Visiting M/SO on Saturday

I'm planning to head to m/so on Saturday afternoon where I'm going to help the theatre group set up for the new show (which opens the following week) and then I'm going to get together w/Dave and Jerry to hang out for the evening. Hopefully I'll see a lot of you at some point or other during my visit.

I've been having a great week, feeling good and have been trying to do as much as possible while I have the opportunity. Guess I've been eating out a bit too much because I've put on 8 lbs in the last week or so (tho I think Dr. I will be pretty happy about). Just got a care package from my sister GOC - lots of salty snacks along w/a t-shirt and baseball cap. All very cool and much appreciated :) Putting the snacks away until treatment starts up again at which point I'll need them (but will be wearing the hat tomorrow).

Have to get up early tomorrow. My pet and cat scans are scheduled for 8:00 but that will allow me to get to work at a semi-reasonable time. I also have an appointment at 2:00 for a trial run of my radiation treatment (which begins for real on Monday) but that shouldn't take too long.

I'm probably not going to write a new entry in the blog until Sunday evening but I will, of course, be reading and responding to comments.


--Dr. D

Help: Netflix Queue is Anemic!!!

So my netflix queue is running low and what's there is hardly inspiring. I need suggestions on good movies so please chime in. Anything but the horror genre; comedies are particularly appreciated at this point.

Probably my favorite recent movie suggestion was 'Serenity', a science fiction movie w/a good sense of humor (watched the entire 'firefly' tv series, on which it was based, afterwards). My sister sent 'The God's Must Be Crazy', one of my all time favorites which I dragged her to see when I was in high school (she liked even more than I did). And extra credit if you get 'I'm Hysterical and I'm Wet!' (bit of a non-sequitor but I've always liked the way it sounds).

Turns out my test today was an esophogram rather than an edoscopy. This is the test where they take x-rays of you while you drink barium. Nice that I didn't have to get knocked out but drinking barium makes me kinda wish I had been :) I'll post the results when I get them but it probably won't be until next Monday when I see Dr. I.

And now for something completely different, here are the boys:

Survey Says: A Good Weekend

It's been a good weekend. Didn't do a whole lot yesterday but did get out for a while for lunch, a bit of walking around, and a some grocery shopping. Min hung out w/me for the evening - we thought about going out to see a movie but, in the end, I decided I was a bit too tired so we ended up watching a dvd instead (Truffaut's 'Day for Night', which I rather enjoyed). Today I headed out to central park and spent the afternoon trading off walking around and reading. It was a little overcast but the leaves are changing and it was quite pleasant overall.

I still don't feel 100% at the moment but I feel pretty damn good and expect I will feel pretty good this upcoming week - really nice to look forward to. Tomorrow morning I am having another endoscopy and on Friday morning I am having a pet scan and a cat scan (still no dog scan); I am having these tests so that they can evaluate how well I am responding to the treatment. As you'd expect, I'm quite interested in the results too :).

Thanks again for the comments and feedback on the bald vs short-hair issue.

--Dr. D

So Far, So Good

Not a bad Friday; a lot like yesterday but no cramps today and no indication of fever so far. Worked a full day and walked home via Central Park. Hopefully it will be an uneventful, albiet boring, evening.

--Dr. D

Not a Bad Thursday

Today went pretty well, all things considered. Woke up feeling pretty good, just a little nauseas, and was good throughout the morning. After lunch, I got some bad cramps and started feeling pretty tired but, just as I was planning to leave work early, they let up and I felt a lot better so I finished the day out (wonder if is was that burrito I ate). Still feel tired tho - it seems Monday's and Tuesday's I don't sleep very well; feels a lot like having too much caffeine before bed, sleep a bit, wake up for a while, sleep a bit again, etc, ad nauseum. Wednesday's seem better, as the chemo meds work their way out I reckon, but even w/a good night's sleep I'm still in a deficit. Hopefully tonight I'll sleep well again and will feel good overall tomorrow.

I am a little nervous about tomorrow - it being the Friday of session 2 which was when I had trouble last time. I believe I'll get through it alright but I do plan to take it easy and stay close to home tomorrow night just in case. Figure it's the sensible thing to do. As long as all goes well, I'm looking forward to a nice weekend.

