October 27: Peacefully on Chemo

Okay, let's see. Today's Thursday. That means they let me out of the hospital yesterday.

To let me go, they have to send me home with "prophylactic" medications. The chemotherapy is going to destroy most of my bone marrow, which means the only immune system I'll have is the antibiotic, antifungal, and antiviral pills they give me. On top of that, due to the "arachnoiditis," or swelling of nerves in the spinal column, I needed pain medication and a medicine to help the nerves heal.

My meds. To some people, not a lot. I'm used to never having more than one at a time.

There was, however, a miscommunication between the hospital and my insurance. As a result, the pharmacy wouldn't release any of the medications.

This was a little frightening for me. Keep in mind that the pain we're talking about was pretty unbearable. I was shaking, sweating, and even yelping out loud from deep muscle pains and shooting nerve pains through my hips and legs. It was about 11:30 when they told me they couldn't release the medications, and I was due for my next pain pills at noon.

"In an hour," I thought, "I'm going to have to figure out how to behave normally in public while I'm in agony."

I did ask the Lord not to spare me anything that was good for me. I often start to feel that prayer is a mistake, but I know my Father in heaven wants what's best for me. It doesn't give him pleasure to torture me.

We went back upstairs and told the nurse what had happened. She said she realized what the problem is, but it would take paperwork and faxes to fix the problem. I told her I didn't know what would happen without the pain medication, and she said she'd try and get that approved separately.

We went to lunch, and then we went to the pharmacy. They told me they were working on my prescriptions, and they had me wait.

Flowers sent to me from friends in California!

By then, however, it didn't matter to me much. It was approaching 2:00 pm, and I hadn't had any pain!

They got me the pain medication shortly after, but I didn't have to take any. The nerve pain is just all gone!

I'm pretty grateful for that. It was very unexpected.

I didn't get all the prophylactic medications cleared until this morning, but I wasn't "neutropenic" yesterday. Neutropenic means that I'm extremely low on neutrophils, the white blood cells that fight bacteria. Those were still up close to 2,000 yesterday. I'm not neutropenic until I'm under 500.

Speaking of which, they also gave me Neulasta shot yesterday.

By "gave me" I mean they released it from the pharmacy. They sent it home with my wife for her to administer it. Before they released me, the nurse gave her a 10-minute session on how to administer a shot to the stomach and how to clean out my PICC line.

That all seems strange to us. Let me explain what that means.

Neulasta is a shot that spurs your bone marrow to make as many blood cells as possible. It is helping my immune system to crash as slowly as possible and to recover as fast as possible. My immune system will crash because Neulasta can't undo the fact that the bone marrow is being destroyed.

It is given in the stomach because it is fat-soluble. It needs to be injected into a fatty area, and on most people the belly is the biggest accumulation of subcutaneous (under the skin) fat. That is certainly true for me.

Oddly enough, for those of you who have ever had such a shot, it's almost painless. There's not many nerve endings in your stomach, and I can barely feel the Neulasta shot.

The other thing my wife had to do was to clean out my PICC line.

As you can see in the picture, that's a line that goes into my arm with two heads on it. It then follows a vein back to the vena cava, the main vein above the heart. They use that to draw blood and to administer medicines, including chemo.

So they gave us some syringes that have saline solution in them. Hannah has to hook the syringe to each of those ports and pulse some saline solution through them to keep the lines open. Our blood has a tendency to clot up around small holes, which is a good thing because that stops us from bleeding. However, that same clotting can block up the end of the PICC line, so we have to flush it once per day.

That's all the basic news.

I'm writing this as I watch the world series with my parents, my brother, and my son. My wife is listening to piano music on the computer. It's a peaceful night, but tonight I definitely feel like a leukemia patient on chemotherapy. Everything is hard. I played a game of cards earlier for about an hour and a half, and I had to have a nap afterwards. I can't imagine what my blood counts will look like tomorrow, but I'm sure they'll be pretty low.

I'm also sort of dazed, like I might be if I stayed up for 24 hours. Nothing's very clear, and my ears keep clogging up. I'm constantly yawning to open them up as though I were on a climbing airplane.

The chemo should be reaching its top strength right about now. I think I have 4 or 5 more days of feeling like this. We'll see how it goes. At least there's not pain at the moment, and that's nice.