Wednesday, September 30, 2009

Feeling better

I had a pretty good day yesterday, with no fever, sweats or chills. My appetite was good and I ate three good meals. However, last night, I suffered from night sweats and woke up about 2:45 am with both me and the bedding drenched. Waking up in clammy, damp bedding does not promote healing, in my opinion.

Today, I feel almost normal; less sluggish than before and enough appetite to invite my adorable wife to Big Lunch. That is a late lunch at a restaurant where we eat dinner-sized portions and have the luxury of lingering over coffee or a glass of wine.

I hope that this may be the beginning of the end for these post-infusion symptoms.

I have been treated very well by Medicare and my medigap provider; having paid almost nothing out of pocket and never having a coverage fight with either. However, I received a notice from my medigap provider that they were denying a bill from provider U, who I had never seen! After a phone call, the billing lady said that she didn't know why it got submitted as provider U, that it was actually provider S, who I have seen many times, including the date on the notice from my medigap provider! She promised to get it fixed and I promised to keep my checkbook sequestered until then. I hope my painless treatment by Medicare and my medigap carrier will resume. This was not, so far, painful; only a minor inconvenience.

Monday, September 28, 2009

Better...or maybe not

Yesterday was a pretty good day; no fever, no chills or sweats and a good appetite. Today, however, about 1:45 pm, I felt warm and had no appetite for lunch. I took my temperature and found it to be 101.2. I took a big dose of Tylenol and confined myself to bed. Now, at 5:20 pm, I feel better and have no fever. I am even looking forward to dinner.

These symptoms seem milder than before and I hope they will turn out to be of shorter duration. I was encouraged by yesterday and this morning, when I had nothing more than sluggishness. In any event, I am one day closer to the end.

Saturday, September 26, 2009

Post-infusion symptoms begin

I awoke this morning feeling sluggish and with a fever of 99.9. I am perspiring profusely. I had hoped to not have these symptoms this time, but I was not to be spared. Of course, the good news is that these symptoms don't last forever and I am one day closer to the end. It looks like I will be a sick old dog for a few days.

Thursday, September 24, 2009

We're done and done

We should be out in about 15 minutes, done with the final treatment! Woo hoo! Then the after-symptoms, if any, can start and subside and then we can wait for blood tests in about a month and a PET scan yet to be scheduled. I am looking forward to remission and a general improvement in my overall health.

Day 2

This is the second and final day, of infusion #4, also the final, hopefully for many years to come. So, far, there has been no drama like yesterday. It's just a long, boring day, but a day I have been looking forward to for a long time; that is, the last day.

History tells me to expect ten days or so of post-infusion symptoms. Then I should be at least as well as I was before this all started. Since my B12 is now normal and my hemoglobin is creeping towards normal, I hope my health overall is improving, and that I may feel even better than before!

Lunch time is a hoot. Some spouses/significant others buzz on over to the local fast-food place and come back with greasy cholesterol-laden food for two, probably not ideal for a cancer patient. Some just don't eat, probably also not ideal. Some graze the provided baskets of cookies and crackers. Mrs. Over-achiever, my adorable wife, brings a fairly larger cooler with sandwiches, chips, bananas, drinks and other treats. We get looks, like, why didn't we think of that.

I asked her if we could start with chips, salsa and beer and then continue on to cold shrimp and then finish up with pumpkin cake and espresso. She just narrowed her eyes and gave me a bad look; I took that to be "No."

So far, so good. More later.

Wednesday, September 23, 2009

Color me outa here!

Bag #4, that is the 400th mg, is just about done. Patients have come, had therapy and gone, until we are the last ones here. We should be done by 5:00 pm and then off to dinner and a restful night before tomorrow, when I get another 339 mg. The odd amount, 739 mg, is derived by a formula, the main components of which are height and weight, thus making the dose proportional to the mass of the patient.

The light at the end of the tunnel is getting really bright now! As the old saying goes, I just hope it's not the headlight of an approaching train!

