Sing a Song of White Cells

Reminisce about the Mamas and Papas, and sing along if you know it:

Monday Monday, so good to me,
Monday Monday, it was all I hoped it would be
Oh Monday morning, Monday morning couldn’t guarantee
That Monday evening you would still be here with me….


OK, so it’s Tuesday noon, and the rest of the lyrics aren’t so cheerful, but —

Another Monday come, another chemo session gone.  Number 7 down, 17 more to go (give or take adjustments along the way).

The Popsicle Report:  Yesterday was a jackpot.  TWO popsicles, not served one after the other as before, but double-barrel.  One blue, one green, so I could even alternate between the tubes, though the green was again a really weird flavor.

“Keep it comin’, yeah, keep it comin’ now · Don’t stop it now, don’t stop it, no, don’t stop it now, don’t stop it, no …  “

The music soundtrack has again kicked up in my brain, even though I’m awake.  My apologies to all of you for a reminder of KC and the Sunshine Band.

Yesterday’s session went well.  I checked in for the usual blood draw and was glad to see my white cell count rebounding, compliments of the two Neupogen shots last week.  We finally cleared up the insurance issue, and I actually got the stuff delivered FedEx to my doorstep.  For some reason (and any of you on the list who know more about the drug-insurance system than I do, please enlighten me), since the drug is expensive, and we were planning to do the injections at home, our local pharmacy  couldn’t be authorized to dispense it, and it had to be shipped by a specialty pharmacy down in Portland, Oregon.  Now I can’t complain about the home delivery since it certainly makes things easier for me, but the confusion and restrictions seem unnecessary.

To my great good fortune, the shots did a world of good (once I got past the emotional frustration of having to take yet another drug because I have a serious illness).  My white cell count doubled over that of last week (from 2.0 to 4.0, putting me at the low end of the normal range, and making me less likely to pick up infections, I hope). Consequently, the mouth sores are rapidly improving, which does a world of good for my appetite (I might even be up for some kim-chee soon!). And I’ve got the “magic mouthwash” (that is seriously what they call it) to chase away any remnant sores.  It’s a mixture of lidocaine (for pain), an antifungal drug, and that miracle steroid, dexamethasone.  (The name of the mouthwash reminds me of a leaflet I once received from a pediatric dentist we took my son to for a filling.  The staff there gave me a list of terms I was to use to help defuse any anxiety the child might have about getting the filling. I was to call the drill a “whistle” and the nitrous oxide was not “laughing gas” but “magic air.”  Seriously.)

The downside of the Neupogen is the side effect of bone pain, primarily in the legs.  The pain stems from the action of the drug pushing the bone marrow to produce more white cells.  I had one bout of it that started around lunchtime Sunday — felt like someone had kicked me hard in the left knee with residual aching the rest of the day. Some Tylenol took the edge off, and it had disappeared by Monday morning.

The substitute doc I saw yesterday (new guy, but seasoned.  Practiced 26 years in California.  I didn’t think I should ask why he left CA.) said we can perhaps reduce the shots from 3 to 2 per week, or lower the dosage of each shot, since the white cells responded pretty well to the first two.  This is apparently an undefined area in the treatment. The chemo drugs are set dosages at set times, but the ancillary drugs prescribed to help patients get through the chemo can be mixed and matched, titrated and revised, according to what works for each patient.  This makes much more sense to me than the steamroller approach I got last week.  I never did start on the antibiotic she recommended, and this week’s doc confirmed that it probably wasn’t necessary.

I did have one bout of intense stomach pain on Friday around lunchtime.  Felt like that proverbial knife being twisted in the stomach.  Perhaps this was the excess acidity the steamroller talked about last week, but eating made the pain disappear and I haven’t had any trouble since, and have not felt it necessary even to take the OTC Pepcid we have at home.  The “grazing” approach (think like a cow, eat small amounts of food throughout the day) seems effective to keep stomach troubles at bay, and since the white cell count is up, I may be able to go back to the probiotic supplement the naturopath prescribed, which helps digestion but can’t be taken if the white cell count drops to 2.0.  I see him for follow-up tomorrow.

I have lost a few pounds in the past couple weeks, but that doesn’t worry me.  I’m currently at 98, which has been my “set point” since my teen years (except for those “weighty” times of pregnancy and working a couple summers at a Girl Scout camp downing starches in the cafeteria).  The 3 or 4 pounds I’ve lost was the yo-yo weight I’ve picked up and lost repeatedly over the past couple perimenopausal years.  My energy level is still good.  The only changes I’m noticing are some periodic sleepiness (not body fatigue, but a strong inclination to close my eyes), and some fatigue in my thighs when I walk uphill to the mailbox or the golf course.  I played as my daughter’s partner in the parent-junior golf mixer on  Saturday and we came in third.  OK, so it was only a field of four pairs in the girl’s group, but still, our score of 61 on 9 holes beat the 99 we shot two years ago.

Meanwhile, I continue with physical therapy.  The therapist said my arm function is up to about 80%.  I’ve got almost full rotation and can lift the arm above my head but not yet straighten it completely.  The therapist is another well-seasoned veteran — 36 years on the job. I am greatly appreciating those among us with years of real-world experience.

The rest of the infusion procedure went routinely yesterday, and I will see my regular doc and have the next round on schedule next week.  But now it’s time to graze again.  Moo.

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