The Cancer Chronicles Part IV – Which is Appropriate since I Just Came from My Bone Chemotherapy IV Infusion

Tuesday, August 4th, 2009

 

Chapter One – Wherein I Delight my Oncologist

Sunday, July 25 – “A day like all days filled with those events that illuminate our times and YOU…ARE…THERE!”

Sunday afternoon is a quiet day usually, a nice breakfast, a visit with the kids and grand kiddies and then home to watch some telly – especially Wind Tunnel on the Speed Channel – maybe a little PBS. My rash mild, except for my nose (pizza-nose, pizza-nose), my stomach settled.

I took my Tarceva at 10PM as usual and an hour later the Doxycycline and settled down to watch the news and whatever, I mean, it was Sunday. About twelvish my stomach starts acting up and I start sneezing. I mean big ah-CHOOOOO’s. They hurt my ears. All this while my stomach wants to return what ever it had. After about eight or more sneezes, in which mucus flows abundantly,

 I went upstairs and no sooner got to the bathroom when all hell broke loose.

(And once again Rudy Turchuk prays at the porcelain altar – only without the benefits of too much alcohol, once again.)

Now, I don’t know what contortions my face went through whilst I was, shall we say paying homage to American Standard, but it  felt as if the skin on my nose had burst asunder. Then I noticed that there was a little red mucous floating on the font. (Very little came up – all fluid, probably the Doxycycline.) I slightly freaked wondering what my ex-beautiful nose looked like. I looked in the mirror and my face was absolutely beet red – crimson – and my nose was not pretty, however not as bad as I feared.

But – WHOA NELLY – my entire head and face and ears and behind my ears was now covered in an angry RASH. The rash. In spades! Yes! I finally got the rash. Oy! Do I have a rash.

I have naches in my tsoris. I am farmisht. [trans.: I have joy in my suffering. I have mixed emotions. (“Like watching my mother-in-law driving over a cliff in my new Cadillac.” – Alan King, comedian)] I sleep the sleep of the farblondget. (Ed. What’s going on? First French, now Yiddish?)

Monday, July 26 – “Meanwhile back at the ranch”…

I call and see the APRN, Nurse M. (They all refer to her as Karen, but I think she deserves a title.) First they draw a little blood to see if I have any and what proof it might be. On the way to see Nurse Martin, I pass Dr. S in the hallway. He looks at me, smiles broadly and loudly proclaims: “You have the rash! I am so delighted! You’ve made my day!” And as he continues on his way: “I am so happy.”

Here I look like I have the worst case of adolescent acne ever, and he’s delighted!

Nurse M, okay, Karen, (it’s easier to type) is also delighted but much less exuberantly and with a touch of sympathy – she is a woman, after all. She looks closely and says it’s early grade three, but a little later upgrades it to borderline grade four. (Grade four means cut back on the Tarceva, but I’m not there yet.)

She prescribed Hydrocortizone for the rash and recommends cutting back on the Doxyshitcline for a while to see if that’s the problem. (There is no connection with the sneezes BTW.) And there’s a word of hope – this is probably the peak of the rash and it should start to subside.

Blood work suggests a regimen of 4 doses of Vitamin D 50,000 units once a week.

 

*****

Chapter Two – Wherein I Delight my Oncologist Again and I Get a “Very Good”

Tuesday, Aug. 4 –♬ “…cause he’s got high hopes. He’s got high hopes. He’s got pie, apple pie in the sky hopes….”♬

Today I had a scheduled meeting with the onco, and some more Zometa.

The blood lady drew blood. And three pages of Mozart’s biography later we’re called to see the Doc. He reiterates how delighted he was to see the level of the rash on Monday, and says he’s happy with the effects of the hydrocortisone cream, as the rash, the scourge, has indeed subsided. We talk the usual check-up Q&A stuff, a few recommendations, we swap a few jokes, and I’m off to the Boom-Boom Room at the Chemo Lounge.

Holly, my infusion nurse (she’s a sweetie; she was also Toby’s IV nurse) sets up my three bags of juice – Decadron, saline solution and Zometa – sticks the needle to me, and I’m off to the races.

[Okay, okay, so you’re saying: “What’s with the Decadron? You never mentioned no Decadron.” (You really ought to watch those double negatives.) Well, remember after Zometa One? When I got all kinds of sick and all? And I told you that next time I was going to take it like a woman?

