Today marked the start of the second of our four four-session rounds of chemotherapy designed to head off the spread of a very aggressive “high grade” micropapillary carcinoma spawned in our bladder and escaped to one of the twenty lift nodes they took along with the bladder and prostate.
Because the cancer is relatively rare, there’s no body of comparative studies on the impact of various chemo regimes on our particular little serial killer, so we opted for the one picked by all but one of the Kaiser oncologists who met to discuss our case [the dissenter argued for no treatment, and because of the lack of documentation].
An optional treatment discussed but not selected was a chemo regime that would’ve left us feeling miserable after every session, as opposed to the regime we agreed on, which confines the real misery to the wake of the first of three weekly IV sessions, followed by a one-week break, with the whole cycle repeated four times.
Today [Tuesday] was the five-hour epic initial session, and featured a whole pharmacopeia: Oral doses of a pair of anti-nausea drugs dexamethasone [a steroid] and ondansetron [anti-nausea], plus IV doses of fosaprepitant [anti-barfing] and the two heavy-hitting chemo drugs, gemcitabine and cisplatin. Preceding the chemo IV bags [the CISplatin comes in a full liter bag] were other saline-only bags to keep the system hydrated during the chemical assault.
In our initial experience of the Dread Double Whammy, the real misery didn’t come Wednesday [when we took two steroid and two ondansetron tablets] but on Thursday and Friday, when we doubled up — as prescribed — on the steroids.
There was one problem.
We were listening but not hearing during a pre-therapy class a nurse told us we should routinely take milk of magnesia after IV sessions because chemo constipates [and, we later learned, ondansetron is a another culprit]. We neglected her advice, and nine days of misery followed [including our second dose of chemo, the first of two two-hour gembatacine-only sessions], and ended only thanks to a cork-popping trip to the emergency room.
With all those ominous Round One misery memories looming, we were deeply grateful that a dear friend drove us to the Double Whammy opening Round two, stayed with us for the whole five hours, then drove us home — just as another friend had sat with us during our first session.
Perhaps surprisingly, the long sessions yielded rich conversations, punctuated by smiles, chuckles, and the occasional laughter. They were life-enhancing, affirming what’s best in our often-miserable species.
We can’t begin to express how deeply we’ve been touched by the expressions of friendship and compassion we’ve received since our diagnosis first came down. Our two daughters, their mother and her spouse, and our son all helped prepare our apartment whilst we lay in a hospital or nursing home bed, and dear friends we’ve met during our years in Berkeley [ten as of this coming July] have kept our spirits up by their companionship, calls, and emails. Then there are the old friends who stay in touch, and our Parisian muse, Moussequetaire.
We’re simply awed that we’ve blessed with riches we never even knew we possessed.
So as we write, we ponder the days ahead. We know, from last week’s visit to our oncologist, that it’s likely that we won’t get our usual energy back until July, the third month after the end of the fourth and final cycle.
But, he says, we’re doing better than most folks, so maybe June?
Who knows, right?
All we can say for sure right now is that we’re deeply grateful.