Wednesday (10/7) I had my second chemo infusion, and Friday (10/9) marks my 18th dose of radiation. That put me over the midway mark. I am half-way to November 3rd, my last dose of X-rays. The radiation burns on my neck and shoulders are getting pretty painful, all the time now. The chemo was another major evolution, requiring me to spend two nights in the apartment Kaiser so kindly supplied, so I could be at the lab at 7:30AM Wednesday and get my radiation about 4PM. I needed the labs to be done by 9AM, so we could start the 6 hours of infusions. Tuesday, I rode the van down to Sunset at noon, carrying a ridiculous amount of stuff (I’ll pack MUCH lighter if I have to do it again) and after getting nuked, I lugged it all to the apartment. That evening, I walked 0.6 miles to a supermarket to get filtered water and some protein drink, and discovered that 3½ gallons of water now weighs about five times as much as it did couple of months ago. I made it back, managed to keep the protein in my stomach, and crashed. The shuttle and the lab and waiting to be allowed into the clinic were not much trouble, and the infusion dance was not nearly as involved as the first one, since they had already given me my orientation. I even managed to get a little work done on the laptop, though of course the WiFi there is slooooowwww… but better than the total lack thereof in the apartment.
The blood test the morning of the chemo showed good levels of most nutrients, and good electrolyte balance, but a loss in lymphocytes (They hang out mostly in the Lymphatic system) a subset of leukocytes (white blood cells) including T cells, B cells, and NK, or Natural Killer cells) which are needed to fight infection and clean up waste. The NK’s are what will finish off any cancer cells left by the chemo and radiation.
Chemotherapy kills many of these very important cells, weakening the immune system. The problem is called Leukopenia. It is sometimes inaccurately referred to as the similar condition, Neutropenia, which is low levels of the neutrophils only.
Leukopenia is expected, and we have been preparing for it. I have to stringently avoid cutting myself, or otherwise exposing myself to infection. That’s difficult with my skin scarred from the radiation wounds, and having to go to the hospital every weekday, but I started with a very strong immune system, and am being careful.
The combination of radiation and chemo makes eating a major problem, with dry mouth, always tasting salty, difficulty in swallowing, and nausea. I tend to stay dehydrated, no matter how I try to force fluids, and that makes everything else difficult. The metallic, salty froth in my mouth makes the very idea of eating, or even drinking, repugnant. Even pure distilled water tastes like a salt marsh. Biotene helps for a few minutes at a time, but then getting nutrition into me and keeping it down remain a persistent issue. I have lost another 5 lbs., and I am getting really concerned.
By 4PM, I am full of platinum poison, and heading into the radiation room. I describe a typical session and prattle on about the cool machinery in the next chapter: