Chemo - Round 2, Cycle 4

So we start the back half of treatment in the first week of the new year. And back to what I consider the normal schedule: 9:00 a.m. labs, 9:40 a.m. appointment with my oncologist, and chemo at 10:30 a.m.

Well, not quite normal. The cancer center was incredibly busy, I imagine partly due to the holidays and things were running behind.

My wife met me in the “small” exam room and we had a bit of a wait. I never mind as my oncologist is very attentive to all her patients. Anyway, it was probably about 10:15 or so before we met with my oncologist.

Fortunately my labs looked good and I didn’t have a lot of questions. My scans also came back good. Or really as good as they could be. No progression for the most part, and some mets have gotten smaller. But there are a LOT of mets. I asked how many there were and she really couldn’t quantify it as pretty much my whole spine was black in the scan, which means there are lots and lots of mets.

My previously swollen lymph nodes (only one or two) had shrunk and my prostate has been getting smaller too. That I can tell because peeing is a lot easier. Yeah, the Flowmax helps, but I can tell the difference with my prostate. One thing I didn’t get at my appointment was my PSA, as it wasn’t ready yet.

We made it to the third floor for chemo just a few minutes late. The waiting room was packed. I did have a longer wait than usual, but nothing outlandish. It was nice to just sit. I did some 4-7-8 breathing exercises and then just enjoyed the wait. Not too long and the pager buzzed and I was on my way in.

This time I got a room with a window. Normally that’s a good thing, but it was cold outside and the windows were drafty. Reminds of a time when I got a rental car that was a convertible, which I suppose is a good thing (despite being terrified of them), but it was December, bitter cold, and it was snowing.

I got my warm blanket and I was happy. The good news is the nurse who would be administering my chemo was this really nice (and very thorough) lady from Ethiopia who I’ve had before, I think during my first round. This is my 10th chemo and I didn’t start blogging about them until this time around so I’m not really sure.

There was some delay in getting the medicine from the pharmacy, so we didn’t get started until about 11:30, an hour later than scheduled. Not a big deal, I enjoyed just sitting. I asked for a sack lunch, but apparently there weren’t any. The Ethiopian nurse brought me some snacks, which was very kind of her. Some peanut butter crackers and a little pack of shortbread. And later she found a frozen peanut butter and jelly sandwich that I saved for later. And my wife brought some Tippins pumpkin pie. Not sure what it is about pumpkin pie and chemo, but for me, the two go hand in hand. My oncologist’s nurse called and let me know my PSA had gone down to 2.8! I can’t remember the last time it was under 3.

Another nurse came in to do the pre-chemo drip. When I mentioned the Benadryl just wiping me out, she said she would administer it to me in one-minute intervals over the course of five minutes. Ok, this nurse deserves an award of some kind. This made a huge difference. It took five or ten minutes before I even felt it. And I simply felt groggy, which is way better than falling asleep in a matter of seconds. I nodded of here and there, but I was with the world for the duration. And when we left I was cognizant and could walk out on my own two legs. Still, it’s 7:00 p.m. and I’m going to bed.

Cycle 3, Week 1

I’m finding cabazitaxel to be less predictable as I go through treatments, and certainly not like docetaxel where side effects kicked in like clockwork. Tuesday and Wednesday were side effect free, which is one thing that hasn’t changed. Normally the jabbing pains in my legs and ankles start on Thursday. This time is was barely noticeable, with the pain being less frequent and less intense. Thursday I had brain fog for the first time this round. When I say brain fog, I don’t mean chemo brain where it’s hard to think of a word or forgetting things. This is more like an out of body experience where I feel like I’m floating and my brain feels like I took way too much Benadryl. This only lasted a couple of days, done by Saturday. If it’s like docetaxel, it will last more days the farther along I go in treatment. Fortunately I’m on vacation, so I pretty much stayed in bed for a couple of days. On Friday I started experiencing metal mouth. I’ve noticed that peripheral neuropathy has increased. Now both my feet are tingly. Up to now, it’s just been in my left foot, primarily my big toe.

Chemo - Round 2, Cycle 3

Today is my halfway mark through this round of chemo and the good news is that PSA is down to 3.8. So for the first time since this whole thing started I'm in the "normal" range.

