Day: June 20, 2008

Chemo day 5, end of week 1

I made it through the first week.

I’m tired, and feverish, and really irritable.  My Parents are trying to figure out what I want, and how to help me, and how to make me happier, but I just want to be left alone.  I tell them that, but they aren’t listening.

Of course, I could not make it through this without them.  At all.  But I also wish I had some more distance.  I need to process this stuff in my head, and I need quiet and alone time.  And my mom is being Jewish-mother on me.  Super well intentioned, but won’t leave me alone sometimes.

I went through a big debate about whether to come home.  I grew up here, but I don’t live in Portland, I live in Brooklyn.  But Brooklyn is loud, and my hospital (Columbia Presbyterian) is all the way at the north end of Manhattan.  And my aparment is tiny.  And it is so hot in the summer.  As I put it in an email:

April 29, 2008

i start the interferon drug treatment roughly June 1st.  i’m trying to decide whether i should stay in nyc for this, or go back to portland.  i get a high dose IV for 1 month, followed by 11 months of self administered low dose.  toxicity is high, and hits hardest in the first two weeks.  not sure whether it would be better to be around friends, my brother, and my mom (who would come out), though with a harder time of getting to the hospital, or to be with my parents, their dogs, and one or two friends in portland, though with easier access to the hospital.  i also feel like being able to go into the studio if only for a few hours, a few days a week, will have grounding effect on me -  its because of the people in the lab more than the actual working (i can do that from home, or from portland.) also the airplane flight will be hard, and is not recommended post-surgery b/c of swelling issues.  i’m honestly torn, and unsure.  though i have some time to figure that out.

But I decided to go home:

May 24th, 2008

i made the decision to go to PDX to have the Interferon.  the range of reactions to the drug vary from 4 weeks of 103 degree fever, to a bad fever for the first two weeks.  it is hard to not know which will happen, but i would rather be in PDX feeling better than I thought, than alone here in NYC with a 103 degree fever for four weeks. and if i do have 4 weeks of high fever, i would def rather be surrounded by quiet, trees, dogs and parents.

the dr in PDX is going to accept my insurance’s out of network pay rate.  i have substantial out of network deductible, which sucks,  but after that, they’ll clear it all fine. it is worth it to be in portland, i think.

My trip to PDX was delayed because the incision is healing slower than expected.  It is quite long, and they had to go quite deep, and it is right at the crease of my leg, so it is agitated every time i move my hip joint.  fun…

i have a plane ticket leaving June 9th, returning July 19th.  my first appointment is june 11th.  that is a wednesday.  i don’t think i will be getting the Interferon that day.  i might start later that week, or i may start that monday.  not sure, and prob wont know until i have that first meeting.

I guess it has been so long since I have spent more than a week with them that I underestimated the parental factor.  I did have some terms (in the next post), but I forgot how my parents can be. It reminds me of when I went on a trip with my father to visit colleges in New England.  After every campus tour, or class visit he would ask me what I thought.  And I would say something like “I don’t know,” which really meant “I don’t know yet because I’m still thinking about it.”  But I hadn’t learned that about myself yet.  But he kept asking.  And at some point I cracked and I think I yelled at him, and then didn’t say anything for 24hrs, or something.  Maybe he got the point, but i doubt it: its not like I was the best communicator then.  I think he was pretty pissed too: flying me across the country and driving me around, and I wouldn’t even tell him what I thought of these things?  The problem was *I* didn’t know what I thought of them.  I had to process.  I needed time to understand my experience.  Same here, kinda.

Chemo Day 4

Today is Friday. I didn’t have Physical Therapy or Massage Therapy this morning, so I slept in.  Until Noon.  And I’m still sleepy, but I have to get myself ready for chemo.

Yesterday was the day I got tired

To quote the literature the side effects for the first and/or second week are “Flu-like syndrome, consisting of fever, chills, malaise and myalgias… This is usually dose-related and appears early in therapy.”  Been there, done that.  My fever is down, my chills are going away, i’m still a little achy.  But now I’m tired.  Really tired.

Again, the literature: “Unlike fever, fatigue does not decrease over time; in fact, it may persist and even intensify as therapy continues. Physical or mental fatigue accompanied by cognitive deficits may occur. Other long-term concerns for patients receiving interferon therapy are fatigue, confusion and depression. This fatigue may be dose limiting and is actually very difficult to manage. Because the peak action of the drug occurs 3–12 hours following administration and its half-life is two hours, the patient should be advised to take the drug in the evening. Patients should also be instructed to pace their activities.”

The nurses, and Bob (the guy from day two) kept saying two things: drink more water, and get more exercise.  The more I exercise the more I energy I have.  And obviously, the converse applies too.  This make sense, though is easier said than done.

I spent most of yesterday sleepwalking.

I went for massage, which was wonderful, and relaxing.  So relaxing I fell asleep on the massage table.  I have never done that before.  I left there somewhere inbetween a trance and asleep on my feet.  I came home and checked my email. Closed my computer, and then fell asleep in a fetal position with my face on top of it. The laptop was still warm, and I guess that was comforting, or at least made me want to sleep.  And I fell asleep in the chemo chair.  I put on “Good Night… Music to Sleep by” that O had uploaded for me. I pulled out the leg rest, pushed back the seat back, and immediately fell asleep.  I woke up right as the Interferon infusion was finishing.

I went to the bathroom with the IV pole.  That was kind of weird.  But I got tripped up by all the long tubes, and stepped on one.  When I came out I noticed that there was blood running up the tubes for three feet.  I was kind of amazed, but I didn’t panic.  I just waived for my nurse Laurie, and she came and helped me back to my chair, and flushed it out of the tubes.  The interferon had just finished a couple of minutes earlier; my timing was perfect.  And Laurie was able to save the IV too.

When I got home, all I wanted to do was sleep. My dad dragged me out for a walk.  I knew it was the right thing to do, but I didn’t want to do it.  I went anyway.  I was really slow.  It did feel good, though.  He started in on this lecture about how I needed to exercise to get more energy, etc.  I cut him off.  I told him to stop lecturing.  I told him I knew he was right, but that I couldn’t deal with the lecturing.  I guess it was also that it seemed like such a clear sign that I was really in deep, which scared me.  And also that I had already been home too long b/c my parents were lecturing to me.

When I came back from the walk KT came over and we watched a movie.  He brought me a jar of origami cranes from his family.  It was really touching.  I have folded them before for people who were sick.  But never been given them.  While its not exactly a first that I had ever hoped for, considering I am already sick I am very glad to have the cranes.

We walked a mile last night.  Today when I woke up my calves ached worse than they have ached in memory.  It feels like I ran 10 miles hard.

My doctor pushed back the chemo treatment by two weeks becuase the incisions from the previous surgeries were not healing on schedule.  Apprently Interferon stops or slows all other normal healing processes.  In order to heal one part of my body another part has to suffer.

And yet, in order to keep my energy up, I have to keep walking.

Which one’s gonna give first?

Today was also the day I stopped being able to reply to all of my email.

Off to Chemo.  I get my IV out today, and a weekend break.