More tomorrow.

In the treatment room

Things started off well enough, including a report from Dr. Hema that my hemoglobin is continuing to improve, albeit slowly, now at 11.2. Also, a sometimes indicator of anemia, B12, is normal! However slight these improvements may be, they indicate my system is slowly returning to normal. I love good news.

Soon after the rituxan was started, my face became very red and I felt nauseous. So, once again, off I rushed to the restroom, IV pump in tow. I felt very sick for a few minutes, but never actually threw up. These symptoms subsided about as fast as they arose after the rituxan was stopped. An anti-nausea drug was administered and then the rituxan restarted. So far, I am tolerating it well.

This will be a long two days. It is now about 1:30 pm and we are just about done with the first 100 mg of rituxan, out of 739 mg required.

My bright spot is my adorable wife who is here at my side helping me every agonizing step of the way.

Sunday, September 20, 2009

Great improvement

I had a great day yesterday and so far today, I have had no fever, no chills or other symptoms. I really feel rather good! These ordeals, post-infusion symptoms, are very difficult, but that's what it takes to get, hopefully, to remission. Today proves they just won't last forever.

Today, we will be visited by my niece A, her husband K and their very cute little son, P. We are looking forward to seeing them and I am very glad I am relatively well, so that we can all have a pleasant visit.

Wednesday and Thursday, it's back to Big City for treatment #4! Hopefully, this will be the last infusion for a long, long time. As always, I will post to this blog from the treatment room. I actually read your past comments right in the chair. They make me feel that all of you are lifting me to do what needs doing and press on no matter how tough it feels at the time. Thank you all.

Wednesday, September 16, 2009

Post-infusion symptoms worsen

I have not posted in a few days because there really is no news. I feel lousy, my symptoms continue and I so want to have this over and done! I experience sweats and then shivers and my body never quite seems to be at a comfortable temperature. I run a temperature most of the time, despite taking the medications Dr. Hema and Dr. Infekto suggested. After the previous two infusions, the symptoms declined in about a week; well, tomorrow is a week. Let the symptoms subside!

The silver lining is that next week, the 23rd and 24th, is my fourth and final infusion! I can see the light at the end of the tunnel.

Today's weight 164.5. It sure was fun weighing 174 for a day or so. I hope the lymphoma going to remission will improve my general health, especially my anemia and low iron, and I can get to a physique somewhere above 'scrawny.'

Saturday, September 12, 2009

Post-infusion symptoms emerge

I had high hopes that the infusion, done slowly, over two days, along with the ibuprofen, would alleviate most or all of the symptoms I have experienced previously. Thursday and Friday I felt rather well. Today, Saturday, I have had a fever, cough, chills and flushing in my face. I have treated them with Tylenol and Benadryl. I read somewhere on the internet that ibuprofen reduces the effectiveness of my cardiac arrhythmia medications. Sure enough, I awoke this morning with a rough and irregular heartbeat. I will decline the ibuprofen until Monday, when I can consult with my professionals.

Never a dull moment!

I will endure whatever it takes to get to remission.

On a somewhat humorous note, my weight has gone up alarmingly! Before we went to Cape Cod, I weighed 158. Yesterday morning, I weighed 174.5! Dr. Hema suggests that the infusions are piped in with saline solution and that after an alarming number of visits to the bathroom to evacuate the excess, I will be back to normal; that is, scrawny. Oh, well, it was fun for a while!

Thursday, September 10, 2009

Back in the recliner again...

Out where a friend is a friend
Where the lymphoma guys feed
On the lowly rituxan weed
Back in the recliner again

I am finishing up yesterdays infusion. Nurse P expects it to take until 3:30pm or so. I took the ibuprofen last evening, as recommended by Dr. Infekto, and I feel really very well. I have high hopes!

As you may know, I am a cardiac arrhythmia patient and take medication to regulate my heartbeat. As a consequence, my pulse and blood pressure are generally a bit lower than most humans, at least the living ones. The nurses were indeed impressed with this reading, 84/42!

