41.6666...% of the Way to the End!

Remember those rational numbers? In this case, I have now completed 5/12 of my chemo infusions (five of the planned twelve). 5/12 is the same as 41.666...%. Yay! Well, technically, this round is almost finished. You may recall that one of the two FOLFOX drugs is completed at the infusion center, while the other is completed at home over a subsequent 46 hours while I am connected to a pump. That infusion is still underway but will end at about 10:08AM on Friday.

In the checkup with my oncologist this morning, I learned that because two different tests indicate a very strong likelihood of no recurrence of the cancer once the chemotherapy is completed, she may stop one of the two FOLFOX infusions (oxaliplatin) after maybe the 7th round. I would still have to complete the other, which is the one administered at home via the pump. This is good news, because the oxaliplatin is the one with the curious side effects related to sensitivity to cold, first byte syndrome, and neuropathy. This will also essentially eliminate the three hour visits to the infusion center each week.

The 14 days of self-administered blood thinners prescribed to deal with the blood clot in my leg seem to have solved that problem. My leg is back to normal, and I am now taking a pill form of a blood thinner once each day at a maintenance dosage level. That will continue until around one or two months following completion of the chemotherapy.

Typically, the 4th through 6th days after each infusion appointment are not so great. I am quite fatigued and have a limited appetite. This time around and with prospects for warmer weather, I'm going to try to get out for more walks, limit my naps, and see if I can bounce back more quickly. My oncologist encouraged this plan. Usually, after this brief slump, the second week or more of each chemo round, is much better. Indeed the seven or eight days prior to today have been quite enjoyable. I've been working in my shop again, and I have done quite a bit of yard work, including clearing some brush and cutting some firewood in the woods at the back of our lot.

This morning, while in the chair at the infusion center, I had this view out the window:

That's Kinnick Stadium, of course. My smart aleck oldest child (a mere 54-year-old whippersnapper) said, and I quote, "Too bad there's no game today. You could be on the receiving end of the Hawkeye Wave!"

I don't know about that, but I did get to thinking about all the time I have spent in that stadium at Hawkeye football games, including a couple games when I was in high school and then many more when I was a student and employee of the University of Iowa, which was called the State University of Iowa or SUI in those early years. Some of you may know that I was a member of the SUI Hawkeye Marching Band during my undergraduate years. So as I sat this morning looking out at the stadium, I realized that it was 60 years ago that I first marched there in the fall of 1962. The football teams during those years were pretty sad, but I thought the band was great! We never got to go to a bowl game, but it was otherwise one of the greatest experiences of my life. We did get to travel to one out of town football game each year and performed with the host university's band during their halftime. I believe the ones I experienced were: Northwestern, Indiana, Ohio State, and Wisconsin.

At home, we shared halftime performances with the SUI Scottish Highlanders, which no longer exist. The band consisted of only 120 members, plus a few alternates, and only men were allowed to belong. (I think over 240 are involved now, including both men and women.) The only woman involved with the band was the single baton twirler, both then and now known as the Hawkeye Golden Girl. Why only men? Two reasons, I guess. One is that the director didn't think women were up to the rigors of marching in the disciplined style that he insisted on. (Don't blame me! This was clearly a chauvinist attitude and wrong, but there it is.) Second, participation in the band was the only way one could be excused from the mandatory ROTC requirement that existed during those years. In exchange for the band providing marching music for various ROTC parades, including the Governor's Review of the Cadets each spring, band members did not have to take ROTC classes or be enrolled in the program. With the Vietnam War hanging over our heads during those years, mandatory ROTC programs and subsequent service requirements were not exciting. One other tidbit is that after John Kennedy was assassinated, a subset of the band, including me, was brought together to quickly learn to march to a funeral cadence and to march to the east side of Old Capitol to participate in a service in honor of the fallen President. I have seen photographs of that event from time to time and believe one may still be on display at the GreenState Credit Union's Iowa Avenue location in Iowa City.

I got my start playing clarinet in the Lowden High School band:

True! I was not a very tall person during my school years. I gained most of the last 6" of my eventual 6' height during the year after I graduated from high school. Here are a couple pictures of me as a proud Hawkeye Marching Band member:

I had that last photo taken as a Christmas gift for my parents. 

Have Now Completed 33.3333...% of the Chemo Journey (Still A Rational Number)

Just FYI from a mathematics nerd, a rational number is one which can be expressed as a ratio of two integers. If one actually converts the ratio to a decimal number, it will eventually end with an infinitely repeating pattern. Often, this pattern is an infinite string of zeroes, so for example, when I was 25% through the regimen, that meant 1/4 of the infusions (3/12) were finished. Dividing 1 by 4 gets you 0.25000000... with an infinitely repeating zero. We all feel more comfortable writing that at .25 or 25%. However, with 4/12 or 1/3 finished, the conversion ends with an infinitely repeating 3. So, it is impossible to write a concise decimal version of that. Hence, we usually cheat and stop at some point, such as .333 or we write 33.33%, which isn't really accurate. Using an ellipsis as in 33.33...% is meant to show that the number repeats indefinitely.

