Tuesday, June 13, 2006

Chemo in Austin, Day 1

I started chemotherapy here in Austin this morning. So far, so good—no nausea or other side-effects. Hurray!

I also spoke to Mary Alma, Dr. Giles’ PA, who had finally received the results of last Friday’s lumbar puncture: rare degenerated cells” in the spinal fluid. These are almost certainly debris, if that’s the right word, from the tumors in my brain—in other words, dead tumor cells that have been killed by the radiation treatments and are now draining away. Hurray for that, too!

The chemo consists of two drugs, Idarubicin and Cyterabine (also known as Ara-C). The Idarubicin in the concentrated form  in which it comes from the Cancer Center’s pharmacy to the Infusion Room looks like red Kool-Aid, according to the nurse; but she said that when it’s mixed with a regular saline solution it becomes more orange. Idarubicin is related to Dawnarubicin, one of the drugs I received at St. David’s last year when I first went into the hospital. (I also received Ara-C then, and “high-dose Ara-C” was the drug I had for consolidation chemo after leaving the hospital last year.)

The Idarubicin is infused quickly—it only takes about 15 minutes. The nurse, Lisa, “pushed” it via syringe into an IV saline drip (she said it was the longest 15 minutes of her life—she had to push the syringe slowly and steadily the whole time). Before the Idarubicin there were two other short IVs: Solumedrol, a steroid to prevent some of Idarubicin’s nasteier side effects (chest pains and other things I’ve repressed already), and Kytril, an anti-nausea drug. When the Idarubicin was finished, Lisa connected an IV bag of Ara-C to a small, portable pump like the ones that I used last year for the evening doses of consolidation chemo (also Ara-C). Then she connected the IV bag to the PICC (pronounced “pick”) line in my left arm (which was inserted yesterday afternoon by a radiologist at Austin Radiological Associates, downstairs from the Cancer Center), and then she  put the pump and the IV bag into a fanny pack and cinched the fanny pack around my waist. Then we left, sometime after 11:00 AM . “we” were me and Sharron Rush, who had met me and Anna for breakfast at Trudy’s, driven me to the Cancer Center, and stayed with me the whole time, which was much longer than I’d anticipated—foolishly, when I heard that the Idarubicin would take only 15 minutes to infuse, I ignored all the previous experiences  demonstrating conclusively that nothing takes only 15 minutes! We drove to People’s Pharmacy on N. Lamar to pick up two prescriptions—one for Kytril to be taken orally, and one for eye-drops to address the fact that chemo evidently dries up the tear ducts or something. None of the People’s Pharmacy locations in Austin (I think there are four) had any Kytril, and there was some sort of mistake in the way the name of the eye-drops was written. So the People’s pharmacist found another pharmacy nearby that had 6 Kytril tablets (the prescription called for 8) and said he would call Tucker’s office to correct the problem with the name of the eyedrops. Then Sharron drove over to the 38th Street Pharmacy on (you guessed it!) 38th Street, just a little bit east of the Cancer Center; I’d never even known it was there. We dropped off the prescription and went to Banzai for lunch. There I got a lovely hug from Rino Pizzi, who happened to come in for lunch not long after we’d arrived. After lunch, Sharron drove back to the 38th Street Pharmacy and collected the Kytril that they had in stock (hope nobody else needed any today!), and drove me home. Thanks, Sharron—I know it was a much bigger chunk of your day than you’d anticipated, too, and I appreciate it very much.

Anyway, it’s almost 9:00 in the evening now, and the pump has been whirring away all day. Lisa, or another chemo nurse, will connect a new IV bag tomorrow morning and send me away for another 24 hours. Thursday I’ll get my last dose of Idarubicin; the pumping Ara-C will continue till noon on Saturday. I don’t mind the fanny pack right now, but I bet I’ll be good and sick of it by then!

We had a great weekend. Two of my best frindes from college, Phil Cherner and Ken Portnoy, came from Denver and Northern Virginia, respectively, and I had  a wonderful time visiting with them, telling silly stories about our Anna Arbor days, catching up on family stories—the stuff old friends do who haven’t been together for a long time. They arrived late Friday night, and I managed to stay up for a little while talking and eating some of the pastries Ken had brought from an Armenian café near his home. On Saturday all four of us (five, of course, counting Dillon!) went to Las Manitas for breakfast , then drove over to Zilker Park and looked at Barton Springs for a while. Then we went back to the house, and Anna went off to do various things (like going to the gym). Phil went for a run—he ran down to the Capitol and back, but the heat and humidity zapped him and he was pretty tired when he got back. Ken and I just exercised our talking muscles… After Phil had recovered from his run, the three of us went up the street to Julio’s for a late lunch, and Liz and Alan came by the house not long after we’d gotten home. Later in the evening, we drove down to Artz’ Rib House (that “z” is not a typo!) for some good barbecue and what turned out to be really bad music. The only line I remember from the performer was “I can’t follow my own train of thought, so why the hell should I expect you to?” which is of course a very good question; we did not stay for an answer.  Sunday morning Anna and I went to BodyChoir (I only danced one song, but I left feeling wonderful—so many people had come over to me and massaged my feet and hands and head, and just made me feel loved and supported), while Phil went for another run (earlier in the day this time) and Ken read around in a volume of Faulkner short stories he’d found on the shelf. Then we met at Manuel’s for a great brunch (as you see, I’m not having much trouble with appetite now, either!). We went back to the house, and after a while Ken and Phil headed for airport. It really was fantastic to have them here, and the fact  that they stayed at the house made it even better—we did a lot of moving from place to place, I realize from writing all this, but at least for me it felt smooth and easy (of course I didn’t have to do any driving; I’m just the navigator), and there was a natural flow between sitting around and talking to driving somewhere so we could sit and talk and eat at the same time. Thanks so much for coming, guys—that makes me feel loved and supported, too. There was a great moment on Saturday afternoon: somehow we got to talking about audio books, and then Phil pulled out his Ipod and dialed in an old Firesign Theatre bit, one of the ones we used to listen to in college and laugh and laugh and laugh. He or Ken handed me the earphones and I put them on—I caught just a split second of organ music and was laughing before I even heard any dialog at all. Then I handed the headphones to Ken and in a moment he was laughing, a deep happy belly laugh, and Phil and I were laughing because he was laughing, and it was just magic. I’m laughing again, of course, just thinking about it.

There’s more, of course, but I’m going to post this as it is and go to bed. Maybe the gentle whir-click of the chemo pump will smooth the path to sleep.

Love to all. It’s the only thing that really matters in the end.


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