I got a note from my mom with the sentiment that she hopes my energy is on the increase. I would have gotten this note on Tuesday, but I didn't have the energy to make the very short walk to the mailbox. I slept 16 or so hours Tuesday, a big chunk of 10 or so overnight and then several naps of 1-2 hours during the day. I just couldn't keep my eyes open. The good news is this is the best I've done with day 6 after chemo, the last few cycles I was spiking a near fever so at least I missed out on that. So yes, more energy would be a good thing!
I did some work on Wednesday, with the most strenuous activity picking up a Red-eared Slider and moving it out of the road. The turtle was feisty, and nearly got under the car seat which would have been interesting to say the least. I let her go in a nearby pond, far better than leaving her napping in the construction area. Birds are more and more the local nesting species, fewer migrants to entertain me.
I ended up at the dentist Wednesday afternoon unexpectedly. My dentist - Unterbrink Dental in McAllen - said the old amalgam fillings will shift with time and move, and mine ended up moving to where it put pressure on the tooth when I bit down on food. Why is it always a holiday weekend when this happens? He also said teeth can become more brittle with chemo so I could have broken the tooth with time. I ended up with a cleaning (since it was due), some rearrangement of the filling, and some fluoride paste to brush with after I brush. So much for all the time I'm saving not brushing hair, now I have to brush my teeth twice!
Facebook stalkers will know I spent this morning sitting on the banks of the Rio Grande. I didn't do any walking, but I enjoyed just sitting on the mostly peaceful river bank.
Send energy!
Thursday, May 30, 2019
Friday, May 24, 2019
Eating White Food
Round 4 chemo in the books, not an especially pleasant experience. I started as usual with a Dr 7 appointment and got the results of the recent scan. The good news is that there is a reduction in size of the tumors, the bad news is that it is slight. The radiologist had to change the scale from cm to mm to show the difference in one tumor or it would have been lost to rounding error. Prior to chemo the tumors didn't change size (or scale, LOL) in three months between scans. The good news is the change in the bad tumor shows a reduction in diameter, but likely not enough yet. I'm going back to Dr 6, my surgeon, after the next chemo (earliest appointment) to revisit how much more reduction in size is needed before she can remove all three tumors and whatever else is lurking.
The day before chemo I have labs done to make sure I'm healthy enough for chemo. This is the main reason I don't like shaking hands with people - I'm worried about catching something that will cancel chemo. Any fever or reduction in blood counts could get chemo cancelled and I really don't want that. I almost drive away after the Dr appointment as I've always done the labs first, but not this time (I was hoping for a huge improvement... I'm more of an optimist than I give myself credit for). I had the car in gear and was backing out when I remembered. So back to the lines. A line to pick up the order for the test. A line for the labs. Lunch time so a long wait with one person checking in and doing labs. The second vial won't fill, so the nurse fiddles with the needle (OW!). Then she switches vials and we're back to a gusher. Bad vacuum on that tube. Finally out, home for a late lunch, and back to work. The only work I have now that is scheduled and in the field is the same day as my pre-chemo appointments. Frustrating. Today with a mid-day appointment I did a couple hours and had to go back in the heat of the day. Yuck. 94F with high humidity. That wilts me on a good day. Good thing is it's mostly in the air conditioned car.
So in for chemo the next day and I draw a new nurse, is this planned? Four appointments, four nurses. I see them all since I'm there so long through the day, but one is generally in charge of each patient. The nurse is shocked I don't have a port and proceeds to show me why I need one (I know it wasn't intentional). She gets the left hand since I've got reports to do and it's easier if the IV is in my non-dominant hand, also I was just stuck twice in the right this week for tests, one yesterday and one Friday. First stick, she hits the vein but it won't let her inject saline and blows out. Yuck. Second stick, same again. Two quarter-sized bruises today (I bruise easily remember), good thing they are on my left hand. Another reason not to shake my hand, that's where they've been sticking me for IVs. She calls another nurse over to try again. I hear again how my nurse is one to help the other nurses with difficult sticks. My veins look great (so the nurses say) but today they then blow out when they try to inject anything. F***. So the second nurse tries again in the left hand. She can't hit the "huge" vein she can see (and I can see). She never gets in. STOP.
Let's try the right. I'm like a porcupine on the left since they are leaving the equipment in so it doesn't bleed when they put the tourniquet on. Big bubbles, no troubles, she gets a gusher and gets the IV catheter in. It holds, no pain on injection. Note to self: Next month the labs are on the left and chemo on the right. Note: NONE of these veins has been used before. They're all easy to see and palpate. The chemo nurses don't want to use the ones at my left elbow since one is "hard", it's right under a scar from some herbicide I got into in my 20's doing field work. It was last used in December for a scan, so it's not overuse. The other one was proclaimed "hard" six weeks ago and wasn't checked this time. It is easier for me to type and do other things (remember I'm there seven or more hours) with the IV in my hand than in the elbow, which needs to bend more, and I let the nurse choose where to stick me. Anyway, all in all a disaster at the start. This soon changes.
