Tuesday, July 19, 2016

Gearing up for round two

Now that I'm starting up chemo again, I intend to post more regularly to the blog.  I imagine I'll be saying a lot of the same old things, but it's definitely good therapy for me to talk about it. To those who take the time to read my muddled and often repetitive thoughts, thank you!
As always, it doesn't bother me to talk about the worst case scenarios, including death. Indeed it does me no good at all to ignore such grim realities. I don't dwell on it. I don't worry about it. I don't give in. But to pretend that it couldn't happen serves no purpose. So I'll briefly report on the negative side, and move on.

I saw the radiology report before we went on our Sunriver vacation, but didn't see the oncologist until after. So I knew about the possible metastasis to the liver. I'm well aware, of course, that this is a bad sign. But I can honestly say I didn't worry about it one bit. Thought about it, sure, but didn't worry. It didn't detract at all from a fabulous vacation. My standard mantra has been very effective: I'm here now. It's a beautiful day along the Deschutes river. I'm riding bikes with my two amazing little grandchildren. What happens next week, or  next month, or next year, is irrelevant.
Yesterday I had a ``refresher chemo course'', if you will, with nurse practioner Susan. Since the oncologist has said that untreated bladder cancer can kill you in three to six months, but never gives examples, I asked Susan point-blank if she had personal experience with such cases. She said yes, but gave only one example of someone who refused chemo and within six months was in terminal hospice care (okay, so the guy didn't actually die within six months, but close enough). One can also judge the seriousness of the situation from the fact that not only did the oncologist think postponing the chemo until after Italy (i.e. 2 months) was too risky, but also Susan seemed dubious about taking even the three-week chemo break that our planned trip would entail (it's only a two week trip, but I need some recovery time ahead of it). However, there's no point in worrying about this now. After the first two cycles of chemo, i.e. in late August, they'll do another scan and we'll re-evaluate the situation then.

Well, enough of that! The fact is I'm feeling very relieved, now that the chemo decision is final. I did pretty well with the chemo last time, but I'm making it my goal do even better with the second go-around. At least now I know what to expect. I'm even looking forward to seeing all the nice folks of 8th floor southeast (the infusion ward) again!

I'm a little disappointed that I don't have Sarah, the opera nurse practitioner. According to Susan, Sarah said ``I hate to give up Steve'' but had to for scheduling reasons. (Or maybe she really said ``thank goodness I can pawn off that Mitchell character on Susan''.)  During the ``refresher'' another nurse poked her head in and said ``oh, you're the opera guy!''.

The doc thinks the chemo will help my exasperating bladder symptoms, which have gotten even worse of late. That alone will make it worthwhile. Meanwhile Susan suggested the use of a ``condom catheter'', a term that is, I hope, self-explanatory. She proceeded to get out some samples and asked me whether I needed a small, a medium or a large. Are you kidding me? Obviously I need the extra-large, the ``Trump special''.  ``Deanna can show you how to use it,'' says Susan cheerfully. Now Deanna is a nurse I hadn't met yet, although she happened to be on duty at a time I was sending irate emails about UW Med's god-awful appointments system. Too late, I realized that if a nurse is going to give you hands-on condom catheter instruction, it's probably best to stay on her good side. Of course I never blamed the urology clinic, and certainly not the nurses. ``That's okay,'' Deanna reassures me, ``your emails always had a sense of humor.'' As it turned out, no rooms were available for the instruction, and I was relieved to postpone it to a future date. In any case, it's good to know it's an option, especially for a transatlantic flight.

I'm psyched up for Thursday, then, which will be a long day since not only is it the double-dose but they have to place the PICC. I've got my math ready. I've got my Italian ready.  It should be a productive session in the old infusion ward!

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