So the next time, like the manly man I was, I asked if there wasn’t something they could give me for the nausea and all. I mean, Toby had these pills. And I thought maybe something like that. Well, for Zometa Two, they add a bag of Decadron, short for Dexa something, something, something. It’s a steroid of some sort that amongst other things is good for calming down the Zometa effects. So, the next day, instead of wishing I was in Cincinnati, I was full of “piss and vinegar”. I had lots of energy. I did things. I could have hit home runs. And Thursday too.

On Friday, the Rabbi Slept. No wait! That’s another book. On Friday I slept, but I felt good.
Somehow, I, uh, forgot to mention it. Just like a woman…. I mean man, man! (Oh, no!)]

So, I’m sitting there, sipping a dark roast coffee, nibbling on a granola bar and reading my biography, when the Doc walks over to me and starts probing my neck around the jugular vein and down into the clavicle and it’s getting slightly uncomfortable (but I didn’t complain; I didn’t complain. I didn’t even wince) and I says: “Did I do something wrong, again?” And he says: “No, not at all,” but he’s still probing. Then he says: “You had a lymph node, but I don’t feel it anymore.”

Then he smiled a big warm smile, looked me in the eyes and tapped my cheek twice the way a grandfather would to a son or grandson and said quietly: “Very good,” and walked away. Toby smiled and felt very relieved.

I think I just moved the Dr. to the optimistic side of professionally neutral. But he’s not going to make any predictions until the CAT scan after 12 weeks of Tarceva. This Sunday will be week 4.

I, on the other hand, am still caustically optimitious, uh, optimitiously caustic? No, cautiously optimistic.

 So that’s the news from Lake Woebegone, where the men are all handsome, the women have handfuls, and children had damn well better get all A’s or there’s hell to pay for the teachers.

Hugs & Kisses

Rudy the Beardless

PS. Oh, I forgot to mention I clipped my beard and hair so that I could get the cream on to the rash. I attached a pic. Ain’t I cute.

The Cancer Chronicles, Part Deux

Tuesday, July 14th, 2009

Greetings from the Center of the Universe,

Tarceva arrived Friday via Next-Day UPS whilst I and my son were at The Glen burning up a lot of 110 octane gas.

Took the first on Sunday night. So far no rashes, no blisters, no side effects. (Watta ya mean, it takes awhile? I already took two! )
As I swallow the pill I imagine it's the Cavalry coming to the rescue, or paratroopers landing behind enemy lines or knights going off on a Crusade - whatever it takes for my warped mind to visualize this thing working.

So, Happy Bastille Day,

Yr hmbl & fthfl srvnt,
R.W.Turchuk

 

Le Chronicles de Cancer, Troisiemme Arondissement

 

Wednesday, July 22nd, 2009

(Don’t ask me why the French or what, if anything, it means. Go with it.)

Saw the doctor yesterday, well, actually she’s an APRN, but she acts like a doctor, she has a killer body, and she seems to know more about my oral chemotherapy than my oncologist does. Anyway, her first question to me was have I had diarrhea – one of the side effects of Tarceva. I said: “Yes, last Sunday”. “Oh, good,” she says. “And look, your forehead broken out.”

Yes, these are things that bring joy to my heart. Diarrhea and a rash. Actually my nose looks very much like pizza. Ugh!

But why the joy? Clinical studies have shown that the side effects are a good indicator of the effectiveness of the drug. It’s directly proportional. The other good news is that the side effects usually peak around two weeks, which will be this weekend. (Oh, joy. More rashes. More …. ) But, more importantly, I found out that the stupid test results finally came in and I don’t have the specific mutation that this drug targets. However, because I’m either an Asian female or a non-smoker male the probability is high that the drug will be effective for me. So zits and shits are a good thing – a good thing.

To help with the skin condition, the oncologist prescribed an antibiotic called Doxycycline. After a week of the side effects of the Doxy…, I’m now taking Prevacid, because the acid reflux was worse than anything I ever got from eating deli (a New York term) or Polish food. I mean, growing up, I had so much heartburn I thought I was Jewish. So who knows, maybe I’ll need something for the side effects of the Prevacid, and something for that and so on.

