One month down. Two months to go.

I’ll be damned.

Am officially 1/3 way through treatment, and it’s definitely going better than I thought. Been experiencing minor side effects, but nothing I can’t handle. Am blessed for this fact, and am hoping it’ll be like this through entire treatment, but only time will tell, mi familia y amigos.

For this entry, I’ll cover few stuff, as I don’t intend to make this long as previous entry (this I can promise!).

In case y’all were wondering why it took me a while to update this blog. I blame this on my bro and sis-in-law and heat wave in NorCal. yea- lame excuses as usual. But, on a serious note, it was great to have a full house at my parents’ home for a week. My bro and sis-in-law drove all the way from Utah with their two dogs last week, adding to my two dogs, sister and parents at home. I barely can recall when was the last time we had our house packed like this. It was jolly good to have everyone back at home, I must say. In addition to that, I finally got to visit Alcatraz Island, aka “The Rock”, for the very first time, along with my siblings and sis-in-law. The transcript of the tour was certainly mind-blowing and the sights from the island were absolutely gorgeous. At the same time, the sights of bustling downtown in San Francisco were enough to drive prisoners to sheer madness, knowing the fact that the city was only a mile and half away. It made me feels like an idiot for taking so long to visit this historical site after living 24 years in bay area. But I know same thing can be said for many of my friends too. :) Regardless, I would like to show my gratitude for my bro and sis-in-law for choosing to spend their one week vacation at home, restoring some sanity in me. So you guys rock!

Boy- last two days, the heat wave here was insane! Just was sprawled out on couch and did nothing but watching tv, playing games on itouch, and reading book (Ender in Exile- excellent read, I must say) all day long. I’m just grateful that I’m not in east coast, tho. why? I cannot… stand… humidity… at… all! Today, it finally cooled down a bit, prompting me to catch up on errands, so here I am now.

Back to where I left out… Remember my white blood cell count dilemma? Had to postpone chemo due to my low white blood cell count (1.4), and take neupogen shots for four straight days instead. Once again- a friendly reminder for you guys: between 4-10 is normal white blood cell count, and 2-3 is normal for chemo patients. Well- here’s the result. On Monday, after those shots, I was notified that it skyrocketed to 28.7! The nurse practitioner was really surprised to see this result, and exclaimed how healthy my bone marrow was. The shots are designed to stimulate the bone marrow to increase production of WBC. So that was a good sign, but the doctor was wary to ask me if I experienced any bone pain, one of its side effects. They were afraid that four shots might be too much for me, thus leading to extreme pain in my bones. Golly gee, as that explains my sore lower back; but luckily, it was not severe enough for me to take Tylenol pills or whatsoever. They told me that if this ever happens again, I would be limited to only two shots from now on.

Oddly enough, this experience left me with a strange visualization of what was going on in my body. With WBC of 1.4, I suppose I was left with several “Rambo” white cells. They were cornered down somewhere in my oozing bloodstream, but able to keep those pesky cancer cells stay put w/ their blazing guns (with striking white bullets). Thanks to those persistent bastards, the good ol’ reinforcements, full of marines, navy seals, etc, were eventually able to join the battle within next few days (after I got my neupogen shots, that is). And my body’s back in business, boys.

However, be aware that the WBC will go down rapidly couple days of taking neupogen shots. I guess it’s like battling King Kong, Godzilla, and Bowser, but all meshed-up together, in my body. But worry not, for I still have those faithful “Rambo” white cells at my service.

After getting my WBC above its “danger zone”, I was able to resume my third week of chemo, which was two consecutive days. I didn’t have too much problems with it, as it was somewhat similar to first week (with an exception of couple different medications). For this week, I had to take one out of three medications for two straight days. It was their standard process, as they didn’t want to put too much medication in my body in one day. Further explanations about Stanford V treatment will be revealed in next entry.

As for fourth week of chemo (last Monday, actually), I was warned by couple of friends (one of them who went through chemotherapy before) that fourth week is usually the worst. Upon my inquires at doctor’s office, I was relieved to learn that my chemotherapy differs from everyone else (it all vary on kind of cancer, naturally), and I’ll be taking same medications from 2^nd week of chemo, which didn’t bother me that much with an exception of tingling numbness in end of my fingers. I’m just fortunate to receive treatment at Stanford and do wonder what it would be like if I had my treatment at Austin instead. So one month is officially done, and two months of treatment await me! Onwards and upwards…

There is actually one more thing that I neglected to mention in my previous entry (due to excessive information). Be warned that this might be a bit grim and is not for people with weak stomachs.

By my first chemo, a nurse told me that the veins in my arms were challenging to find. I did not find this as a surprise, as I had this problem my entire life. After clarifying this with doctor, I was informed that this problem was common in many cases and is perfectly normal. Alas, this was the very reason I was now wary at the very sight of needles due to my bad experience with an inexperienced nurse years ago, who made four frigging attempts to draw my blood and failed at every attempt (EPIC fail big time, I know). This time, it took nurse second attempt to find my vein, but she highly recommended me to get a peripherally inserted central catheter (PICC). It’s a line inserted in vein in my left arm, a form of intravenous access that can be used for a prolonged period of time. The pro of this is that I wouldn’t have to deal with needles poking in my arm in hope of striking mother lode (aka my vein). After conferring this with my doctor, she encouraged me to get it after my 2^nd week of chemo. She even claimed that if they couldn’t find my vein, then there’s a possibility of chemo being postponed to another time. Furthermore, if they were to miss my vein by mistake and proceed w/ chemo, it’ll be REALLY toxic for my body. So with that in mind, I figured it’s wiser if I proceed with doctor’s recommendation.

