Friday, August 23, 2002

Event horizons, my hair, lots of drugs, and more "fuzzies."

Dave’s Great Adventure
Chapter 2, Verse 2
August 23, 2002
The “Fuzzies” Redux

Well, if I’m going to get anything written soon it better be today. I’m feeling the “fuzzies” coming on after the three days of therapy I’ve had with this cycle. I have day four of the infusions today, so I expect it only to get worse over the next few days.

The infusions themselves have become very routine. I go in, they plug in the IV, show me what they’re giving me to be sure it’s the right stuff, and then run it in. There are still no immediate effects I’m feeling from the infusion; no pain, nausea, etc. I’m lucky in that regard. When things get going, I start reading and/or listening to my CD player. I still have been laughing out loud at the book I’m reading, the one my sister Deb in Sacramento sent me a few months ago. I need to control my laughter some times because there are some pretty sick people in that room getting their infusions, transfusions, etc. Some don’t look like they’re in the mood for laughing. After all, they’re all terminal or they wouldn’t be there, and some look fairly frail.

I need to tell you about this wonderful book, one of two that Deb has sent me. It’s called “Mirth of a Nation” and it’s edited by Michael J. Rosen. It’s a collection of humorous short stories, conversations, etc. I find it extremely funny and if you have a weird sense of humor you will too. $15.00 a copy. I’ll bet has it.

Kathy tells me that I need to define my “event horizon” that I referenced in my last missive. Surely you all know to what I was alluding, but perhaps the reference itself is a bit obscure. One of my many hobbies is astronomy, a hobby I get to practice all too seldom as there are only a few dark nights that are suitable each month, at the time of the new moon, and many of those nights are clouded over. Because of this hobby I study many astrophysical events, even ones I cannot see with my very nice telescope. Anyway, an “event horizon” is the edge of a black hole at the center of a galaxy. Beyond that point the gravity is so strong that even light can’t escape so we can’t see beyond that point, and anything that crosses that point will never return, so strong is the force of gravity. That’s what I was referring to.

I guess most of you don’t know that I’ve started to lose my hair, to some extent. My hair is pretty thick and fine so the loss isn’t too noticeable yet, but I’m leaving more and more behind in the bathtub each day, and I’ve just now started getting into round two of my therapy. It will be interesting to see what I look like at the end. As a guy, it will be easier than it would be for a woman; I can just shave my head and assume the “Vin Diesel” look, or just wear a cap. I’ll let you know how this develops over the next few months.

I mentioned last time that I was pre-medicated with benadryl and cimetidine before my Rituxan infusion, but really didn’t explain why. As you remember, the Rituxan is an antibody that attacks certain antigens (specifically shaped proteins) on leukemic B-lymphocytes (as opposed to the T-lymphocytes which are not leukemic). Well, white cells are like little baggies full of nasty chemicals. They’re filled with these nasty chemicals because their job is to search out bad guys and destroy them. You remember them, don’t you, from elementary school, with little amoeboid shapes and smiles on their faces as they swam through your blood looking for germs! If we then destroy them, they release all their chemicals, called lymphokines, cystokines, enzymes and a bunch of other things that I don’t remember. These chemicals then cause inflammation by causing the release of histamines and other substances from other cells, like mast cells and others you don’t want to hear about. Generally this reaction is localized at the site of an infection, so you get a sore thumb or something, but if we get the reaction all over the body, one’s blood pressure can drop, the kidneys don’t like to work and you can really get sick. The benadryl is, of course, an anti-histamine and the cimetidine is a histamine-2 blocker, so they reduce the overall effects of these nasty chemicals flowing through the bloodstream. So, there you have it! They seemed to have worked extremely well in may case. I only got the Rituxan the first day of therapy this week; in subsequent cycles I’ll be getting the Rituxan with the chemotherapeutic drugs on the same day, as the short studies we have show that the effect is greater against leukemic cells if they are given at the same time. So, my first days of therapy will be longer from now on.

Just a short aside, many of you remember that I sent you a warning about a computer virus I contracted about a year ago. I actually got it from the Mrs. Rommel I mentioned in my last letter. Her computer was infected by an attachment she opened and was sending copies to everybody on her e-mail list. She had no idea, as her husband had handled all the e-mail before his death. She had to get one of her brothers to fix the situation. Speaking also of such things, since someone is using my e-mail address to send out porn, or whatever, if you get anything from me that doesn’t seem right, before you open the attachment ask us if we really sent it to you. Folks out there are able to change the headers on e-mail to make it look like it came from someone other than who really sent it. And make sure you have your Norton or McAfee up-to-date!

I told you I was able to work four half-days last week. Well, I thought that with enough lead time I might be able to get in more work after this cycle, since I do have a little experience with how long the side effects last. However, I’m beginning to feel a bit like Trent Green. You remember him, don’t you? He was the highly regarded starting quarterback for the Saint Louis Rams who got hurt in a preseason game a few years ago. He was replaced by an unknown arena football player named Kurt Warner. Warner took the team to the Super Bowl and won the whole thing! Trent never got back into the game and was eventually traded. You want a even more obscure reference? I feel like Wally Pipp. He had a headache one day so didn’t start at his position at first base. His slot was taken by Lou Gehrig who went on to set the consecutive games played record which lasted for years. Wally never got his position back. Gosh, I’ve been so effectively replaced that I can’t get back into the starting lineup. I could only get one day of work out of my “good” week that I’ll have next month. (Note to those of you in the clinic reading this; these are just my own thoughts, don’t go running to the boss and tell him I’m whining about this. I’ll just deal with it, okay?)

I’ve told you about the remarkable drop in my white cell counts after just one treatment, even without the Rituxan. I’m just a little bit concerned about how far the counts will drop this time. I mean, if they dropped 95% before, and they drop another 95%, I’ll be at some very critical levels. I’ll guess we’ll see what happens and, again, deal with it.

I need to mention again that I’m continuing to get cards and things from my wonderful friends at the clinic. Joan and Debbie send me cards just about everyday, and I get e-cards on the weekends too! Meanwhile Tammy sent me a “Doctor’s Survival Kit” with a number of joke items, plus a nutrition book for chemo patients. And yesterday I got a slab of barbeque ribs which had been imported from Kansas City by friends we know socially. They were in KC getting their son off to college and stopped in to get ribs for me, too. What great friends!

I guess I’d better quit. I’ll have Kathy proof this for the many typos I know are hidden within the text, then I’ll try to get it sent out CORRECTLY tonight. On the FIRST TIME, I hope.

Until later,


PS: Now it’s much later. Kathy and I went in to the clinic for my last day of this round’s infusions. I was really feeling tired and “fuzzy” so instead of reading and laughing, I just put the headphones on and went to sleep through most of the process. It took a little longer than expected as my nurse forgot to open the infusion line for a while when she started the second bag of stuff, the Fludara. We got finished about 4:30 or so.

Kathy’s sister Sharon and her husband Ray were coincidentally passing through town tonight on their way to Stillwater, Oklahoma so we met them and their daughter and son-in-law for dinner after my infusions were completed. I wasn’t sure I’d be much company but after my nap in the infusion room and a glass of ice tea I was doing pretty well. It was so good to see them; they live in Montana and we don’t get together too often. We, unfortunately, got the news that my good buddy and brother-in-law, Ray, was diagnosed with Huntington’s chorea last week, a slowly terminal neurological disorder. So he and I are commiserating about our terminal prognoses and some end-of-life strategies. He’s not too badly affected yet, and he’s relatively old to even come down with the disease so there’s hope that it won’t be too quickly progressive. (Kristy, your folks don’t know this ...Sharon and Ray aren’t sure they want to tell them yet.)

After a too-short visit with Ray and Sharon, we came home to another surprise. Our friends from work had raided our home and left behind an anniversary surprise for us. Our back deck was decorated with Wedding Anniversary streamers and stars, and there was an anniversary cake in a cooler with a bottle of champagne! They had decorated our tables and left a couple of cute little angels and a book, signed by the author, titled “A Place on Earth,” filled with poetry and good feelings! Nobody signed the card that was left for us with a “21 Pun Salute” on our 33rd anniversary but we know who did this. Our friends at work are just too good to us. Thanks guys!

Bye for now. I may not be back for a few days if the “fuzzies” hang on for too long, but don’t worry. If anything really bad were to happen Kathy would let you know.