next day part 2

i failed to explain that I did not start my new medicine today because the instructions say to start it at night because it likely makes you drowsy. Too bad I did not think about that last night. Looks like tomorrow may be another late start day.

New medicine starting tonight. Check in in a couple of days to see (2) how the labs on Thursday go and (2) if I am still awake enough to add to the blog after I start the Gabapentin.

next day

I let the dogs out and went back to bed. I woke up at approximately noon ish when someone called me. Apparent;y that post-chemo famous steriod boost does not work as powerfully as it used to on by the 6th cycle. Although I did take a sleeping pill last night. But at about 10 pm and it only lasts for about 8 hours. And in the past often was not very effectively at all.

Oh well, sub total of accomplishments today:
1. made further progress on the necessary arrangements to be made to close out my original checking account and operate contiually out of the new and hopefully more secure one
2. becaue it was such a beautiful day (63-66 and sunny) and because my white blood cell counts had been the highest they have been in months yesterday due to the week vacation from chemo (4,500 - almost low normal) I decided to take advantace of the beautiful day to get out and run some necessary errands before my energy faded
3. dropped off and picked up dry cleaning, out breakfast/lunch out at panera bread, did grocery shopping for essentials (OK mostly for cravings like crystal light drinks and coconut cake for Easter, but also fresh fruit and other good healthy things), and tracked down and identied the driving route and time to the local place in Atlanta where I go for chemo next Monday on account of my usual chemo nurse being on vacation.
By the time i got home and feed the dogs it was after 4 and I was pooped.
4. so it looks like probably no more paperwork accomplished today. Unless i whip through my medical bills while watching TV from the recliner chair.

Still over all pleased to be starting my 6h and last round of standard chemo. a few small wrinkles.

I did not start my new medication - Gabapentin also known as neurotin. Despite my eager description of how the week without chemo had really improved it and although I occasionally had trouble opening things the frequency with which I was aware of it beyond my hands and feet (legs, back face) had really receded and practically disappeared. they were not impresssed and thought I should start this drug, normally given for seizures, which is supposed to slow the progression of neuropathy and then after I finish the standard chemo to increase how rapidly it receeds. Apparently it can take years to receed.

Also, this morning I looked down and noticed petecia around my ankles. these are little red spots that often form when platelets are low. If you are a fan of CSI or NCIS or other detective shows, these are the little red spots that medical examiners point out to the detectives as evidence that the dead person was strangled or someimes drowned. But I promise you no one has been sneaking in and trying to strangle my feet while I sleep. Remember, the dogs lack pre-hensile thumbs. And low howls at the first evidence of intruders. so....

Likely these date from last week when we know my platelets were low and I just failed to notice them until today. If not, it may be a sign that my platelets are dropping rapidly in response to this latest round of chemo. On the good side - that is clear evience the chemo is doing what it is supposed to do. On the down side - it may suggest another delay may lurck in my future. Time will tell. We will get the first hint when i have my blood tested this thursday.

The people who clean my home every other week came this week and suggested that could help me take down the Christmas decoratins and put them away. Hmmm. I told them my cousins were coming on April 25 and I had promised them they could help take down and put away the Christmas decorations as a celebration of finishing my chemo. That made my cleaners happy. I hope have have finished chemo by then but if not, I will still be ready for the Christmas decoratioms to go away. Somehow once Easter passes they cease to seem festive and become sort of tired.

That is all the news that is fit to print for today.

6th cycle successfully started

Blood counts were adequate today, so we successfully started the 6th and last cycle of standard chemo. That means after starting the day getting blood counts done at the hospital, I received my 3 chemo drugs, had a doctor visit (well really with the nurse practitioner who works with dr. Green but he also dropped by later), and got the schedule straightened out for the next part of the chemo.