I went to hospital by myself on Friday for my PICC appointment. It was at main hospital instead of Stanford Cancer Center where all of my appointments were usually at. My interpreter (as of now, I have two “personal” interpreters of my own, and I got to befriend them) was already there and was familiar with the procedure. She took and introduced me to my nurse who would be responsible for inserting PICC in me. I was pretty much a train wreck at that point, as who would like the idea of having a longass line being inserted in my damn arm? Right before proceeding with the procedure, the nurse had to explain me the risks involved and how I should take care of it at home and so on. Other than usual warnings and concerns, I was devastated to learn how this would restrict me in my daily activities. For instance, I was no longer able to go swimming or hit the weights. The catheter would protrude good 6 cm above my skin; therefore I’ll have to wear a stretchable armband around it to keep it contained. I was planning to begin my push-up program the following week, and the nurse said I should avoid it, because last thing I want to do is to aggravate the line in my vein. Oh boy- there goes my plan to rack up on my muscles while I have time in the world to myself. just great… The nurse said I still could decline it if I want to, or I could go ahead with it and if I feel bothered then I can ask nurse at transfusion (ITA) to remove it immediately. I was really hesitant to go ahead with the procedure, but figured it’s worth a shot. Let me get a feel of it for couple of weeks. If it gets too bothersome, then I could have the nurse remove it right away. So I nodded in agreement…

The interpreter left the room, leaving me alone with the nurse and her diabolical smile while holding weapons of minor destruction in her hands. Whimpering at my helplessness, I could do nothing but to stare at lonely dark corner of the ceiling, leaving my left arm to become frog in 7^th grade science class. Once again, I’m relieved for anesthetic shots, as it made entire procedure easy to bear with. Oh yeah, forgot to mention one minor detail. As the nurse insert the line in my vein in my upper left arm, she will keep on pushing the line through vein until it reaches my upper chest (right in middle of rib cage, I guess). Scary thought, I know. And guess what? I actually could feel the nurse sliding the line through my vein slowly. It was harmless, I can assure, but definitely a surreal feeling to have it rubbing slowly through the vein. It’s like having a tapeworm slithering its way through your body. Bad image, I know, but that’s what came to my mind at that time. After approximately twenty minutes, the nurse said she was all done, but would need to take me to chest x-ray to make sure that the line reached its proper destination (standard procedure). I had to walk across half of hospital in my hospital gown with bulky dressing wrapped around on my left arm to room where chest x-ray was taken. After being preached by a young male nurse few times to take a deep inhale and hold my breath for them to take x-ray of my chest, it was completed in a minute. Sure enough, the nurse said it was a cm too long. Yes, we had to go back to operating room just for the nurse to pull a cm of the line out of my arm. And that was it. I’m now an owner (emphasizing on the absence of “proud”) of catheter in my upper left arm.

Well, I have it inside me for last couple of weeks. It is not exactly in my way, but it’s been a bit tiresome to deal with it in some ways. For example, I’ll have to wrap my left arm with plastic bag (provided by hospital) every time I take a shower. I’m not able to swim at all. I cannot hit the weights or do simple push-ups, as the last thing I want to do is aggravate the vein in my arm. Most annoying of all is that it will constantly serve as a reminder on a daily basis that I’m a victim of cancer. It is certainly not easy to cover up for any kind of outings. In overall, the pros of having PICC were beginning to wear out. It was last Monday that I decide to make a request to my doctor to have it removed so I can resume my daily activities, especially my push-up program I was dying to begin. But noooooooope. My main doctor finally returned back to United States (she was absent for last several weeks to take care of her ailing father in India), and I met her for first time last Monday. Upon my first impression, I could tell that she was a tough lady to deal with, and other doctors EVEN seem to be nervous around her presence. Just my luck, she decided to deny my request and claimed that having PICC is safer for my vein. Just like that, and I’m screwed. I’m going to be stuck with this flapping catheter peering out of my arm for next two months. Just great.

On the bright side, throughout this entire ordeal, I did receive some excellent news. Remember when I explained the peculiar situation about my lungs. They weren’t sure if the enlarged lymph nodes in my lungs were cancer-related or another kind of infection. I was supposed to have another PET scan after fourth week to see if the sizes of lymph nodes were decreasing or not. However, it was from that chest x-ray which confirmed the reduction in size of lymph nodes in my lungs! From this data collected, the doctors could now acknowledge that the lymph nodes were also cancer-related and that chemotherapy is indeed the correct treatment for this. So my PET scan was postponed to after 6^th week of chemo, as it was really supposed to be at. The news did set me at ease; since I was afraid that I might be dealing with another kind of infection in my lungs and might have go through lung biopsy to determine what kind it was. So in a sense, it’s somewhat irony that it was because of PICC that I got this good news earlier than I should have.

Despite all of this, I’m still dying for PET scan after 6^th week of chemotherapy to see how exactly my body has progressed. Only a couple of weeks left, though. Of course, I’ll post the result of my PET scan right away when I receive them.

Here are two pictures of my PICC for you guys to get a better idea of what it looks like. And yes, I got a major haircut from my mom a week ago. :) But I got a feeling that it’ll be couple of weeks before I shave it all.

Before wrapping this entry up, I want to send my heartfelt thanks to everyone who showed tremendous support to me after I shared my news. I was overwhelmed with e-mails from many of you, especially your sincere well wishes. Some of you sent cards to me, which definitely made my day (couple of them, I literally cracked up from their sense of humor). It was more than I could ask for. So thanks again for all of your constant support, as it’s greatly appreciated.

“There is nothing better than the encouragement of a friend.”
-Katharine Butler Hathaway

Well said. :)

til’ next time,
adam j.