Heuristic

Once again I’ve been sent home after having my blood examined. I continue to not be studying hard enough for my blood tests. My platelets are doing very well with the every three week regimen, but my white blood cells just can’t keep up. This is likely due to the effects of radiation: all that pelvic bone marrow is no longer as robust as it used to be. My numbers are fine when I’m not taxing my bone marrow with chemo, but the combination is too much.

There’s a treatment for this, an injection called Neulasta, that I can have in conjunction with my next three chemo treatments (by which I mean LAST THREE), that raises white blood counts. It of course has its own side effects, the main ones being sticker shock and bone pain from the marrow being stimulated. I’m hoping my insurance takes care of the first one, and that the latter isn’t too bad. Like everything else in this cancer business, people’s responses vary enormously, from being achy for a couple days to needing narcotics.

I was dreading this week’s chemo, since the last round was brutal. My anti-nausea meds aren’t cutting it, and while Monday and Tuesday were really not bad despite being infusion days, Thursday and Friday had me running for the bathroom. (Things that cause vomiting: drinking water; walking to the kitchen; walking to the bathroom; pretty much anything.) But I’d still rather get it over with than keep extending this out. My final treatment will now be the first week of May. Bah!

And I’d already had to rearrange everything, and now I’m doing it again. I keep finding things that are messed up by changing weeks, including the meeting this week that I didn’t prepare for because I couldn’t attend it, and now I can and I’m totally unready. And the medical appointment I had to cancel, and for which the next available opening was June, and which now I didn’t need to cancel at all.

I set up a bunch of time-consuming work projects to process while I was out this week so that I could work on them next week, and now I’m here at the computer and none of my stuff is ready for me to do anything.

With the Neulasta, at least there shouldn’t be any more health-related delays. We’re keeping the three week spacing for the remaining treatments since that is working for my platelet counts; there’s no Neulasta equivalent that boosts platelets. I just really want this over with, so I can get on with figuring out how my life is going to work now. (More on that later.)

I bombed a test today. Specifically, my blood test: I haven’t enough platelets or white blood cells, and they sent me home without my poison. I have to go back next week instead, and I’m going to be on a three-week cycle instead of every two weeks.

On the one hand, I get some extra time to recover, and may feel a bit less lousy, and I get today as a holiday. But now I’ll be doing chemo thru mid-May instead of the end of March. Bah.

Tamie pointed out that I’d screwed up last time: I had not completed 4/6 treatments, I had 4/6 left*. I’m not even halfway done yet, and this stretches it out further.

I mean, I appreciate that my doctors would like their cure to not kill me, and I do rather need both platelets and white blood cells for routine life. With my liver still growing back, my body is not processing the chemo drugs as efficiently as it did last year, so I need longer to recover and they’re making me sicker. Just no fun. But if all goes according to plan, then I will never have to do it again.

* Chemo brain: it’s a real thing.

After these contacts with the Middle District Court:
one letter mailed from my oncologist;
3 emails from me, detailing progressively more disgusting chemo side effects and progressively stronger ADA requests for reasonable accommodation;
one phone message from me;
(no reply to any of the above)

one phone message from my oncologist;
one fax from my oncologist;
one phone call to my oncologist;

accompanied by assorted voice and email messages between me and oncologist, and a whole lot of complaining on twitter (and it’s really too bad the court doesn’t have a twitter account, or they’d have been SWAMPED with appalled people):

Status: Excused
You are not required to report for jury duty at this time.

WHY WAS THAT SO HARD?

Re: Federal jury medical waiver request

As per my oncologist’s letter submitted last week, I am undergoing intravenous chemotherapy for stage IV colon cancer. Since this was not considered sufficient grounds for a medical waiver, I would  appreciate your assistance in making arrangements for the delivery of chemotherapy drugs to the courthouse should I be required for jury service, for the provision of the home nurse necessary to monitor the 46-hour continuous infusion of these cytotoxic drugs, and for ready access to bathroom facilities due to the nausea and diarrhea caused by these drugs.

Alternatively, you could inform me of the channels necessary to follow to have the decision on my request for a medical waiver reconsidered.

Thank you,
Sarah Goslee

Sorry for the radio silence; the first round of chemo last week was rough, and I spent as much of it asleep as humanly possible. Back to normal this week. Not that “normal” has very many posts in it either.

A year ago today* I got That Phonecall. You know, the one that nobody wants to get, and that those who have gotten it will never forget, the one that uses words like “malignant.”

It’s been quite a year: nine rounds of chemo, six weeks of radiation, removal of liver and colon and three weeks in the hospital.

I still don’t know how I feel about it.

And how do you celebrate such an anniversary? By meeting with your oncologist, of course.

The year of horrors was very effective. I have no cancer that is detectable by CT scan or blood test. But we’d like to make sure that I have no cancer at all, and the way to do that is more chemo. After running through various options, we decided to repeat what has already worked and do six rounds of FOLFOX, the IV chemo I spent last spring on. There are two other drugs that are used on metastatic colon cancer, avastin and irinotecan, but those are going to be held in reserve just in case. No sense in using all the drugs up front and developing resistance. It’s possible that I have a reservoir of FOLFOX-resistant cancer cells hidden away, but I responded so well to these drugs before that after the surgery and radiation it’s unlikely. And, well, if I do then there are the other drugs available.

I can do this. I did nine rounds already, and know how it works. There’s no longer the frantic air and the panic of last winter. Everything is as under control as it can possibly be. This is prophylactic, not immediately life-saving but a long-term investment. We’re being aggressive now, because I’m determined to have a long term. And chemo isn’t even the hardest thing I did in 2014. Besides, we’d talked once about six months of chemo; three months is considerably less awful.

My oncologist put the orders in while I was there; we’re starting as soon as possible, maybe even next week. I’m healthy enough to get going. Aggressive, remember? And I’d like to get it done and over with so I can spend the summer doing good things.

But it does offer me a dilemma, and one I need to solve quickly. I’m signed up for the Rainforest Writers Retreat in early March. My oncologist has no problem with shuffling dates so that I can go. This is not urgent like last year; moving a week won’t hurt anything. But three rounds in, will I want to travel that much?

I missed so much in 2014, and had so little time to devote to things nonmedical, I’m really longing for this brief escape. But if I’m sick and miserable, it won’t be much of an escape. I will probably cancel for this year, but I’m REALLY REALLY unhappy about it.

I’ve been called for federal jury duty for the entire month of February. I was actually looking forward to seeing how it works, but I think I’d better submit a medical waiver. It seems like “receiving intravenous chemotherapy” is probably an acceptable excuse.

How else does one celebrate such an anniversary? Pillow fort? Dinner out while food is appealing? Drinking heavily? (I haven’t been drinking while my liver grows back, except Christmas, but I’m willing to make an exception here.)

* It was Monday, January 13, 2014. The 13th is tomorrow, but I believe marking this on a Monday is just more appropriate.