Thursday, August 1, 2002

Officer Beavers, and more new therapies offer promise.

Dave’s Great Adventure
Chapter 1, Verse 7

Well, I guess my boss was more prescient than I. I should have known that just because I felt great on Monday was no indication that I’d feel well three days later, during the time my blood counts would be at their lowest. What was I thinking? Today I have really not felt unwell, but have just been lethargic and sleepy. It was another hammock day. I spent most of the day listening to old tunes on the DiscMan as I dozed out on the deck.

I’ve decided that I just need to relax and not worry about when I can go back to work. There is absolutely nobody putting pressure on me to go back except me! Quite the contrary; the folks at work are telling me to stay home. So I will, until I can be relatively sure what I’m going to feel like a few days or a week into the future. That’ll probably require that I complete at least one full cycle, though. And I need to make myself realize that I’m only in to week two of a six month long process. There is no hurry!

I took a little side trip in my medical management Wednesday. I’ve had a long-term problem with one of my sinuses getting infected and painful on a regular basis. I’ve been letting some gynecologist treat the problem for years but it doesn’t ever go away. Now that my immune system is compromised, I was afraid that it would really become a problem and get out of control, so I made an appointment with an ENT doc Wednesday morning. She talked to me, looked up my nose ( a first!) and put me on a course of mega-antibiotics, steroid inhalers and nasal douches (yeah, you heard me) for the next three weeks. Then I get my head CT’ed to see what my sinus looks like. If it doesn’t look good, she’ll operate to open it up. That would have to be scheduled around my chemo appointments, of course. So, you can look forward to hearing more about my maxillary sinus too!

After leaving my appointment, which was the first thing in the morning, Kathy and I went to (where else?) our favorite Mexican place for breakfast. I love their huevos ranchero and she always gets the chilaquiles. Then we headed home for a bit. But we needed to go back out to go by the clinic pharmacy to get the meds my ENT doc had ordered.

When you go from our home toward my clinic, you travel on a road with a 45 MPH speed limit. Then, for a very short distance, maybe a quarter mile, the limit drops to 35 MPH before it then goes back up to 40. Weird. Well, it’s a favorite speed trap.

I entered the 35 MPH area doing my usual 50 and saw the cop just as she saw me! Too late to do anything except say... well, you know what I said. She pulled me over and after a friendly discussion of the local ordinances (during which time I could not find my proof of insurance) she gave me a $60 ticket. Now for the really weird part. Her name was (and, really, I’m not making this up) officer Beavers. There is a joke here somewhere, don’t you think?

HEADLINE: “Beavers puts bite on gynecologist”
or, “Gynecologist caught by the Beavers”
or, how ‘bout, “Gynecologist says: Bad day with the Beavers.”
I’ll add the best additional headline to my next publication if you can come up with something better. And I know many of you out there in e-mail land can.

(Note to my German friends [and perhaps my mother too]: the term beaver refers not only to a large dam-building rodent of North America but is also occasionally used as a rude reference to the female genitalia)

After my interaction with The Beavers we proceeded, more slowly now, to the clinic to pick up my prescriptions. While we were there we spent a bit of time with our friends there. They are just so great! We love them all. They’re so willing to do anything for us and are about the best friends anyone could have. It was nice to be able to spend a little time with them.

I was feeling a bit tired by then so we didn’t do much else the rest of the day. Just a few chores around the house and lying on the couch.

Today we went over to Office Max to look at a CD writer (I want to be able to copy some of my CDs to be able to carry with the DiscMan) and I was getting weak just standing around looking at stuff. Kathy kept trying to get me to sit down, but I just told her to make sure to raise my feet above my head level if I passed out. We ordered a pretty good one (they were out of stock all over town) and headed home. And then I spent most of the day out on the deck listening to some tunes I hadn’t listened to in years. I did go to the clinic to get blood drawn for my “Ralph” and I’ll get the numbers back in the morning before I hit the “send” button on this message.

And now I’m eating fresh-out-of-the-oven chocolate chip cookies Kathy made for me! Isn’t she great!! The perfect end to a very lazy day.

In my last epistle I told you an awful lot about the treatments that are bring looked at as possibilities for a cure for CLL. Probably more than you really wanted to read. Well, I’m not finished yet! For some reason I’m now fascinated by the topic and there are even more cool things on the horizon. Things you NEED to know about.

One of the coolest things that is being tried, and is, I believe, already on the market, is a combination of Rituxan and radioactive iodine. What they are trying is to attach radioactive iodine (I-131) to a molecule of Rituxan. The Rituxan, being an antibody, will attach only to the CLL cells, but those cells are generally in the company of other CLL cells too. When the Rituxan binds to the leukemic cell, it not only kills it but also delivers a little nuclear bomb to the cells in the area! Isn’t that a cool concept! If you’re George Bush, that would be a “nucular bomb.”

Another thing that is currently in clinical trials is stuff called Genasense. What it does is not kill the bad guys, but tells them it’s time to die naturally. You see, leukemic cells aren’t really deadly by their nature. It’s just that there are too damned many of them and they eventually crowd out the normal cells. They really aren’t even made any faster than normal lymphocytes, but they just refuse to die when its their time to do so. Many cancerous cells, including leukemic cells, have a protein that is abnormal because it inhibits natural cell death. Well, Genasense blocks this protein’s ability to inhibit the death of the cell, so it goes on to die a natural death at a normal cell’s age (a few months or so). This is a great concept too as it would not affect ant normal cells at all, so side effects (if any) should be minimal. Keep your fingers crossed.

I just had to go out and get some more chocolate chip cookies (more doctor’s orders). Ummm, good.

Speaking of side effects, I have been remarkably free of all the miserable things that I could have been experiencing. So far, so good. The list of possible side effects includes nausea, diarrhea/constipation (I just wonder how one could have both extremes of this function), hair loss (none yet), fatigue, headaches, “certain” sexual side-effects common to the male, rashes, mouth ulcers, etc., etc. We’ll see if the side effects, other than the fatigue, get any worse in my subsequent cycles. We’ll find out in a couple more weeks.

And that’s about all the nonsense I can come up with for now. I’ll add in the blood count numbers tomorrow with some comments and get this out to all you good folks.

By the way, several of you have told me that you are forwarding, or would like to forward, my ramblings to others who are interested in what’s going on, and have asked my approval. I certainly have no objections whatever to you sending my missives to others. In fact, if they have a continuing interest, just send me their e-mail address and I’ll add them to the list so you won’t have to forward the stuff all the time.

Until later,

{Now it’s later: My blood counts are back and there’s lots of good news. My white count has dropped from 60,000+ when we started to 5,000 now! That’s and incredible drop. No wonder I feel so wiped out! And there is more good news; my red cell and platelet counts are still normal. My neutrophil count, though depressed, is still adequate. That all means that I should be able to start the Rituxan in a couple of weeks. Yippee!}