Things started a little earlier than usual, with labs at 8:00 a.m. Then downstairs (floor 1) for an 8:40 appointment with my oncologist. My favorite receptionist was holding down the fort, and *blushes*, I heard her tell someone I was one of her favorites. We're both interested in history of local architecture, but she also experiences some of the same Sensory Processing Disorder that I do. Anyway, almost no wait and I was taken to the "little" exam room. (Eventually I'll remember the room number. It's either 2 or 4. But that's less descriptive.) Had my blood pressure taken, and it was actually 102/68! How I  managed that, I'll never know. A few minutes later my oncologist entered the room and we got down to business. My white blood cell counts and platelets and all that were fine, so I was good to go for chemo. I had a few quick questions for her and then we were done. I love that I basically get all the time I need for questions. I won't say today was rote, but just didn't have much today. The clinical trial coordinator came in next and we went over how I was doing (find) and I gave her my cycle 2 medication diary.

Last, but not least, headed up to floor 3 for chemo. I got in the chair, got a warm blanket, and then had my per-chemo drip pumpkin pie. Speaking of pre-chemo drip, once again I was totally wiped out by the pre-chemo IV Benadryl. First up was the dexamethasone. Then the Benadryl. And then, zzzz.

Happy

Occasionally I have someone who knows I have stage 4 cancer ask, “How can you always be so happy?” My response is simple - “How can I not be?” #LifeIsWhatYouMakeIt

Chemo - Round 2, Cycle 2

Before I get to the details, the main news is my PSA went down to 7! Holy crap, I did not expect that...it was 55 when we last checked it.

So today I had treatment later in the day than I usually do. I almost always do a Monday morning, but due to scheduling, I had to have treatment in the afternoon today. Labs at 3:00, meet with oncologist at 3:40, chemo at 4:30. Things were running a bit late as we had a blizzard the day before, and the weather and roads were still bad. No complaints from me, though. Just bring me that warm blanket. Oddly enough, I still enjoy going to the cancer center. Well, I guess enjoy may not be the best word, but I do like the attention and care. Even better when results are good.

One thing - the Benadryl in the pre-chemo drip...wow. I joked with the nurse in the chemo room about how sleepy the Benadryl had made me last time. So she let me know when the Benadryl was going in. A few minutes later I thought, this isn't so bad. And then a few minutes after that it hit me. I nodded in and out for a while, and then finally fell asleep before she even switched me over to the chemo. I got a nice hour and half nap.

One down side to the afternoon treatment - no sack lunch! But they did have peanut butter crackers and cranberry juice. I ate the crackers pronto, I was starving, but I fell asleep before getting to the juice, though. Speaking of eating, I think all the Thanksgiving pumpkin and apple (most pumpkin) pies must have fattened me up a bit. I was down to 157 lbs last time I was in, and today I was back up to 163.

I ended the day leaving the cancer center completely incoherent. Good thing I had my wife pick me up. When I got home around 7:30 p.m. I had a quick dinner and went straight to bed. Out go the lights, zzzzz.

Chemo - Round 2, Cycle 1, Week 1

It's been nine months since the last cycle of my first round of chemo. Ringing the bell back in February seems so long ago. And just as it was a year ago, the first week of chemo really wasn't too bad. Just like clockwork, it's chemo on Monday and shooting pains in my legs, ankles, and hands on Thursday. The pain is a little more intense than it was a year ago. By Saturday the pain began to subside. I experienced a little of the metal mouth today. If it's like the first time, hat usually gets worse the farther along I get in treatment.

Chemo - Round 2, Cycle 1

Well here we go. I get to go through chemo again. Like last year (round 1 - docetaxel), I go in every three weeks for an IV infusion for six cycles total. I've already grown used to the familiar bump in my upper right chest like a port was just a natural part of my body that I was born with.

An interesting coincidence, the dates of my second round of chemos are exactly one year to the week day from last year. I tend to like things to go the same way, so I guess someone was looking after me in the scheduling department. If I can get any comfort out of all this, I reckon this is it.

First up is the nurse lab visit. Today that's at 9:00 a.m., so I need to be there by 8:45. Generally this is pretty quick and simple. Check at the front desk, repeat my name and birth date a few times, get the patient wrist band, and then I'm handed a pager and head to the waiting area. After a short wait, the pager goes off and I head over to they do the blood draws. This is the first time we get to use the new port, and it's good to go. First the nurse draws blood through my port, and then sets me up with the tubing for chemo. The jab of the needle is almost nothing. You get used to needles pretty quickly. I wish I could say it's a bonus. Actually, I guess it is.

