Chemo round 3 tomorrow

Chemo round 3 is tomorrow morning.

The past week has offered some much needed respite. I’ve been feeling strong and reasonably healthy. The G-CSF injections have been working; I’ve been able to fight a pretty significant bronchial infection on my own. There were some touch-and-go moments as I did have light fever about a week ago but it never exceeded the 100.4 degree threshold that requires an ER visit. But that’s now gone, just an innocuous dry cough remains.

Physically I’ve been able to get in a couple jogs (slow with lots of walking, but still). My weight is up a couple of pounds. My deadlift strength/weight ratio – the benchmark I’ve set to gauge strength – is a solid 1.7. I even felt strong enough to fast for Yom Kippur. So I’ve felt more comfortable getting out more and seeing friends etc. to take advantage of the window.

But psychologically it’s a real challenge to feel healthy one day, sick the next (or often that afternoon). Not just that but there are also systemic reminders in place to reinforce the reality of my situation, lest I get too comfortable! The most annoying of these are the routine labs. Generally the phlebotomists are great and the blood draws are smooth. But every so often I get a terrible one that stabs me at an unlucky angle, leaving me sore and clutching my arm for hours. The pain isn’t the issue. Instead it’s the feeling of aloneness that can stir up the emotions.

Take last night, for example. I put the kids down at 8pm and headed out the door into the darkness to get pre-chemo labs done. We need to know that my white blood counts are at a safe level to proceed with the next infusion tomorrow. I drove to mission bay cutting through the thick SF night fog. I parked in the lot, one of only a handful of cars. Some kind of parking lot robot/drone was roaming the lot. The Caltrain horn echoed off the concrete walls. The whole parking experience felt dystopian.

I entered the Kaiser building. I walked through the white fluorescent hallway and realized I was the only person there except for a couple of night shift workers. Just me and the medical system. I felt totally out of place like the whole thing was a mistake – why on earth am I here!? I take a number at the waiting room entrance and have a seat. A moment later the automated system, “now serving number 72“. The guy at the counter and I acknowledge the oddness of the hollow announcement. We’re the only two people in this huge room and I was literally two feet away from him. It’s like medicine can’t happen without coldness.

Anyway he checks me in. I walk to the back room. I fumble with the receipt, license and medical card and shove them into my pocket. I extend my arms straight out to check the veins and decide which will be the lucky one. With a smirk he says, “Good veins you decide, bad veins I decide“. I have good veins so I go with the left one. He ties the tourniquet. Here goes, “small pinch“. A few minutes later we’re done (this guy was great). He puts the tape and cotton gauze on the vein. I keep the pressure on for a few minutes. Then I walk back into the empty hallway. Just me and the questions swirling in my head: why am I here? how did this happen, and other equally useless lines of inquiry. Mostly feeling like I’d rather be at home with my family. I felt a bit sicker, my steps were slower, my shoulders and back were more stooped, looking down…

It’s vital to remain aware of how these little insults can impact one’s psyche; water eroding rock. Awareness enables the opportunity to replacing subconscious patterns of thought like doubt, fear, self-pity with something more hopeful. So I pulled myself together out of that funk, straightened up and walked out the building.

Tomorrow morning I’ll again submit to the chemo drugs. I will get knocked back down to the ground. Then I’ll fight my way back, likely emerging weaker than today as chemo effects are cumulative; a backwards ratcheting effect.

We’ll see.