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!

How Unsavory

I watched The Next Iron Chef the other night. I didn't really want to, but there wasn't much else on TV and since I seem to be suffering from a serious cold on top of everything else, I couldn't just close my eyes and sleep - attempts to sleep are punished by the gods with fits of coughing that leave me trembling and light-headed.

So I watched it, and I didn't like it. I don't think much of "competitive cookings shows" in general, and I cringe when the "competitors" say things like "If someone comes after me, I'll go right back at them." It would be different if now and then the "competitors" really went at one another with Chinese cleavers, or even especially robust bunches of celery, but come on, you're making a broth here, not duking it out with Ivan Klitchko.

But the producers made the show many orders of magnitude more unappetizing by choosing insalubrious ingredients. Grasshoppers? Unlaid eggs and chicken fallopian tubes? Sea cucumbers? I know they were testing the "fearlessness" of the cooks, err, I mean, "competitors", but what's the point of cooking something that most people won't eat?

I didn't like it, and I won't watch another one. They had one chance to win me, and what did they do? They sprayed me with ingredients that as far as I'm concerned are garbage, not food. A pox upon the whole thing.

Sunday Night

I was going to shave my hair today, but I just never got around to it. My hair and moustache are getting skimpy enough that they would be better off shaved, but I just never seemed to have the energy. Chemotherapy is the gift that keeps on giving, in that respect at least.

I was also going to give my little dog (the Blawg Dawg) a haircut, but I never got around to that either. She's getting awfully scruffy, but she doesn't care. Nothing dampens her mood; she's just as happy sitting in a cold mud puddle as she is sleeping on a folded-up blanket at the foot of the bed. I'm trying to learn from her example, though I confess that after a year of cancer and chemotherapy I feel, in the words of Bilbo Baggins, "Thin, like butter scraped across too much bread."

My nephew got married yesterday. How often does your nephew get married? Not often, and I wanted to go, but chemo makes one unfit for public appearances. Suffice it to say that I just couldn't go, but I felt guilty about it all day.

Afghanistan

Today I take keyboard in hand to talk a little bit about all the recent palaver about the war in Afghanistan. Specifically, I heard on NPR the other day some Democratic politician saying that we had no more business being in Afghanistan than we had being in Vietnam. I'm a Democrat and all, but I support the war in Afghanistan and think that comparisons between Afghanistan and Vietnam are invalid.

VIETNAM: Why you think we got involved in Vietnam depends to an extent on your political philosophy. Was it commercial interests? Were we bailing out the French? Were we truly worried about Communist expansion? Was it all the Domino Theory? Either way, a Communist Vietnam never posed a threat to the United States. Uncle Ho never seemed inclined to carry out terrorist attacks in the United States, and the Domino Theory was in any event proven to be largely false.

AFGHANISTAN: Here we are fighting against a religio-political movement that hosted Osama bin Laden, that continues to host him, that supports social and political "reforms" that anyone in the West must surely find repellent. They probably also provided material aid to al Qaeda when they were planning the attacks on New York, the Pentagon, the Embassies in Africa, the USS Cole and so forth.

It strikes me that we had no compelling reason to become involved in Vietnam. It blew up out of the larger Cold War (my wife would probably refer to it as a "penis-measuring contest") and had no larger ramifications. Indeed, thirty years on, the grip of Communism on Vietnam is failing and one could reasonably argue that though we technically lost the shooting war, we are going to win the larger cultural and social war in the long run.

But Afghanistan? Let's remember who the enemy in Afghanistan is. This isn't some Cold War contretemps being fought out for the sake of doctrinaires; this is a real war against an enemy that struck us first. It seems to me that there are no parallels between Vietnam and Afghanistan, except the obvious one that both involve young men dying before their time.

It seemed a pity to me at the time, and an even greater pity now, that we (meaning President Bush and his team) allowed Iraq to distract us from the main mission in Afghanistan. If we had piled those 120,000 troops we sent to Iraq into Afghanistan on top of what we already had there, we wouldn't be having this conversation today.

