12.03.2008 - They Couldn't Do Much For Me

The past several days have been horrible. Now, we knew on Thanksgiving that Grant had a cough, but we didn't know it would turn into the nightmare of all colds and flues. I hardly ever get sick and have been suffering from this since Saturday. My nights have been so awful. I get hardly any sleep, toss and turn, and am so congested from the excessive phlegm. I had an appointment on 12.03.2008 to get more Avastin and have my blood counts checked, but I was so out of it that I thought I might run the risk of crashing my car. Carissa and I packed the kids in the car and she drove me to my appointment. I had already decided that I wouldn't be doing the Avastin IV due to my illness and I wanted to have my nurse and doctor assess my symptoms. The doctor told me that I did not have pneumonia. I told him about the restless nights, the neverending phlegm, the coughing, the hacking, the fatigue, etc. I also asked him for a prescription for something to help me sleep. The sleepless nights have probably been the worst thing I have been dealing with. Severe sleep deprivation can exacerbate the risk of seizures too and we don't want that. He also wrote me a prescription for a cough suppressant with codeine to help with the coughing. What I really wanted was to be magically alleved of all my symptoms, but that was not to be. I was only at work for 90 minutes yesterday and didn't go today. I don't anticipate being at work tomorrow either based on how this has been going. I just want it to end.

11.17.2008 - Three Day Chemo

11.17.2008, I am actually at the doctor's office at this very moment using my wife's laptop computer and the hospital's wireless network. I came in a couple hours ago and did a pulmonary function test, went to the cafeteria to eat lunch - something I often forget to do on chemo days - and then went to my doctor's office to get chemo.

This round is the drug, BCNU, which used to be administered over 72 hours as an inpatient in the hospital, but is now administered for four hours a day over three days. This one is something that usually doesn't cause much discomfort for me and I can drive myself to and from the appointments since there they don't give me any benadryl.

In a couple weeks, the effects will be more significant - I won't feel worse, but my blood counts will drop noticeably. We knew chemo would happen today because the last time I went in for a blood check - two weeks ago - my chemo nurse said that my blood counts were beautiful. I don't know if I had ever heard her use that word to describe my blood counts before.

I will be off of work 11.22.2008 through 11.24.2008 and depending on how I feel, I could be out 11.25.2008 and 11.26.2008, but probably not. The oral chemo drug that always accompanies my intravenous chemo, Temodar, can cause me to feel somewhat nauseous. We'll just have to see.

I was off work Friday of last week as well. That day off wasn't for my medical needs though, I took my wife to get laser eye surgery so she will never need to wear contact lenses or glasses again. It was a great investment. She is loving not having any optical aids.

I have had side effects from the Thalomid (the trade name for thalidomide). My doctor and chemo nurse have reminded me many times to be attentive to signs of peripheral neuropathy. It is tingling and numbness in the hands and feet. I have been having difficulty buttoning up my kids’ clothes and using zippers some times and never associated with the Thalomid. I was browsing a web site that talked about the effects of Thalomid and saw that this was a sign of neuropathy, so I brought it up to my doctor. He wanted to keep an eye on it and for me to let him know if it got worse. It wasn’t too bad of a problem

I then began noticing about a week or two ago that I had numbness in my feet. My right foot was pretty numb from the ball of my foot forward and my left foot was pretty numb just in my toes. I had thought my right foot was asleep sometimes, but then I realized that it was “asleep” all the time and that wasn’t right. I told my doctor about it today and he wanted to take me off the Thalomid immediately. This neuropathy (loss of sensation) would likely only get worse over time and is sometimes irreversible. It is better to stop the process as soon as it is this significant. Hopefully, everything will go back to normal after being off of it for a while.

There is an alternative to Thalomid, it is something called Avastin. Avastin is given every two to three weeks intravenously and takes about half an hour to administer. The big issue is usually insurance coverage. Many insurance providers don’t like to cover Avastin because it is expensive and a newer drug, so it doesn’t have the same established track record of some of the older drugs. It is an angiogenesis inhibitor, which means that it slows/prevents new blood vessels from forming in the tumor like Thalomid, but it has hardly any side effects.

On 11.18.2008, I am here again at my doctor's office, sitting in a leather recliner chair waiting for all the drips to leave this last IV bag. I already did my four hour BCNU session and am now almost done with the Avastin session. The first round of Avastin is given over 90 minutes. The second is over 60 minutes. Every subsequent dose is over 30 minutes. I feel pretty tired and some of it is due to the chemo and some of it is due to a restless night. The Thalomid causes significant fatigue and I was at the maximum dose for brain tumor patients - 1200mg - and now I am not taking it at all. It will take a little time for my body to adapt to not having it.