Enuf for tonite - enjoy the pictures!

--Dr. D

My Bald Head - In Color!

I like it shaved, cold head not withstanding. Went shopping for hats tonight for a while but didn't find anything I particularly liked - have to stick w/baseball caps for the moment.

New poll: short hair or no hair?

I Am Bald

Master barber Jeff used hot-foam and a straight-edge razor and it didn't take long for the massacre to be complete - no prisoners. At the end, I got the hot towel and it was everything it was cracked up to be :)

Looks good, much improved over the christmas-tree like, quickly thinning, short hair and I won't have to deal w/hair all over the apartment any longer (particularly on my pillows & sheets). My head is pretty white tho - the woman who cut my hair last time was really pushing for the tanning salon option and said she'd go with me. May actually consider tanning but, as T said, I'll have talk to Dr. I first. But I think I'll try a bit of natural tanning first - we do have a few sunny days coming up.

More later

--Dr. D

Round 2, Session 2 Done

Quite a while ago actually - everything went pretty quickly today and I got back home around 2:30, which was cool.

Dr. I and I talked for some time in our usual session before chemo. All of my bloodwork looks good and I'm definitely tolerating the adjusted treatment much better. This week, I'll be keeping an eye on my temperature just to make sure I don't have a negative reaction again like I did in Round 1 Session 2 but we're both pretty confident that things will go well this week.

I also asked him about why I only take the anti-nausea meds on Tues and Wed and then move on to Zofran for the rest of the week (which is good but doesn't seems as effective overall). There are 2 anti-nausea meds involved and the answer is different for each. The first one I take is Dexamethasone - this is a steroid; it helps in the short-term but the long term side-effects, which includes supressing the immune system, make it unusable for more than a couple of days. The second drug is Aprepitant - I need to learn a bit more about this drug but, according to Dr. I, it works for three days and that's it - you can keep taking it but it won't help any longer (my guess is that it is a kind of seratonin blocker and there some kind of receptor multiplicity/adaptation at work, but that's just a guess based on some things Dr. I said).

I have set up an appt w/the master barber for tomorrow @ 9 to get my head shaved. As I mentioned, my hair has continued to fall out faster than republican scandals and my hair is starting to look fairly uneven so I decided to clean it up before starting up work this week. I think it will look good but I definitely need some more hats (and sunscreen). Will post picts when I get the chance. Maybe :).

--Dr. D.

Another Nice Weekend

Friday was a decent day; still had some nausea but worked a full day. That evening I had dinner w/my roommate, which was really cool, and went to bed fairly early. On Saturday, I felt about the same as Friday but I pushed through it - kinda hung out for the day then went to Maplewood in the evening for the Stroller's Gala, as suggested by Peter. It was awesome, great to see so many friends and nice to know that so many of them are following my blog. I got there a bit late but Gene and Betty found me a seat (thanks for ur seat Leon) and got me hooked up w/some food - I ate like a fiend too. After dinner, the entertainment was a bunch of scenes/songs/skits from various plays performed by the membership. I enjoyed *every* minute of it; everyone was fantastic but, I have to say, the scene created by Peter and Bob completely killed me - Bob has offerred to come out to the city in drag to reprise his role if it will help. Afterwards, I talked with everyone until I finally had to leave to catch the train back to the city. After such a long evening, I slept kinda late today and then went down to SOHO for a late brunch w/Min where I ate like a fiend again. Good stuff - anyone interested in brunch in SOHO sometime, drop me a line.

So Round 2, Session 2 is tomorrow. As you can see, last week went pretty well and I am hopeful that this week will go equally well. My hair is still falling out pretty fast - kinda reminds me of a christmas tree 2 weeks after christmas - shake it too hard and thar she blows :p. I figure in a week or two I'll just have to shave it all but that doesn't bother me. The only thing is that my scalp is quite white which will probably blind my coworkers - been thinking about tanning salons but if anyone has any suggestions, I'm listening.

Final thought - most people seem to prefer the short hair to the long, went over particulalry well last night at the Gala. You are all very kind. Or a bunch of Philistines.

Regards,

--Dr. D

Some Haircut Picts

Which is better? You decide ...

