What did the elephant say to the naked man?

Thursday, June 22nd, 2017
Baltimore, Maryland

​It's cute, but can you really breathe through that thing?

​That's a favorite joke of mine. I originally heard it as part of the 2006 movie version of A Prairie Home Companion. Although that movie, and A Prairie Home Companion (the radio show) and Garrison Keillor are all favorites of mine, lots of folks don't necessarily share my interest. However, one of the fringe benefits of being the chemotherapee is that when you say "I think I'd like to watch (insert obscure movie or TV show here) tonight" everyone in the room says "Oh sure, that sounds good." Of course, many of them tend to wander away noiselessly before the show starts.

​What's with the belly?

​More likely, that's what the elephant would have said had I been the naked man in question. That's because I look a bit odd in a full-length mirror: "skeleton with a pot belly" describes it best. I've lost about 35 pounds since my downward spiral began early this year, down from 198 to 163. My joints are pointy and angular; my collarbone, clavicle, shoulder blades and even spine have become prominent. Of course, I am far from emaciated, since I started all of this with some decent flesh on my bones. My doctor back at home would probably say "finally, you're at your ideal weight!" I suspect that's true, but I would have preferred a different course to get here.

As for the belly riding along with the skeleton, that's caused by my spenomegaly, a really cool word that means (somewhat anticlimactically) "big spleen." Your spleen recycles old red blood cells (among other functions), but my malfunctioning spleen has also been sequestering new red blood cells for a while now -- so long, in fact, that my spleen has grown from the size of a fist (normal size) to that of a hot water bottle. That water bottle is what's powering my pot belly. The good news is that my chemotherapy treatment has already put a good dent in it. Now, it's more like a pan belly.

Looking back

​Looking back over the last week, this is what has transpired:

• Thursday​. ​First day of my second cycle of chemotherapy. Eight hours of the R, I and E from my R/ICE regimen.
• Friday. ​Second day of the cycle. Eight hours of the I, C and E.
• Saturday. ​Third day of the cycle. A mere four hours of the I and E, then home to sleep it off.
• Sunday. ​​20 hours of sleep. The world was a blur.
• Monday. Started battling a wicked (not quite "slap your momma" painful, but close) headache, a common side effect of the reduced cerebrospinal fluid after last week's lumbar puncture. However, the headache only occurred when sitting up. So, I took to the bed. 
• Tuesday. Headache persists. Lots of time in the bed.
• Wednesday. Headache persists. Lots of time in the bed.
• Thursday. More blood tests, then IV fluids and caffeine to combat the headache, finally starting to subside.

During all of that time in bed, I did some research into the I, C and E portions of the chemotherapy regimen. I think I've got a handle on how they work, but in the spirit of a biology-free blog post, I'll save that for next time.

Alison's girlfriends cleaned our house!

​Looking ahead

​The coming week should be uneventful medically, given the elapsed time since the second cycle of chemotherapy. In anticipation of that, we will return to Richmond tomorrow (Friday, June 23rd) and hope to stay there through the following weekend. If any of you would like to pop in and say hello, this week would be a good opportunity. We hope to spend July 3rd and 4th (our 14th wedding anniversary) visiting with Cameron and (fiancée) Nancy as they pass through Washington on their way back to St. Croix.

The next big decision point arrives on Wednesday, July 5th. That's when we will do a followup CT scan in order to assess how well the first two cycles of chemotherapy have knocked back the malignancy. The assessment will fall into three broad categories:

• Good. The chemotherapy has done its job better than expected and we'll proceed immediately with the stem cell transplant. No need for a 3rd cycle.
• Meh. The chemotherapy has done exactly as expected and we'll proceed with the 3rd cycle followed by the stem cell transplant.
• Bad. The chemotherapy hasn't done as well as expected and we need to consider a different chemotherapy regime.

Strictly speaking, the CT scan will be done on Wednesday and the decision how to proceed will happen on Thursday, July 6th. Mark your calendars!

Click to enlarge

​Pictures