I Have a Cold

I Have a Cold

(with a description of what exactly “maintenance therapy” is)

Okay, every day people are getting colds…no big deal.  But Saturday I slept from 4 p.m. to 11 a.m. Sunday (19 hours for a person who has always needed 6).  Then, went back to sleep from 3 p.m. Sunday until 10:30 a.m. (19 hours. 30 minutes) on Monday.  When I was much younger and pulled all-nighters at bars and libraries, I could do that.  These days, no.

Yesterday morning (that same Monday), I called Doc Onc1 (I’m supposed to do that if something odd happens).  Here’s the odd thing that was happening:  bad headaches, flatulence and belching (gross, I know), sore joints, sore lower stomach, sneezing, low-level fever. (Plus, my sister-in-law was visiting--that's a good thing, by the way)  The doc called back within five minutes and had set up an appointment for me to get a chest X-ray at STRIC, had set up an appointment with my superb PCP, and had set up an appointment with him.  My medical life was flashing before my eyes!  Everyone except my pulmonolgist, my nephrologist, my urologist, and my gastroenterologist).

The X-ray was negative.  Even trained X-ray technicians can no longer see the lung cancer, but the X-ray did pretty much rule out pneumonia.  Next, to the PCP's office:  a nose swab.  I hate those!  I sneeze for thirty minutes afterwards.  That ruled out the flu!  Everyone is listening to my lungs...clear.

An hour later, I dragged myself into the START Center for Cancer Treatment.  No pneumonia, no cold.  Doc Onc1 said, “H. Palmer Hall, you have a cold.”  *sigh*  But they also did a Complete Blood Count (CBC) and my platelets were down to 77 after last Tuesday’s maintenance chemo.  Not so low as to be dangerous (I was at 21 two weeks earlier!), but low enough that they wanted to do something about it.  What?  An IV drip of Saline Solution to rehydrate me.  That took an hour and a half!

A couple of you have asked precisely what “maintenance therapy” is.  So:

About five years ago, oncologists got tired of watching their lung cancer patients die.  Two of my friends died of lung cancer that year:  Carla Saenz and Cynthia Harper.  Carla was the Community Relations Director for the largest Barnes & Noble in town and that store donated $1000 to Pecan Grove Press each year plus readings to all of my San Antonio authors.  Cynthia was a superb poet and dear friend.  As editor of Chili Verde Press, she published my first two chapbooks:  From the Periphery and Deep Thicket & Still Waters.  We had lunch every Wednesday at the Blue Star Brewery.  I continue to miss them both very much.

So, when I found out that I, too, had lung cancer, I became almost fatalistic.  Until I met the oncologists at the START Center.  For the past five years, oncologists have been debating something called “maintenance therapy.”  It works like this:  They give you large amounts of chemotherapy (in my case carboplatin, limta, and avastin) for six visits (one each month in my case) and then they check you out with MRIs, PetScans, blood workups.  If there has been sufficient shrinkage of the tumors, they give you two additional rounds of major chemo.   This brings you close to death, but should kill off most of the remaining bad cells. And then, they move you to maintenance.  An additional series of scans prior to maintenance showed that the brain cancer was gone, nothing left but scar tissue (oh, yes, plus the original gray mass that passed for a brain).

Maintenance, in my case, includes similar treatment to pre-maintenance, but the carboplatin is left out.  The IV drip last for 2.5 hours and not 4.  The after-effects are supposed to be neglible, but “H. Palmer Hall has a cold!”

Maintenance remains a fairly new therapy for oncologists and is still debated.  Some maintenance patients have been on maintenance for all five of the years doctors have been doing it.  There is no guarantee, but I feel pretty good abut it. 

There are two possible goals, neither with guarantees:  1) remission and 2) new therapies coming along.

So, there it is.  I have a cold.  But with chemo reducing my immune responses, colds are a bit harder on the body than they used to be.