The next 2 weeks, assumeing my cell counts hold up, I will get taxol alone on Monday. My wonderful chemo nurse Elizabeth will be on a well earned vacation in Hawaii the following week, but has arranged for me to get my chemo here in Atlanta in the office of Dr. Green's partners. And the third week in addition to the Taxol on Monday and the labs on Thursday, I will have to get additional labs, have another doctor's visit, and get a CT Scan. It will be a very busy week.

If I have the schedule right, and if all the counts hold up, the following week I will be finished with standard chemo, but not with the whole run. I will start the part of the investigational trial where I get Avastin alone the first Monday of every 3 week cycle and will continue this part for nearly a year.

I also hope to start back to work that fourth week.

All in all it will be a pretty busy 3rd and 4th week. Wish me luck.

Z-Z-z-z-z-z-z

So after all that bragging about my stamina yesterday i spent most of the day today dozing in the recliner chair again.

Oh well, I still have the weekend to try to knock off more of the past due paperwork before I get dosed with poison again - I hope. The clinic called to say my platelets (labs from Thursday) were up but only to 95,000. So I have to have labs tested again Monday morning before I can get the chemo. Since they only have to rise another 5, 000, hopefully they will accomplish that by Monday and I can proceed to start the 6th and last cycle without further delay.

My day in court

A week without poison is a wonderful thing. My amazing increase in mental concentration and physical stamina is remarkable and reassures me that the recovery period (once I stop pouring poison into my body every Monday) may be a lot faster than I had been thinking.

Today was the day I was required to appear in court because of that speeding ticket that I received about a month ago while en route Gainesville to get my labs tested. the assigned time was 2 PM.

Today was also the day I had to drive to Gainesville to get my labs tested. So I started my day rather early in order to get to GAinesville, collect all the labs, get back to Atlanta, and find the court which is a long way from my house in southwest Dekalb County.

I have been quite worried about my stamina and ability to manage the court date. I have also been worried about spending time in a crowded court room full of people, some of who were likely to have things like colds, flu, possibly even multi-drug resistant TB. But there was nothing optional about the citation. Show up or your driver's license will be suspended and a warrent issued. No other alternatives were offered.

So it was a relief that my last transfusion was last Saturday in prep and that this week I happen to have bonus energy because of the deferred chemo. Little did I suspect how important that would turn out to be.

After dressing in a suit and putting on make up for the first time since I quit working, I drove to Gainesville, gave blood, and got back, and went to CVS to invest in a supply of surgical masks with still an hour to spare before I was required to be in court. Seemed at that point like I was doing excellently well.

About the surgical masks: those are the little green masks that people can put on by looping things over their ears (used to have to tie them around your head). How good a job do they do preventing infection? Well that is debated. We used them when I was a medical student and only about a quarter of our class converted their PPD skin test and had to take a year of medicine to prevent TB illness. The official recommendation for both H1N1 flu and TB from CDC is currently an N-95 respirator, which will make it almost impossible for a virus or other microbe to get in. As it turns out I own an N-95 respirator - a large grey mask with large bright pink filters on either side issued to me during the Hantavirus outbreak. Any of you who received Christmas letters back in 1993-4 may recall one with a photo of me, gowned, gloved, wearing a large loud face-obscuring, alien-bringing-to-mind face mask and shaking a rodent out of a trap into a plastic bag. Yup. that is the one.

So I considered wearing it to court today. Probably if I had been a doc advising a patient how to prep for a long day in court surrounded by lots of people of unknown health status that they could not avoid closely associating with, I woudl have said "Look, it is your health on the line. Just wear the mask and look foolish but protect your health".

But doctor's make bad patients, I was not eager to draw so much attention to myself in a public display, and a little afraid that the court woudl think I was grand standing or trying to be a smart alack, so I went for surgical masks instead.

Circumstances of my citation: entering the Interstate to drive to Gainesville I noted 3 Dekalb count police cars lined up on the right hand edge of the interstate (an uncommon sight) with the door of the middle one open and a policeman aiming what appeared to be a radar gun directly at me. So naturally I checked my speed. Fortunately for me it was 63 and since I thought I was in a 65 zone I breathed a sigh of relief and continued with my habit of immedaitely moving over to the 5th lane just next to the HOV lane. This is the least trafficed lane. Further more when I exit for Gainesville I do so by moving onto 985, which exits from the left. So... it is certainly the easiest and probably the safest way to make this particular commute. I remember noting that the traffic was heavier than it usually was on my Thursday commutes to Gainesville.

