My Treatment Entries

February 2010 Semi-Annual Update - Unremarkable....

All is well - scans were unremarkable/unchanged/etc... The doc was pleased (as were we).

I had a CT scan on Friday (2/19/10), but no PET scan this time. I figured insurance would start to question/push-back on the PET scan, as they're quite expensive, and as I'm 4 years out from treatment, there's a point where they'd want to have something evidence itself in a dr visit, or the CT scan. Really can't argue with that... So, CT scans they were, with contrast, and had pre-med of 3x50mg Prednisone, and took 3x25mg benadryl. The scans went uneventful - quite a bit faster than having the CT and PET to do.

The doctor visit involved the usual wait (north of an hour), but I got to see Mary and Alex (both nurses that used to be on the Chemo floor, and are now in Dr. Goy's staff). Coleen and Dr. Goy are doing well, and it was great to catch up. Goy's been busy, but still does 2 days a week seeing patient appointments, and of course makes rounds, etc. He's Deputy Director of the Cancer Center, and Chief of Lymphoma, and a big advocate of administrative resources still maintaining a hand's on approach.

I'm still going for 6 month checkups - which is good, and I'll go back in September, after all of the fun of summer!

I talked to Jim (cell-mate), and he's doing well - another clean visit, and we're of course thrilled to hear. Steven's doing well, and I need to sync-up with him.

My firm has an annual appeal where you can donate funds to various charities (comes out of your paycheck, and some matching of funds takes place), and the Hackensack University Medical Center is one of the choices, so I picked that, specifying the Cancer Center. I sent a note to some colleagues at work, nothing that if they didn't have any charity choices of their own, that they consider this one when making their election. I know most everyone has their own issues/challenges to work with, but in the event they were looking for something to contribute to (outside of the generic firm's choice - a good charity of course), they consider this one. I raise this issue on the blog, as I'd (1) encourage readers of this to do the same if they don't have any specific choices in mind, or (2) you may want to encourage others to donate to whatever facility you attended. (Seems it's when you were first starting to work that you didn't have as many issues, or compare as many pains with friends/colleagues, that you simply chose the generic charity - years later, there seems to be an abundance of worthwhile choices that have a personal attachment!)

Many thanks for looking, best wishes to all!
John

Again - 'unremarkable' is one of the best things to see on a pet/ct report - and i had a bunch of them ('unremarkable's).

I had the scans done on Friday, 8/17/09, and I got a copy faxed to me last week - allowing me to review them before my appointment with Dr. Goy today. Again - this is a key thing to do, as you can question the report when meeting the the doc. On mine, I was happy not to have to question anything. (As an aside, I have to prep w/Prednisone and Benadryl to supress an allergic reaction to the dye that I developed - seems to work well.)

I'm feeling great, still need to lose weight, and my buddy Andy is on me to get cycling again (sage advice). Still, spending time with the family is more fun than being out on the bike for a couple of hours - but then, those that do it say they do it so they can spend more time with the family in the long run...

I got to see Dr. Goy - he looked great, same spirit as ever. His father is apparently as energetic as he is, and at 80 is patenting devices that help with wood splitting for some renewable energy source device he has. Amazing... must be in the genes... Coleen, Mary, Hillary - got to see them all today, and very happy to - great people all of them.

Dr. Goy noted that at 4 years out (i'm 3.5 now), he'd go to an annual checkup. I've discussed this with another buddy of mine, whose wife had a cancer, and his logic is - why would you want to delay identifying something if it came back? The inconvenience of an scan and appointment isn't too much to deal with, versus the other downside. I think I'd prefer to stay at 6 month intervals. We'll see...

Asked about Steven, and he's doing well. Jim's going in shortly I believe, and I'll send a note out to Cory to check in on him. The hospital (Hackensack) is sponsoring an event at Ellis Island on 9/13/09 for Cancer Survivors (Goy said he didn't like that work, and neither do I really), and I think we'll be attending. I'll check with Steve and Jim - would be good to catch up....

Thanks to everyone for checking in, summer has been great - we did vacations to LBI and Boston/Cape Cod, as well as a Sand Castle day at Belmar that was pretty neat. The family is doing great!

