The Final Stand - A Daily Recount (D-day)

Hello everyone. I am absolutely amazed at the number of people that follow this blog regularly. I am even more surprised to see how many people are new to this journey and take the time to read all the blog entries, from beginning to present. Many of you have sent private words of encouragement. Some have even went as far as to thank me for being courageous and inspirational. But, allow me to set the facts straight... it is you, the reader, who has inspired me to continue with this blog. I couldn't imagine fighting cancer alone, and having all of you standing at my side has been the greatest medicine I could hope for. You have inspired me to continue fighting with my head held high. So... thank you!

Today was day one of what we all hope is my final stand against cancer. I very badly want to capture a daily recount of what is going on day by day as I inch my way towards victory. This recount will take us through the entire chemo and radiation therapy experience. It will include the six weeks of treatment plus two weeks of after affects, and will include things like: my current weight, how I'm feeling physically, how I'm doing mentally, what I'm eating, and other tidbits of information. I'm going to provide one of my typical stories for days one and two because they will be my first chemo and radiation sessions. After that, I will simply post an update letting you know how I'm doing. Eight weeks from now, we should have a sixty day battle journal.

 Now that we've addressed the formalities... allow me to recount what happened on day one (D-day).

I had my first chemotherapy treatment today. Jess had to go to work for a few hours, but made it home to join me for lunch before we headed to the cancer clinic. We stopped at a Southern gastronomy pub called The Parish. It is located in Northwest Tucson and is well worth the trip if you're looking for a brilliant play on Louisiana style Southern cooking. For an appetizer, Jess and I shared a plate of hush-puppies infused with crawfish flavoring. For our mains, Jess had the shrimp po'boy and I had the fish and chips. Both dishes we extremely satisfying at a decent price.They also had a killer looking bar which serves a micro-brew Jess and I used to frequent when we lived in Mississippi. I hope that someday I might be able to enjoy another round of those hush-puppies... only alongside an ice cold brew. Only time will tell.

After lunch, Jess and I had just enough time to get to the cancer center for my scheduled appointments. I had three appointments back-to-back: first at the lab for some blood draws, then a face-to-face with my medical oncologist, and finally upstairs for my first cancer treatment. We got there right on time. I waited in line to sign-in while Jess ran over to the in-clinic Walgreens pharmacy. I asked Jess to pick-up a mouthwash they sell there that helps prevent dry mouth. I had been wanting to get some to carry with me on doctor visits, and today was the ideal day to purchase it considering I had just eaten fish. I would like to think my health care providers appreciate me not breathing hot fish all over them.

It wasn't long before I was called back to have blood drawn. I attempted to greet each medical technician as I walked back towards the blood letting stations. I greeted three technicians, and received the same ran-down, lack of enthusiasm response from each. I don't usually get this type of response from people here at the cancer clinic, so I am going to label this as a case of the Mondays.  I am sure my next experience will be more on par with those of my past visits.

The blood draw went well. The technician that stuck me was able to do so in one quick stick. The vials were rushed back to be tested and I was excused back to the waiting room.

Jess and I moved to another area of the hospital. It was one the same floor as the lab, but far enough away that there was a separate waiting room for this particular area. We were early and I knew my blood would need to finish testing, so I assumed we might be waiting for awhile. Much to my surprise, we were called back sooner than I would have expected. The nurse that called me back ran me through the normal drill: weight, vitals, and questionnaire. I weighed in at 232, which is both good and bad. Its bad because it is much higher than it should be, but its good because I am expected to loose a lot of weight throughout this process. My blood pressure was 128/72, heart rate 68, and temperature 98.2. Everything looked good!

After the nurse had completed a full collection of my vitals and medications, she left Jess and me to wait for my medical oncologist. We sat there for quite awhile; I guess us being early caught-up. It felt like a half an hour elapsed before we finally heard a knock at the door. I was a man. A man we had never seen before. He introduced himself and explained that he was one of my doctor's fellows. A fellowship is a form of training used in the medical field when doctors are trying to obtain a license or certification in a specialty medicine. In his case, I am assuming he is studying to be a medical oncologist. The fellow asked me many of the same questions I would expect from my doctor. I don't know why, but it always feels awkward talking to a medical student in your doctor absence. Part of me knows they are only doing so as practice. There is little effort made to establish rapport, which is why I feel those visit are always less informative and productive than those with the primary physician.