So cruising along in the 5th lane, imagin my surprice when a cop car comes up behind me with his lights flashing. I pull over (which took a while since I had to traverse 5 lanes back to the right hand side and pull over). (but it also took the cop a while to get up the nerve to get out and walk up the edge of the interstate to my car. you would think that if you were driving along and you saw a car pulled over to the right and a cop car right behind it you would automatically move into at least the second lane to decrease the liklihood that the cop would get flattened when he tried to exit his car and walk up to mine. But apparently this thought did not occur to my fellow motorists so... Flinch...flinch... eventually get out and come up.

to my surprise he told me that the laser gun, operated by a different cop whose name he gave me, had clocked me at 75 in a 55 zone. I told him I thought it was a 65 zone. I was wrong. I also told him that I would protest that because my speedometer when I was directly by the guy with the gun had read 63, which is no where near 75. He repeated the name of the guy who had the gun, in a way that seemed to disclaim responsibility for the accuracy of the clocking. And gave me a citation that required me to present to court today at 2 pm. No option not to just pay the fine and skip the court call.

So today, after weeks of worrying about my physical stamina and risks of infection, i went to court. So did, by my count, about 50% of Dekalb county. When I arrived the first clue this was not a normal day in court was the fact that I passed 3 filled parking lots and had to keep driving into what felt like the wilderness to find a lot I could park in. the second clue was the line of citizens that snaked around 2 sides of the building just waiting to get into the building. The third clue was the fact that the traffic violations were being tried in 3 courtrooms divided by first letter of your last name. The final clue was that a policeman was screening at the door telling you if you just took yourself over to the far lane and got into the line where you immediately paid your fine today they would knock 10 miles an hour off your citation.

Amazing - I have never been aware of the police having fire sales for discount citations before. I have never seen such a mass of people being herded into court before. But then I have never seen the police lining up on the interstate with 3 cars on the sholder using a lazer gun and the other 2 police to chase and issue citations before. The effort seemed puzzling since this is not a part of the interstate that has many accidents. I travel it regularly and have never seen a crash. But the county and city governments are experiencing financial hardship leading to furloughs of critical public safety personnel, and therein lies, I suspect, the motivation behind this set of speed traps (I witnessed the same performance 2 more times in the next couple of weeks with 3 Dekalb county cars, and now frequently notice one gwinnet county or Hall county car further up the interstate sitting on the side of the road in the more usual (and safer) manner looking for speeders.

The problem with this is, puzzeled how my speedometer could read 63 and the laser gun read 75, unable to convince myself that between the ramp where i entered and the very next exit where I pulled over I could have possibly sped up more than 12 miles per hour beyond the last measurement I noted on my speedometer, I had done some research on the accuracy of laser guns. And here is what I learned.

They are most accurate when following the car for longer periods of time. Whether a laser gun or a radar gun, they cannot lock onto a car and follow it despite larger vehicles passing in between then with out a clear line of sight to that car. So for instance when I was riding along in the 5th lane (the only time I could have sped up without noticing it) with 4 lanes of moving traffic between my little compact car and the guy with the gun, it is likely that the speed the speed of the intended target car (my car) but rather that of some in between vehicle. And lastly there was information I did not fully understand that talked about cosine effects and stated that if a radar was 30 yards off the target lane with a 300 ms sample period (I assume this is 30 millisecond but who knows...) and a +/- 1 mph accuracy, the gun could not measure a target going 65 miles per hour accurately if it was less than 230 feet (77 yards) away. While I did not understand all the physics, I did understand that the only time he could have directly tracked me before I crossed over to the 5th lane I was far closer to him than that, due to the position there on the shoulder.

