Contrast Medium

I had my PET scan last week. It was actually a combined PET/CT scan, now my third. They want you to drink contrast medium to help visualize the intestines, and you actually have to drink quite a bit of it. They say "two cups" but the cups are the size of McDonalds milk shakes, so when you're trying to get the second one down, it feels more like two quarts.

My old oncology clinic made me drink this nasty white stuff that had about the consistency of 90 weight gear oil. At first the light blueberry flavor tastes pretty good, but the stuff is slimy and nasty and in the end the blueberry flavor becomes unpleasant. It takes some work to chug that stuff down, and it isn't always inclined to stay down, if you know what I mean.

The stuff at the hospital is different. It looks like, and for all the world tastes like, extremely weak strawberry-flavored Koolaid. It's easier to drink that the gooey stuff from the oncology clinic, but much messier on its way out of my system. Machs nichts, I guess - it's all ugly, just ugly in different ways.

My wife tells the story of when she and the kids were driving through South Dakota looking for the Badlands and they stopped to ask a highway department employee where the Badlands were. "Lady, it's all bad land," was his laconic reply. Quite. It's all bad land; the only question is whether it's going to be bad up front or later on.

Lately I've been having troubled dreams about an ugly brown Oldsmobile 98 with no visible driver trying to run me over. I don't think you have to be Freud to figure out what that dream means, but it does highlight the fact that my body has recovered from chemo sufficiently that I can at last actually achieve REM sleep. For several weeks I couldn't sleep for more than about ten minutes at a time, and that's not hyperbole, that's the actual fact. It's difficult to get much of a dream going on in ten minutes and the REM deprivation reaches the point that you'll do anything to knock yourself out for a while, including drinking half a bottle of Old Grand Dad. At least these days I'm not half-crazed by REM deprivation. I'm just half-crazed by dreams of ugly brown Oldsmobiles.

It's all bad land.

Flushing The Line

I have to flush my central venous line every day. I got some new syringes preloaded with the right heparin-saline mix so it's actually pretty easy to do in a technical sense. A little rubbing with some alcohol swabs, connect up the syringes, and squirt away.

But it's hard psychologically. There's always a lot of air in my tubes - they're clear and the bubbles and voids are easy to see. There's no good way to get the air out, so I have to push it in, and it takes a bit of willpower to knowingly depress the plunger and watch all that air go straight into my circulatory system. I'm told that it takes an awful lot of air in the bloodstream to cause any particular problems, but still, every time I do it I can't help but think of air embolisms and The Bends - not to mention worry if somehow an errant cat hair got into the works and is going to go on a cruise around my circulatory system for a while.

It doesn't help that practically every time I flush my line I come down with a dull headache. What could be causing that? Air? The heparin? Stress? Maybe I don't want to know.

But all of this leaves me in possession of approximately 90 preloaded syringes, and about 120 clean, empty syringes. I'm trying to figure out a way to use them in home repair or craft projects. Maybe built some quasi-Egyptian water pump out of 100 syringes and a wooden crankshaft. There has to be some use for them. (None of them come with steel needles, just the goofy thick plastic "safety needles" whose chief function seems to be to squirt heparin into my eye when I try to express the air bubbles, so I can't actually use them for any injection-related purposes.)

I had my PET scan last week and will presumably get the results this week. I can still feel a lump in my groin so I'm still at Stage I at least. I knew it was too much to expect for the ESHAP chemotherapy to have cured me. According to the statistics I read, it does have a small chance of effecting a complete cure, emphasis on small. And of course, it proved to be too much to hope for that I would have fallen into that small chance.

But I'm plagued by a different problem today. I have three USB thumb drives that I keep various documents, pictures and other geedunkery on. When I got my new computer I consciously put the thumb drives in a safe place, so if the worst happened and the transfer of my junk from one computer to the other went south, I'd at least have the thumb drives to fall back on. Trouble is, I can't remember where I put them. Oh, it's a safe place, all right, so safe I can't find, and don't think I haven't looked. I have a very vivid memory of having seem them only a couple of weeks ago, but the memory does not come with location information. It could have been on Mars for all I can remember. I think it was in the garage, but that doesn't make any sense either, as the garage isn't a particularly safe environment for electronic devices.

But hey, it's still more fun than watching The Next Iron Chef. I've come to detest that show with a heartiness that I'm sure isn't healthy, and is probably immoral to boot. It even colors my perception of Alton Brown - he seemed like he would have enough sense to steer clear of such a train wreck, but there he is, in it up to his elbows, as culpable for that mess as the rest of them. The only thing worse is Chopped, which to my mind has become stranger and even less palatable with its new season. I guess it's endless repeats of Barefoot Contessa and Tyler's Ultimate for me, and you know what? I'm okay with that.

In The Bank

I have about 5.2 million stem cells in the blood bank right now. I only needed 4 million, but I'm apparently a rich source of the little bastards, since in two sessions of apheresis I produced 5.2 million. Better too many than not because, because apheresis isn't much fun.

It doesn't hurt in any way, but you have to lie relatively still for four hours. Any movement, any coughing, even arm movements unsettle the apheresis machine, which sets up a horrid beeping sound and grinds to a halt. Until I figured that out, I ran the poor med tech guy crazy getting the machine up and running again.

After each session I got extremely wobbly and unsteady, not to mention extremely nauseated. Apheresis may not hurt, but it isn't without consequences. The guy who runs the street sweeper in the hospital parking garage who had to clean up after me can vouch for at that consequence.

But my cells are banked, and now things can slow down a little bit. We had to move extremely quickly to get me ready to harvest stem cells within a few days of my last ESHAP chemo treatment, but now that we have the cells in hand, the time pressure lets off. In fact, it lets off considerably - I hate to jinx myself, but I can't feel a single cancerous node, not even the two that were left over in my groin after the ABVD chemo.

An open appeal: when I go into the hospital for the transplant grande, I would appreciate anyone who reads this to smuggle me in some paper packets of salt and pepper. I had hospital lunches Thursday and Friday, and they had all the makings of nice meals. One was a baked pasta dish with vegetables; the other beef stew and a reasonably flaky biscuit. Unfortunately, neither dish had ever heard of salt or pepper, let alone had any sprinkled on them, so even though they were well made and as palatable as they could be under the circumstances, I'd have given my shoes for some salt.

Pineapple Juice

I went to the hospital yesterday to have my Hickman line installed. The chemo, however, had devastated my platelet count and my blood was hardly clotting at all - I had a constant low-grade nosebleed and my arms were slowly being covered by livid red subcutaneous bleeds. Before they would install my new line, I had to have a transfusion of platelets. It turns out that a bag of platelets looks a lot like pineapple juice, only it's somewhat more gooey and sticky. But, with the platelets in, the doctors installed the line, and now I have more plastic in me than a cheap Chinese radio.

All we're waiting on now is for the Neupogen to boost my stem cell count so we can have a good harvest. Maybe tomorrow, maybe the day after, maybe in a few days, but soon, either way. And then I can stop taking Neupogen, which makes my bones hurt. That will be a happy day for me!

That's Done

The second round of ESHAP chemo is done, and it was... well, bad. I expected it to be bad, and it didn't disappoint. The Vesuvian diarrhea that could well have killed Pliny the Elder if he wasn't already dead, the bizarre mental disturbances, the racking pain, oh yes, we had it all, plus truly delicious few days spent throwing up all of my internal organs and eroding sores in my mouth with stomach acid. I was pretty sure that I was going to want to keep that thing that looked like a pancreas, but too late, I flushed the toilet too soon. Once I took a Percocet and about thirty seconds later threw up. Not one to waste a waterlogged if perfectly useable pain pill, I strained it out with my fingers and saved it for later. This anecdote may lack the clear coherence and drama of Caesar's dispatches from Gaul, but it's the best I could do given my circumstances.

Does anyone know what a pancreas looks like? My understanding of what innards look like comes from the old Visible Human model, where I think with reasonable artistic license I painted the pancreas sort of a pale yellow color. In practice, I imagine most internal organs look reddish, gristly, and unappealing.

Now that I'm starting to recover from chemo, I'm fricking starving, but not very much sounds very good yet. Other than a couple of oranges and some bottles of Ensure, I haven't eaten much of anything in a week. I'm tired of the overly rich chocolate flavor of Ensure and sometimes when you're on chemo it has a peculiar slimy consistency that is most unappealing, but I found that if I didn't drink an Ensure once a day, I tended to get really weak and lightheaded.

Here's a statement from the Surgeon-General: taking a pain pill again that you've already thrown up once will produce an aftertaste in your mouth that will crush your soul for weeks.

So back to my point. What should I eat now that I think I actually CAN eat a little bit? There's a little store in our non-town of 400 people or so that sells a variety of halfway decent food. The store is a wreck and the customers are usually unwashed and extremely fidgety people who I usually suspect have been partaking in controlled substances, but the food isn't bad - just don't think very hard about it. Bizarrely, inexplicably, the fish and chips sounds good. Why?

The last thing I ate before I got really sick was a fish sandwich from Burger King. Maybe my body is clinging to that last halfway pleasant memory and thinks that if I have fish again, things will be better. Actually, the last thing I ate was half of a turkey wrap my mom brought to me at the chemo clinic, but I was past the point of really being able to eat anything by then. The idea of eating a tortilla right now fills me with a kind of strange terror.

Yes, Virginia, there were mental disturbances! I became convinced that I had two colons, and that if I could only get the right one to properly void, everything would be better. Every time I went to the bathroom I kept hoping the right one would let go, but it was always the left one (even though I'd built the Visible Human model and knew that humans only had one knobbly pale blue-purple colon). At one point the third Brendan Fraser mummy movie was blaring at me (a loud, disappointing mess that was, too) and I was trying to turn down the volume, and after failing for quite some time I realized that I was gripping my left wrist in my right hand and attempting to turn down the volume with one of the small bones in my wrist (the Visible Human model was not detailed enough for me to attempt an identification). I also became convinced that Elmo the little dog wasn't really Elmo the little dog. Beats me who he was at the time, I just didn't think he was really Elmo (though since all Elmo really does is sleep and want to drink out of my water glass, he's easy to impersonate).

Day Four

Day Four is in the books and boy am I ever sick. I'm wearing a transderman patch for nausea, and I got intravenous Aloxi for nausea this morning, and the nausea is still intense. And it isn't even over; I have one more day to go, though tomorrow I don't get etopacide or cisplatin; tomorrow I get cytabarine or whatever it is. I can't remember. The chemo is causing a market fuzziness of thought and I'm having trouble with words. This to me is one of the most disturbing aspects of chemo. I know the nausea and diarrhea and whatnot will eventually go away, but this strange feeling of slowly losing my mind is scary. I hate the feeling that comes over me when I try to read something as simple as a magazine article and I have to put it down because the words become confusing and almost threatening.

They say that come Monday I'll be transferred to the care of the transplant team. Things are going to start happening with considerable speed, I think, though I personally don't know what the schedule is yet.

But for now, I'm going to take a compazine and a percocet and try to sleep.

Where The Last Wave Broke

I was goofing around on iTunes tonight, mainly checking to see if the new Insomnium album Across the Dark might be available by chance, and instead found a new three-song EP called Where The Last Wave Broke. What giveth, dudes? I find nothing on their website about this EP, so it's something of an enigma to me. Where did it come from, and why?

Still, I'm not complaining; new Insomnium, even if it is enigmatic, is better than no new Insomnium. Musically, the three songs all sound like they came from three different epochs in the band's development, making me wonder if they weren't demos or trial runs that never made it onto their actual releases. I like the sound of "Into The Evernight" in particular, though the drums seem to have about fallen out of the bottom of the song. It also reprises chunks of an earlier Insomnium song, but in a fairly tasteful way that doesn't automatically put me in mind of recyling.

Day Two

Day Two of ESHAP chemotherapy is in the books, and do I feel like crap? Let me count the ways!

We gots nausea. We gots whole-body ache as though I've got the flu again. My hands shake. My diarhhea is growing significantly worse again. I'm about as tired as that nameless Greek who ran all the way from Marathon before allegedly dropping dead. The usual, in other words, no better and no worse than I expected.

But here's the fun part: I'm already starting to have strange mental symptoms. My wife bought me from frozen chimichangas (yes, heresy to the foodies, but I like them) and told me they were in the refrigerator. I started looking for them and couldn't find them, even though they were right in front of my eyes - as near as I can recollect matters, I was looking for something that looked like eggplants, not chimichangas.

The last time I went through ESHAP I developed several bizarre mental aberrations that lasted for days. I couldn't turn to the left. If I wanted to turn to the left, I had to turn 270 degrees to the right. It wasn't that something said "No, you can't turn to the left." It was more the case that I had forgotten that I had a left side at all. All directions to me were right, in the same way that at the North Pole, all directions are south. I also developed the strange idea that Bobby Flay and I were sharing a communal digestive tract and that every time I had to bolt to the bathroom, it was to equalize pressure with Bobby Flay's part of the digestive tract (that is, is was all his damn fault. Sorry, Bobby). These weren't dreams, these were bizarre mental fixations that lasted for several days. (I also lost the ability to read but didn't realize it for a while).

This time, I was lying in bed last night, trying to sleep, when I suddenly and quite consciously became convinced that my skin had detached from my body in a single sheet and had adhered to the sheets. Only by lying in a specific way and pulling the covers up just so could I realign my skin so it would reattach itself to my body.

I have to say, chemo is pretty bad, but these strange Lovecraftian touches are kind of amusing and interesting, at least by the light of day.

Maldiction!

I got a call at 4:15 Friday afternoon that I am supposed to show up for round two of ESHAP chemotherapy at 9:00 Monday morning. Am I alone in regarding this as desperately short notice? Now I have to call work with basically no advance warning at all and tell them that I won't be working at all next week, which I'm sure will go over extremely well indeed. Sigh.

And since the ducks are not properly aligned for the stem cell harvest to take place, this is going to be a "placeholder" chemo. The plan was to do the harvest a few days after the chemo, but I don't have a cost contract from the hospital yet, I haven't had my Hickman line installed, and things just aren't ready, so I'm probably going to have to wait till the third chemo for the stem cell transplant to begin. Sigh. Again.

ESHAP made me feel so bad the last time that the prospect of having to go through it three times instead of just two fills me with an urge to blurt a long series of bad words. A while back we went to the Mexican Riviera on vacation (somewhere south of Playa del Carmen, but I forget the name of the resort) where my nephew and I shared a hotel room. One night we watched Kill Bill on cable. I think it was Kill Bill. I don't honestly remember. But whatever it was, it was in English with Spanish subtitles, and there was a lot of cussing in the movie. Every time someone in the movie wound up and spat out a meaningless empty curse, usually of the reproductive sort, the subtitle merely read Maldiction! That means "bad word", doesn't it?

So here I am, reviewing my limited options, and muttering maldiction! Maldiction! Oh, maldiction!