Dora, my nurse, is extremely efficient with the meds and checks on me often. Now I know it's no mistake they keep me close to the nurses station. Once we straighten out the Benadryl is oral and not IV we rocket through the two oral meds (Benadryl and Tylenol) and the IV pre-meds, one pushed and the others total an hour and a half total with a flush and the usual short wait to change bags. Then on to the chemo drugs, first one for 3 hours and then a flush, then the last for 30-40 min and a flush. I'm out by 4:30 PM. Given the delay at the front end with the IV and Benadryl this is really early - not a bad thing, just efficient use of time and limited down time between IV drugs. I had plenty of time for the oral Benadryl to act still as I didn't react to the chemo as I did on round 1. Yay!
So I'm back to eating white food. I have very little appetite the first week after chemo and what I can stomach seems to be mostly white. Bananas, the protein drinks that KR and SH got me at Sam's, half a bagel, mac and cheese, and bonus - potato casserole in the fridge seemed to pass the eye test today. Hoping to expand into apples. That's my diet the first week, nothing else looks at all like it's edible. I'm going to try to clean up some veg and hummus but don't have high hopes - but I do hate to waste food. With the protein drinks at least I get more than the 500-700 calories I was eating the first cycle. My weight is stable now and I am trying to keep it that way, so I don't fret about eating less the first week and make up for it the next when I have more appetite and tolerance for a variety of food. Remember I was losing weight before treatment started and in the first weeks before I got the protein drinks.
Before round 1 I would not have imagined writing about round 4. Onwards!
The day before chemo I have labs done to make sure I'm healthy enough for chemo. This is the main reason I don't like shaking hands with people - I'm worried about catching something that will cancel chemo. Any fever or reduction in blood counts could get chemo cancelled and I really don't want that. I almost drive away after the Dr appointment as I've always done the labs first, but not this time (I was hoping for a huge improvement... I'm more of an optimist than I give myself credit for). I had the car in gear and was backing out when I remembered. So back to the lines. A line to pick up the order for the test. A line for the labs. Lunch time so a long wait with one person checking in and doing labs. The second vial won't fill, so the nurse fiddles with the needle (OW!). Then she switches vials and we're back to a gusher. Bad vacuum on that tube. Finally out, home for a late lunch, and back to work. The only work I have now that is scheduled and in the field is the same day as my pre-chemo appointments. Frustrating. Today with a mid-day appointment I did a couple hours and had to go back in the heat of the day. Yuck. 94F with high humidity. That wilts me on a good day. Good thing is it's mostly in the air conditioned car.
So in for chemo the next day and I draw a new nurse, is this planned? Four appointments, four nurses. I see them all since I'm there so long through the day, but one is generally in charge of each patient. The nurse is shocked I don't have a port and proceeds to show me why I need one (I know it wasn't intentional). She gets the left hand since I've got reports to do and it's easier if the IV is in my non-dominant hand, also I was just stuck twice in the right this week for tests, one yesterday and one Friday. First stick, she hits the vein but it won't let her inject saline and blows out. Yuck. Second stick, same again. Two quarter-sized bruises today (I bruise easily remember), good thing they are on my left hand. Another reason not to shake my hand, that's where they've been sticking me for IVs. She calls another nurse over to try again. I hear again how my nurse is one to help the other nurses with difficult sticks. My veins look great (so the nurses say) but today they then blow out when they try to inject anything. F***. So the second nurse tries again in the left hand. She can't hit the "huge" vein she can see (and I can see). She never gets in. STOP.
Let's try the right. I'm like a porcupine on the left since they are leaving the equipment in so it doesn't bleed when they put the tourniquet on. Big bubbles, no troubles, she gets a gusher and gets the IV catheter in. It holds, no pain on injection. Note to self: Next month the labs are on the left and chemo on the right. Note: NONE of these veins has been used before. They're all easy to see and palpate. The chemo nurses don't want to use the ones at my left elbow since one is "hard", it's right under a scar from some herbicide I got into in my 20's doing field work. It was last used in December for a scan, so it's not overuse. The other one was proclaimed "hard" six weeks ago and wasn't checked this time. It is easier for me to type and do other things (remember I'm there seven or more hours) with the IV in my hand than in the elbow, which needs to bend more, and I let the nurse choose where to stick me. Anyway, all in all a disaster at the start. This soon changes.