The fellow didn't have a whole lot to offer, other than a recap of information Jess and me already knew. He left once he had met his requirements. Jess and I were left to wait again... this time for my medical oncologist.

The oncologist must have been busy because she took much longer than I would have hoped. When she did finally enter the room, she reinforced the plan of action with me. She explained what I could expect from chemo and gave me very strict guidelines for contacting the clinic if I experience anything outside of what is to be expected. I was also told to report any fevers because they could be an indication of infection. You see... now that I'm taking chemo, my immune system will become extremely compromised. The chemo is going to attach and kill many cells within my body... especially my white blood cells, whose primary purpose is to fight off infections. After a brief rundown of rules, roles, and expectations, I was released so I could make it upstairs for my last appointment of the day... "the chemo treatment."

All-in-all, my first chemo treatment went down well. I checked in a separate registration desk the clinic has setup for cancer patients receiving treatment. Once checked-in, I was directed to wait in the waiting room until called by one of the nurses. Jess and I sat there for a couple minutes playing on our cell phones. I decided I wanted a tour of the place so I took a walk to the long corridor. I could hear Jessica's name behind me before I could get to the end. She was talking to the nurse that was looking to bring me back.

Jess and I were escorted into one of the treatment wings. I was put into a private room with its own bathroom. I was pretty excited by this considering last time I was in an open bay where four people could be there receiving their respective treatments the same time. The nurse had me sit down and get comfortable. I covered up with the new blanket I brought along with me. I also surrounded myself with any electronics I might need to keep me busy.

The nurse was a great lady. She was very funny... the type of funny that comes with a heavy does of sarcasm and matter of fact. The three of us in the room established rapport as the nurse began prepping her tools for running an IV line. She asked if I had a port. I'm assuming she asked that because it looked as though most of the patients receiving treatment had one. I explained to her that my medical oncologist decided against one because I was young and was only receiving six treatments. If only the oncologist listened to me...

The nurse covered my arm in hot packs before wrapping it in a warm blanket. She was hoping to get my veins to surface. You see... I have big veins, but they like to live deep in my arms. I've had nurses in the past have difficulties getting an IV started... so I have no doubt these nurses will have a heck of a time with me... especially after a couple weeks of chemo and radiation.

The next twenty minutes were spent trying to hit oil. The nurse tried twice before asking for some assistance from another nurse. The two of them eventually found a vein that would play nice.

I was all setup for chemo. My IVs were ran and the medicine was ready and available. We were told the entire treatment should last approximately two hours. Before starting the drip, the nurse gave me a list of possible side-effects I should be aware of. The most obvious is nausea... which can happen in a moments notice and over a period of a week, which is why they are first pumping me full of some pretty heavy duty, long-lasting anti-nausea medicines. Some of the other side-effects I could experience... fever, chills, headache, a sudden breakout of rash, pain at the injection site, a lose of hearing, thinning of my hair, and a dramatic drop in energy levels.

So, the IVs were opened and the medications were quickly pushed into my system. There were moments when my skin felt warm around the injection site. I also felt the slightest hint of a headache, but nothing debilitating or worth getting worked up over.

Do be honest... this first treatment was a breeze. I know they will not all be like this, but I am grateful the first was. It took the whole two hours to get all the fluids and medicines in me. The time went by fast, and I really have nothing negative to report. The nurses were great and other than the IV starting issue... the entire ordeal went smooth.

At home... I was able to eat dinner and ever had myself some dessert. I didn't expect day one to be rough. In fact, I don't expect things will get rough until week three... maybe four. Regardless. I will continue to blog daily to provide you updates from the front line. You should receive another lengthy blog tomorrow describing my first radiation visit, but after that, the blog entries will be brief.

I wish you all well. Thank you again for your support, especially as we enter into this final campaign against cancer.