Dateline Hemotropolis - The Continuing Saga

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Dateline 2014, April 15/16. 4AM. City of Hemotropolis, State of Bart’s Body. Bart’s Brain reporting. Well, it appears the renewed U.N. peace keeping forces (2nd chemo treatment) decided to go on special maneuvers and marching drills all night long on the streets of Hemotropolis (my blood stream). Like tanks rolling down main street, all the inhabitants of fare Hemotropolis and indeed the whole state of Bart’s Body are being kept awake by the roaring chemo streaming through town.

Yup, I started this post at 4:00am and I have insomnia. I actually put myself to bed at 8:30pm last night but have been up and down all night. The only explanation seems to be the treatment. I created a video shortly after the treatment where I was very disoriented and exhausted and then another one at nearly midnight where I was very alert & coherent. Yet I had not actually slept between those two videos. I had dozed off for 5 minutes or less at least a dozen times, but no appreciable sound sleep. I mention in the 2nd video that I'm hot and yet cold to the touch. Especially my hands and feet are extremely hot but now, even as I end up this post at 5AM on Wednesday, only my torso, arms and legs feel cool enough to cover up. I need to leave today in just 3 hours to go for my second session in the 2nd month of treatment and I don't feel the least bit tired.

Finally laid down at 5:15AM and woke at 7:30AM.

(See 1st post: Bones Visits the 20th Century)

Addendum: Date 5/16/2014

Rather than start yet another article, it seemed more expedient to just append here. I had my 3rd chemo treatment on Tuesday and Wednesday this week (May 13 & 14). Typical reaction: Exhausted, dizzy, weak. For some odd reason, after the second day's treatment I get the hiccups that evening and it lasts (on and off) for about 48 hours. The doctor said that what is prescribed for that symptom is actually an anti-psychotic medication. I declined it. I found that the anti-nausea pill he prescribed worked for the hiccups but only about an hour or two. Since the pill can only be taken once every 12 hours, that leaves me with about 10 hours of strong, loud hiccups. This is especially disruptive when I try to sleep at night--which further compounds my exhaustion during the day.

Another issue that came up this time (and with the second treatment) is that leaving the vein tap in after the Tuesday treatment so that on Wednesday all they have to do is hook me up isn't working. Once again, when they started the line, I felt immediate pain and the process had to be stopped; another vein identified; and infusion started up again. But now they are running out of good candidates for the tap. Both sites for this week's treatment are swollen and painful to the touch. One site from the second treatment is still not healed. The nurses urged me to talk to my oncologist about having a "port" installed. I did speak to him and asked what the downsides were. He mentioned infections. I asked if the port would be removed after my last chemo treatment. He indicated that Kaiser usually doesn't remove it but it remains with the patient for their lifetime. I decided against it but am now beginning to wonder which is the lesser of the two evils.

Addendum 6/10/2014
Nothing significant to report. Had 4th treatment. Very tired. The dosage of one of the chemo drugs was boosted slightly because of my body's favorable tolerance of the last (3rd) treatment. Took 2 capsules of "Lip-Flavonoid" when I got home. This over-the-counter supplement was reported to reduce ear ringing, which seems to get worse after my treatment for several days. I'll be interested to see if really does anything. Oh, I did decide to finally have a port put in. That will happen in the coming weeks before my 5th treatment. I opted for this because the nurses were running out of surface veins to tap for the infusion. Also, I spoke to the head infusion nurse who calmed my fears and concerns regarding this procedure.

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Bones Visits the 20th Century

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Nearly three decades ago there was a Star Trek movie whose theme was “Save the Whales.” In one scene, Chekov had taken a bad fall and ended up in 20th-century surgery to relieve pressure on the brain. Somehow, I mistakenly remember Bones, after beaming down, coming into the operating room and exclaiming that drilling a hole in a man’s head "was barbaric." Here is what he really said.

