Good News... It's About Time!

I only have the energy for a quick update. Last Friday I had a CT scan to see what effects chemotherapy is having on the tumors in my liver. I saw Dr. W today and although the final report is not in, he looked over the scans and said that there is definite improvement from where I was three months ago. My CEA number (a blood marker that is raised by cancer cell growth) has been going down. Overall, things are going in the right direction. This is all VERY good news.

Just Take My Blood Already

Sometimes I have these doctor visits that appear to be quick and easy trips. Usually for something as simple as a blood draw. Yesterday I needed a PT test which involves one quick blood draw. The last time that I went in specifically for this test, it took over two hours because there was no authorization and they were unable to get a hold of Dr. W. This time I had a prescription written out by Dr. W to get this test done weekly. I knew that it would be busy because the office had been closed on Monday for President's Day. Sure enough, the waiting room was packed. I checked in at the front desk and was informed that there was a line for blood draws. After a 45 minute wait, my name was called. Instead of taking the quick blood sample that was all that was necessary, he sent me to the front labratory because the orders for my test were on a prescription sheet instead of a lab slip. So I went and checked in at the main lab for the UCLA Medical Plaza and was given a number... 92. They were on 72. After another 45 minute wait, my number was called. They sent me back in one of the little torture cubicles to wait. Finally someone came to draw the blood. I've mentioned before that I am still a little needle-phobic and a lot of that stem from having difficult veins. The woman, who does this for a living, couldn't find a vein! She searched for a while and then settled on trying the inside of my right wrist. If you've never had someone stick a needle in there, I'll tell you that it REALLY hurts. I had been so frustrated by waiting so long and the pain pushed me over the edge and I just started crying. AND it didn't work - she couldn't get blood from there. Then she pulled out the hot pack and started looking on the back of my hands. First the left and there was nothing. Then the right and she found one that has been used before because there's still a mark there from more than 6 months ago. So she went for it and it REALLY hurt too. Thank goodness that time it actually worked. Then I was finally done and able to leave with two wads of gauze taped to my right wrist and hand... attractive. Twenty minutes later I took them off and the spot on my hand was already bruising AND it was swollen and still painful. All this for one little vial of blood.

Today I got the results of the blood test. My INR is at 1.5... it went from 3.9 to 1.5. We're trying to get to 2.0. If it drops any more, I'll have to start the shots again. Now I have to alternate dosages of coumadin between 7.5mg and 10mg. We'll see how that is working on Monday.

Please Don’t Hit Me, I Bruise Easily

It’s been about a week since my last update. I spend about half of that in my chemo-induced stupor. Every morning I have to make a conscious effort to recall what day it is. Most days it bothers me, but on Valentine’s Day it was very welcome. With all the crap that I deal with on a daily basis, one would think that Valentine’s Day wouldn’t bother me, but I still hate it. I am not going to go on a V-Day rant though. I do have to thank my friends and family who gave me gifts and cards. They were all much appreciated.

My white cell counts were up high enough to receive treatment this week. The number was just above the normal range – by 1/100ths of a point. Because I’ve had to miss two treatments due to low white cell counts, my doctor has decreased my dosages by 20%. Initially, I was concerned because it seems that logically the treatment wouldn’t be as effective at a lower level. I discussed this with Dr. W and he explained that they have discovered that it is more effective to receive treatments on time at a lower dosage than to have the schedule continually interrupted.

My INR was also tested on Monday. The INR is the ratio used to test the viscosity (thickness/thinness) of the blood. When it was tested Friday, there had been no change – it was holding at 1.2. That meant that the shots continued through the weekend. On Monday, it jumped all the way to 3.9. Oops! It looks like we overshot the goal of 2.0. The shots have been halted for now and I took a couple days off from the coumadin and restarted at a lower dosage. I’ll go back on Monday to have my INR tested again. They never seem to think twice about taking blood from someone who is anemic.

Let's Hear It For More Injections!

I have another week off from treatment. My white cell count was too low when I went in yesterday morning. This throws my schedule off because I'm supposed to have a CT scan on February 28. It will have to be postponed since I'll have treatment the day before. I don't think I can have the scan while I'm still hooked up to the pump. Plus, I don't think that I could handle the barium sulfate smoothie the day after treatment. It made me feel sick the first time and I hadn't even had chemo yet.

The twice daily injections have to continue for now. Although my blood has thinned to the point that I'm bruising more easily and I have had a bloody nose, it is not even close to thin enough. "Normal" is 1.0. I need to get to 2.0. I can stop the injections at 1.5. I am at 1.2. UGH!! So we've upped my dosage of coumadin and will continue the injections. I have to go in Friday to get another blood test done. At least I already have an surgical follow-up Friday, so it's not going to be an extra trip... always find that silver lining.