Dora, my nurse, is extremely efficient with the meds and checks on me often. Now I know it's no mistake they keep me close to the nurses station. Once we straighten out the Benadryl is oral and not IV we rocket through the two oral meds (Benadryl and Tylenol) and the IV pre-meds, one pushed and the others total an hour and a half total with a flush and the usual short wait to change bags. Then on to the chemo drugs, first one for 3 hours and then a flush, then the last for 30-40 min and a flush. I'm out by 4:30 PM. Given the delay at the front end with the IV and Benadryl this is really early - not a bad thing, just efficient use of time and limited down time between IV drugs. I had plenty of time for the oral Benadryl to act still as I didn't react to the chemo as I did on round 1. Yay!
So I'm back to eating white food. I have very little appetite the first week after chemo and what I can stomach seems to be mostly white. Bananas, the protein drinks that KR and SH got me at Sam's, half a bagel, mac and cheese, and bonus - potato casserole in the fridge seemed to pass the eye test today. Hoping to expand into apples. That's my diet the first week, nothing else looks at all like it's edible. I'm going to try to clean up some veg and hummus but don't have high hopes - but I do hate to waste food. With the protein drinks at least I get more than the 500-700 calories I was eating the first cycle. My weight is stable now and I am trying to keep it that way, so I don't fret about eating less the first week and make up for it the next when I have more appetite and tolerance for a variety of food. Remember I was losing weight before treatment started and in the first weeks before I got the protein drinks.
Before round 1 I would not have imagined writing about round 4. Onwards!
Monday, May 20, 2019
Gramercy
So many things have made me smile recently.
I went digging through my backpack (drawn to the aroma of over ripe fruit after leaving it in a hot car) and found a card hidden in there from JY, proclaiming me a Tough Cookie. What a great surprise, even funnier that it took me three weeks to find it! All I can figure is that he hid it in my pack when we did the Big Sit at Estero.
Then there was this card from JD with an awesome illustration of a Red-winged Blackbird that makes me smile every time I look at it. It's a glorious male fraught with hormones in a song or fight pose but seemingly about to fly off the page. It's stunning! What a great surprise to find that in my mail box, so much nicer than the usual contents.
I'm using Audible, a great service that provides recorded books, thanks to LF. They have two shorts a month included, so I'm sampling a much wider swath of genres than I normally would, and enjoying the variety. The readings are excellent and some of the performance pieces (think old time radio dramas) are supposed to be fantastic, I'm looking forward to one of those next.
The Tech at my last test, Matt, was great. I'd been kept waiting around for an hour and a half, but he had me in a good mood from his introduction, impressive given that he was waving needles around and saying how difficult he found these new ones to use... Then the front office had me logged into the computer incorrectly, and he kept me informed and entertained for the half hour it took them to straighten it out. He even walked me to the door on the side I parked (through a staff zone) so I wouldn't have to walk around the whole building in the heat and humidity. His thoughtfulness was greatly appreciated.
And so many more little things, from offers of a tram or van tour to places I can't walk and even a house on the arroyo offered for some get-away time. I am grateful.
I went digging through my backpack (drawn to the aroma of over ripe fruit after leaving it in a hot car) and found a card hidden in there from JY, proclaiming me a Tough Cookie. What a great surprise, even funnier that it took me three weeks to find it! All I can figure is that he hid it in my pack when we did the Big Sit at Estero.
Then there was this card from JD with an awesome illustration of a Red-winged Blackbird that makes me smile every time I look at it. It's a glorious male fraught with hormones in a song or fight pose but seemingly about to fly off the page. It's stunning! What a great surprise to find that in my mail box, so much nicer than the usual contents.
I'm using Audible, a great service that provides recorded books, thanks to LF. They have two shorts a month included, so I'm sampling a much wider swath of genres than I normally would, and enjoying the variety. The readings are excellent and some of the performance pieces (think old time radio dramas) are supposed to be fantastic, I'm looking forward to one of those next.
The Tech at my last test, Matt, was great. I'd been kept waiting around for an hour and a half, but he had me in a good mood from his introduction, impressive given that he was waving needles around and saying how difficult he found these new ones to use... Then the front office had me logged into the computer incorrectly, and he kept me informed and entertained for the half hour it took them to straighten it out. He even walked me to the door on the side I parked (through a staff zone) so I wouldn't have to walk around the whole building in the heat and humidity. His thoughtfulness was greatly appreciated.
And so many more little things, from offers of a tram or van tour to places I can't walk and even a house on the arroyo offered for some get-away time. I am grateful.
Friday, May 10, 2019
Like a Rat on a Wheel...
Here we go again. Cycle 3, feeling good days 2-4, and lousy (low energy, short bout of fever, acid stomach and the like) on days 5-7. Day 8 things are looking up again, but energy is still low with the massive humidity and high temperatures in the LRGV.
One good thing, I've been able to drive into the horse farm pasture to actually see and touch (and even groom) my horses. I shouldn't have gone last night due to the heat and humidity (90F near sunset), but I had to try before the rains forecast for the next three days. There is a lot of good to be had in seeing the horses. It still takes a lot out of me.
