Slouching Towards Completion
9/29/06

The title of this, O Best Beloveds, was going to be "Four More Chemos! Four More Chemos!" Then I forgot to write before chemo yesterday. And then chemo was--well, wait. That's the point of this email.

Before heading off to what should have been the fourth-to-last chemo, yesterday morning, I took a walk to the bank. Now, we live in a very hilly neighborhood, and the walk home is mostly uphill. Also, in this part of Los Angeles, there are these nifty street access stairs, built in the twenties, so that one can slip from one street to the next, without having to drive a long distance to circle around to the street below/above. These stairs are quite steep; it's common to see fitness buffs using them as free aerobic workouts. I got to the point where I could either walk the (long, hilly) way around, or take the staircase shortcut. Now, as I've mentioned, Dr. W's tender ministrations have left me short in the wind department, and it can be painful and puffy for me to walk up inclines or multiple stairs. I was already a bit tuckered from the walk to this point. But I figured, oh, don't be a weeny, it's good for you and your buttocks on which you will be sitting a bunch later today, just go slowly. Which I did, but even so--a couple of women came up behind me and were worried I wasn't going to make it. One had me hold her hand, for a little boost. At the top, I was a bit swoony, and I wondered "Huh. Could I be transfusion-needing anemic again? Given how much this took it out of me?"

So off we go for chemo a few minutes later. Now, I've been meaning to do a Port Report. A regular blood draw, believe or not, doesn't need to hurt; if you have a skilled nurse and a good vein, the needle can slide in like butter. I've many, many blood draws (once a week since late Nov, just this chemo round alone), and there are times when I don't even feel it. But with the port, I feel it. I put on some special numbing cream about a half hour before going in, Chemo Nurse Lisa uses a numbing spray as well, but each time, there is a pinch of greater or lesser intensity. That's because it's not easing in the needle, as one does with a blood draw, but there has to be some force behind it, to penetrate not just my skin, but the rubber of the port itself, just under the skin. It's not like Eric Stoltz jamming in Uma Thurman's lifesaving goop in "Pulp Fiction," but it's still a small punch. Don't get me wrong--it's much much better than a vein hunt, which is what I had to look forward to twice a week if I didn't go the port route, and by "look forward to" I mean "dread so much it actually made me queasy" which is totally no longer happening. Consequently, I'm not complaining, but it was a little surprising that I could feel as much as I do. This week, though I put on extra cream, and Chemo Nurse Lisa sprayed me twice and, glory be! I didn't feel a thing! (CNL even said "I bet you put the cream on thicker this week.") Ports are fab.

Now, before I get chemo, CNL draws some blood, to check my various counts. This week, platelets came back at 26,000. This didn't seem a big deal to me--Dr. W. has done my chemo at 40,000 and I thought at least once in the 20,000 plus range--but CNL still had to get permission to go ahead. I was more interested in my 9.1 red blood cells; 8-something was when I felt really cruddy and they gave me a transfusion, which likely meant that post-chemo, I would slip back into that zone and require more vampire infusions.

Oh, did I say "post-chemo?" Because CNL comes back with the news; nope, not so much. I have finally hit bottom and I am off the hook this week! See, it turns out that normal platelet count is from 150,000 to 450,000. And apparently, under 20,000 is life-threatening! Because of the spontaneous bleeding n' stuff! Ooops. Anyway, Steve and I skedaddled out of there before anyone changed their mind, and I promptly celebrated my still-settled stomach by having a flank steak (iron, for those red blood cells, don't you know, and isn't this a hell of a time for me to be craving fresh spinach?) and gorgonzola sandwich from a local restaurant that is due to close its doors after twenty years, a lunch I was worrying I wouldn't be able to time before they went out of business. Thanks, Dr. W!

With whom we met today to go over this latest how-d'ya-do. It seems that at some point, everyone burns out on this chemo, in precisely this manner, and so I'm probably at the end of it all, in that my body can't take much more. Yes, my hopes were up, and I was busy picking out the celebration dinner for tonight, but his natural inclination to take things to the edge kicked in, and it was decided I would get three weeks off, instead of two (counting this week), and then head back for that one, final round of three "Though I think you are only going to get two out of it." This is fine; that moment he clearly was considering halting the chemo entirely and how much I would have enjoyed that notwithstanding, the more I have, the better. It would have been nice to have it suddenly be over, but there is a certain security in going a little longer. Next month, I also start the Faslidex, which surely isn't spelled like that, the aromatase inhibitor that will kill off the estrogen receptors in any cancer cells, thus cutting off their nutrition supply, and forcing the little buggers to die. This surprised us; we thought it was like Femara, and was preventative, but no, it's actually continued treatment. So if my tumor markers don't quite get to the magic 32 (they were at 41.7 before the last two chemo rounds), the new goop will get them there.

Meanwhile, I not only have a doctor's note to get out of chemo this week--and boy, was it unexpectedly sweet yesterday when I realized I could work and read and eat and whatever without drugs and weird stomach and all the other things I have to set my mind for on chemo days--but I also have a doctor's note to avoid strenuous exercise (like climbing butt-busting stairs) for a little bit, along with contact sports (as if, but this includes playing with our enthusiastic dogs) and other things that might prompt bleeding. Oh, and no knives. (Man, does he know me and my clumsiness!) Platelets can spontaneously regenerate overnight, but today (they drew blood again) mine were down to 24,000, so it's going to take a little longer than that, and I have to be a little cautious. Otherwise, I feel great, which is awesome; how nice to be officially "sick" but not feel sick! Although, come to think of it, three times I've been diagnosed with cancer when I've felt fantastic. It's never the cancer that makes me sick, but the cure. Again, did I say I was complaining? No, I am not.

Three more chemos! Three more chemos! Not quite the same ring, but even so.

Plus, it might only be two,

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