It Might Get Messy

Although, after last week, it could hardly get any messier. Actually, as of this writing (it’s Thursday, chemo infusion was Tuesday), this is the fourth day in a row I am feeling really, really good. As in healthy, not producing huge clots of mucous, not in any real pain.

I don’t know what’s happening physiologically, but it scares the crap out of me. Because if I feel this good and the treatments fail to arrest the cancer, I’m going to be really pissed off about dying. It will be a hell of a lot easier to let myself go if I feel like shit. If I’m feeling happy and healthy, I’m thinking whatever Ingmar Bergman form the “grim reaper” takes, he or she should stay away. I’ve got a state-of-the-art compound crossbow and I know how to use it!

Does everybody know the story of key anti-cancer drug Taxol? In the 1960s, the National Cancer Institute funded the Dept. of Agriculture to collect North American plants for evaluation. The bark of a Pacific forest understory yew proved to have an extractable compound that blocked cell division in malignant tissues rather effectively. Not surprisingly, harvest of Pacific Yew bark expanded until it plateaued at several hundred thousand pounds per year. The bark of a single tree yielded a single dose of Taxol. Bristol Meyers, plugged in by agreement with the NCI, figured out an alternative method for obtaining Taxol in larger quantities. They isolated a similar but therapeutically inactive chemical from the common ornamental yew, and manipulated it chemically into Taxol. Thus, in my drip bag on Tuesdays, one of the most important compounds is a Taxol derivative, Paclitaxel. Got some horrible side effects, and much of the OTHER material in the drip is intended to block those side effects. Last week, the blockage clearly failed. This week, it seems (so far, at least) to be holding up. 

Anyway. Most of my week is taken up not with chemotherapy, which is a once-per 3 hour infusion, but by twice-a-day doses of radiation. The radiation beams are generated by powerful machinery, probably creating enough radioactivity to sicken whole neighborhoods in Baltimore. Yesterday, the machine “broke down”, as the technicians put it. Had to call the radiation repair people. I sat in the lounge working for the hour it took the cavalry to arrive. When the repair guy DOES show up, he’s wearing plumber’s overalls and carrying a small toolbox in one hand, flipping a screwdriver in the other. I’m thinkin’: this is the guy who’s gonna repair a dangerous and fussy radiation generator? Apparently so, half an hour after he showed up, we were back in business. 

Got home late, took my anti-Taxol-side-effect steroid. Took another one this morning. Seems to be working—I just ate 3 cartons of liquid “food”. My weight is dropping like a shot pigeon—the metabolic boost of the radiation, compared with being sick last week, has me well under 190 pounds for the first time since high school. Plus, I get desperately hungry. Which, lacking a tongue and a functional oral cavity, is frankly frustrating.

Oops. Spoke a little too quick. After Colin buzzed me home from the hospital, my tummy tightened up. And I started into a fit of uncontrollable vomiting. What a pain in the ass! By sheer force of will, I stifled the waves of nausea for enough time to take two of the steroid tabs. Kept most of that down. And it seemed to truncate the actual vomiting. I don’t feel that great any more—stomach is churned and churning. But so far I haven’t vomited again. If I get through tomorrow without…or at least with minimal…vomiting, it’ll be a victory for steroids. And for keeping me the hell out of the damn hospital!

The gold standard in anti-nauseals is a drug called Zofran. It’s so effective there’s a worldwide shortage. Zofran basically blocks the cascade of nervous system changes associated with vomiting. Problem is, in the chemotherapy infusion package, the primary antinauseal is a steroid called dexamethasone. This drug works great in truncating all the nasty, almost caustic effects of the chemo mix. However, for several days after chemo, the dexamethasone locks up all the Zofran receptors and prevents Zofran from working. This frustrates the hell out of emergency room staff when people like me show up dehydrated and weak. 

This week, I didn’t start intense fits of vomiting until Friday. I spent all day Friday taking dexamethasone and attempting to suppress the vomiting by the deepest meditation of which I am capable (given pain and discomfort levels, this is difficult at best). Finally last night I recalled that in the hospital last week they put be back on Zofran by Friday night. So I took one. I remained queasy and unable to sleep—finally passed out at 4 a.m. after watching Loreena McKennit’s video from the Alhambra. Today I have a baseline queasiness, but I got a couple cartons of food down. I’d say I may have beaten the vomiting this week. Two more chemo sessions to go. I’d love to avoid the hospital for both. But we’ll see. 

But I’ll get by. Especially if I continue to feel this good.  Starting Sunday night, don’t forget to check in at the rest of the weblog empire: http://docviper.livejournal.com/, http://theresaturtleinmysoup.blogspot.com/ ,  http://sustainablebiospheredotnet.blogspot.com/,  plus professional blog at http://www.aehsfoundation.org/ (go to lower left and click through to sustainability weblog), and never forget Dr. Crossley’s wild west weblog at http://daccrossley.typepad.com/ .

Love to everyone. Glad you’re here—you’re making the fight easier and sweeter. Special shout-outs this week to Lex and Darby for the menu, and Ms. Terry for the PhD pen and magazines, plus much love. Hang in there everybody!

PS--a couple photos from the hospital campus for your delectation: