This Is Your Brain On Chemo

This is your brain on chemo. Well, technically, my brain on chemo. Note the general air of seediness and disrepair about my person. Note the hairline, which is racing up and over the top of my head and heading for the back of my neck with great speed. Note the complete absence of large swollen tumors on the side of my neck which made me look a bit like someone with a bunch of tennis balls stuck in his throat. Note the dull look in my eye, which typically sets in about halfway through the Big Fun Bag of dacarbazine. Not so visible are the increasingly pronounced cheekbones and chin that serve to highlight the fact that I've lost roughly 50 pounds since this rodeo started back in December. Oh, and my moustache is falling out too, just not as quickly as my increasingly wispy and insubstantial hair. And here's a curio: I haven't shaved in a week, yet I show no particular sign of stubble. Chemo is wild stuff.

Chemo happens. But not without difficulty, some of it caused by the blood cell counting machine at the oncology clinic, and some of it caused by getting authorization from the new insurance company to proceed. Once you add white blood cell boosters to chemo, it gets pretty dang expensive, and insurance becomes not just a good idea but an actual necessity. For a time it looked like it chemo wasn't going to happen at all, but Jean and the insurance billing coordinator at the clinic managed to get through to the right people in India (the insurance provider apparently outsourced its call center to India) who then approved of everything.

I guess the short story is that thanks to Jean and the insurance coordinator, everything got worked out, and my oncologist figured it was safe to proceed without a CBC so long as they dosed me with Neulasta again. My bones hurt already, a dull and apparently meaningless ache that Tylenol never seems to touch. I'm tired, but the ache in my legs and pelvis make it difficult for me to sleep. A fresh refill of pain pills later this evening should bring blessed albeit somewhat sweaty relief. Anyone got any idea why Percocet makes me sweat?

Better?

I guess it's a sign that you're getting better when small annoyances start to become noticeable again. For a long time most things didn't bother me at all. I simply felt too bad for the ordinary run of minor irritations to even register on me. There were a couple of weeks when I probably could have lopped off a foot with a Sawzall and not even noticed.

But not any more - little things are starting to bug me. Like this morning, when I walked outside to go to work and went down to the barn area where my wife was. I was standing there, minding my own business, when my coffee cup emitted a sad little tink sound and fell off the handle. The handle stayed in my hand, and the cup fell and landed on my left foot.

That's a bummer. A waste of a coffee cup, but even worse, a waste of a perfectly good cup of coffee, now steaming on the ground like deep-seated regret.

I've thought about this, and not surprisingly I've come up with a theory. On the one hand, one has a cup of hot coffee. On the other hand, one has the handle of the cup exposed to reasonably cold air. There was ice on my car, so it was in the vicinity of freezing. I think these temperature extremes caused uneven patterns of expansion and contraction in the ceramic cup that eventually caused the handle to shear off.

Or maybe it was just a crappily-made cup with a built-in manufacturing defect; who knows? But it's a banner day when a broken coffee cup becomes the worst thing that happens to you in any given day!

These 32-Hour Weeks Are Killing Me!

Well, I've reached the end of my first week of work after chemo. It was pretty gruelling, I have to say, but it got a little better with each passing day. Monday was dreadful, Tuesday was kind of dreadful, Wednesday was merely difficult, and today was only interminable. Tomorrow is a normal day off where I work. I was thinking about working tomorrow just to accumulate some hours, but I think I've changed my mind. Though I'm stronger and fitter now than I was at the start of the week, I also think it's important to rest and not overdo things.

I'm continuing to improve. My leg is lots better than it was. It isn't quite back to normal, but it won't be long, and I find that I can do just about anything I need to without too much difficulty. If I have to get out of a chair many times in a row my leg starts to tire out, but things like driving, walking and getting dressed don't bother it any more. My oncologist is quite pleased with the swiftness of my body's response to chemotherapy, and believe me, it doesn't delight anyone more than me.

My only complaint (for today) is that I've developed a few sores in my mouth, which can happen. Compared to what I've been through in the last month or so they hardly qualify as uncomfortable, but they do make it difficult to eat tortilla chips, Cap'n Crunch cereal or certain species of hard candy (I really love those Valentine's Day hearts made by Necco, the ones with the little slogans like "Do me!" (not really) stamped on them, but they seem to drive my mouth sores nuts. They may be why I have mouth sores in the first place).

Today I feel almost normal, for the first time in months. My leg is almost normal. I have almost no chemo side-effects going on. My tumors are all shrunken to the point that they don't impact my daily activities. I feel... normal. And it's good.

So normal that I'm strongly inclined to work on a model. This isn't a particularly world-shaking announcement in the greater scheme of things, but it's a pretty powerful indicator of how good I feel, because I always seem to give up model-building the minute I start to feel bad. My main difficulty now is that I have about eleven different models in various stages of construction and I can't decide which one(s) I should make progress on. Should it be the S7-class torpedo boat? Or the Wells-Fargo stagecoach with four-horse team? Or the SA-2 antiaircraft missile?

It's good to finally have to confront a nice inconsequential problem like what model I want to work on. Personally, I'm sick of confronting much more serious problems, and I'm sure everyone else is too.

Back To Yon Grind

I went back to work today after a month off, half of which was an alleged "vacation" (try to convince yourself that it's a vacation when you've been diagnosed with Stage 4 lymphoma and you're waiting for chemo to start) and half of which was just me feeling too awful to work.

Work went okay, by and large. I started to get a little over-tired in the afternoon so I left early, fearing that if I stayed much longer I'd run the risk of falling asleep in the car on the way home. And by then my leg was heartily sick of standing up and sitting down. But it didn't go badly, all things considered. Other than being tired in general and my leg finally giving out, I didn't feel too bad, though I had to deal with a million and one interruptions from A) my adoring fans, and B) people who didn't even realize I had been out of work. Yes, both groups exist.

The fun part was sanitizing my cubicle and phone because of my low white blood cell count. How often do you get to play with Lysol disinfectant wipes at work? Not nearly enough, I aver.

Tomorrow's another day. Given a decent night's sleep tonight, I should be able to make the full nine and a half hours. I don't see why not. I just wish I could figure out why the Ambien the doctor gave me don't work worth beans. I swear they make me nervous instead of putting me to sleep, so maybe I'm better off with warm milk or a half a fifth of spiced rum...

Successful

I was successfully chemotherapied today. Is that a word? My blood counts were acceptable, though my white blood cell count was deteriorating and they saw fit to give me an injection of Neulasta to increase my body's production of... can I remember? Neutrophils? I think that's right. My legs seem to ache just a bit, something that I attribute to the Neulasta because I haven't had that particular sort of pain before. My red blood cell count is also slightly low, but it was slightly low before I even started chemotherapy - there is a family history of anemia in the men in my family, and apparently I did not escape that bequest of the past, though I'm sure my lack of appetite lately has something to do with the anemia as well.

But all in all, it was a pretty positive trip to the oncology clinic. The bone marrow biopsy suggests that I have no involvement in my bone marrow, though they can't be entirely definitive because they only got a partial sample when they did the original biopsy. They want two sorts of tissue to test. First, they suck (or "aspirate") a small volume of frothy red marrow out of the bone, and then they want a little core sample of bone material itself. In my case they got the aspirate with no problem, but my hip bone was so hard the core sample portion wouldn't come loose and stayed in the bone. So, technically, without both samples to test, they can't say my bone marrow is clear, but the aspirate tested negative, which is a jolly good sign anyway. It means I'll have to have another bone marrow biopsy in roughly five months, which is about as welcome a thought as digging up the septic tank, but it does tend to rule out the possibility that I'll ever have to have a bone marrow transplant.

The oncologist was also pleased with the speed with which my nodes were responding to treatment. I used to have a big icky thing under my chin, but it is now almost entirely gone. I can hardly tell it's there, and if you didn't know what you were feeling for, you'd probably miss it entirely. The nodes in my neck and behind my ear are definitely shrinking (some faster than others, notably the ones on my left side, which are at this point practically gone) and my left leg continues to improve as the deep nodes in my groin shrink. The sensation of strange surface numbness and hypersensitivity (what an odd contrast in symptoms) has largely vanished. I'm not ready to start full-scale rehab on my leg, which is weak as a collection of wet linguini at this point, but I can definitely walk, drive and work, and that's enough for now. A certain amount of rehab will happen by default as I walk and do things.

I myself am pleased that the chemo didn't really knock me on my keester today. I get four drugs: DTIC, bleomycin, vinblastine, and Adriamycin. The DTIC (also known as dacarbazine) comes in a fair-sized plastic bag that takes about an hour to empty into my port. Both times now, I've suddenly felt myself get old, tired and slow about three quarters of the way through the original blast of DTIC. It feels a great deal like suddenly realizing that you're coming down with a cold - you become aware that your limbs are suddenly heavy, you're suddenly very tired, and you really want nothing more than to lie back and sleep (to the detriment of those who sit through chemo with you, as it makes them think that they are uninteresting). But other than that one attack of the DTIC Malaise, I didn't feel too bad, and I only slept for an hour or two after I got home, after which I felt pretty good, all things considered.

So I feel pretty good tonight. No nausea, a sense that I'm making progress, a sense that my body and chemotherapy are going to win the war against cancer, and the realization that I'll be ready to go back to work on Monday - that's comforting, all of it.

CBCs

Today I go in for another dose of chemotherapy - if, that is, my blood cell counts are good enough to qualify me for the championship round. I didn't realize they could count blood cells that quickly; I only had it drawn yesterday and they'll know today if I'm robust enough for treatment. What I find amusing is the notion that it is somehow my fault that my white blood cell count is too low, as though I've been somehow slacking. Yeah, you got me, I was deliberately not making enough white blood cells...

I'm pleased to say, though, that most of my chemo symptoms are gone. The pain is all gone, or at least nothing that a few Tylenol can't deal with, so I've weaned myself off the Percocet entirely. This is good news. My leg continues to improve. The swollen thing under my chin continues to recede. So viewed from that perspective, my treatment has been a whopping great success thus far.

I just wish I wasn't STILL nauseated. It usually sets in around noon and it stays with me all day. It isn't always intense, though sometimes it can send me scuttling to the bathroom where I gag and retch uselessly for a few minutes. But it's always there, always, and it serves to depress my appetite, which I'm sure has something to do with potentially low blood cell counts.

My appetite is a funny thing. Certain foods appeal to me, like tomatoes, grapes, canned peaches, lean beef, soup, salad, cheese and, curiously enough, tacos. Other foods gag me with a spoon, like sausage, bacon, anything with gravy, fried chicken, anything with a cream sauce and pork. The idea of a full cup of coffee makes me retch; the idea of a half a cup of coffee appeals to me. A banana makes me uneasy; canned peaches sound infinitely comforting.

Well, we'll see what the blood cell count stakes have in store for me. I'd just as soon get the chemotherapy over and done with without any postponements or rain delays, but I'm not in charge, am I? Time to go drink apple juice and try not think about my stomach.

Chemo

It's been a while since my last post, mostly because I've felt like crap. Let me count the ways!

Nausea. Yes, there's been some nausea, but it hasn't been too bad. It started for real about two days after the chemo treatment, and lasted for maybe three or four days in declining potency. I only threw up a few times in total, but I spent a few days thinking I was going to throw up. Still, the yellow pills provided seemed to help, and I can't say that nausea was ever much of a problem.

Chemo Pain. Yes, there was a lot of that. The chemotherapy stopped my digestive tract dead in its tracts. I don't want to dwell on this in any detail, for the details are horrid, but suffice it to say that about a week after my chemo treatment I developed a most painful sort of intestinal impaction. Heavy use of laxatives finally brought relief to this problem, but only after a few days of significant pain.

Cancer Pain. Once the chemo pain let up, it was time for the cancer pain to start up again, that horrid pain in my side, lower back, hip and leg that I had just before my first chemo treatment. The treatment for this pain is more chemo, which happens on Wednesday, but for now I can do nothing about this pain save take lots of pills and scowl a lot.

Right now I don't feel too bad, but that's mostly because I've beaten the pain back with four Tylenol and the trailing edge of a Percocet. I decided to post a brief update while I felt halfway decent, because halfway-decent states don't last long.

So, what have we learned? Mainly, that one neglects the digestive tract at one's own peril. And that lymphoma sucks. But Wednesday I'll get a fresh dose, and I fully expect for things to get better. We now know what to expect and how to treat the digestive issues, and I think the chemo will help with the cancer pain. So my main strategy at this point is to stick it out till Wednesday.

Mix Muddle

I got up this morning and found myself once again blessedly without a pain. Well, that's not quite right. I had a mild headache, which demonstrates that my pain receptors and processors are working, but that there is simply no real pain input from my body. It's still too soon to celebrate, but can I be permitted a moment of hopefulness that the chemotherapy has done something good for me?

So I thought this being New Year's Day and all, I'd listen to "New Year's Day" from U2. Normally I'm not a huge fan of U2, though in the sense of "I don't listen to much of their stuff" rather than "I can't stand the poser bastards." Once you become roaming ambassadors to the United Nations and are presumably powerful enough you've gained the Sinatra-like power to have anyone silenced with a mere telephone call, you are sufficiently elevated above the hoi polloi that their cries of "Poser knuckleheads!" or "fruity artistic blowhards!" are meaningless.

But I do like "New Year's Day", a song I've never evaluated in terms of lyrics, but I do like the way it sounds. Or sounded. Because in the world of iTunes, odd things have happened to this song. There are about ten different mixes, and none of them sound like the one I'm used to. They bear relatively unhelpful labels like "War remix" and "Kevorkian Remix", neither of which sound aupicious to me, and when sampled, none of them sound right. All of them seem to have screwed with Edge's guitar work on the side. They all have the evocative piano doodle and the bass track, but why must they always step on Edge and squash his guitar like a stinkbug? In some, it's gone entirely; on others its been made mushy and indistinct. And unless I'm greatly mistaken, none of them are an improvement.

Maybe that's the curse of being successful. You find yourself having to remix your existing music to suit a variety of powerful but niche audiences, and you find yourself with enough money and spare time that all that remixing becomes fiscally rewarding, or at least painless. This leaves your casual fans scratching their heads and saying "How come I can't find the radio version of New Year's Day on iTunes?" But since I'm not liable to sink more than 99 cents into U2 over my lifetime anyway, maybe I'm a market segment that can be safety ignored.

But it does make you (me, anyway) wonder if one of the reasons death and black metal tends not to be remixed is because black and death metal bands never have enough time and money to screw with the existing oeurve. One imagines the conversation taking place in the Bunker-like confines of the basement beneath the Norwegian Mother Record Store:

"Dude, we should remix the song Funeral Fog."
"What?"
"We should remix Funeral Fog. Pop it up a little, maybe get some play on AOR stations."
"We're going to have to pawn your boots for food money as it is; how do you propose we buy the studio time to remix anything?"
"I could sell a kidney..."

So what I'm saying is that I've bought two various mixes of "New Year's Day" and neither of them is the version I'm used to, so I'm calling this U2 expedition off before it turns crazy.

But, for whatever it's worth coming from my U2-impaired world, Happy New Year!

A Trip to the Oncology Clinic

I had my first chemo treatment this morning.

You show up and sign in, and then you're encouraged to sit wherever you want. There is a large open room with about 25 black leather recliners arranged in it, each one with its own IV stand and portable cabinet of sharp stuff. You can bring in whatever you feel like - blanket, food, book, iPod - but this time I mostly read what they gave me, a set of extremely ominous articles about the drugs in question (one of them, did you know, is chemically related to mustard gas? Two of them were classed as "irritants" and the other two were classed as "vesicants", AKA "blister agents", and all were said to cause gross damage if they got out of the vein...

But not to worry, I guess; it's just more of the boilerplate. They hook up the IV to the port and flush it out with a snog of saline, then they run a little bag of some anti-nausea drug and some steroid that's apparently helpful in a general way. Then comes the first chemo drug, a large bag of toxicity that takes about an hour to run. After that comes another bag of saline, then they push two small syringes of two additional chemo drugs in. Then comes a large syringe of some red fluid; it's plenty toxic and they actually time how long they take to push it in; too fast and it can get nasty.

Then there's more saline, a final hosing-out of the port with heparin, and you're free to go. Total elapsed time, about two hours, not even enough to nibble my caramel popcorn.

I didn't feel a thing the whole time I was there. I didn't know what to expect. Immediate retching? Burning heat in my veins? A sudden desire to belt out songs from Oklahoma!? But really, I didn't feel anything at all. Side-effect-wise, the worst thing was having the tape ripped off my chest when the IV came out.

I went home and took a rather long nap, and when I awakened, I felt for all the world like someone was sitting on me. Someone fairly big and heavy too, Magnus ver Magnussen or someone of that sort. The sensation was very much like waking up and realizing that one has come down with something without knowing what it was. I felt heavy, slow, lethargic and drained, and since that's how I've felt for the last month, well, it's hard to say that I felt any worse.

Now, about 12 hours after the chemo, I detect the first leading edge of nausea. I was watching LSU destroy Georgia Tech in the Whatever-It-Was Bowl (I'm bad at remembering bowl names) when something somehow made me very queasy, and it was obvious that the TV was making it a lot worse. So I downed a nausea pill and got the hell away from the TV, and thus far my nausea is tolerable. I don't think I'll be eating anything for a while though...

Now here's the interesting observation. By far the most bothersome symptom I've had, far and away worse than just "feeling bad", was the agonizing pain my left lower back, left groin, left hip and left groin (left kidney to left knee, roughly). It was for this pain that I was taking Percocet about as fast as the instructions permitted, and it was this pain that made me think "Oh my God, how am I ever going to go back to work? This is impossible! This is going to require either a medical leave or unprecedented quantities of painkillers, and neither one is really good!"

But for whatever reason, that pain is gone. Not reduced, but gone. Did the steroid tamp down some inflammatory process associated with the tumors? Are the tumors themselves shrinking, or "debulking", as they apparently like to say? I don't know. All I do know is that if this is really a lasting consequence of chemotherapy, I'm going to have to put chemotherapy down in my book as a legitimate medical miracle no matter how fiddlesome the process is.

That's the news on this, the last day of the year.

Time to end this year and move on to a new one unfreighted by bad omens, bad luck and bad karma. And what more fitting way to do that than to have the year go out kicking and screaming in my first chemo treatment?

I don't know what to expect. I will be under the drip for roughly three hours. They suggested that I bring a blanket, a book and something to eat. Imagine that! A medical procedure so long you have to pack a lunch! I don't think they really intend for me to bring lunch, necessarily. A few crackers or something. But still, nobody said I couldn't bring a picnic basket with fried chicken and cole slaw, did they? They also said that when (not "if") the nausea started, they would supply me with drugs to control the vomiting. With that in mind, a fried chicken picnic basket maybe isn't the best idea in the world. Maybe just an apricot or something.

Anyway, it sounds like I'll be under the drip for three hours, and from roughly the halfway point on will start to "feel tired". I interpret this to mean that from the halfway point, the chemo drugs are going to work me like an Army mule. Is the blanket for warmth, or to dampen the sobbing and whimpering? :)

Actually, I think the blanket is mostly to mop off my corpus. These lymphoma sweats are truly impressive things and the odds are that if I'm there for three hours, I'm going to have one, and I'll need the blanket so I can exploit its large-scale absorbency and thus (hopefully) not look like I just crawled out of the pool.

Maybe I should take nothing but an apricot, a bucket, my iPod, and a Sham-Wow. Write down another use for that thing!

Portion Size

Dawg in her "I swear I heard potato chips around here somewhere" pose

I find that I eat a lot less these days. Not that I'm complaining - for person who historically could eat most of a medium-sized ham at one sitting, this new dietary restraint is welcome and overdue. It means that we waste a certain amount of food, though the word "waste" may not be entirely accurate, since what I can't eat generally finds its way onto the floor for Dawg to consume. The laws of dog karma say that I should divvy out the excess food evenly between Dawg and Elmo, but Elmo doesn't like most Man-Food and it takes him forever to make up his mind to eat things like dressing or hot dog chunks. Meantime, Dawg has eaten her entire share and is slavering for his, scrabbling and clawing in a desperate attempt to get to his spuds before he makes up his mind.

So the usual process is that I pass the plate to Dawg and say "Don't tell Elmo about this." Within seconds the food is gone, and other than the suspicious hint of brown gravy and Italian dressing on Dawg's breath, nobody is the wiser.


I suppose there's some actual scientific theory to explain this reduction in appetite, just like the theory that explains why Hodgkin's makes you itch like a naked man in a room full of mosquitoes. But I think it's merely that feeling bad as a consequence of overeating is now piled on top of feeling bad as a consequence of cancer, and my body is slowly learning to avoid things that make it feel bad. You'd think that by this age I'd have already figured that one out, but NO.


But we have to get this portion size thing figured out, because the real loser in all of this is Dawg. She's always had a certain tendency to run on the chunky side, but she's starting to show a certain plushness - good for those times when it's three in the morning and hugging the puzzled Dawg is the only thing left that I can do without waking Jean up, who needs sleep worse than I do, but not so good for Dawg's own health.

Holding Pattern

I continue to wait for my opportunity to start chemo, and in the meantime, I don't know what to say. I don't want to report that I'm getting worse, but I think I am. The pain in my left thigh, hip and left lower back have become chronic and intense. I think my foot and lower leg are actually starting to decompress a little, that is, to become a little less swollen, but it turns out that the lymphoma has slipped the bounds of the lymphatic system in my leg and it's infiltrating my left thigh and groin, which also accounts for its oddly swollen nature, perhaps, and its extremely painful nature, perhaps. I have occasional difficulty swallowing. I'm so doped up that most of the time I'm not entirely sure what I'm thinking.

I'm probably setting myself up for disappointment by hoping that the first chemo treatment on Wednesday will debulk the tumors in my groin and leg to the point that I'll regain reasonable use of my leg, but I have to believe in something. The alternative is to sit awake all night and reflect upon the fact that I haven't had any treatment at all yet and am, technically speaking, dying of this shit. Stage IV. Lovely.

I'd rather hold out hope for an unrealistically-rapid cure, if it's all the same to anyone else.

I have the strangest craving for canned peaches. What can it mean? When I get over this lymphoma stuff I'm going to publish a list of Immutable Laws and I suspect at least a third of them are going to involve canned peaches in some way.

Just Too Much

Here's a photograph of mild interest, at least to me. First off, it's a photograph of a model displayed on the hood of the truck and posed in a way that it causes a kind of unintentional confusion. Plane? Car? House? Sky? Runway? Or doofus with a camera?

Second, it's a picture taken with my cell phone and emailed to my computer, which for me is an act of almost frightening cybernetic sophistication. Why, next thing you know I'll be programming up artificial intelligences and making pivot tables. This is not normally the sort of thing I do. I still half-expect to have to look down into the tops of cameras, so that's how advanced I am.

Third, it's a picture of the Italeri re-release of the old and treasured AMT/Ertl XB-70 Valkyrie nuclear bomber, not to be confused with the Tom Cruise nuclear bomb of the same name (I'm sorry, Tom Cruise as a Junker aristocrat? I'm just not seeing it). The XB-70 was too much of everything. Too powerful, too big, too expensive, too fast, too radical, just too damn too everything, so obviously it's the sort of model airplane that's right up my alley. Six J-79 jet engines? I need me some of that! I thought after the demise of the AMT/Ertl issue that we'd never see this particular model ever again, but those charming lads at Italeri have stepped into the breach and rescued it from oblivion.

I probably won't start working on the XB-70 for a while, but at least I have it. It is far too big and cumbersome a model to work on in bed, and sitting up in a hard chair to work on a model isn't particularly pleasant yet. Though my lower left leg and foot seem to be improving a little, my left hip, thigh and lower back are still pretty bad, and I find that when I'm in a lot of pain, I lose patience for some of the finer aspects of model-building.

"Honey, you glued the cowboy to the horse's belly; was that on purpose?"

"No, I just lost patience."

Day After Christmas

Twas the day after Christmas,
and all through the house...
Not a creature was stirring,
and neither would I have been had I had the sense to have taken my Percocet on schedule.

The Marrow Of The Issue

I had my bone marrow biopsy this morning. The oncology clinic called and said "If you can get here in half an hour or so, we can do the procedure." So once again I found myself being subjected to a medium-painful procedure without so much fortification as a single cup of coffee!

Oh, it wasn't that bad. The doctor used a goodly quantity of anesthetic (Lidocaine?) so I didn't feel the various needles passing through my skin and flesh. But the big needle jamming into the crest of my hipbone was a pretty intense experience. Not painful, really, though it was quite painful. Mostly it was just really intense. I'm reasonably tough, or like to pretend that I am, but the biopsy left me drenched with sweat and and shaking. It didn't help that my bones proved to be very hard and dense. "You won't suffer from osteoporosis later in life," the doctor remarked as he leaned on the T-handle and tried to drive the needle into my bone. (The first biopsy needle bent and they had to get a new kit.)

Later I found that the copious quantity of anesthetic he used had partially shut down my right leg, so I had a bit of a Walter Brennan gimp going as I left the office. Dag-nabbit, Little Luke.

So now I have a new dressing, this one on my back, and once again I can't take a shower. Arrrgh! I'd give almost anything for a hot shower at this point. Twenty dollars, fifty, take my dawg, I don't care!

Chemo starts Wednesday, of a form he described as "medium-aggressive". It's one day of chemo followed by two weeks off, repeated as necessary but for at least six months. Interspersed will be a PET scan and possibly a bone marrow biopsy (whee) to see if the treatment is working.

Time for orange sherbet, which sounds incredibly soothing to me right now.

Symptomology

I can't sleep to save my life tonight. Or at least, not at this instant. I slept earlier, but once I awaken under these circumstances, sleep doesn't always return. One of the symptoms of Hodgkin's Lymphoma is what the books circumspectly call "night sweats". I call them "an absolutely disgusting torrent of sweat." Doesn't matter if you're awake or asleep either, apparently - I soaked the sheets and woke myself up, and now I'm soaking my shirt and shorts in front of the computer.

Another symptom is a sudden attack of nonspecific itching. Normally it's just the broad surfaces like my back, shoulders or chest, but sometimes (like right now) even the small, fiddly patches of skin get involved. Even that structure that lies between my nostrils itches. The skin behind my ears itches. The whole sweep of my back itches all at the same time. I have vivid fantasies of taking off my clothes and standing in a car wash so the industriously-whirling scrub brushes could itch every part of me simultaneously.

