One more test and Chemo U

On Wednesday I had my last test (Yippeee!) and then my chemotherapy education or Chemo U as I call it. The last test I had to have was a PET scan. This scan is designed to see if the cancer has spread to anywhere else in my body. The way it works is you are injected with a radioactive sugar based substance and then sit still for 45 minutes. The fast growing cells absorb more of the radioactive substance than the slow growing cells. The reason for sitting still is to avoid having your muscles absorb more and throw off the scan. I couldn't even read the paper.

After the 45 minutes you are then put into the scanner. It looks something like a CT Scanner. It took around 40 minutes to complete the scan. This is one test that is not offered at a permanent facility in Ithaca. There is a mobile lab that comes to the hospital every Wednesday to do the tests. The substance they use has a half life of around 2 hours so it took about 12 hours for the radiation to completely disperse. During that time I truly had a radiant personality! (Yes, I know don't quit that day job.)

In the afternoon we went to the medical oncologist to meet with the nurse in charge of chemotherapy. This was an education session to let us know what is involved and how to prepare. The chemo schedule is 3 heavy duty sessions scheduled 3 weeks apart followed up by 3 lighter doses of the same drug and an infusion of another one. The 3 big treatments coincide with the radiation treatment plan. The drug they are using helps get any stray cancer cells but also makes the radiation more effective by causing the existing tumors to be more susceptible to radiation treatment. The downside is that this is one of the drugs that can really cause nausea. It only lasts for a day or two if it happens but it is a concern due to the other side effects of the drug. The drug can effect the kidneys. The way to combat this is drink lots of fluids, at least 64 ounces a day. During the chemo treatment they actually spend most of the time giving you fluids. Until you have a certain amount of output (you can figure that one out for yourself :-)) they won't give you the main drug.

This is where nausea becomes a problem. You really need to drink the fluids. To combat this they have prescribed a chewable drug that I bring with me on the day of chemo. I take the first one when I am there and they the other 2 on the following 2 days.

The way chemo works is that it attacks the fast growing cells like the cancer cells. Unfortunately your body also has some good fast growing cells. Things like hair and the production of blood cells. I think they mentioned something about the stomach as well but I am not sure. This particular chemo drug won't affect my hair so I can't blame my continual hair loss on this. It does effect the blood cells and that is a cumulative effect. What this means is that as the treatment goes on my white blood cell count will drop and I will become more susceptible to infection. Fortunately my job and life style in general will lend itself well to minimizing contact during that period. I will be seeing the radiation oncologist daily and the nurse there will be checking me out from time to time to see how things are going.

Back on the nausea front the nurse that did our chemo education provided some good information and even a cancer cookbook. One of the keys to fighting nausea from chemo is to not have an empty stomach. I found this interesting because my only experience with nausea has either been something I ate or from a bender in college. Then you want to avoid eating anything! Here the key is to graze as often as possible. One thing that I haven't mentioned is that between the radiation oncologist and the medical oncologist they are encouraging a diet that I would have otherwise never imagined a medical professional encouraging. All rules are thrown out the window. They want me to consume only whole milk products, no more skim milk during treatments, pack on the calories, eat lots of ice cream. Basically its anything goes. The idea is to eat whatever it takes to keep the calorie and protein content up and the fluid intake going. Now as the radiation treatment progresses and I get the mother of all sore throats some foods are just not going to work out like spicy foods or things with rough edges like tortilla chips. I did ask if they gave me a referral to a cardiologist when all of this is over.

Those were the last scheduled appointments until treatment starts next week. Its been 3 weeks exactly to the day since I first when in for what I thought was a sinus infection. For most of that time the schedule has really been changing day by day with more and more tests or consultations being scheduled. I think I have had just about every scan you can have at this point. There are a few days off until treatment starts next week and then I will finally be able to get into a regular routine. Its not that I am looking forward to the treatments, it will be a rough time, but it is something that has to be done and the sooner I start the sooner I am through it.