The lady at the front desk is the same lady who was at the front desk when I started my first chemo last year. I still don't know her name, but she reminds me a lot of the actress Mary Steenburgen. In another interesting twist of fate, she started working in another area for a while and this is the first time I've seen her at the front desk since she had moved elsewhere. Oh.And that other area was my oncologist's office, so I still got to see her when I was coming in every six weeks for a checkup. But still, first day of chemo and there she was at the front desk, just like she was when I started this whole thing. So far I kind of feel I'm being dropped back a year ago, but with the knowledge of a year of treatment.

After the lab I head downstairs to my oncologist's office. The appointment is scheduled for 9:40 a.m., arrive by 9:25. The wait is normally pretty short. Again, I check in at the desk, repeat my name and birth date again, and then head back to the office. I guess not everything was going to line up. The same girl has taken me back to my onncologist's office since I started. Today it's somebody different. But he's just a nice as everyone else in this place, so the small change doesn't throw me off. Fist we check my weight on the scale outside the office. This time I weigh 157 pounds, so I'm down five from last time. Not a big worry, though, I'm still well within normal BMI range, and truthfully, I prefer to be around 155. Then we head into the office to check my vitals. I tend to get really anxious when I visit a doctor, though really I'm so used to the cancer center, and everyone here is so nice, I'm not sure if I really get the same anxiety. Blood pressure a little on the high side, as is my heart rate, but it's never been enough to worry about.After that I'm left in the room alone to wait for the oncologist.

Quick side note - my oncologist is amazing. Every quality you'd want in an oncologist, she has it. I sometimes think she's my guardian angel. I hear so many horror stories from other cancer patients about their doctors, their treatments, their medications, I can't believe what I'm hearing because it sounds nothing like what I've experienced. It's not just my oncologist, either. The entire staff at the cancer center are incredible.

While I'm waiting for my oncologist to come in, I get a notification on my phone that I have a new test result in MyChart. I look and my PSA has gone up again. This time it's up to 54.76, up nearly 20 points from the last time, so the decision to go on the trial and do chemo again was a good one.

My oncologist will let me ask as many questions I want, and is never in a hurry to leave. She's very attentive and knows my case well. She allows me to work with her when it comes to decisions. I do a lot of research (I'm her "enlightened patient.") and that makes it easier to discuss options with her. I get the feeling that most patients just want to come in and get the magic pill. I've become nearly (but not quite) obsessive about cancer. A good part of my reading is cancer related and I listen to several cancer related podcasts. I don't let cancer define my, but it is part of my identify. Working together with my oncologist gives me some feeling of control over my treatment, and she gives me every opportunity to do so. That's a really good thing mentally.

After brief discussion about the PSA results, which was really no more than confirming that the trial was the right decision, I get the green light for chemo. My white blood cell count generally does't get very low, so I've never had to miss a chemo due to white blood cell count being too low. I  love talking with my oncologist, but I don't really have many questions, so we keep it pretty short. The clinical trial coordinator is there as well, and she gives me so forms so I can track when I take my medications each day, specifically what I'm taking for the trial, which is prednisone and abiraterone. (Zytiga) She wants me to start today, same day I start chemo.

Next is the actual treatment. We go up to the third floor where the chemo rooms are. Once again I check in at the desk and repeat my name and birth date. (You get used to it.) This time I get a bed as whoever was scheduled for that room wanted a chair instead. I have no preference, actually, so bed it is. Now one thing I learned about mid-day chemo is to ask for a sack lunch. I don't know if other cancer cernter's have them, but they do here. Bed, warm blanket, sack lunch, it's almost like a mini-vacation! I know someday I won't feel that way, but I'm making the best of the situation.

So this time I'm on a different chemo, cabazitaxel. It's another Taxtane like docetaxel, so I'm assuming the side effects will be similar. One big difference, though, is that there's Benadryl in the pre-drip. I ended up sleeping through most of my chemo, and it was really kind of nice. Other than that, chemo was rather uneventful. My wife drove me howand within a few hours I was in bed and out for the rest of the day.

Cycle 1 done, so lets see what the next three weeks will bring me. I also forgot to take my meds, so I'll start that tomorrow.