So I had decided that I would not just pled guilty and pay the fine, I would agree to pled guilty to my offense (63 in a 55 zone) but not to the citation (75 in a 55 zone) which was obviously an erroneous measure for all the reasons outlined above.

a note, the week before I got the citation a law had changed that raised the ticket price considerably for anyone going more than 20 miles an hour above the speed limit. Further suggesting to me that it was not a coincidence that the citation said 75 in 55. The county needs money.

but between then and now the little parades of 3 police cars on the edge of the interstate targeting cars have disappeared. and today the county is offering a deeply discounted sale on tickets if you just quietly give them your money right away and go away. I interpret this to mean that someone in the county police office had figured out the same things I did about the likely accuracy (or lack thereof) of laser citations under these circumstance. That Plus the more junior cops probably got tired of putting their lives on the line pulling people over on the interstate and then having to get out and walk along the side of traffic flinching every time a vehicle sped past for no reason that had to do with public safety.

I declined the deal, but sat in court watching long lines of folks who had accepted it being processed before court started for the rest of us who stubbornly chose to skip the sale. Which, by the way, still packed the courthouse. Then they processed us into two groups - those pleding guilty or nolo and a second group pleding not guilty. This group was much larger and would have to go to court at a later date. I suspect that it is rare for more than half the people required to show up in court to pled not guilty and agree to go to court. So maybe many of them had been doing the same research I did.

But court is intimidating and scary. Sitting there I began to worry that I had made a bad decision. Could I prove what my speedometer said? Well, no, I was alone in the car. Did I want to incur the cost for the state of a court trial (which woudl likely exceed the cost of the ticket) for something so trivial? Well not really. Suddenly it seemed utterly inadequate to stand up and explain what had seemed really logical before - the discrpancy between my speedometer reading and that of the laser gun which exceeded all reasonable margins of error, the multiple aspects of the physical situation that raised the probability that the laser reading was, indeed, inaccurate. As it appeared to be too late to just knuckle and pled guilty, which I truely do not believe I am but court and disagreeing with police is scary, I decided maybe I needed to call a retired judge that I knew and ask for a good lawyer. This whole thing seemed to be blowing out of proportion, but then that was what they counted on when they did mass citations of people targeted under conditions that likely did not result in accurate laser gun readings, then required them all to show up at the courthouse and offered a deal where 10 miles an hour were knocked off the citation if you just lined up and paid your fine immediately. Which does not seem right, no matter how much financial trouble the county is having. And tends to undermine trust in the police. At least my trust.

In the end, when I was called up to talk to the clerk to schedule a courtdate I handed her my paper pleding not guilty and told her I was unwilling to pled guilty to 75 in a 55, which I believed was erroneous. I did, however, prefer to avoid going to court and I was willing to pled guilty to what I was guilty of, which was 63 in a 55 zone. She told me if I went downstairs to the cashiers and paid the fine today they would knock 10 mph off the citation, so it would be 65 in a 55. I said fine, hot tailed it to an ATM, took out a bunch of cash, and went back to the cashiers where I stood in line for nearly an hour to pay my fine. Sometime during that hour it occured to me that this was the same deal the cops were offering to anyone they could convert before the court hearing.

Not sure if I won or lost that one. But no one in DEkalb county should really need to pay property taxes this year and I am confident we raised enough money this one day in traffic court alone to practically stop all furloughs of public safety officers and to build new schools all around.

Another odd thing - the crowd was more than 95% black. I don't know the composition of Dekalb County, but the repsentatives from 3 of the 6 districts are black and the other 3 are white. If that reflects demographics, the people in the courtroom were way disproportionately black compared to the county population. Racial profiling? hard to imagin since the cops, court clerks, and cops present in the courthouse were almost universally also black. But it does seem that something is disproportionate in who winds up being required to come to court for traffic citations. Maybe there was some deal I missed where you got to have 10 mph knocked off your citation AND did not have to actually show up and spend your day in court.