Random Thoughts before Round Five

Tomorrow I have my 5th round of chemo. I've very curious to see what my blood counts will be. Two weeks ago my hemoglobin was at 9.7 and my white cells were at 3.1. If my hemoglobin drops below 9, I will likely have a blood transfusion. Every two weeks I have an injection that stimulates the bone marrow to produce more red cells, so I don't think it should drop below the magic number. My white cells are on their own though. The chemo drugs attack the healthy white cells along with the evil cancer cells. The reason behind the two week break between treatments is to give the healthy cells a chance to repair the damage caused by the drugs. Cancer cells aren't able to quickly self-repair. We hope that my white cell count will recover during the two weeks, but after the first two treatments it had dropped so low that I had to take an extra week off. If that happens too many times, I'll start receiving an injection for white cells as well. This is all more information than I ever wanted to know about blood counts.

I'll also find out tomorrow if I need to continue the twice daily shots of blood thinner. If my blood is thin enough, I can stop the injections and just take the daily pill. Unsurprisingly, I am really hoping for that. I'm getting little bruises all over my stomach from the shots. I wonder if it would make a picture if I connected the dots?

The last two sessions there has been a problem doing the initial blood draw from my portacatheter. This delays the treatment because they can't start until they get the results from the tests. Maybe with my newly thinned blood, it'll flow like a runny nose. Ew.

To prepare mentally and physically for this next treatment, I am heading to a superbowl party which will likely evolve into a poker game. It should be a lot of fun and a good distraction.

Everyone Who's Anyone is Wearing One

I can't take credit for the title of this blog. Shortly after my diagnosis, my friends organized a couple of benefits for me. They designed tshirts to sell at one of the benefits. On the front, they say "Colon Cancer Sucks Ass." My roommate Jim came up with it. On the back, they say "Nip it in the Butt." My roommate Robert is responsible for that.

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Kristen, Robert and Jim - Aren't they cool?

We still have quite a few of these tshirts left so if you are interested in owning one, email me at CCSucks@gmail.com and I can give you the details. They are available in large and XL. Supplies are limited so hurry!

Ultrasound of an Armpit

A couple of weeks ago a pleasant new side effect developed. My jaw and neck muscles tensed up and just stayed that way. Some days were worse than others, but there was always some pain. Last Saturday it suddenly worsened. My neck swelled up. Not to the point that it was bulging out, but it was noticeably swollen. I thought that I looked like a toe with hair, although I was reassured repeatedly that it was not the case. It actually looked more like I was storing food - like a chipmunk. It was not as cute as it sounds.

I was mildly concerned as well as highly self-conscious at these developments. On Monday night, I emailed my oncologist, Dr. W, just to update him and see if there was anything I could do to further alleviate these symptoms. He replied late on Tuesday with a request to come in to his office. I called my study coordinator Wednesday morning to set up the appointment. She talked to Dr. W and they were both concerned that I had developed a blood clot because of my portacather. If this were the case, I would have to have it removed... right away. Another emergency surgery, albeit much less serious this time. They wanted me to go to the hospital right away to get an ultrasound on my neck. The radiology department had agreed to accept me as a walk up patient. Oh, a silver lining - no emergency room visit necessary!

My roommate Jim agreed to drop everything and come with me. We went to the hospital and located the ultrasound area in the basement. They located the faxed orders for my test and told us to have a seat in the waiting area. The waiting area consisted of four hard plastic chairs in the hallway. Over the next three hours we became very familiar with those chairs. Without an appointment, the wait was considerable. They finally called me and proceded to take an ultrasound of my neck, shoulders and even my armpits! There is a big difference between the ultrasounds that they show on tv (mostly of pregnant women) and the ultrasounds that I have actually had. They don't lightly run their tool over your skin. They dig it in, really pushing on areas that are already in pain. After about 30 minutes of this, they let me go back out into the waiting area.

They have a policy that the radiologist does not give the patient the results. They are supposed to be given by the ordering physician. Unfortunately, they were having a hard time getting Dr. W on the phone. I had figured by their mannerisms and urgency that they had obviously found something. Finally, the radiologist brought me into a room and said that they had found two blood clots - one on each side. Then he asked me what we usually do. Yes, that's right, the doctor asked me what we usually do. I looked at him increduously and told him that it's never happened before. He said that he'd try to reach the study coordinator.

Finally, Dr. W called back. He wanted me to come to his office, but I was not allowed to walk. They called an escort and brought me to the shuttle since Dr. W's office is in the UCLA Medical Plaza and I was at the Medical Center. We had to wait a while to see Dr. W because he was with another patient. I never mind waiting for him though because he is such a great doctor. He takes the time to explain everything and you never feel rushed.

Dr. W explained that when you have cancer, your blood tend to thicken making clots more likely. The two clots they found were only partially blocking the veins. To dissolve these clots, I need to get injections twice a day and start on a blood thinner (pill form). The injections are only temporary - we're hoping that my blood will be thin enough by Monday to stop them. The pill I will be on long term. I need to carry something with me at all times that states I am on this medication. Does anyone know where to get a fashionable medic alert bracelet?

Anyway, it was a really long, draining day and I've really had enough of medical issues for a while. At least I only have appointments Monday, Wednesday and Friday next week.

A special note to all of you who know my roommate Jim and are aware of his needle phobia. Not only did he watch the nurse last night when she showed me how to give the injection, he actual gave me the injection this morning. Since no one he has told actually believed him, I thought I'd confirm it myself.