Afghanistan is a mess and no mistake, and I can't say I know exactly what should be done. But I don't think that crying "Vietnam!" and throwing our hands up is the right answer. What would I do? I'd commit the 101st Airborne and a full infantry division of the US Army to the theater and see what happens.

No News

There's no real news on the stem cell transplant front. I called them to see if they are waiting for me to do something and they haven't returned my call, bu as far as I know we're just waiting for things to fall into place (HP Lovecraft might say that we're waiting for the stars to return to an ancient configuration, which may be appropriate because this super-chemo may be about as dreadful as a picnic on R'leyh).

Further bulletins as events warrant.

What A Relief!

I'm glad someone in the pharmaceutical industry took time out from working on drab, boring problems like malaria, MRSA, cancer vaccines and Alzheimer's and finally attended to the pressing national problem of Brooke Shields and her skimpy eyelashes.

Not that I'm doing any special pleading for a vaccine or cure for Hodgkin's (though it would be cool if there was such a thing) but on the scale of medical problems that need attending to, skimpy eyelashes must rate just about a zero, right down there with renegade nose hairs and the tendency to snort when you laugh.

The Next Iron Zombie

Does the world need another Iron Chef? I don't think so. I'm comfortable with the current assortment, and frankly I don't know who any of the potential future Iron Chefs are on the ads for The Next Iron Chef. I recognize Amanda Freitag, but that's it. The rest of them are cyphers to me, unpalatable ones at that.

But I think to a large extent it's the way the ads are filmed that puts me off the project. They're all shown in this cold, dead light that makes them look like zombies or corpses. Whose idea was that? "Hey, I got an idea, let's light them in a way that makes them look sallow, unhealthy and dead! Even Alton Brown will end up looking spooky and diseased! It'll be great!"

Yeah, great. The lighting on Dr. G Medical Examiner is more flattering than the Next Iron Chef ads. How strange it is that a TV show about a morgue seems warmer and more inviting than a show about people cooking things in a kitchen. But it could be worse - it could be Chopped, with its endless loving footage of sweat dripping off the noses of the various competitors and falling into their freakish dishes. That's appetizing.

Sleepless in Wittmann

I've had my share of sleepless nights of late, understandably enough, and one of the things I sometimes do when I can't sleep is wonder what might have happened if I'd signed on the dotted line back in 1978. Let me explain. Back in 1978, when I was a senior in high school, I had every intention of joining the US Army, with particular emphasis on armor - tanks, that is.

My family doesn't have a particularly rich military tradition. My dad was drafted into the US Army in World War Two and though he remained intensely proud of his service in what he called "The Big One", he was demobilized along with practically everyone else and was back in civilian life by the time of the Korean War. My grandfather served as a Seabee on Guadalcanal and throughout the South Pacific, but was never the most military of men - nor did he really want to be; I think he found the various challenges of building airstrips and bases on jungle islands fascinating, but the military life itself didn't mean much to him.

So I didn't have a long history of forebears pushing me to join the Army. Mostly I succumbed to an extremely slick recruiting film I saw at the US Army recruiter. My dad and grampa did a lot of work with bulldozers when I was a kid, so I was sort predisposed to have an appreciation for heavy tracked vehicles. But that recruiting film, oh my! The front line tank of the day was the M60A1, a vehicle that doesn't get nearly as much credit as it deserves, and the film was full of M60s in action - high speed turns, firing at target tanks at Fort Irwin, accelerating across the desert amid clouds of dust and diesel smoke...

So I had it all figured out. I'd join the US Army and serve in an armored division in Europe, preferably one equipped with M60A2s, a highly unconventional vehicle whose nickname "Starship" did a good job of reflecting the tank's high sophisticated technical nature. Unfortunately, the 152mm Shillelagh gun/missile system was not a spectacular success and once the Army figured out that a 105mm-armed M60A1 was as efficient in an anti-tank role as the M60A2, most M60A2s were converted to M60A3s or into engineering vehicles.