But for now, it is over and I am grateful. And when I remember practically lying on the counter when forced to stand in line for an hour in the post office to mail something important by overnight mail, and compare that to today when the only weird thing about my behavior was wearing a surgical mask, I am grateful that this was the week chemo was deferred and my energy level way up.

On the way home I dropped all my tax prep paperwork with the accountant. Another chore knocked off before I again start droping poison into my system weekly.

http://www.moesmisadventures.blogspot.com/

My college friend Gina (Mac '74) in Seattle is a smart lawyer, savy political commentator, and as the daughter, sister and mother of physicians and currently a lung cancer patient, a person with an acute interest in health care legislation. I just discovered that over the past couple of days she had posted a series of thoughtful and informative (summarizes key components of the health care legislation passed by congress and provides informed commentary on the probability that the lawsuites arguing that the federal government does not have the constitutional right to impose a requirement to buy health insurance will succeed) on her blog, the link to which I have taken the liberty of posting above.

The purpose of her blog is not to debate health care, so if you have negative reactions please send them to me in an email instead of bothering Gina with them (unless you are a friend of Gina's in which case, swing away).

Myself, add me to those who believe that the current American system needs reform. And that a base of government sponsored "socialized" medicine that provides the basic essential medical care to all Americans to supplement the better policies that all cannot afford would be a very very good thing.

After all, government medicine is providing my health insurance (Tricare) and medical leave (PHS policy on medical leave) and is the insurance and health care provided to all vets who seek care at the VA, to all uniformed services active duty and retired and dependents, and to medicare and medicaid beneficeries. Not to mention members of congress.

Time will tell whether the specific provisions in this legislation were wise or not. But for myself, I think it is time something began to change. If you have access to good medical coverage, and you do not work in clinics where you prescribe necessary medication that patients cannot afford to fill or EDs where people with no coverage present for emergency care that could have been avoided if they had had the option to present for preventive care, and if you do not work with these folks enough to learn their stories which rarely are as irresponsible as it is convenient to believe if you want to maintain the self -protective belief that others have less benefits than you because their behavoir has made them less deserving - then it is easy to think that the system is not broken for far too many Americans.

This does not solve anything - but at least it is a start in the right direction.

If you think we can't afford this, then raise my taxes (and those of all Americans in my tax bracket and above - but not below). We can afford to provide minimum care for our most needy and prehaps it is a better thing to do than buying bigger houses, redecorating more expensively, or investing in additional stock portfolios.

Just my opinion, but i am sticking to it. The wealthiest nation on earth should not have one of the lowest prenatal visits and highest perinatal mortality rates and the majority of bankruptcies should not be due to unexpected familial medical expenses. It just should not be so.

Gifts this week

On Sunday a friend from work brought over a large supply of home made Irish Stew and stuck around to watch TIVOed Harry Potter movies with me.

On Monday my neighbor took me to chemo and back, then brought over a large supply of delicious home made beef and vegetable soup.

On Tuesday I recieved a note from the Sylva First Baptist Wednesday night prayer circle and a large CARE package from my neice Emily, who thought the remainder of my chemo would go better if I was supplied with popcorn, her favorite movie, a large U Oklahoma T shirt and spotted Sooner socks.

By Wednesday night when my neighbors across the street supplied hot fresh home made pancakes and grapefruit for my dinner, I had realized that having to delay chemo this week was a blessing in disguise. My energy and mental concentration has been notably better allowing me to (cumulatively since Monday) return to work and clean out my cubicle and check the job postings, catch up on bills and paperwork in most cases (still behind on going through all the medical bills...), and get all my paperwork organized to be able to take it to the accountant before the March 30 deadline for this tax season.

Wednesday I also receieved calls from my sister in law Dore and my cousin Ed confirming plans to visit in April. and from my sister just checking in.

All in all, not a bad week. Tomorrow I have to return to Gainesville for lab work, go to court to argue that I think the speeding ticket erroneously recorded my speed (my speedometer said 63, not 75, and the difference in fine is considerable). Then I have 3 more days to finish the remaining paperwork before I get dosed with poison again (hoepfully) on Monday March 29.