And for those who are keeping score, my blood counts are good and they told me to increase my intake of vitamin D3 to 2000 mg daily.

All-in-all, I feel good physically and mentally. And when you consider the shape I’m in – fat and out of – that’s pretty good.

So, tata for now.

Rudy the T

The Cancer Chronicles

And So They Began…

 

July 10^th, 2009

[I’m writing this before my bone chemo kicks in and I feel like warmed over home-made $#!+. Please see note below.]

 

As much as I dislike newsletters to the world, I realized that after I started making phone calls to sons, daughters, relatives, closest friends, dear friends, concerned friends, colleagues, old maid aunts and hare-brained cousins, that I would be on the phone or writing e-mails forever. And to tell you the truth, the more I talk about it, the more depressing and morbid I become. So, I’ll just write it once and be done with it.

Hence: The Cancer Chronicles.

On June 3^rd 2009, my oncologist, Dr. S, and I decided to start my cancer treatment with a new drug called Tarceva^® (Erlotinib), a pill taken orally once a day, four hours before and after eating – this, instead of the original plan of three bags of intra-venous side effects. But first, he’ll have to send samples of my biopsy to a lab to see if I had something called the epidermal growth factor receptor (EGFR). He made the call, and they said they’ll have the results to him in two weeks. Two weeks later he called the lab and found out that they performed the wrong test. We have to wait two more weeks. Those two weeks came and went – no results.

On July 6^th, the good doctor found out that the lab had mis-logged the samples and hadn’t tested them at all. Doc Is PO’d. I’m PO’d. Well, I’m scheduled to see him the next day, so we’ll talk.

Tuesday, the 7^th I went in for our consult and some more bone chemo (Zometa^® – zoledronic acid). Doc is tired of waiting for the test, so we discussed starting Tarceva now, because, he said the chances are very high that I, a non-smoker white male (as well as Asian women) would have the right mutation.

The only problem would be paying for the pills. They retail for $4300 for thirty tablets. The nurse checked into several different plans and found one that would allow me to pay only $750 a month. I said let me try my insurance company to see what they say. So I called them and they said it would cost $720 for ninety tabs. Whoa, that’s a heck of a lot better – only $240 a month. I could do that. I called the nurse and said send the prescription to my pharmacy provider.

Now, wait, it gets better. The pharmacy people called me and the lady said she had my prescription yadda yadda yadda, and the co-pay will be $0, do I accept the co-pay? My brain went what? So, I said could you repeat that. And, she did – blah blah blah zero dollars, do I accept the co-pay? I thought it over for a second (I didn’t want to sound too anxious), and said, as calmly as I could, yes, while my brain’s going YES! YES! YES!

All I can say is: Thank God, the CT State Teacher’s Retirement Board and the taxpayers of the State of Connecticut for what has been a great insurance plan.

That’s about it for now. I wait for the pills to come. The side effects are an upper body skin rash with the possibility of blistering – hey, it beats the alternative. So, I stay out of the sun and moisturize, moisturize, moisturize. And, drink Margaritas!

My G.P. Dr. Phil – honestly that’s his name – says there is a high recovery rate with Tarceva. My oncologist is pessimistically neutral, and my good friend Elaine B. says don’t believe the doctors. Well, a man’s gotta believe in something, so I believe I’ll have another Margarita.

 

Tata for now,

Rudy the T

 

Note: The first time I took the bone chemo (Zometa), it was a Friday morning. By Friday night I had chills, shakes and a slight fever and went to bed early. Woke up feeling I like I had the worst hangover known to man. And, I’ve had some hangovers. Couldn’t eat, couldn’t move, waves of nausea. And all I wanted to do sit in my TV chair and sleep it off. Woke up at 1:00 PM, took some nourishment, back to sleep, same at 5:00, and crawled up to bed at 11:00.

But I took it like a man, by which I mean I whined about it; I complained about it; I let everyone know how much I had suffered. What a wuss!

After thinking about what my wife went through and how she went through it and after talking to my good friend and three-time cancer survivor, Elaine B., I decided to start taking things like a woman I’m keeping  my mouth shut (Could you imagine a guy going through child birth? The first three months of pregnancy would kill him, let alone the actual child birth. Ha!)