If I'd joined in 1978, I would have retired in 1998, just as the M60A3 was finally giving way to the M1 Abrams. The M60A3 TTS was an excellent tank - its thermal imaging system was better in 1990 than the most systems are even today. But the M60A3 didn't have Chobham and probably couldn't have accommodated a 120mm gun, so off it went, most of them ending up in Egypt.

Anyway, that was the plan. What would my life have been like if I had retired from the armor in 1998? There's no way of knowing, but I can't help but think that it would have been worse. Twenty years of dunderheaded second lieutenants and alcoholic NCOs would likely have driven me mad, or alcoholic, or both. I don't regret not having joined the Army. I probably wouldn't have made a very good soldier anyway and the Army might well have "accidentally" lost my re-enlistment papers in the event that I decided I could stand a second hitch.

I went through AFEES, but never signed the dotted line. It's probably a good thing. Who ever heard of a six-foot-four tanker? I probably couldn't have fit in an M60 even with no clothes and a thick layer of chicken grease on my person. I tried to climb into an ex-Soviet T55 in a park in Leningrad and found the experience laughable (and I could only conclude that the average Soviet tanker was short, wiry, and had a very high threshold of pain).

Anyway. Enough of the tanks.

Alopecia Maximus

This morning I discovered that my hair is falling out again, and falling out way faster than it ever did on the ABVD protocol. Back during ABVD I could pull on my hair and come out with six, eight, ten, maybe fifteen hairs. But today, I can pull it out by the handful. Entire shocks of hair come out. There's no pain, no sense of tension, nothing - I pull, and out comes big masses of hair.

I almost burst into tears when I made that discovery at work this morning. I expected my hair to fall out, and I'm not that attached to it anyway. It was just a reminder of how sick I really am. Pardon my language, but the CHOP protocol is fucking awful, and when your hair falls out in big wads you're reminded of how bad it really is.

I'll survive. I'm just a low ebb emotionally. I'll feel better when my hair is finally gone and I can go back to wearing my little black beanie like a proper chemotherapy patient.

Horsepital

It looks like I can take my laptop to the hospital with me, and they have a wireless presence. That'll be fun, blogging from the depths of the transplant isolation wing, but what I wonder even more is what the staff will think of Amon Amarth. There might be something a little strange about listening to death metal in a hospital room, and I intend to find out.

I'm also considering putting together a little kit so I can build the occasional model while I'm there. Nothing too spectacular, mind you. I think I've settled on a couple of older Revell models of World War One airplanes, specifically the Sopwith Triplane and the Fokker Dr.1, also a triplane. These are small and inoffensive, confronting one with neither complex assembly nor great cost, just the sort of thing to stick together with nontoxic citrus glue while listening to Amon Amarth and waiting for one's hair to fall out.

Phood Network

I watched an awful lot of the Food Network while I was sick, as is my usual wont. Here are a few of my random observations drawn from this experience.

1. Watching Chef Versus City is no fun when you're sick. Watching them force down those giant Chicago-style pizzas and threatening to blow chow while I was in turn threatening to blow chow was altogether too much. I don't care for the show much to begin with, but the forced eating and the loving close-ups of nausea-wracked faces just don't work for me.

2. I chuckle every time someone on Chopped says something like "I'm from (pick one) India China Columbia Bratislava and cooking is very important to my culture." Well, duh. Name me one culture that cooking isn't very important to. It sounds like mindless jingoism to me.

3. I have to apologize to Bobby Flay. In the past I've insisted that he's a jerk, but I think I have to retract that statement. He seems much more decent than I ever gave him credit for. I also have to say that while I like his cooking style, what with all the spices and peppers and whatnot, I wish he'd stop putting octopus in everything. Ugh.

