop over the weekend and represents the lowest they have ever been since treatments began in May. Of more importance this level means I now suffer from chemotherapy induced thrombocytopenia. This condition makes me at a significant risk for bleeding as the clotting factor in my blood has been compromised. It isn't quite at the dangerous level for internal bleeding but the downward trend is alarming and needs to be monitored. (http://www.chemotherapy.com/side_effects/platelet/managing_platelet_count.html) It also might be why I have been so friggin' fatigued inside my bones - basically I have no strength. None. Nada. And no stamina. Climbing stairs is almost embarrassing for this once physically fit male. My hips ache, my knees and legs have no energy or strength. I sometimes even have to grab the banister to pull myself up - when noone is looking of course.
My neutrophils dropped to 1.88. This is above the lowest threshold for treatment but represents a significant drop in three days even after a round of Neupogen injections the week previous which are meant to stimulate my bone marrow to produce neutrophils. So the downward trend is alarming and makes me immune compromised...at risk for infection, fever, illnesses that would otherwise be warded off in healthy individuals but unfortunately can pose a serious threat to cancer patients like me whose immune systems are compromised. A simple fever or infection is an Emergency room visit. Admittedly I have been seriously fortunate all things considered for the course of treatments...I haven't yet succombed to any flu, fever, sickness in the 5 months of chemo on top of the side effects of the therapy.
What does it all mean? Well it means that I was not well enough to continue treatments today. In fact, Dr. Lingas has requested a delay of an entire week for the next treatment. Damn. I am trying really really hard to focus on something positive but it is tough to do so. I guess I feel very fortunate that my Oncologist insisted on doing bloodwork today even after having it done on Friday and that she is putting my safety and health at the forefront. Delays in chemo treatments are crappy. Ironically we cancer patients want to get through these treatments according to the prescribed schedule for maximum efficacy - the protocols are designed with a schedule that sets dosing and cycles of treatment to maximize/optimize their results. My attitude from day one has been let's go....full dose...manage the side effects as best as can be but stick with full dose to optimize the results. Kill the beast...do their job.
So I will cling to the positive that my safety is top priority and accept that treatment #11 will have to wait another week. That means that my last treatment will be at minimum October 30 and possibly not until the first week of November. Victoria's due date is November 27. With treatments going into November we are both sad, anxious, desperate for the end of the treatment cycle. I soooooo badly want...no...need to be stronger and feeling better than I have been when the baby arrives. I have no idea how long it may take for me to recover from these treatments...I would imagine some side effects will take much much longer to resolve themselves if they indeed do such as the peripheral neuropathy, mucositis, fatigue. And now to add to the list my fingers are a complete mess...I mean they are a disaster...it is painful for me just to type this blog post. The nails are disintegrating and my fingertips are constantly in nerve pain. My chemo coach, Aunt Diana, has "warned" me about this possible side effect and it has now come into effect full force in the past month.
It is what it is. Treatment #11 will have to wait a week....but then there is just one left after that. The end. No more chemo.
So in tribute to my friend and fellow battler, Barb...BRING IT ON.
Oh Dave, I am so sorry that you are going through these delays and concerns even while being so close to ending this chapter of your life. I can't say that I know what you are going through because for some reason my platelets and neutrophils have remained stable throughout all this. The only issues I really had was in the beginning with low hemoglobin and that was fixed rather quickly with a handy-dandy blood transfusion. Since then they have found evidence of protein in my urine a few times but nothing ever came of it. And on my most recent scan they found a wedge shaped dark patch (for want of a better word - don't have a copy of the report myself) that was a minor worry, but the onc said it was more indicative of an infection than canser, so she put me on Levaquin and I am feeling better already. Didn't even realize how crappy I felt and the shortness of breath I was experiencing until a day and a half into the script and I started feeling good again. I'm telling you all this to illustrate how many things can happen to us at this time and how quickly they can deal with them. Just remember, there are only two left! And with no sign of any metastases, no reason to ever have to go through it again. This is nothing more than a completely-life-changing experience that will make you appreciate Victoria and that new little baby all the more. And you will be amazed how quickly you will forget all the nastiness once it is over. Thinking about you everyday Bud. Take good care. Hugs.
ReplyDeleteHey, Barb. You nailed it on the head...it's hard to explain to those that aren't going through this experience or haven't experienced this personally just how a delay in treatment can make us feel, make us react with such emotion and worry. Even though in my case I have had such positive news lately I cannot help but worry at my core that every day of delay in treatment gives those f$%^ers an opportunity. And to hell with that!!! No way...but damn if my immune system and platelets put me at too much risk to undergo treatment #11 on schedule. You are so right. This has been and will always be a life-changing experience that has put everything into perspective. I absolutely appreciate Victoria for all that she brings to my life -and will forever feel blessed with both her and our child. I don't know when I will ever forget all this nastiness...probably not until I physically start to feel normal again assuming that I one day will. It feels like forever since I felt normal that I don't even truly know exactly what "normal" is. All I know is that I cannot wait to be able to taste again, to be able to grasp a pen in my fingers and be able to write LEGIBLY, to feel things normally without the nerve sensitivity, to not be exhausted from walking up and down Bloor Street where I live, to not need to hold on to the bannister walking up stairs, to not be nauseous or sour or just without any appetite for days and days, to no longer look and feel like a 12-year old boy with all the bare patches on my body...to have my hair grow back and no longer be completely thinned out...I could go on. But what I am most looking forward to is to regaining my energy and my strength to be there 100% for Victoria when she needs me most. Thanks, Barb for the pep talk. I needed that. Hugs back.
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