After all that excitement

Phase II
As I emailed you all, the results of the bone marrow biopsy and lumbar puncture show no leukemic cells; I am in remission and starting phase II. This is all very good news. I think the docs don’t really need the bone marrow biopsy and LP except to confirm what they already know but can’t legally say, and that is why it is not foremost in their mind to GET ME THE DANG RESULTS! I let them know the patient’s perspective.

Speaking of perspective, last Thursday at Stanford when the new resident doctor came in to give me the preliminary inspection, he started out by asking all these questions. Now, I just had the bone marrow test and the lumbar puncture to see if I am in remission or am I going to go back to induction and need bone marrow transplants. He asks a couple questions, and then he starts asking about my siblings. How old are they, where do they live, do they have any cancers? Dana and I trade glances, thinking Oh Shit, I am not in remission and they are setting up for bone marrow transplant. It turns out he was filling in blanks on the patient information sheet. Scared the heck out of me.

We started phase II yesterday, Tuesday, and it was quite a cocktail party. I had an IV of cyclophosphamide, a subcutaneous shot of cytarabine in the stomach, some steroids and anti-nauseas to counter the side effects, and some 6-mercaptopurine (6MP) in a pill when I got home. They gave me these handouts showing all the side effects of each. A couple said I had to drink 2 to 3 quarts of fluid to flush the bladder, but another said one of the side effects was an inability to urinate. I asked the nurses if anyone had ever exploded from this combination, but they ignored me. Just about every drug in phase II causes hair loss, low blood counts and nausea. I took some spare anti-nausea pills home, but I had no ill reactions. Until today.

Doc, did you say Bulimia or Leukemia?
I guess it was bound to happen sooner or later; you just can’t pound the human body with that many chemicals for that long and not get a reaction. The drugs they are giving me all target fast growing cells, because cancer cells are cells that cannot stop dividing hence they grow fast. The other fast growing cells that get hammered in this process are hair, mucous membranes and nails. My hair is trying to grow back, my nails are like rocks, and my mucous membranes have been fine until today. I went in for a shot of cytarabine this morning, in the stomach again, and took my 6MP pill when I got home at 9:30, along with docuset, protonix and augmentin for the ear infection. Most of these chemo drugs cause a nadir (low point) in 7-10 days, so I am still having effects from the last round.

All morning I was having problems with diaphragm spasms, not really hiccups or belches, but some variant. Given the chemistry set that got dumped in me I wasn’t surprised. Around 1:00 I heated up a bowl of soup, made some toast, then went in the bathroom and puked about 5 times. I just couldn’t talk myself into the "nausea is really hunger" thing that had worked in the past. The puking ended the whole gas problem I was having, and I really felt better.

After resolving Mike’s crisis of dress rehearsal pants, and let me digress here by asking if it doesn’t seem reasonable to expect a kid to do something all by himself after you have prompted him 7,567 times? You tell a kid to brush his teeth every morning and night for 11 years; you would expect it to sink in. That’s over 8,000 times, and yet try skipping telling him for a night. Anyway, in spite of asking 2,378 times if you’re all ready for school the night before, Mike forgot his dress rehearsal pants. After I drove him his pants, I ate my soup and toast, and I felt fine.

I am having a pretty low-key week, Phase II is starting with a slam, because of the lack of daily steroids I think. I am still gaining weight, up to 176, thanks to all the food the Sinsheimer School (Dana’s school) staff keeps sending over, and no energy for walking. I have to get a grip on the income/outflow side of the energy equation; maybe bulimia is the answer. This phase goes on for 8 weeks. It seems like Phase I was a mental battle, like the first round of a fight, where you size up the opponent, find his weakness and strength and formulate a game plan. It starts to become apparent in Phase II that this is one of those 42 round bare knuckles fights they used to have. Stamina is going to count for a lot.

Gypsy Moths
In the early ‘80’s in RI and New England, we had the attack of the gypsy moths. These moths increase their population for 7 years to huge levels, then they decrease for 4 years. They are so thick in the woods that their feces falling to the leaf litter sounds like falling rain, and cars skid on the caterpillar corpse juice all over certain roads. They make for great eyebrows, though.