The Old Man and the Heave

Contrary to popular myth or expectation, I'm not dead. I've just had a pretty busy couple of weeks. No, busy isn't really the right word. Unpleasant comes closer to the truth.

WEEK ONE

Here we have five days of chemo, a combination of etopacide, cisplatin, and cyto-something. I don't remember the third drug. One day of chemo isn't too unpleasant, but five days in a row? It has a way of piling up, in the same way that one day's worth of dirty laundry is nothing too harrowing, but a five-day pile of dirty laundry starts to get kind of daunting.

The chemo brought the usual run of unwelcome visitors, like fatigue and intestinal distress, but it also brought a grande-sized helping of nausea. During the ABVD protocol I did my share of vomiting, but I probably threw up more on the five days of this protocol than six months of ABVD. And it's hair-trigger vomiting too, with very little advance warning.

Five days of chemo is a lot. It's what a friend of mine used to call e-goddamned-nuff.

WEEK TWO

Now the fun really started. On the fifth day of chemo I started to get sick from something else. Nobody did any cytological studies or anything, but it was probably a virus of some sort, perhaps egged on by the disordered nature of my immune system. My symptoms began with dizziness, confusion and something akin to stupor, followed by crippling abdominal pain and the most spectacular diarrhea I've ever heard about, read about, or experienced. At times I was busily ejecting fluids from both ends of my body simultaneously and I didn't know which end would be most profitably aimed at the toilet.

For several days I couldn't even read. I was so confused and disoriented that I couldn't make sense of words on a page. I'd look at the words, they would confuse me, and I would become kind of angry. Then, as often as not, I would become nauseated.

I stopped eating and drinking, and since my body was enthusiastically jettisoning fluids from both ends, the result was severe dehydration. By Wednesday I'd gone about five days without eating anything and had lost so much water my arms, legs and face were developing a gaunt, bony aspect that I should have found more troubling than I did. We went to see the inestimable Dr. Adoo at the oncology clinic on Wednesday and I could hardly walk the fifty yards from the door to the office, and for all practical purposes I simply gave out in his examining room.

They were going to transport me to the hospital when one of the nurses (whom I affectionately but privately refer to as "Madam Hooch") had the idea of tapping into my port for rehydration. They connected me to a bag of saline the size of a North Korean and presently I began to feel better. Another thing I remember is this conversation with the doctor:

"Are you taking Imodium?"
"Yes."
"How much?"
"As much as the box instructions permit."
"Double it."

Armed with fresh fluids and a doubled intake of Imodium, I slowly began to make progress against the virus. At first I couldn't sleep for more than a half an hour at a time and I couldn't take any pills that would make me drowsy because I had to be able to get from the bed to the toilet in a matter of a few seconds. Over time I could sleep longer, the pain receded, and I slowly began to stockpile some water in my system (it felt like I was drinking several gallons of water a day, but even that probably wasn't enough).

WEEK THREE

Back to work! That was bad. After being bedridden and dehydrated for a week, my muscles just didn't seem to want to work any more. My gait devolved into a laborious shuffle that reminded me of The Carol Burnett Show and for whatever reason walking even short distances left me sweaty and winded. I lasted two hours at work the first day before I was simply overwhelmed by fatigue.

On Tuesday I was clearing out old voice mail and found two voice messages from the Banner Transplant team arranging an appointment for me at noon on Tuesday! Bugger! I tore out of work and drove like the wind to the hospital, where the only parking place I could find was about five hundred yards away from the door. I had to stop to rest several times on the way to the door, and each time reflected upon the windblown exhaustion described by Krakauer in Into Thin Air. Is this what climbing Everest is really like? None for me, thanks.

By the time I found the transplant office, I was positively reeling from exhaustion. Fortunately all I really had to do in the appointment was sit and talk. More on the appointment later.