If all goes as planned, I will start my 6th and last cycle of chemo on Monday MArch 29 and complete the 3rd and final dose on Monday April 12.

Fingers crossed.

Last Chemo cycle delayed

Today when I went for chemo I started the day by reporting to the hospital to have a STAT blood count done. this has been required every time my lab test on the prior Thursday show a white cell count or hemoglobin (red cell) count that is too low to allow receipt of the chemotherapy. Which means it has happened essentially every week (every week except for 1) for the last nearly 2 months. Every since before my first transfusion.

This Thursday my hemoglobin had been low enough that I was required to go in for another transfusion (the third) last Saturday. And the white count was low enough that I had to repeat it this morning before I could get chemo.

But this morning for the first time I had blood counts that were too low to get chemo. Ironically not the white cell count, which was 2,200 which is higher than it has been for some time. (it has to be at least 1,500 before they will give me chemo). And my hemoglobin was so high that I did not even qualify to get the shot of erythropoitin that I have gotten nearly weekly for some time.

But the platelet count was low - 85,000. Normal is over 100,000 and that is what is required to receive the chemo treatment. Below 50,000 there is real danger of bleeding problems since platelets are important to help blood clot.

So the start of cycle 6 has been delayed a week to let my blood counts recover.

This may be a good thing. The neuropathy (numbeness and tingling in my hands and feet) has been getting worse and interfering with my ability to open packages sometimes. Hopefully with a week of no chemo it will improve a bit before I start poisoning the system again.

Also, while the original sporothricosis lesions have cleared up on therapy, I noted Saturday night some new lesions on my right thumb. So maybe it is good to give a full week of Itraconazole treatment for the sporotrichosis before I knock my white blood cell down again. It can spread widely in immunocompromized hosts and I don't really thing that would improve my exprience, so happy to do whatever I can to keep it contained.

Of course this will delay my completing the course by a week, as well as my returning to work by a week.

In the big picture I am quite lucky to have gotten this far without delays, and this is really a rather small thing overall. I am just getting impatient to finish and move on to the next phase.

Well, I can manage one more week.

how we talk about cancer

http://well.blogs.nytimes.com/2010/03/15/with-cancer-lets-face-it-words-are-inadequate/


the link above takes you to a New York Times Health article that discusses experiencing cancer and the language we use to try to describe it. Gina Cullen (Mac '74 from Seattle) identified it on her blog, where she often shares her experience with lung cancer, and I appreciated it enough to copy it here.
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For myself, I agree that "fighting" does not sound like what I am experiencing. Neither does "bravery". More - since i have given up on working for the remainder of my just over 3 weeks of remaining chemotherapy and mostly spend my days sitting in a recliner chair watching South Park, old Harry Potter movies and other things TIVOed from cable with the dogs - I would have to say I can't remember when i have felt more relaxed - a state not really compatible with "fighting".

Nor does "brave" seem to describe my internal emotions. More like "acceptance", a far less demanding emotion.

I am optimistic about outcome here, but recognize realistically that the optimism may not predict outcome. Putting things in order internally and externally is an easier stage than the periods of life when I have been struggling with persistent hard battles. This one is mostly out of my hands - although I fully intend to do whatever i can to make decisions and take actions that will tip the balance in optimistic directions.

Beyond that, each day the primary thought is, given the limits of my time or (these days mostly) energy, what is the most valuable use of the time available to me today? that is the most important decision I face these days. Actually probably the most important decision any of us face any day - just much of our lives we have the luxury - or disadvantage - of not being conciously aware of that.

Thanks again to all of you for your support, your friendship, and your gifts to my life.

68 degrees and climbing

Atlanta weather took a sudden change into spring. The past couple of days the temperature has been sunny and in the high 60s, lovely spring weather resulting in large numbers of daffadils blooming out in the yard.

