Welcome to Monday in blog world. You have all been waiting with quite patient hearts for me to get my ass back at the keyboard. To that end, I have sat my ass down at Right Brain Brewery in beautifully fall-festooned Traverse City, MI this afternoon. Old fashioned oldies playing on the speakers, just a few quiet patrons, a rainbow sampler laid out before me, fresh guacamole and chips for munching, and a few hours on my hands. (By the way, cucumber basil saison - it's a legit tasty beer!) Afterwards I shall go pick my sister up from her local office and we will visit the downtown food truck row for vittles to take on our mini evening color tour. That's all the good stuff... moving on...
Met with my medical oncologist this past Thursday to go over the lung biopsy results. Which they screwed up and pulled tissue from the atelectasis instead of actually getting into the tumor. Overtly conservative surgeon, which isn't quite a bad thing as getting into the hilum area is a difficulty and full of pitfalls near all those anterior arteries of the heart. However, this (my doc and the tumor board that discussed my case last week) confirmed my thought that the biopsy really wasn't necessarily needed in the first place. *sigh* Clearly this is a metastasis from the rectal cancer and it has thrown cells further into my system. Considering the statement about heart arteries above, surgery is an even more complicated and worrisome choice. They won't necessarily be able to get full, clean margins without removing more lung than I can afford to lose and the surgery would weaken my system. Not the best choice before starting chemotherapy rounds again. Plus, it's already thrown into my system and the brain... so although we want to remain as aggressive as possible, we don't want to make decisions that lead down more difficult paths without the proper rewards.
This makes the next treatment step chemotherapy. The brain mets have been addressed and we will know how that worked out in six weeks-ish when I get the results from my follow-up MRI. Now we address the lung tumor by poisoning the crap out of it for a three-month course of the FOLFIRI chemotherapy cocktail. This is almost the same cocktail mix I got the first two rounds a couple of years ago. Though, bonus!, it replaces Oxaliplatin with Irinotecan hydrochloride. Those who followed this the first time around may remember that the oxaliplatin has the side effect of neuropathy, which is an extreme cold sensitivity. This was something I was very affected by and definitely decreased my quality of life while on chemo, especially in the cold winter months. Not having that drug in the cocktail kind of has me excited, weird as that may sound from the outside. The neuropathy last time meant that everything I ate or drank had to be 80 degrees or better for the first several days post-treatment. The lack of limitation on my diet is fantastic. And as the first frosts have already hit around here, it will be nice to not have even more problems trying to keep warm and feel like my skin wants to tingle off my body constantly.
Side effects I can expect will be nausea (duh), diarrhea, and of course the immunosuppressive effects of full scale poison in your system. Last time I had no other of the secondary effects, though my hair did thin a bit and I suspect any fullness I have left will continue to dissipate. Thank goodness my hairdresser's new layered cut makes up for all that. I see a fresh cut in my next couple of weeks. 'Cause as you all know I will continue to dress my best for chemo sessions and do no less than continue to be fabulous through all this to come. Newcomers might wish to visit The Cancer Fashion Guidebook post.
The chemo will be every other week, ideally beginning next Monday. Four hour infusion in the middle of six-ish hours at the cancer center. I will go home with an infusion pump still connected for 48 hours and will have to return to have that disconnected on Wednesday. The infusion pump is about the size and weight of an early eighties Sony Walkman tape player in a over the shoulder bag - super great fashion accessory. Does make showers challenging, but otherwise just a low level frustration. And of course, two more days of constant chemo. You know my love of silver linings... and the first half of chemo week is full of ALL the sleeps! I turn into a cat with the 12+ hours of sleeping for three and four days. By the first weekend my energy may be low but my sass is back in high gear. And off-week is practically normal with the possibility of continued cat-like napping tendencies.
After the first three-month course there will be a brand new PET scan to see how well the chemo is blasting the tumor. I'll have to check my medical journal, but I'm pretty sure that will be big number 10 PET! We should start the betting pool for superpowers soon. It will be re-evaluation at that point and likely another three-month chemo course to follow. The key here is keeping the lung tumor in check so that it doesn't throw anything more into my system. In that ideal world, we keep on systematic chemo with the possibility of using radiation in between courses to give me some extended off-chemo time (say 6-8 weeks) in which I can get some proper recovery and do some more awesome world traveling.
That's a whole lot of details and medical know-how I've tossed at y'alls feet. Google the hell out of what you want to know more about. Or toss me an email or FB message or text if you want more dirt. I've been showing my ass around this place for a few years now (HA!!!) and that's not bound to stop.
In case I hadn't made it quite clear... My spirits are high and I'm determined to kick this shit in the dirt as best as I possibly can. At least weekly updates will happen from here on out. There will likely be the re-establishment of the Live Chemo Blogging (super exciting napping fun times!). And there will certainly be philosophical, pretending I am deep and full of life advice shite to come. So stay tuned to this Bat Channel and POW! BAM!, Holy Tuxedo Batman, you will be full of the Know!!!