Before:



After:

Happy Birthday T (10/12)

In case I forget to call tomorrow. I'm thinking about you bro.

Got a Haircut

Hey All - feeling pretty good. Haven't slept well over the last couple of nights but I don't think it's chemo related and I have a feeling I will sleep well tonight. Been feeling a little nauseous but nothing I can't handle. Kind of strange, I felt so good over the weekend that I have a much better feeling of how the chemo is affecting me now because I am much more aware of the contrast; this actually gives me much better insight on how to deal w/the issues.

Still losing hair so I went and got my haircut yesterday (Tues) at a barbershop near work where a number of my co-workers go. My first time there. I arrived a few minutes early so the master barber asked me if I wanted to wait or to have his assistant cut my hair - a nice looking Italian woman - so I said 'why not'. I told her that I was going through chemotherapy which was causing me to lose my hair and I needed a really short cut. She didn't seem to understand anything other that 'short cut' but that was sufficient. After cutting for a while she said 'you have a lot of hair, you're not losing you're hair' so I explained to her again that I have cancer and that the treatment is causing me to lose my hair. She understood that time and stopped, asked me my name, introduced herself, and we talked for a while along w/the master barber who came over as well. Yet more nice people in the world. I felt kinda bad, tho, like I was exploiting my cancer situation for sympathy or something but I'd brought it up just so she would know what she was dealing with - particularly if large amounts of hair started coming out while she was cutting. She cut my hair the most meticulously it has ever been cut and it is by far the shortest I've ever had it cut (except that time I was 5 and Dad took me to the barber shop for both the first and last time) and it actually looks pretty cool. I also asked her to clean up my beard and trim it down into a goatee, something I was planning to do myself, but she did such an awesome job on my hair that I trusted she'd do a good job there too - and she did - much better than I would have done on my own. The best part was when she cleaned up the hair on my neck - hot foam and a straight razor. My co-workers tell me that having the master barber give you a hot shave followed by a hot towel is the ultimate barber shop experience; I may just have to give it a try next time.

I am now starting to play around w/posting pictures. I'll try to post a picture of my new haircut sometime soon but, for now, here's a picture of my friends Dave (far left) and Jerry (far right) when they came to visit me at my apartment on the Thursday before my hospital visit - enjoy :)

Another One Down

Got home about an hour ago. As I mentioned, I got all 3 meds today and they take a while. At the end, the nurse came in and said "That's a long day for you" to which I responded "Yeah ... but it beats the alternative" to which she said, quizzically, "What's that" to which I responded "Dying" to which she laughed and said "At least you have a sense of humor about it" to which I said "I'm serious, this is much better than dying" and we both started laughing. Always good to have a nurse w/a good sense of humor. I told her this was going up on the blog. So here it is :)

Met w/Dr I. before treatment, as per usual. He explained that, given the reaction I had vis-a-vis the white blood cells as well as some other minor problems I've had, the culprit was most likely the Irinotecan (one of the two chemo meds) and that he would decrease the dosage slightly which should 1) prevent me from having a recurrence of the white blood cell count problem and 2) generally improve my day-to-day experience w/chemo. I'm all for that.

I also talked to him today about travel/vacation during the 6 week period between the end of the chemo/radiation treatments and the operation. He thought it was a great idea to take vacation then and that they would coordinate w/my plans. He recommended I wait 2 weeks after finishing treatment before vacation as it would take that period of time to fully recover from the side-effects of the radiation and I would probably prefer to have vacation when I was feeling my best. So my plan is to take about 3 weeks off from work and go home for the holidays (Christmas and New Years). While I'm there, I'll not only be able to spend time w/my family and friends but also be able to spend time outside getting some exercise (biking, kayaking, swimming, hiking, camping, and, of course, bowling) all of which will help prepare me physically and mentally for the operation.

Well, that's enough for today. I'm getting a bit of cabin fever so if anyone is up for a visit sometime in the near future, give me a holler.

regards,

--Dr. D

P.S. - bought a 'Livestrong' wrist band today at the hospital gift shop. Apparently they are no longer trendy/fashionable but it seems to suit me just fine.

P.P.S - finished rereading another Murakami novel in chemo today. Haruki's been a fine companion getting me through these sessions.

Round 2

starts tomorrow. I'm getting all 3 meds so it's going to be a long day. yin and yang, man.

Had a good weekend, been feeling really good since I got home on Thursday. Took Friday off from work to take care of some things what needed taking care of (including a bunch of food shopping). Friday night I went out to dinner at a place I've gone to quite a few times. Last time I went there was just before I started chemo and I was really struggling to eat that night because swallowing had become so difficult; Friday I ordered the same thing I had that previous time and was able to eat it w/o any difficulty - it was awesome and clearly shows that the tumor is shrinking. Saturday I just took it easy and laid around the apartment all day reading, watching movies, and eating. Kinda felt I should have taken more advantage of feeling well but it was a good day all the same. Today I took care of a bunch of paperwork and such in the morning and went to central park in the afternoon. Walked around the park for a while and then sat down and read for a couple of hours. Awesome day, lots of people outside having fun, it was just nice being part of it all for a while. My goal this weekend had been to gain a bit of weight and I seem to have been sucessful - will get the official word tomorrow when they weigh me at the Dr's office but my scale shows I've gone up 2 lbs (really weird experience to want to gain weight).

I'm starting to lose my hair. It doesn't seem to be coming out in clumps but rather evenly all over but there's sure a lot of it. Losing my hair doesn't bother me except that it's getting all over the place (you should see my hair brush), particularly since it is so long. I plan to get it cut short sometime this week, probably on Tuesday which should address the problem. If it gets too thin, I'll eventually just shave it all. Planning to buy a beret this week as well ;)

That's pretty much it for now, I'll try to post tomorrow and let you know how chemo went. Until then,

--Dr. D

I'm Getting Out

My white blood cell count came in at 5400 so they are going to let me go home today. Just a matter of paperwork at this point. Can't wait for them to take this IV out of me so I can walk around w/o dragging it around w/me.

I'd like to thank the various people who helped me get through this one. My mother, who was visiting at the time, who stayed here w/me through my first couple of days. Min, who helped me get in here on Saturday and has visited every day since. Lorraine, who put my mother up and ferried her back and forth. My sisters and father, who called frequently (multiple times per day, in some cases) to keep my spirits up. Thanks everyone.

I'm feeling good today and looking forward to a weekend of feeling good before going the next round on Monday. They weighed me the other day and the good news is that I haven't lost any weight this week - gonna try to gain some this weekend ;)

Looks like it's time to go,

--Dr. D

Still in the Hospital, but Feeling Much Improved

And I now have my laptop and internet access.

So a quick recap of what's happened over the last week or so.

As I've mentioned, my chemo treatment is 2 weeks on/1 week off. The reason for this is because chemo reduces your blood cell counts and it's cumulative such that the second week is worse than first in that respect; you get the third week off so that your body can recover and build up blood cells. One thing that can happen, particularly in the second week, is that your white blood cell counts can get dangerously low, the main symptom of which is a fever. This is not so much dangerous in-and-of-itself but rather because you now effectively have no immune system so you can get sick very easily.

Last week, my second week of chemo was going pretty well. Thursday I was a little tired and Friday a little queasy but, all in all, nothing too bad. The only thing was that on Friday I felt a bit chilly all day at work. After work, I ran a few errands then went home and went to bed early. That night, I had chills and some really weird dreams, both of which were probably caused by fever. Saturday, I felt pretty decent in the morning but in the afternoon the fever returned so I called MSKCC where the doctor told me to go to the Urgent Care Center and get checked out. Luckily the Urgent Care Center is only a block from where I live so I was able to get there pretty quickly/easily. There they determined that 1) my temperature was now 103, 2) my white blood cell count was dangerously low, and 3) I was going to be staying for a while. They put me in isolation to keep me from being exposed to any illnesses, started pumping me full of antibiotics, and gave me an injection of something which stimulates white blood cell production. My temperature stayed around 103 most of the night but started falling eventually early Sunday morning and was eventually back to normal around Sunday afternoon and I was feeling pretty decent (though still tired).