Wednesday, September 9, 2009

Back home

As predicted, infusing the rituxan slowly enough to not trigger severe side effects, and cause a minor panic amongst the medical staff, did not allow the entire dose to be given by 5:00pm. Therefor, we must return tomorrow for the remainder. It'a bummer, but by this time tomorrow, I will have three infusions out of four under my belt...well, under my skin! I will again blog from the recliner.

The only great news is that we passed by many high calory, high carbohydrate, grease-ball retaurants on the way home. We stopped at one of my favorites and I stocked up on all the calories I could manage.

This morning's weight: An encouraging 164!

Treatment room II

About 12:00pm, I experienced a beet-red face and extreme anxiety. I also felt that I could be nauseated if I just let myself think about it. Of course, if you try not to think about something, that's all you can think about, so off I went to the restroom, dragging my pump behind me. I was not sick.

Nurses, physician's assistants and Dr. Hema appeared just about instantly. They stopped the rituxan and started a medication to counteract nausea. After thirty minutes or so, when I was feeling much better, they restarted the rituxan at a very slow flow rate. They now seem to think that I will not be able to get the entire dose of rituxan infused today, since it is being administered so slowly, so that I will have to come back tomorrow. After all, these people have lives, spouses, children, etc. and like to go home at a decent hour.

I am hooked to a blood pressure cuff and pulse oximeter (see photo, used to check oxygen saturation in the blood) all the time. My vital signs are checked frequently. So far, they are fine.

In the treatment room

Dr. Hema was pleased with the report from Dr. Infekto and we are going ahead with rituxan treatment #3 of 4. He expressed admiration for my willingness to go through the post-infusion symptoms in order to get the treatments done. I told him that if that's what I have to do to get to hear the "R" word (remission) from him, then I was going to do whatever I had to do. The final treatment will be scheduled in two weeks, after any symptoms have subsided and I am back to full health. I hope that the symptoms will be alleviated by the medication that both doctors recommend.

This is my home for the next eight or so hours. More news later.

Edit: Some things I put in the blog to document my progress for my own needs; you are very welcome to read it, although it may seem obsessive/compulsive to you, it helps me document my progress.

Dr. Hema showed me my blood test result from today's tests. My hemoglobin reading was 10.9. The first blood test he ever gave me was 9. The normal reading is 14-17, with older men tending towards 14. The improvement from 9 to 10.9, almost 2 points closer to normal, suggests good things are happening under the hood! This is a bit of good news that I am thrilled to hear, however slight it may be. I love good news!

Friday, September 4, 2009

Another visit to Big City

I saw the infectious disease specialist, Dr. Infekto, this morning. He took a very thorough history and description of my post-infusion symptoms. He examined me carefully and pronounced that while most patients have few or no post-infusion symptoms, some do. I am just lucky enough to be in the some category. He suggested an over-the-counter medication to try to counteract the flu-like symptoms and said he saw no reason to not proceed with the next two rituxan infusions. He said he would fax his findings to Dr. Hema by the end of the day.

Whew!!! I was afraid he would stop everything while he put me through another battery of tests which would further delay the progress towards, hopefully, remission.

My adorable wife and I celebrated with a big lunch and a movie. We are planning to further celebrate with dinner with friends.

Wednesday, September 2, 2009

Back from the Cape!

We are back. I feel stronger than when I left and I certainly made a pig of myself at every meal, so I hope I gained some weight.

Our son G and I went on a whale watch and I was lucky enough to get this shot. It is a humpback whale starting a deep dive to feed on the bait fish that thrive in the Stellwagen Bank. It was a beautiful, sunny day and I actually got a bit of sunburn. I am almost starting to look human again.

I have high hopes that my two remaining rituxan treatments will go relatively uneventfully.

Thank you all again for all your well wishes; they help encourage me to fight on, even when I feel terrible.