So here I sit, itching and scratching and sweating. Lovely image, isn't it? I feel filthy. Nobody can be this itchy and sweaty without needing a shower, right? And, truth be told, showers sometimes do help. I mean, at the very least you don't have to feel beads of sweat running down your legs and into your socks. But I can't take a shower yet - surgeon's orders. I sport a gay festoonery of dressings from my biopsy and Borg Implant, and the surgeon doesn't want them to get wet. Inasmuch as one of them could provide bacteria with access to my vena cava (superior or inferior? I wish I knew) I guess I should take orders seriously.

I guess the modern approach is to sponge betadine in huge quantity over the areas of interest and to let it dry afterwards. I have (well, had) dried betadine all over my chest and neck, and even had a good deal of it in my hair. Tonight's profuse night sweat has sort of mobilized the betadine, however. It's flowing down my chest in streaky rivulets of rust-colored sweat and betadine, as if I didn't need another reason to desperately crave a shower.

But oh God this itching it driving me mad. It isn't like a rash, where the same spot itches over and over. It's different. It's every spot itching at one time or another. You scratch your nose, then the small of your back, then behind one knee, then an eyebrow, it just goes on and on and on like a childhood game of Locate All Your Body Parts.

And now I'm starting to hurt again. I can feel my pain pills losing their edge.

So let me wish everyone a merry Christmas, and let me wish us all peace and prosperity.

That said, I'm going to go take some pain pills and see if I can convert a broom into a high-speed overall-body scratching apparatus. Yowzer.

It Has A Name

Well, it has a name. The surgeon who did the biopsy apparently kept prodding the pathologist, who said it was Hodgkin's. The official report hasn't worked its way through channels yet so I guess technically I still don't have a diagnosis, but the "telephone diagnosis" is Hodgkin's. And it's good to know.

But in a way, I was hoping for one of those other lymphomas that didn't have a name, just so I could call it "Earl's Lymphoma" or something. I didn't really want to name it after me. It's like Lou Gehrig's Disease; everyone shudders and thinks "Oh man, that poor bastard." I don't need a lot of poor bastard shudders associated with my name, so I was going to name it after Earl.

Another Step

The biopsy node has been taken out and the port, central line or whatever you choose to call it has been put in. I feel really no pain at all from those incisions, just some generic pulling and tugging from the patchwork of dressings I wear on the right side of my chest and neck. I'm supposed to be in bed and not up and "farting around", as they say, and soon enough I will be. The catheter from the port goes down into my vena cava and they really won't want it to come out. They don't? Me either!

The worst part was the weird bulge in their operating table. Maybe I was on it wrong or something - I routinely overflow hospital beds and operating tables - but it was pushing a bulge of something into the small of my back that was extremely painful. They tried for a few minutes to rearrange me with pillows, then the surgeon finally told them not to bother; I would be out within a few minutes anyway. And I was.

One step closer, though I'm festooned with dressings and can't really move my neck in any direction at all. It reminds me a tad of the grand old bypass days.

Man of Few Words

Biopsy tomorrow. Vicodin tonight. Comedy at some unspecified point in the future.

Holland Loader

Sometimes, when you feel bad, only a Holland Loader will suffice.

http://www.hollandloader.com/Default.htm

I first saw one of these many years ago somewhere near Las Vegas. Like the time I beheld one of those Petersen DD9G Quad-Tracs converted to a ripper, it was an experience that remained with me. This modern Holland Loader is yoked to what appears to me to be a pair of Cat D10s; the one I saw had a pair of Allis-Chalmers HD-41s. The D10s are better dozers by far, but back in the day the old HD-41s had a certain machismo.

And having ruminated thus, I feel better.