Tuesday, May 12, 2020

TREATMENT TRANSITIONS AND OTHER ITEMS, 5-06 to 05-12-2020

05-06-2020, Thinkin’ ‘bout Lymphoma(still); money remarks; Covid 19 and stem cell transplant (starts tomorrow)
Yesterday, Tuesday, May 5, I completed Cycle 3, Day 1. Tomorrow I travel to Oregon Health Sciences University to begin the preliminary stuff for the stem cell transplant. I predict the stem cell schedule will hold pretty much to the treatment cycle I’m on with Kaiser. So, if nothing changes date wise should expect to be at OHSU Tuesday, May 26, for, up to, two weeks, which is when they infuse the drugs to kill the malignant cells and put in my good cells. Vacuuming out my stem cells will happen before Then I am sent home and for the next 30 days, monitored for any significant reactions, such as, vomiting, diarrhea, and temperature. If I need all the preceding time to accept the transplant, I will be looking at 45 days more of treatment.

Yesterday’s infusion went well. It took longer due to my RN having to make a couple consults with higher ups.

05-09-2020

Thursday, I went to OHSU to begin the preliminaries for a stem cell transplant. Navigating the complex was my big challenge. I had two appointments with 30 minutes between them. The first was up on the hill in the Hatfield building then down to the waterside for the big meet in the Knight Cancer treatment complex. I became distracted on my way up to my first appointment’s floor and got off when a fellow passenger got off the elevator. 

Proper distancing was practiced or at least as much as an elevator with two people in it will allow on the diagonal. 

Anyway, I was on the wrong floor. I walked into one area and was immediately asked if I needed help. An RN escorted me to the correct elevator and floor I needed to go to(return to) and go back up to the floor I needed to be on. I made it but, not on time. I’m not sure if this appointment simply was an assessment as to where transfusion should occur, or they were looking to install a line. Now that I think about it, installing a line, like my PICC line in my right upper bicep, requires a sterile setting and some time. Someone may be overthinking it a bit. The nurse assessing me called out to another nurse at a computer, “We’ll put a port line in on his left side.” The nurse at the computer acknowledged receipt and subsequent entry. An appointment has to be made. This is where I would undergo transfusion. T-cells out, sent out to be cleaned by Norvartis, frozen at Norvartis, then brought back to be infused into my system when ready. Oh yes, did I mention Norvartis has a role in this transplant. Just so you know Novartis is involved. Novartis. And so, I am pretty sure after so much emphasis Norvartis is part of the process.  

05-10-2020

Saturday and Sunday were days of fatigue. Whole lot of sitting and sleeping, cat napping.

05-12-2020
Cycle 3, Day 2, I woke up around 3:30 this morning to pee. I completed my obligation then headed back to bed. As I was laying there waiting to fall asleep, I noticed a rather uncomfortable sensation in my stomach. ‘What is that,’ I thought to myself. Wow do I have to throw up? Ah yep. Dry heaves. 4 or 5 heaves, big sloppy runny nose, alligator tears and I was through. Made it back to bed and chose to lay on my left side, which proved quite unremarkable given my past history with the left side. I fell asleep and was awakened by my 7 AM alarm. I felt like shit. I did not want to get out of bed. I did not want to go get a blood draw in preparation for today’s infusion, I did not want to go to my chemotherapy, I did not want to Sam I Yam. So, I laid there until Dameon rousted me out of bed. The stomach was nauseous. After 5 minutes of sitting in my lounge chair/throne, it was pretty apparent I wasn’t through with the dry heaves. Another bout of 4 or 5 heaves with the same extra-curriculars as earlier on the side and I was pretty wasted. Dameon had prepared a cup of coffee and a glass of water to ease my stomach’s transition. I knew a cup of black coffee would not do well in my sensitive stomach. I asked Dameon to blend some ganja butter into the cuppa. He did so and I experienced the delight of a hot beverage offering me comfort. The ganja butter offers two benefits off the top to me. One, ganja has anti-nausea properties, and two, it stimulates the appetite. The nausea abated and I was able to shower before hopping into the pickup to start the day’s adventure in Salem. 

First stop was a blood draw. By the time I was finished with the blood draw my appetited was robust. The problem is chemo has an effect on my taste. I experience some sort of coating but isn’t a coating. The taste of food is masked. Masked in such a way it appeals to me as uninteresting. I think about a food and the coating comes to mind and obscures(may not be the right word) the taste. Best way to express this phenomenon is food has no appeal, the thought of a particular food item can leave me flat, no desire. Thus, if I’m hungry I now run a menu thru my head to see if something jumps out to my senses. 

This morning, after my blood draw, I fixated on a pancake with one fried egg, over medium, please. I was in the pickup ready to eat and then I remembered this is he time of Covid. Order by phone and pickup. We did so. Ate in the pickup.  

There is an expression used by the patients and caregivers called ‘chemo brain.’ I bring it up now as it has many manifestations. Alertness is a challenge. Not tracking my behavior very well, meaning how I am operating the unit named Dennis is becoming real interesting. I managed to dribble syrup over my clean shirt, later spilled a part of a latte on self and car seat. I find these
Instances frustrating even though others may find them minor in their impact. Another aspect of chemo brain is thinking, conversing, logically, coherently. I’m falling way short there. 

An example of chemo brain: On the way home after running a couple more errands I received a phone call, which, turned out to be my oncologist. The phone call was to inform me I had been approved by Kaiser to continue on with the OHSU stem cell treatment. The process is interesting to my eye. My oncologist notices the chemo treatment is not 100%, so, writes up a referral and presents the proposal/referral to the tumor board. The tumor board is a meeting of all the Kaiser oncologists once al week or every other week, not sure. Cases are presented for feedback and suggestion, I imagine. My case was presented as a viable stem cell transplant. The tumor board approved this first step, to refer the case to OHSU and see if they are interested and if I’m a good candidate for success. I interviewed with the DO who will be my case physician. The DO thought I was a good candidate and said the next step was to get Kaiser’s approval(not the tumor board) before moving forward. Kaiser’s approval had to do with who pays. Kaiser said they would. I’m in the program and now awaiting the next schedule of tests, and meetings.  

But wait, this was supposed to be about chemo brain thinking. Back on track. I had a question about timing as did Dameon and started in to ask my question and then lost my point, and the subject. The good news for me is I hung in there and finally remembered my question was about timing. When they take my healthy T-cells will I begin my approximately 30 days of close observation? My chemo brain kicked in around ‘approximately.’ I gasped and hee-hawed and made other exclamations of frustration. And, I persevered and was able to pull the missing piece of the question out of my chemo loaded brain and get some clarity, both for myself and Dameon who knows the 30 days of close observation may be highly dependent on him. Unless we can get him help. All things will be revealed as the process rolls along. Dameon had one very interesting question at the end. He wanted to know how clean would our house have to be to pass inspection(Dameon, I would imagine) for a very immunosuppressed individual(me after T-cell vacuuming) to live in said house. Three bachelor Engbloms, what the hell do you think it’s gonna look like, huh? Rough and ready, baby, rough and ready.

Thank you for reading and until next time peace be with you.

And not a single word or comment about money and how Covid intersects the conversation. For some other time.

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