Initially,given that today marks the beginning of the Olympic games, I thought that I would be able to cleverly integrate various Olympian themes into this post -- the thrill of victory, the agony of defeat sorts of things. But, while walking earlier this morning, the olympic muse failed me, and I returned again to war metaphors to describe where I'm at regarding my cancer and its treatment.
This past Tuesday I had a CT scan and lab work done. I saw my doctor on Wednesday, and once again the results showed that I'm holding my own. The scan showed that the disease continues to be stable. No new tumors have appeared, and existing tumors have not grown. My CA19-9 levels remain low, and other lab work shows that my liver and kidney functions are normal. The chronic anemia -- low red cell and hemoglobin counts -- is still there, but other blood work is within normal ranges.
The image, then, that came to mind while walking was one of cellular and chemical trench warfare going on inside of me with new cancer cell growth being constantly countered by surges in my army of chemical agents. Unfortunately, as in all wars, there has been a good deal of collateral damage as well as friendly fire incidents. It's become clear that some of the post-treatment symptoms I have been experiencing, in particular the increasing edema, tendonitis and muscle fatigue in arms and legs, are clearly due to the toxic effects of the gemcitabine that I have been receiving three weeks out of four. It has gotten to the point where symptoms have not been completely relieved even during my rest weeks, and the effects have been accumulating. As a result, there will be a troop reduction of sorts in my battle plan. Beginning with this latest cycle (Wednesday was C9D1 for those keeping track), I will be receiving treatments every other week rather than three out of four. Essentially, it cuts out the gemcitabine-only treatment on day 8 of each cycle. On days 1 and 15, I will continue to receive the same doses of gemcitabine and avastin as in the past.
Hopefully, this reduced dosing will provide the additional time needed to recover from the side effects while continuing to keep the cancer cells in check. This change does not come without some concern that it might give the cancer just a bit of an edge in our ongoing battle, but as I've learned from the start of this process, what happens inside of me is really something I can't control. I will continue to do all I can to supplement the chemotherapy with diet, exercise -- and I'm hoping to be able to get back to biking and running if the toxic side effects are reduced -- alternative therapies, and hope and prayer. Yep, back to attitude as the only thing I can really control through all of this. And, while the emotional roller-coaster ride continues, it's much tamer these days -- more of a kiddie ride without the screamer drops I've dealt with in the past. I feel pretty good most days and am trying, as a new wrist band reminds me, to make every day matter. The uncertainty about what lies ahead provides an ever present and strong undercurrent that impels me to do so.
So, I continue to spend time with family and friends, sharing laughter, meals, walks, what passes for wisdom, and more. Last week, Jane and I had the opportunity to get away to Maui for some welcome R and R. We enjoyed the time together whether walking a beach, playing tourist, eating ono-burgers, birding (12 new species including some native Hawaiian honeycreepers), watching sunsets, or simply sitting and reading (mysteries for me, romances for her). I had a chance to snorkel at Molokini -- thanks for that go to Meghan Ritchie, unofficial travel advisor and concierge -- and even body-surfed some shore break with a bunch of kids and felt a bit like a kid again myself. My repeated thanks to John and Lorraine Ritchie for the use of their house on the slopes of Haleakala and for the continued support of so many others. The prayers, good wishes, reminders of times and events long past, and more are all contributing to my feeling of "wellness." God bless.
Peace,
Don
Friday, August 8, 2008
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