This was good timing, as the SHEA (Society for Health Care Epidemiology and ?) meeting took place in Atlanta this weekend and large numbers of medical scientists and other professionals descended on our fair city as a result. Including Stu Johnson with whom I had a lovely dinner on Friday night. Between the two of us, we caught up on most of our fellow interns from so many years ago. Stu came equipped with a thumb drive full of the latest photos of his family and friends, but neither he or I could figure out how to download it to my Mac. So I had to settle for verbal descriptions.

My ability to enjoy the lovely weather was impaired by being required to again travel to Gainesville for the usual weekly laboratory testing on Thursday, but then in addition to spend part of Friday being typed and crossed (lab testing in prep for another transfusion) at Northside Hospital in Atlanta and then spend most of today at Northside actually getting the 2 units of packed red blood cells. The Friday experience was prolonged because for the first time my port did not seem to be working well - but that was straightened out in the end. (My port is a permenant indwelling thing that allows me to have blood drawn and receive chemo or transfusions or other things by vein without having to have a new IV placed each time).

But now post transfusion again my energy is higher and tomorrow, Sunday, is another open day. Hopefully the good weather will hold, I will get some chores done at home and have some time to spend sitting in the yard enjoying the weather...

Monday will be the first treatment of my last cycle of standard chemotherapy. That means it will be my last 3 drug treatment day (Taxol, Carboplatin, and Avastin), and will be followed by 2 successive Mondays of 1 drug only (Taxol - the flower power drug), after which I will have completed the standard chemotherapy portion of this treatment. That will be followed by the investigational phase during which i will continue to get Avastin IV once every 3 weeks for approximatly a year. However, the Avastin alone is not expected to have a big impact other than further beating the cancer into submission. I expect that after April 5 my hair should start growing back, my strength and mental concentrating ability should begin to return, and I should be able to start building back in multiple way and return to work.

Small victories

Yesterday my friends Robert and Cuca worked together to get me to chemo, although only Robert drove because Cuca was nursing infection and thoughtfully did not want to share. Completing this chemo treatment finished my 5th cycle of chemo therapy. Now I officially only have one cycle left to go, which will begin next Monday March 22 and end the Monday after Easter - symbolic timing for a new beginning.

The chemo-associated neuropathy (numbness and tinginling in my hands and feet seems to be progressing (legs, back face) but the good news is (1) now that I am taking vitamin B 12 and B stress complex in for 2 weeks and in recently larger amounts it seems to be stabelizing or even receeding. Much better today. (2) at least part of the increase is likely due to the addition of the Itraconazole for treatment of my sporotrichosis since numbness in hands and feet is an identified side effect. (3) all should recede (hopefuly back to normal) when the chemo is over. (4) if need be they can decrease my doses or change to another drug. HOWEVER since beating back this cancer is more important than short term discomfort I am hoping to finish out this last cycle with full dose first line drugs so...

Today - my steroid burst high energy day - I was able to make lots of progress on that pesky home paperp work. Did not totally finish making all the changes nescessary to close out the old bank account and open the new. Did not start on putting together the stuff I need to send to the tax preparer. Did not finish with the credit card straightening out (the slow phase being reviewing every thing to ensure no fraud before I pay) but substantive progress none the less. And tomorrow is another day when I should make it to noon on the residual chemo steroid burst before I start losing energy.

Made it all the way through the day today with out a nap. Although I did pause mid afternoon for a long soaky hot bath using (1) the little blue floating ducky from the Gina in Seattle care package, (2) the lavender bubble bath, liguid soap, and after bath body lotions from the First Baptist Sylva Care packages, and (3) the home made pepermint skin rub from the Emily Buchannan Care PAckage. I decided if my standard chemo time is running out then I better pick up the pace on using up my chemo-support care package contents. I think I am making pretty good progress. Thanks guys, for all the raw ingredients.

All in all a good start to the week. Now to see what I can accomplish tomorrow.

first Daffodil of Spring

The first fully bloomed out daffodil of spring was spoted in my back yard today. Other good things: Managed to get the dogs to the vet for their shots.

