Flu, Cedar...maintenance and bright weather

So, maintenance chemo again yesterday afternoon, followed by a B-12 intramuscular injection and then a Neulasta shot this morning.  The injections are to stave off some of the damage done by the chemo.  The numbers:  I have now had nine (9) IV drips of Avastin.  Each injection costs right at $12,564.80 for a total (thus far) of $113,083.20.  The Alimpta costs $1.80 less per drip; so, the cost if approximately the same.  I’m fortunate in that I have decent health insurance from my university.  I wonder, though, about those not old enough for Medicare and who cannot afford health insurance and do not have an employer that provides health benefits.  This is part of why we need the Affordable Health Care Act or, as its detractors call it, Obamacare…and sometimes even RomneyCare.

I am also aware that the costs provided by my health insurance company are not realistic.  Those are the costs provided by Genentech and other drug manufacturers.  The cost paid by health insurance providers have been negotiated downwards from the peak cost by a goodly percentage.  And that is why the Republican deal not to allow Medicare to negotiate with suppliers is so noxious and is so expensive to the government.  Okay, no more politics in this blog entry.

So, the previous time I went in for maintenance therapy (chemo therapy by another name), I developed a bad case of the flu.  Remember:  chemo reduces your natural immune system's ability to protect you.  It took two weeks to get rid of that with powerful antibiotics and, as soon as I did, the billions of cedar trees between here and Fredericksburg and north to just west of Fort Worth decided to get sexual and spread their pollen.  So, I continue to sneeze and cough though the flu is gone.  Neither here nor there.  Doc Onc1 tells me that my lung cancer is no longer visible on X-Rays and that the chemo has shrunk it remarkably on the CTscan displays.  That’s pretty remarkable since the diagnosis of Stage-4 lung cancer was a definite death sentence less than ten years ago.

I am typing this from work this morning and am rushing through it…do bear with me if some sneaky little grammatical problems creep into some of the sentences.  But, it’s a beautiful day and I ventured to work with the top down in spite of pollen dancing in the air and am, off and on, sneezing onto my keyboard.  I do hope you catch nothing from all that.

We have re-jiggered my maintenance schedule so that I can go to Beaumont for a reading at Lamar University (they’re actually going to pay those of us who are reading!) and then fly to Chicago on Leap Day for the annual conference of the Association of Writers and Writing Programs (AWP) where I’ll be hosting a party at the Gage Gallery (arranged by my former St. Mary’s Colleague, Scott Blackwood—a fine fiction writer).  By the time I return, the cedar trees should have ceased their winter frolicking and I should have stopped sneezing and coughing.

Two more doctors to see in the next three weeks:  my pulmonologist and my cardiologist.  Crap!  Add in my ophthalmologist.  More after those visits.

Ah, the effrontery of it all...allergies!!!!!!!!!!!!!!

Perhaps the only real downside of living in San Antonio, Texas, is the fact that we have a huge arc of millions, perhaps billions, of juniper cedar trees to our north and west.  Each year at about this time, the junipers get randy and start broadcasting their pollen.  We call them “mountain cedar,” but they’re really juniper ash trees and they are, as one web site calls them, the “plague of trees.”

“The Allergy, Asthma and Immunology Clinic of Georgetown, Texas has a web site describing the awful effects of cedar allergies http://hovanky.com/allergy/mountain.htm .  From December through February, many people experience an itchy, runny nose, sneezing, nasal blockage, excess tearing and itchy eyes. Others complain of itching of the palate, throat, or ears, and postnasal drainage. Some have fatigue, mild headache, facial discomfort, sore throat, partial loss of sense of smell, and sensation of ear plugging. If you experience the above symptoms every year during these months, the chance is great that you have Mountain Cedar allergy.”

Just after Christmas, local television weathercasters predicted that the next day we would receive 1,800 units of cedar pollen per whatever they use to measure the damned stuff.  Instead, we got 21,000 parts per….  That’s nice and academic.  Look at the list of symptoms up there and please note that I NOW HAVE ALL OF THEM PLUS MY VOIC IS GONE.  People assume I am coughing and acting close to death because I have cancer, but it’s the allergens in the air.

I have been back to Doc Onc1 since my last report:  low platelets, high white blood cells, the adenocarcinoma is in retreat still.  But I am getting extra liters of IV drips to replenish my dehydrated body.  I may wind up wearing one of those silly little masks everywhere until the end of February, perhaps my voice will come back.

In the midst of all this, I may have to go see an allergist.  I may wind up walking in a haze of strong antihistamines, shooting myself with whatever mix the allergist comes up with, along with my insulin shots.  I may be able to breathe again, to function again.  And I suppose it would have been worth  it after all.  I suppose.

And so it goes...maintenance is boring

I had the second of what will be many maintenance chemotherapy treatments yesterday and feel pretty good today.  I need to feel this good tomorrow when we have a sales rep from a major library furniture vendor coming to present a new line of furniture.  Usually, after-effects from chemo are felt the second and third days after treatment.  Maintenance therapy, though, is supposed to have a much less strenuous effect on the patient.

Good news yesterday was that all the blood work (including those naughty platelets) was normal.  So, I sat in the recliner re-reading Moby Dick and waited for the 2 and a half hours of IV to finish dripping in.  That’s much better than the old four-hour IV drip (though I would have made more headway on Melville).

Nurse Maggie, my IV nurse, is a wizard with needles and always manages to get the IV in with the first thrust.  Much different from the male nurse at my gastroenterolgist’s office who jammed the needle through the vein and quoted Rick Perry (“ooops!”).  That attempt oozed for three days before stopping.  Nurse Maggie is one of a platoon of fine nurses working in the treatment room (AKA Cancer Ward) and responds, in a nearly Pavlovian way, to the beep beeps when an IV bag empties itself into the vein and then rushes over to attach the next bag.  I get four bags a visit now:  two for chemo and two to flush the vein.  Before maintenance I had six bags full (Baa Baaa Baaaa).

And so, it continues.  I do have a cough, but the Docs Onc say the cough is not caused by the cancer and are referring me to a different Doc to see about that.  The ENT Doc couldn’t do anything but prescribe Benzonate (didn’t work) and, so, we’re trying a trip back to the pulmonologist this time.  Doc Rafael is the doc who first caught this thing, these things, whatever.  So, maybe he can do something about my waking up coughing at night.  We’ll see.

Anyway, it’s a beautifully brilliant day here in San Antonio and I am in my office instead of being out in the sun’s rays swinging long sticks at dimpled balls.  Three more weeks before the next chemo treatments and a bit more than a month before I head to Chicago for the national meeting of the Association of Writers and Writing Programs.  That last should be great fun.