Archive for High Dose Chemotherapy

Hear

Posted in Cancer Life with tags , , , , on October 7, 2012 by lawler

It has been just about four years since I checked into the Simon Cancer Center at Indiana University. I still remember sitting in my hotel room the night before checking in to the hospital with my old friend Tara watching the poll returns for the 2008 Presidential election (we didn’t have to stay up late for the results). The day before Dawn and my brother Jeff watched a machine harvest stem after my apheresis catheter was put in place, and then headed north (Jeff to a flight home to L.A. from Chicago, and Dawn home to Madison). Earlier that day I sat in my hotel room alone (probably writing on this blog about something), and looked down to see a giant blood stain on my chest. I tried to stay calm, disappointed that my Obama tshirt was probably forever ruined, but thinking that it was at least a meaningful stain. I called the hospital, and then called Tara (who was in route to Indianapolis from her then home in Cincinnati). Back to the hospital I went, where the nurse said something like, “Gosh, I thought your catheter was fine when you left.”

This is all to say that it’s been a while. And things have changed for the better. Except one: my hearing. The high dose chemotherapy I endured in November and December of 2008 permanently damaged my hearing, and I’ve spent the last four years coping. I guess the thing that has made it the hardest is Jack, the awesome two year old kid Dawn and I are lucky enough to call our son. I mis-hear him all the time, and I don’t want to miss any more of what he has to say. So, tomorrow I get hearing aids. I’m excited. It’s exciting, right?

The finish line

Posted in cancer, Cancer Life, testicular cancer with tags , , , , , , , , on December 18, 2008 by lawler

There is a dry-erase calendar on my bathroom door, where my treatment is tracked meticulously in numbers. It looks like a strange, evolving mathmatical equation. But every square represents a day, and each day contains very specific information. The key information is represented by the letters W, H, and P — White Blood Cells, Hemoglobin, and Platelets. The H and the P are important, and the numbers aside them dictate whether or not I am in need of a transfusion of some sort. But the W is king. It is the number to watch.

This morning, I was awoken by the scuffling feet of my day nurse, just starting her twelve-hour shift. When I opened my eyes, she was standing in front of the dry-erase calendar, erasing and writing, making that squeaky noise that dry-erase pens are famous for. But her head was in the way. I couldn’t discern what numbers were being written after the W, the H, or the P. I moved  my head around, trying to get a  look. Nothing doing.

When she stepped away from the board, I was relieved. The box for today, December 18, read:

The important number here is the 1.6 next to the W

The important number here is the 1.6 next to the W

My white blood cells have “grafted.” My Absolute Neutrophil Count (ANC) is up at 600. Tomorrow they should spike even higher. The finish line is in sight.

Later today, I will have a CT scan to assess the effects of the last several weeks of treatment. I have no doubt it has done the trick. The question that remains is whether or not Dr. Einhorn will recommend the RPLND or not. That is the big question for me.

So, when I have the results I will let you know right away. Thank you all again for the love, energy, prayers, cards, packages, support, gifts, vibes, thoughts, and everything else you’ve sent along to both  Dawn and myself.

Goodbye Dawn; or, Dr. Einhorn answers all of your unasked questions

Posted in cancer, Cancer Life, testicular cancer with tags , , , , , , , , , , , , , , , on December 15, 2008 by lawler

So, clinically speaking, here’s the deal:

It’s Monday, my white blood cells are still hovering at 0.5 (if your curious about the number they consider the bottom of the barrel it’s 0.2 or less), my platelets (remember yesterday’s lesson), and hemo are still low, but okay.

My ass still hurts. Riley’s Butt Cream still applied regularly.

Dawn left early this morning, to make the six hour drive back to Madison in the best possible weather conditions — an attempt to avoid Indiana’s rain and sleet.

And Dr. Einhorn made his Monday morning visit. You may recall, Dr. Einhorn is really the reason that I am in Indianapolis. He and his team are the leading experts on testicular cancer and have forged treatments that have made testicular cancer the success story that is in the world of oncology. Oh, and he treated Lance Armstrong too.