On the other hand, catching up on personal paperwork is going very slowly, as I seem to wear out after a couple of things and spend a lot of time in the middle of the day napping. And the chemo-associated neuropathy seems to be progressing. Hopefully it will recede after I finish chemo, but I have upped my daily doses of Vitamin B-12 anyway.

Well, A little progress a day is better than none. And only 1 cycle left after the last dose of the 5th cycle this coming Monday.

What I need now...

Thanks to all of you who have offered to drive me to chemo. As of now I think all the remaining Mondays already have an associated volunteer driver. However, i am keeping the list of those of you have have offered available in case I need back up. And for all of you who have taken the time and effort to drive me to 1 or more chemo appointments, Thank you very much. You have made this experience so much easier and kept it from being lonely.

Also thanks to those of you who have, as my energy has receded, come by the house with food, company, assistance with delivery of dog food, grocery shopping, folding laundry, cleaning house, or other efforts. Each little effort has really helped. And I am also appreciative of those of you who have offered help when I need it. If I have not taken you up on the offer, that does not remove the support provided by the offer. I have all the cards still displayed in my living room, where they will all remain along with my Christmas decorations until i finish the standard chemo part of my therapy in April.

So again I thank you all for your remarkable support. I have no unfilled needs at present, but appreciate all your offers of support for when I have and may yet need them.

I am very fortunate to have a community of friends like you all.

Louisa

More Good News

A study out of Japan says that women who get "dose-dense" chemotherapy - which means Taxol (my flower power drug) divided into equal doses each Monday while getting carboplatin only on the first Monday of each cycle - have an approximately 2 year survival advantage on average over women who get all carboplatin and taxol only on the first monday of each cycle.

I am getting dose dense chemotherapy - so this is good news. Add that to the avastin advantage and i am feeling very good about having decided to enter this clinical trial.

Also getting rather tired of constant and growing fatigue and being confined and being bald. ONLY 5 more weeks to go!

What's New?

I hear Brother in law Joe is not only home but back in the office working. Martha, on the other hand, is exhausted and trying to catch up on school.

Jacob P Dawg Chapman has ceased his falling spells and appears to be in no more pain. Whatever went wrong with his spine or hip seems to have corrected with a few days of rest and that new pain med the vet gave him. Hopefully it won't return for a long time. No more falling spells.

Louisa post-transfusion went to the doc on Tuesday and got diagnosed with sporotrichosis (a fungal infection) in her finger and is now on treatment for that. This probably has nothing to do with chemo, except that I got stuck with a splinter from a table that had spent most of its life outside sometime in early January, and acquired an infection from that that is slowly spreading. MAybe the chemo gave it a foot hold, or maybe I was going to get it anyway. The good news is, I finally have an interesting case to present at the InterCity ID Dinner Conference...

Louisa post-transfusion gave a massive push to get through the paperwork that was building up before terminal fatigue sets in again. Good thing, as I discovered today that someone was faudulently having his CITI AMEX automatically paid out of my account since January. Closed that account, opened a new one and now I have to find the energy to transfer all the things that are automatically paid into or deducted out of that account... Sigh. A lot of work. And I still have to work my way through the credit card and medical bills that I did not get to today.

My sister Martha is due for a visit this weekend and to take me to chemo on Monday. I am looking forward to the visit.

The dogs have enjoyed the string of visitors through this house (the large contingent of Arkansas cousins, the small (n=1) contingent of Ark Cousin, and soon the sister). They are somewhat lonely left with just me. Further, they seem puzzeled as to why only 1 of us was allowed to watch the olympics from the perch of the recliner chair. Occasionally Balsam challenges my supremacy there - yesterday he tried to sit on my lap again which was how he went off to sleep for the first phase of his puppydom. Unfortunately (or fortunatly) a large 70 pound Plott hound does not fit securely on the lap of an adult sitting in a recliner chair, so he rapidly fell out and did not try again.