Isn't that fun? Just in case you wanted to know, irrational numbers also continue indefinitely but not with a repeating pattern, and they cannot be expressed as a ratio of two integers. Maybe the most famous irrational number is 𝝅 (pi). Why did I bother with all this explanation? Who knows? It crossed my mind as I chose a title for this posting. Maybe I just felt good about all my mileposts being rational, rather than irrational, ones. Although recent events are making some of them feel a little irrational.

To bring you up to date, regarding the leg pain and blood clot, the injections of blood thinner appear to be having a positive effect. I have less pain today than a week ago. Sitting up is more comfortable. Walking has been OK and even helpful at times. Often I just keep it elevated, but it is definitely getting better I think. Evidently, we'll be switching to an ongoing blood thinner after the injection Rx is completed in another week.

Yesterday, April 4th, was my rescheduled chemo infusion. Alas, the blood samples resulted again in clumped platelets. All other measures were good. The doctor accepted a microscopic evaluation of the platelets that said they appeared to be normal, so the chemo was allowed to proceed--four concluded of a planned twelve. I'll be moving back to a "Wednesdays cycle" with the next one, now planned for April 20th. I also have an interim meeting with my oncologist's assistant to review these pending leg pain and clumping problems.

In the meantime, the rest of my life has been OK. I say only OK, because the leg pain has kept me out of the shop. I'm eager to get back to the construction of a bench we intend to use at the foot of our bed. I'm making it from some cherry I salvaged from the woods at a friend's home. There will be photos to share eventually.

I finished reading Lies My Teacher Told Me which I highly recommend. I also read a fun new novel by Harlan Coben called The Match which was essentially a thriller/mystery that involved lots of DNA tracing and services like 23andMe. Another book just completed was The Vanishing Half about twin African American girls, their daughters, and the very different lives that the lead. I also recommend this one. Now I'm reading the second book in the "Broken Earth Trilogy" by N. K. Jemison, a gifted black science fiction writer, who won the Hugo Award three consecutive years for the three novels in this trilogy. This is a very different sort of science fiction but utterly fascinating and intricate.

Of course, I may have watched a fair number of basketball games recently. Alas, my two Hawkeye teams bowed out way too early. I'll probably watch some of the Masters Golf Tournament this coming weekend. Tiger Woods indicates he may try to play! That would add an interesting element to the tournament.

Well, I may be rambling a bit here. Am doing OK. Part way to the end!

A Cancer Journey Has Twists & Turns

A good friend, someone also on a cancer journey, provided me with the title for this blog posting.

March 30th was to have been my fourth chemo infusion. About one week earlier, I developed a constant pain in my right leg. This has manifested itself as a strong cramp in my calf and additional cramping in my thigh. Standing has been hard and though walking sometimes seemed to stretch it out, I was best with the leg elevated and me on the couch. A heating pad gave some relief. Tylenol didn’t help, nor aspirin. You know I tolerate pain well, but this has been difficult.

I reported the problem to my oncologist on Monday. When they were finally able to get back to me, it was the morning of my planned infusion. My doctor scheduled an ultrasound of my leg sandwiched between my labs and my infusion. I was to meet with my physician's assistant during my infusion.

However, the plot, along with two other things thickened! (Going for a little humor there. 😋) We seemed to be waiting and waiting to be called in for the infusions. When they did come for me, it was to redo one of the labs (platelet count). The platelets in my first lab had clumped. For more information click here. You will see that this is most often a lab process problem, and is not an indication of anything about my very high quality blood🧛‍♂️! We resumed our wait for the infusion to start. When they came the third time, it was to say that my infusion was canceled for the day, and that they needed a third blood sample because the second one also resulted in clumped platelets. Each of the three tries was drawn in a different way, but guess what—the third one also clumped!

So next we met with the PA. She indicated they were all scratching their heads about the platelets but would work something out by Monday so that the infusion can be done. She also reported that the ultrasound showed a blood clot in my leg which as I understood extends down from my thigh to the lower part of my calf. I have always thought of clots as being more like a marble, but this one is more like a string. There was no suggestion that the clot and platelet problems are related. Anyway, this clot explains the pain in my leg. This is likely a new chemo side effect, but I did advise them of the genetic marker I have that may increase risk of clots and deep vein thrombosis or DVT, which is what I have. Thanks to my sister and 23andMe for alerting me to the presence of this marker.

I’ve been put on 14 days of self-administered shots of blood thinner. This is the same one I had after the surgery, but whereas that was a precautionary dosage, this is a higher dosage and requires two shots a day. I have four done as of this morning. I also have a prescription of tramadol to manage the pain. After the first shot and one dose of tramadol, I was able to sleep much better than during the prior week. Perhaps by Monday the leg will start to feel even better, and the platelet problem will be resolved. Until then, more reading and couch time for me.