This morning, Dr. Einhorn gave us two previously unknown bits of information — slices of possibility for the future to come, really. First, he reminded me that I will have a CT scan scheduled here later this week so that they can determine what effect the HDC/transplant treatment has actually had. Simple questions to be answered mostly: is the tumor gone? is the cancer anywhere else? are my lymph nodes gone? Wait. What was that last one?

When I first came to the IU Simon Cancer Center, Dr. Einhorn’s partner, Dr. Williams told me upon evaluating my case that he recommended I go through HDC/transplant and that in January I would have surgery — 100%, no doubt — a Retroperitoneal Lymph Node Dissection (RPLND). Definitely.

This morning Dr. Einhorn was not so sure. He said there is  a chance that following the HDC/transplant there may be no need to remove  my abdominal lymph nodes because they may already be gone as a result of the treatment. Say what? I can only keep up with so much of the science of my disease, and am thankful that experts like Einhorn exist.

What can I say? New things come up all of the time, and I generally chalk it up to my lack of expertise, and my doctor’s sheer volume of it — filling him up, as it seems to, to the point that he must lack certain other basic knowledge. Is he a poor driver? A horrible cook? It doesn’t matter. Just check out some of the papers he has authored or co-authored on very specific matters that have everything to do with my life HERE. (Of special note: document nos. 15 [Is full bilateral retroperitoneal lymph node dissection always necessary for postchemotherapy residual tumor?], and 16 [High-dose chemotherapy and stem cell rescue for metastatic germ-cell tumors] )

Another bit of new information: they want me to continue oral chemotherapy for three cycles once I am back at home. The drug is a common one to me now: Etoposide, or VP-16. According to the studies they have conducted here, continuing this oral chemo improves my rate of survival by 5%. The side effects will be minimal, mostly consisting of prolonged baldness, and I can live with that. I just hope my hair comes back at least to the not-so-thick-but-enough-to-stay-warm stage it was in before all of this went down.

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Bye Dawnie…I miss you already — but I’ll be home soon.

Chemo Complete

Posted in cancer, Cancer Life, testicular cancer with tags , , , , on December 6, 2008 by lawler

Moments ago nurse Linda removed the line delivering carboplatin to my body.  If all goes as planned, this will be the final bit of chemo administered to my poor body.

On Tuesday I will receive an autologous stem cell transplant (meaning simply that they will be my own cells, rather than those of someone else), and will then spend the next couple of weeks recovering from the chemo and transplant.

I hope to arrive back in Madison shortly before Christmas, where Dawn and I have decided to bring home our very first holiday tree. It will be a live tree, that we can re-plant after the holidays, perhaps on our land near Dodgeville. Anyone interested in being a part of the replanting of the once used holiday tree should let us know — perhaps we can make a celebratory party out of it!

It’s nice to think ahead to such different times. It’s always a good thing to have on hand when your laid up in a hospital bed not feelling to hot: the future and what it holds if you want it to.

Hurry Up…And Wait

Posted in cancer, Cancer Life, testicular cancer with tags , , , on December 3, 2008 by lawler

What can you do when a big hospital like IUPUI is out of beds for patients? You wait. You wait some more. And then, full of apology, the hospital staff tells you they’re putting you up in a hotel for the night.

That’s right. I’m back at the now comfortable Candlewood Suites, alone, waiting for a hospital bed so that I can begin chemo.

So, a night of respite. I’ll write more tomorrow to confirm that I actually am admitted…

Day 16

Posted in cancer, Cancer Life, testicular cancer with tags , , , on November 20, 2008 by lawler

One of my favorite nurses, Rebecca, left me a wonderful note this morning before she left her shift (and without waking me):

2.1

Mike, The voodoo worked!

Have a great day!

Rebecca

Translated, this means that my white blood cell count came back this morning at 2.1 (and my ANC is at 1700)! Though my Hemo is a bit low, and they will be giving me a bit of blood today, the doctors are currently discussing whether to release me TODAY or TOMORROW!