In the elevator scene, before finding Chekov, there were two young doctors discussing “radical chemotherapy.” Back when this movie was made, I had no clue what that was. Now that I am undergoing chemo treatment for leukemia (CLL), and discovering that one of the infused treatments I am receiving had an element in it that appeared it was derived from the words “mustard gas,” I got curious. I looked up Mustard Gas in Wikipedia and was shocked to discover I was right. If you read under the “History” section, there is a sub-section on how mustard gas is being used to treat my form of leukemia. Why? Because back in World War I and subsequent to it, medical science discovered that one main side effect of exposure to mustard gas (on a cellular level) is a significant drop in white blood cells. (I confirmed my suspicions with the nurses at the Infusion Center that told me the reason they dawn protective gear when starting my I.V. is because the mustard gas is extremely dangerous.)

In my case, that is the exact results the oncologist wanted because my white cells had turned into a spontaneous mob riot, replicating to more than four times the norm for an adult. They were bashing in the windows of my platelet counts, overturning the cars of my oxygen-carrying red blood cells, and killing and maiming the innocent bystanders of my immune system. Medical science's answer? Declare martial law, call in the national guard of chemotherapy and systematically kill all looters and curfew breakers. More accurately, the best answer is to commit genocide on my white blood cells—how’s that for barbarism!? LOL

To date, I've only had one chemo treatment. I must be hyper-sensitive to stimulus of any sort because my white cell count crashed to the bottom end of the normal range. To illustrate—most people live in a small range of elevation—from sea-level to the lower mountains. That corresponds with the white cell count for most humans (3.5-12.5 K/uL). In contrast, my white cell count was living on top of Mount Everest (49 K/uL). Within two weeks, it was brought to just above sea-level (5.8 K.uL). (Did anybody hear that “splat!”?)

Don’t get me wrong. I’m not finding fault with medical science. It just seems so “dark ages.” Instead of having found a treatment method that would be akin to using the finesse of precision microscopic surgery tools, for all of medical science's advances, cancer treatment methods seem akin to using a harpoon. (I'm sure medical science would balk at such a comparison, but chemo is undeniably harsh on the body--more like the proverbial "bull in a china shop.")

My oncologist has been the absolute best doctor. Very thoughtful, compassionate, patient and understanding. His treatment of my leukemia has been tailored for my needs. In fact, even though the original chemo infusion was, as he stated, the weakest dosage he would ever start with, after he saw the fantastic results, he is now thinking of reducing the dosage even further.

Although the post-riot scene is quiet, it is still a disaster. The National Guard (chemo) is still patrolling the streets of Hemotropolis (my bloodstream). Although some of the good citizens (my immune-system Neutrophils and blood-clotting platelets) have started roaming the streets in greater numbers, transportation (oxygen-carrying red cells) is still greatly impaired. Although it appears that leukemia has been arrested and the riot has been squelched, my oncologist is still planning on completing the 6-month-long chemo treatment. I think the UN calls these forces "peace keepers." (LOL) 

I am still dealing with the fallout symptoms from chemo, which cause extreme vertigo and fatigue (not to mention numerous other symptoms). For the time being, I have decided to stop driving—for my own safety as well as others on the road--at least until the dizziness goes away. That decision has been the toughest. I've basically become housebound and dependent on others to transport me. I am glad to see the excellent results with just one treatment. I’m still apprehensive about my future "quality of my life." But “one foot in front of the other,” “one day at a time,” and so goes my life right now.

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Below, the left chart is pre-chemo. The right is after just one treatment of chemo.

Addendum 4/4/2014: Just came from meeting with my oncologist. As I understand him, although the riot has been squelched, there are trouble-makers lurking in the dark alleys of Hemotropolis. They are opportunists that are waiting to rebuild and reorganize. The refreshed forces of the National Guard (The remaining 5 rounds of chemo) "can" (no guarantees) completely crush the rebellion and restore real peace in the city. The downside is that this is not without impact on the good citizens. Right now, his main concern is on transportation (oxygen-carrying red cells) -- they are already low. Crippled transportation can starve a city.

Another insight (that I had already suspected) is that the results achieved in this first treatment were more drastic than the doctor had anticipated. He indicated that normally these results are not seen until after the second or third chemo treatment. This confirms that I do indeed seem to be hyper-sensitive to these drugs. Part of the balancing act of dosage is the body weight verses bone density. In my case, I am about 100 pounds over-weight, which adds to the complexity of dosage calculation. Guess I need to lose weight (Duh!)

Story continued here: Dateline Hemotropolis-The Continuing Saga