Oh, the drips just stopped dripping. Maybe I can leave now. I was gone for nine hours yesterday and I have been gone for almost eight so far today. You'll hear more from me tomorrow for my last dose of BCNU.

On 11.19.2008, I did not feel well after I got done with chemo yesterday. I just felt ill all evening and then had difficulty again going to bed. It was another rough night. Once I did get to bed, I woke up two and a half hours later to then go in and out of sleep from then until a little after six in the morning.

I wanted to try to get to the office early because my nurse said I could come as early as I wanted (her schedule is very busy today) and the earlier I come in, the earlier I get to leave. I ended up arriving only a few minutes early due to gridlock traffic on the freeway. It was seriously like traffic in the Bay Area of California. It took a hour and a half to get to the doctor's office.

I will be so happy to be done with this. It has really drained me. No appointments next week because BCNU usually causes delayed effects, so they will check my blood counts the week after Thanksgiving Day. One perk about being in the office on Wednesday is that they have a massage therapist that comes in every Wednesday. I asked my nurse to tell me when she arrives.

10.23.2008 - Bad Lab Results

I went in for lab results on 10.23.2008 and they drew my blood and five minutes later had my results, as usual. They can do it that fast because they are a hematology lab and don't send anything out. My neutrophil count was zero. That level alarmed my chemo nurse. Evidently, neutrophils are the most active of the white blood cells and are the first to attack microorganisms. My nurse wanted me to begin injecting myself with Neupogen daily and taking an antibiotic daily until my next appointment, which will be on Tuesday.

10.17.2008 - Another Round of Chemo & A Timeline

On 10.17.2008, my wife took me to my doctor's office and I got my intravenous line started and then went to radiology at the adjacent hospital and had a MRI. After that, the doctor met with my wife and I and reviewed the scans. The scans revealed that everything was stable and unchanged. The tumor is under control. While the chemo usually lasts a year, my doctor asked me if I could continue with aggressive treatment for four to six more months. His rationale was that he is treating an aggressive disease and most people don't survive it. His goal is just to get me to the three year mark, where the survival curve flattens out and most people survive indefinitely after that point. Since chemo is only something I have to deal with every four to six weeks, I thought I could do that. He wanted to keep me on Thalidomide as long as we could, possibly even up to three years. If I needed to lower the amount I was taking at some point, he thought that was quite reasonable. My body has adapted to the Thalidomide well and I don't notice the fatigue nearly as much these days. My wife and I felt all of it was reasonable. I didn't feel so hot from the round of chemo and will likely be laying around the house the whole weekend and probably Monday and possibly Tuesday as well. This one, while a one day session, usually kicks my butt pretty hard. What I had today was Irinotecan and Taxol. My wife had to drive me because I can't drive myself home after the chemo due to all the benadryl that they treat me with to prevent any allergic reaction to the chemo drugs. I will also be taking Temodar orally for the next five days and usually don't feel good until that is over with. Wednesday or Thursday will probably be the first day I feel good again.

09.03.2008 - Three Day Chemo Session

09.03.2008, 09.04.2008 & 09.05.2008 were spent at my doctor's office receiving BCNU. I received it for four hours a day for each of those days. They had to lower the dose from what I had received before since it caused my blood counts to drop for such a long time. I don't feel too bad, but I don't feel great either. The BCNU rarely caused much distress to me. I am able to drive myself to and from the appointments. It does cause delayed effects to my body though that will show up two or three weeks after I have it.

08.11.2008 - Unbelievable Fatigue

It is 08.11.2008 and I still haven't returned to work since having chemo five days ago. I hope to return to work tomorrow. All these drugs make me feel so tired. How many naps can I take? I always feel tired after all the additional rest. Feeling tired all the time gets old and I wish I could just feel normal. It is all part of a greater plan to knock the cancer out, but it is difficult to be patient. The photo is what I take every night and that isn't including chemo. Do you know anyone who takes more pills than I do?

08.06.2008 - Another Round of Chemo

On 08.06.2008 I had chemotherapy again and it went pretty well. This is the stuff that should make all my hair fall out again. Just when my beard was coming in thick and full and my hair was coming in the same. I don't feel awful today, but won't be going into to work today or tomorrow because of how I have felt in the past following this type of chemo. I have had to lay down for a while this morning and expect to rest a decent portion of the next couple days.

Things are going pretty well here. We finally got a lot of rain last night. We need more though to catch up for our lack of rain so far this year. The job is going well. I do miss being a first responder so much. Being a police officer is the best job I have ever had and I would love to return to the profession at some point. What I do now is fulfilling, but not so much as being a police officer was.

A Denver PD sergeant already tried to recruit me during a trial a month or so ago. It would be a pay cut and I don't think my current health would permit me to do it at this time.