You may have noticed from Rebecca’s note that I asked her to put some “voodoo or something” on the blood she had drawn at four o’clock this morning.

I will keep you posted.

Would You Rather?

Posted in cancer, Cancer Life, testicular cancer with tags , , , , , , , on November 18, 2008 by lawler

Yesterday, while watching some exciting TV (one of those author talks on CSPAN), author Bill Bryson made some interesting comments about the idea of being taken out of your normal sphere, your daily routine, and put in a place where you have all the time in the world to think. He was referriing to his time spent hiking the Appalachian Trail (about which he wrote A Walk In The Woods), and the sheer mental challenge of having severely limited his lists of tasks for a given day. Just lots of walking, and lots of thinking.

Sitting in a hospital room is not much different. Unlike Bryson, ambling through Appalachia, the contours of the land and the natural beauty of his surrondings giving some kind of focus to his inner monologue, I have been holed up in a small room with a singular view containing mostly other buildings for two weeks now. When I go for a walk here, it means nothing more than dressing up in a silly (albeit necessary) costume consisting of a robe, booties, gloves, and a duck-bill shaped mask, and ambling the u-shaped hallway that makes up the Bone Marrow Ward. There are no windows in the hallway.

This leaves plenty to think about. Sometimes it’s too much, and the easiest thing to do is pick up my Nintendo DS and play soccer with my custom team (Saul Bellow is my goalie, Sam Peckinpah and Art Vandelay both forwards).

So, when I manage to let myself think what happens? Not much usually, which I suppose is okay. Though on the other hand I recognize it as a privelige of sorts that most people aren’t afforded — Dawn, for instance, is at home in Madison running around every minute working, rehearsing, teaching, and generally holding our life together (and that statement encompasses a whole lot). She hasn’t the time to lie about and think about anything but her day, her moment, her next task on a very long list of tasks.

I think about Thanksgiving, and how fortunate I am to be able to be at home in Madison that week, seeing people that I don’t see much of like Aurelia, and Andrew, and the Walton’s.

I think about what to do with my life when I can once and for all kiss cancer’s ass goodbye. Will I keep forging ahead, planning and plotting new creative projects? What will they be? Will I be more motivated to see more of them through to completion? Will I finally start trying my hand at painting? Will I break free from work (paying bills) that brings negativity into my life or that I am not well-suited for?

What else do I want to experience? Should I train and hike that Appalachian Trail as Bill Bryson did? Anyone want to go along?

Tara, who spent pretty much all of last week here in the hospital with me, occassionally jettinig back to Cincinnnati to teach, bought a silly book one day called Would You Rather? Don’t get me wrong, it is not a particularly thought-provoking book (sample question: would you rather have nunchucks for hands OR ice making nostrils?) It’s the title itself that seemed most appropriate for this post.

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The Nitty Gritty Details

I am currently at day 14 in the hospital. For the past couple of days, the doctors I see everyday have been telling me that my white blood cell count should spike at any time. This is really what we’re waiting for in terms of my discharge for this visit. I was disappointed this morning when they came back only slightly higher than yesterday, and not nearly high enough. They continually tell me that it usually happens quite abruptly, so perhaps tomorrow will be the day those suckers make a showing. Once they do, I am uncertain of the wait period before they release me back into the world. I will, of course, keep you posted.

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My Little Corner of Humbleness

This morning my nurse Angie walked into my room with a bundle of mail and said, “I feel like UPS.”

I simply cannot express enough my feeling of gratitude to you all for the cards, notes, custom postcards, books, videos, pictures, heart and soul that you have sent my way. It brings tears to my eyes when I pause and think about all of you around the country taking a moment or two from your day to think about little ol’ me up here in Indianapolis of all places. Life is funny thing, and I thank my lucky stars that I’ve managed to gather up the right kind of people in my life. I don’t know how I found you all, or how you found me, but I’m glad it happened.