Thursday, May 24, 2012

Chemo sucks (finally)

Sorry I've been a bit absent as of late.  It's been busy at work and to be honest, I just haven't wanted to think about having cancer for a while.

Last month I had my usual finger stick and my doctor informed me that my platelet count was too low to start the month's round. 53,000 per microliter (normal is about 150,000-450,000). He told me that it's nothing to worry about, no real concern, but that he wanted me to wait a week to recover before starting my next round. A week later I'd rebounded to just shy of the lower end of normal, so he gave me the go-ahead on the lower dose. It was kind of a bummer, since I'd tolerated the chemo so well for so long. My other counts (RBCs and WBCs) were fine.

How he explained it to me, when a patient takes chemo it damages their bone marrow and reduces their ability to produce blood cells. Give the body some time to recover and it can usually repair about 99% of the damage. Now, that's the number he gave me so it's what I've got to work with. I have no idea how accurate that is. So even though the body can almost completely recover, there is a small amount of permanent damage. Then next time, the patient will recover to 99% of their new normal, for a little more permanent damage, which brings them to about 98.01% of their original baseline.

The makers of Temodar suggest that patients only take it for a maximum of 2 years, regardless of its effectiveness. 24 doses means their blood's about 21.4% compromised.

I've always hated math.

I saw a series called The Unusuals on Netflix that has an interesting take on brain cancer.  It's about a group of NYC detectives.  It's not a particularly great show - each character basically has exactly one character trait - but one of the characters has a brain tumor and shows a lot of the same symptoms and anxieties I've seen in myself and other patients.  He decides to try to ignore his tumor, because he doesn't want to end up a vegetable in a hospital even though his doctor tells him he'll be dead within months if he doesn't get it treated.  Throughout the nine episodes I watched (not sure if there are any more), he suffers hallucinations, changes in his sense of taste and smell, headaches, and of course all the fear and uncertainty such a diagnosis brings.  I think the show got canceled after that so I don't know if he ever does get it treated; the closest he got in the episodes I saw was sneaking into a hospital with the coroner for an MRI.

It's a good enough treatment of the disease that I wonder if it isn't based on some real life experience.  Worth a watch if you have Netflix streaming and nothing better to do.


  1. I had a similar experience with my Temodar dose, except my platelets responded immediately on the first month. They dipped to about 40, and I was delayed. I ended up on a lower dose for the whole treatment (I did 12 cycles, 210mg Temodar each), but my blood work looked good from there on out. It was always unnerving to wait for the results of blood work to come back to get the go ahead to start my next cycle. Especially because I was living in a different state than my hospital and relied on Quest Diagnostics to report my blood work in a timely manner. My doc indicated that every body responds differently to the meds and it seemed that I was just a bit more sensitive. I'm hopeful that it still did it's job- so far no signs of new disease!
    I'm sorry that it is sucking so much for you right now. You must be nearing the 1 year mark- has it been effective?

    1. Yeah, I really shouldn't complain since I have had hardly any other symptoms. I guess I just hadn't expected that to change. I mean, the body gets adapts to medication, right? So side-effects should decrease over time? Not so much, it seems.

      As for whether or not it's been working, well, I haven't had any signs of recurrence or growth, and my local doctors as well as those in MSK concur that if that's still the case when I hit the 1-year mark in October, we can discuss taking me off chemo entirely. So, make of that what you will, and I'm glad to hear you're doing well too. :)

      I'm fortunate in that I'm treated at a nearby hospital (with a second opinion from Sloan-Kettering) and that my blood's kind of funny in that the platelets will start to clump if they aren't counted immediately. They usually have my results minutes after they've drawn my blood, which I then discuss with my doctor in person.