Thursday, November 3, 2011

And we're back

Sorry for the interruption.  My area was hit by a severe winter storm (one that is apparently named Albert), so I've spent a little time getting in touch with my roots.  Like most roots, mine apparently spent a lot of time sitting motionless in the dark.  My power was restored before that of my parents so I let them come over to do their laundry and use my shower.  For my trouble I received a lint filter full of shredded tissue paper and a blast of cold water when I went to shower this morning, because my shower head was angled out into the bathroom for some truly inconceivable reason.  But enough about that.

On Monday I went to see a new oncologist, one we selected not for lack of faith in my previous one but because he too is highly skilled but much, much closer.  We figured that since the more intensive treatments were over - the surgery and the radiation - that we no longer needed to travel a hundred miles for the very best; though to be honest this new doctor, let's call him Dr. C., may well be top tier.  Certainly he's accessible, and has no problem with patients calling his personal cell number.  On top of that, he used to be my neighbor, when I still lived with my parents.  We're still going to keep the other oncologist in the loop and send him my blood test results and MRIs, but Dr. C. is now running the show.

Dr. C.'s office is in the hospital where I was born, about a 25 minute drive from home.  Their cancer center is comfortable and inviting - or as inviting as a cancer center can be - and their people are warm and skilled.  Their lab tech was excellent at drawing blood, and they processed the sample within minutes so they could get an accurate platelet count despite the tendency of my blood samples to clump.  She seemed surprised and saddened as she took my medical history and drew my blood.  She looked at my birthday and said, "you're almost the same age as me."  Then she looked at my address and asked me where I went to high school.  She thought we might have been classmates.  Unfortunately, I grew up elsewhere. 

I like Dr. C.  He's friendly and good-natured, and seems to really know what he's talking about, which I'd hope to be the case judging by his wall full of certificates and awards, including a recent one for "Best Doctor."  He ran a few basic tests for things like balance, strength and sensation, and was very impressed with my results.  He said that I'm "remarkably" stable for someone who has had such extensive brain surgery. 

But I don't like everything about him.  He said that he was highly optimistic about my case, which is good to hear but I disagreed with his reasoning.  Basically, he was going by the pathology report and not giving as much weight to the MRI.  I understand where he's coming from, that the pathology report is as solid an analysis as we have and we can't go second-guessing it, but I pointed out to him that the pathologists had never seen the cells that remained in my head.  I did not mention that the MRI seemed to contradict the report, or at least cast its results into doubt.  He admitted that yes, the reports are imperfect.  The distinction really isn't all that important; we're treating my cancer the same way we would a grade 3 anyway, with a year of 5/28 cycles at 330mg of Temodar (might as well put a name to it since it's the standard for gliomas).  Except he spoke as though we could cure it.  The "long life" language came up again.  It's a possibility, I admit, and definitely what I'm hoping for, but I still don't think he ought to say it unless he's reasonably sure that's what our outcome will be.  I saw that hope in my mother's face again.  She'd been hurt like that before, at least once. 

I'll be honest, I'm starting to hope a bit more myself.  Maybe it's because I've been doing well so far, maybe it's because I've responded well to my treatments, maybe it's even because I feel pretty good.  Maybe I really can beat this.  Maybe that's what's important.  As a doctor, it's his job to try to make me well, or as well as I can be.  Maybe keeping me as optimistic as possible is part of that.  If he's wrong, I won't be in any position to call him on it.  Ultimately I need to trust him.  He's a good doctor and he knows what he's doing. 

So I took my first dose of my first round last night.  Two 140mgs, two 20mgs and two 5mgs.  If taking Temodar is scary, taking a handful of it is worse.  I took some Zofran, then an hour later I swallowed the Temodar 165mg at a time, as I had during my radiation treatment.  Not the sort of thing I want to choke on. 

I feel fine.  My friend Will up in Canada told me that his first cycle was very rough on him, that he felt exhausted and nauseous, and even threw up.  I felt a little heavier than usual as I got up this morning.  A quick shower and a cup of coffee later and I feel pretty much like I do on any other day: a little tired, but tolerable.  Maybe a little congested as I think I'm getting over a cold, but nothing so severe so as to hold up the chemo.  We'll see how I feel by day 5 but so far, smooth sailing.

330mg down.  19,470mg to go.

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