The rest of the week I slowly got stronger. Even day I'm not fully recovered. Walking is still a struggle and I tire out with great ease, but I still seem to be getting stronger. It's taking me much longer to recover from this than normal, but then again, I've never been sick in the immediate aftermath of five days of chemo either. All bets are off, apparently.

THE TRANSPLANT

The stem cell transplant is on. I was hoping to avoid it, but there is apparently no avoiding it. I met with the transplant people at the hospital on Tuesday, where they not only accepted me into the program but described me as an almost ideal candidate: relatively young, no major underlying health problems, and a garden-variety nodular sclerosing Hodgkin's that should prove easy meat.

The great thing about the program is that they have specialists on hand to do my worrying for me. I have a case worker who is responsible for all my scheduling and appointments. I have another case worker who is responsible for getting, filing and transferring medical records. I have a social worker who worries about my emotional readiness. I have financial case workers who worry about financial matters. My job, my only job, is to bear up under the procedure and get better. That's it.

Final scheduling of the stem cell transplant is not yet fixed, but it'll probably start toward the end of this month or the middle of the next. It's a 100-day process, most of which consists of monitoring and recovery. There is a roughly two-week period before the transplant where one undergoes tests and has one's stem cells harvested (they need 4,000,000 of my stem cells for this to work, by the way). Then there is a one-month hospital stay where they do the actual high-intensity chemo and the stem cell transplant. Then the rest of the program takes place at home, where one tries to rest and avoid contagion.

This means that I had to tell my boss that I can't work for six months. The transplant people said it's sometimes as short as four months, but six months is a fairly good general-purpose guess. My boss has been very understanding about all of this and simply said "Try to let me know a week ahead when you're going to leave." It's up to me when I want to stop working; I think I'll probably stop when my second chemo starts.

Here's the general process.

1. Undergo second five-day chemo protocol
2. Begin injections of Neupogen
3. Wait for stem cell population in the blood to peak
4. Harvest 4,000,000 stem cells
5. Complete various tests
6. Go into the hospital
7. Have a week of super-intense chemo that kills practically everything in your body
8. Have the stem cells reinjected
9. Stay in the hospital till the immune system starts to recover
10. Go home and stay home till the immune system recovers
11. Begin testing to see if the cancer is finally gone
12. I guess that's about it

So it's been a fraught few weeks for me - chemo, physical illness, physical incapacity, facing the reality of being out of work for six months, and confronting the reality of the stem cell transplant. None of it much fun. No indeed.

I really have to give appreciation to Jean, my wife, who really went above and beyond the call of duty in taking care of me when I was practically incapable of doing anything. Thank you, honey!

Two Down

Thus ends day two of my new chemo regimen. Gawd.

Monday, Tuesday, Wednesday and Thursday I'm under the IV drip for five to seven hours each, taking aboard a gigantic bag of epotacide and a slightly less gigantic bag of cisplatin (not to mention a dose of Lasix, an anti-emetic, and a steroid). Then I go to work for as long as I can manage.

It makes for a long day, but I guess it's nothing I can't bear in the long run, especially since it seems to be working. The pain in my back is already gone, the pain in my leg is dramatically reduced, and the swelling in my neck has already receded by about a third in only two days. I can stand a lot of suffering if it seems to be for a reason, and thus far, it seems to be for a very good reason.

So what are the main side effects so far? The most memorable is a truly vile, sour metallic taste in my mouth. It's like licking a mummified penny, only it doesn't go away. If I eat anything, I can still taste the metallic taste and think "That would be good rice if rice normally came mixed with mummified pennies." The chemo also tends to make me a bit headachy, a headache that reminds me of nitroglycerine or even Neulasta. And I'm beat. Exhausted.

Fortunately nausea doesn't seem to figure into the picture, at least not yet. That'll take five to seven days to crop up. Whee.

I'm not sure what happens Friday. I know I go in for chemo, but I get a different drug whose name escapes me. It also doesn't take five to seven hours. Further bulletins on that as I figure out the details.

Repeat for six months and hope for the cancer to just DIE.