Thursday, December 17, 2009

So How Am I Doing?

How Am I Doing?


So far going well and I love the fringe benefits of this disease. (1) without any particular effort of will power on my part I have lost almost 30 pounds since pre surgery. (2) by starting chemo on Dec 7, I simultaneously turned 57 while getting medically reclassified as “Young and healthY” (...”young and healthy people like you have a better outcome than the overall statistics of 20-40% 5 yr survival”...)


So far going well, but I have not yet had to cope with losing my hair or gaining oral and GI ulcers. Still I can’t complain. I feel amazingly well, I have wonderful insurance (Tricare) and a generous medical leave policy, and have been almost overwhelmed by the support I have received from family and friends both nearby and far flung.


While I would not recommend an exploratory lap or chemo for your next vacation, I have to say that compared to what I was expecting based on what I observed during my residency more than 20 years ago, this is a whole new world.


I undoubtedly benefited from an excellent surgeon and surgical team, including the post-surgery nursing staff at Emory. But I have also benefited from advances in surgery and management of peri-surgical complications including pain. Thanks to an epidural and excellent pain management I really was minimally uncomfortable following surgery. Initial efforts to get up and walk were not particularly fun, but I can honestly say that gas pains were the worse thing.


They now clamp these pneumatic devices on your ankles that alternate compression massage of your calves post op – which was WONDERFUl. I found myself pushing the assitance button in the middle of the night and saying things like “Could someone please remove the spa treatments from my legs and assist me to the rest room?”  I recognize the intent was to decrease the liklihodd of a life threatening blood clot in my legs, but the effect was really luxurious and relaxing.


And these days you are immediately issued post op an elastic abdominal binder similar to the ones that men who do heavy lifting on the job wear to protect their backs. This terrifically decreases the stress on the abdominal muscles in the post-op era and made it much easier and more comfortable to move, get up, walk and so on.


And of course I benefited massively from the assistance of cousin Jane and Sister-in-law Debbie for the first couple of weeks after surgery.


As for chemo – the old days of nausea and vomiting are apparently history. For me at least, the new meds are remarkable. The only time I had any problem with nausea was when I made the mistake of taking my meds before I put my glasses on and, as a result, mixed up my compazine and my oxycodon. That resulted in a little vomiting and a day of napping instead of work, since it was easy to reverse the nausea with meds once the error was recognized, but removing the effect of the already ingested narcotic was not so simple. A really dumb and dangerous mistake. I now have  firm rule that I am only allowed to take medication when I have glasses on.


The nausea is controlle with a pill I take every 12 hours and another shorter acting one that I take when needed (compazine). For the first 3 days after chemo as long as I religiously take the 12 hour pill on time I have minimal awareness of nausea. For the first 2 days I usually take the short acting compazine one at what I think of as “Shift change” (pop it an hour or 2 before the next dose of the 12 hour pill is due) and that suppresses any discomfort as the longer acting pill is wearing off.


Really it is pretty amazing how well these medications work these days. I feel very blessed.


My energy is variable. To date I have been able to take medical leave on Mondays (for chemo) and Fridays (for lab work) but work either from CDC or from home the other 3 days of the week. I admit I am not as productive as I usually am, but I have been able to consistently develop and distribute the weekly special report on H1N1 response that I have produced since last spring, and do a bit of additional consulting with the Plans Decision Unit, peer review for the medical literature and other odds and ends. I anticipate this may decline as time goes on, but for now it is working well for me.


So put away those visions of me languishing alone and ill at home. I am getting out several days a week, accomplishing at least a little bit at work, and generally except for fatigue feeling really quite well.


But thank you very much for your concern. I can’t say often enough how very appreciative I am of the incredible support you all have provided.


I intended to provide an update on chemo, but it seemed more important to address these concerns that keep coming up. And my energy is a bit low right now. So I am deferring the chemo update for another day.

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