I got through the NBC survey yesterday only to remember the three Breeding Bird Surveys I normal do each May. The weather is quite iffy for now, but I may have to give one a shot pretty soon and see if I have the energy to finish those off. One takes more organization - it's on private land - so I may leave that one for the upside of the next cycle.
Onward. Hoping for increased energy levels the second half of the cycle.
One good thing, I've been able to drive into the horse farm pasture to actually see and touch (and even groom) my horses. I shouldn't have gone last night due to the heat and humidity (90F near sunset), but I had to try before the rains forecast for the next three days. There is a lot of good to be had in seeing the horses. It still takes a lot out of me.
I got through the NBC survey yesterday only to remember the three Breeding Bird Surveys I normal do each May. The weather is quite iffy for now, but I may have to give one a shot pretty soon and see if I have the energy to finish those off. One takes more organization - it's on private land - so I may leave that one for the upside of the next cycle.
Onward. Hoping for increased energy levels the second half of the cycle.
Friday, May 3, 2019
That's More Like It
I had another positive appointment with Dr. #7 the day before chemo and had the pre-chemo blood testing. Oddly, the lab didn't have the paperwork from the infusion office or from Dr #7 office for the blood draws, so I ran around getting that sorted out. I still had time to do that and get the blood drawn before the Dr appointment. All systems go.
The next day I got to the infusion department 15 minutes early at 8:15. I'd been advised to get there at 8 because they start signing people in then, but traffic made me late. I signed in at about number 6 and right at 8:30 was paying my copay and getting my bracelet (all drugs are keyed to the bracelet, I get scanned before each drug). By 8:40 I was in the new windowless infusion suite and the IV was in and started by 8:45. This is a record early start! Instead of starting with a flushing weak NaCl Edith the nurse I was assigned today went straight to the pre-meds. We're rocking and rolling!
I sailed through the pre-meds and was starting the first chemo drug just after 11 AM. This three hour plus drug eats up a lot of time. The last chemo drug and flush got me out of there and scheduling my next appointment by 3 PM. Two hours plus earlier than last time! Woot! Love the way Edith kept the drugs flowing. No reaction, no problems at all. Best thing, the TVs weren't working for most of us so the noise level was WAY down. Too bad, they will likely have that fixed by next time.
SH helped me drop off my car at 5 PM for needed service since I thought I would want to take it easy and work on the computer the day after chemo. Turns out a Black-throated Blue Warbler was reported at Quinta Mazatlan in McAllen.
A blatant request for a ride on our valley RBA and HH picked me up (out of his way) and we spent the morning looking with no success. We did have a Yellow-green Vireo singing and seen but not great looks (I always want better) and some interesting behavior with Northern Mockingbirds and Curve-billed Thrashers mobbing a brush pile - we figured there was a snake in there. It was great to be out birding! After lunch at Taco Express (you knew that) HH dropped me off and headed back to Quinta - it's just too hot for me. I feel good if a little tired, and I'm ready to have my car back and running better!
Chemo #3 is in the bag. I feel good.
The next day I got to the infusion department 15 minutes early at 8:15. I'd been advised to get there at 8 because they start signing people in then, but traffic made me late. I signed in at about number 6 and right at 8:30 was paying my copay and getting my bracelet (all drugs are keyed to the bracelet, I get scanned before each drug). By 8:40 I was in the new windowless infusion suite and the IV was in and started by 8:45. This is a record early start! Instead of starting with a flushing weak NaCl Edith the nurse I was assigned today went straight to the pre-meds. We're rocking and rolling!
I sailed through the pre-meds and was starting the first chemo drug just after 11 AM. This three hour plus drug eats up a lot of time. The last chemo drug and flush got me out of there and scheduling my next appointment by 3 PM. Two hours plus earlier than last time! Woot! Love the way Edith kept the drugs flowing. No reaction, no problems at all. Best thing, the TVs weren't working for most of us so the noise level was WAY down. Too bad, they will likely have that fixed by next time.
SH helped me drop off my car at 5 PM for needed service since I thought I would want to take it easy and work on the computer the day after chemo. Turns out a Black-throated Blue Warbler was reported at Quinta Mazatlan in McAllen.
A blatant request for a ride on our valley RBA and HH picked me up (out of his way) and we spent the morning looking with no success. We did have a Yellow-green Vireo singing and seen but not great looks (I always want better) and some interesting behavior with Northern Mockingbirds and Curve-billed Thrashers mobbing a brush pile - we figured there was a snake in there. It was great to be out birding! After lunch at Taco Express (you knew that) HH dropped me off and headed back to Quinta - it's just too hot for me. I feel good if a little tired, and I'm ready to have my car back and running better!
Chemo #3 is in the bag. I feel good.
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