Since then, it's pretty much been a waiting game. I haven't had a fever and the blood tests have been negative for any evidence of infection. My white cell count has to get above 1000 before they will release me (and 1500 before they will do chemo). On Saturday, my white cell count was down to 300, Sunday it went up to 400, Monday to 500, but yesterday it went back down to 400. Today, my white cell count was measured at 1300 - so it came back pretty strongly. They plan to keep me for another day or so to make sure that it doesn't dip again but everything's looking good.

I talked to my oncologists office yesterday. Dr. I has been monitoring my progress and plans to continue w/my second round of chemo this Monday. He will adjust the treatment somewhat so that it does not have the same impact on my white cell count - I'll be talking to him more about that on Monday. I was relieved by this because, despite the problems, each day of treatment gets me one day closer to being cured and that's the important thing.

Quick Update

All This is Dr. D's sister. Just wanted to let you know we had a slight set back this weekend. Dr.D's white blood cell count got low (a common side effect of Chemo) He needed to be hospitalized to bring down a fever and help avoid any additional infection. His fever is back to normal today, but they are going to keep him in the hospital a few more days to make sure his white blood count gets back to were it should be to fight infections. Please keep your good thoughts and prayers coming. Dr. D's family appreciate all the love and support you provide to him.

No News is Good News

This time anyway. Yesterday went well overall. Had a slight bit of nausea but a bit of ginger ale helped alleviate it (thanks for the suggestion Min). Worked all day then came home and rested. Getting a little bored actually. I've been eating and my weight has started to come back up already and I'm feeling good this morning after a nice sleep.

Dave & Jerry, some good friends of mine from Maplewood/South Orange (M/SO), are coming out on thursday night for a visit. There is an Italian restaurant/bar where we all used to hang out quite a bit (they still do), the owners of the bar have been very supportive since they heard the news and will be supplying food for them to bring to me. A lot of good people in this world.

Got to head to work,

--Dr. D

Home and Feeling Alright

Got into chemo around 1:45. The first thing they do in chemo is put in an IV to hydrate you w/a liter+ of fluid and then hit you with a lot of anti-nausea meds to make sure you tolerate taking the chemo drugs and then they administer the chemo meds one at a time. Each of the chemo meds takes about a half hour and there are two of them that I am taking, Irinotecan and Cisplatin. This week I didn't get the experimental drug, Bevacizumab (aka Avastin), as I only get that every 3 weeks. This cut 90 minutes off of the overall time and I finished up around 4. On the way home, I stopped by the grocery store and bought a whole bunch of stuff. Since I got home, I've been resting and eating like a pig. Feeling pretty good, all things considered.

I'd meant to give more of a summary of my treatment this last weekend when I had some time but that didn't work out too well this time around so I'll give a quick overview now. For the chemo, I'm 2 weeks on/1 week off over 12 weeks. This means next week, no chemo (yeah). At week 6, they will run some more tests to see how I'm responding to the treatment and then they will add in radiation treatments - radiation will be 10 minutes/day, 5 days/week over 6 weeks. I will be getting the experimental drug (Avastin) every three weeks during this time frame as well. It doesn't have the side-effects that the chemo drugs have and is pretty well tolerated overall. Dr I mentioned today that he has been trying to get it for clinical trials in the treatment of this cancer for the last 2+ years but FDA approval was slow in coming despite its positive results in similar cancers - he just got approval in August.

Swallowing has already become easier for me and I asked Dr. I if this was likely just placebo effect. He said that, based on trials w/other cancers, the chemo & Avastin had quite likely shrunk the tumor considerably already. It'll be interesting to see the results when they retest me at the end of week 6.

All the best

--Dr. D

Waiting for Chemo

Currently at MSKCC, just saw my oncologist, Dr. I, and will be getting my chemo treatment shortly. Dr. I and I discussed my first week - he thinks I'm responding well already and gave me some advice on how to deal w/some of the problems I was having this weekend. According to my blood tests, I seem to be tolerating the treatment well and the only negative is that my weight is down this week which pretty much happened over Frdiay and Saturday. Dr. I thinks I'll bounce back from that by making some slight adjustments to my diet and encouraged me to stop drinking just water (in such large quantities that I feel full) and instead start drinking more fluids w/calories in it - he recommended soy shakes in particular; I plan to try them and a bunch of different things as well.

More when I'm done w/my treatment.

--Dr. D