Enjoy the rest of summer, Happy Labor Day, and thanks again!
John

I'm cutting this from a friend's site, but I was amazed as I read it. So much of it rang true for me, that I wanted to post it. He had the same cancer that I did, and went through a similar treatment at HUMED, under Dr. Goy's care. He had more complications than I did, but went through it like a champ. Here's part of the post:

"Again, when I look back at what went on in 2008, it was easier for me to experience those challenges, than some of the challenges that I face today. I never felt as stressed back then as I do sometimes today- even though my life was on the line, and I was in the emergency room 6 or 7 times in 12 months. I know so many of you can relate.

I say these things, knowing that some of my friends are without jobs right now due to the economy. I can say these things, knowing that despite the stress, I am blessed and successful and grateful for my job. But I just am puzzled by the variance or dichotomy.

I go through each day, grateful for my family, my friends, my faith, my job, my challenges that teach me a lesson in patience, persistence, gratitude, and the desire to continue.

I thank God each day. I pray for forgiveness for my weakness, thankful for my gifts, and patience to accept the challenges that we all face each day.

I know that the gifts I have are more than the reasons for the strength I have to face each day with a smile."

I could comment on each line, but I'll spare you that; rather note that Jim, the author, captured some amazing sentiments, and all hold true for me as well.

Thanks Jim - keep up the good work.

John

Another clean bill of health!

I had my PET/CT scans on Fri, 2/20/09, and the follow-up meeting was with Dr. Goy's associate, Dr. Feldman.

I had the normal PET/CT scans conducted the week before (complete with pre-medicating with Prednisone and Benadyl, as I have a reaction to the contrast dye). The scans looked good, again 'unremarkable' is a great term to see! Guidance to those going through this - get a copy of your scans so you can read them as well, and so you have a copy. I keep a paper copy, and scan them to the PC so I have soft copies of all records, and can package them up if needed (to be sent to someone, print them without photocopying all of the records I have - a rather large binder at this point). CBC's look good as well.

All else is well, feel great, family's well, got in some skiing, and enjoying life!

Best to all!

John

Good news again - clean bill of health!!

I had my scans done about 2 weeks ago, and got copies of the results as soon as they had them - a few days later. It's important to get the reports for yourself, as it's (1) good to have your own history, and (2) it's good to review them before you see the doctor.

The scans were good, so I felt good there, but it always seems there's some term or something on the scans that you don't understand, so it's good to have it highlighted prior to your visit, and ask the question - rather than see it after the visit, and have to ask the follow-up question. Most of the things end up being sinus congestion, etc. Again, a clean bill of health!

Chris and I went up to HUMed for a 9:50am appointment, and ultimately saw Dr. Goy around 1pm. Like a good restaraunt, you don't want it to be empty, but it can be frustrating at times. I do take solice in the fact that I know when I had fevers, etc, he would make time for me, and I know there were Saturdays when he'd make rounds seeing 70 patients, and then do add'l work. It's a job I couldn't imagine having, and am thankful there are doctors like Goy that dedicate themselves to the cause.

It was good to see Dr. Goy, Coleen, Noel, and Jesse, with the added bonus of seeing Alex, Mary, Hillary, and Maureen (from a distance) - the latter group of four were all phenominal nurses on 5PE where I got treatment. As much as I'm happy to see them at the clinic where Dr. Goy is, I know the patients are missing some of the best nurses there are - and I've expressed previously just how important the nurses are to chemo care. Regardless, I'm thrilled they're still with Dr. Goy and Hackensack.

Dr. Goy was as energetic and busy as always. He's been seeing over 100 MCL patients, from all over the world. This is key to understanding the disease, and getting more treatment options for it. We had to wait hours to see him, but you know when you do, you have all of his attention. He sits back and talks with you about your life, what's happening in the field, etc. He's got a great presense.

It's another 6 months before a visit, and I'm of course grateful for that.

Many thanks for all the wishes, prayers, and inquiries. I asked Goy and Coleen about Stephen, and they said he's doing well. I'll mail him shortly to get an update in person. I'll also mail Cory to see how he'd doing. James, another 'cell mate' has recently completed 6 rounds of treatment - including a study drug (velcade), and is doing well. He's had his battles, but he came through with flying colors (some black, some blue!).

On the personal front (like the above wasn't), it's been a great summer, with lots of good family time on the weekends, some good vacation getaways, and a great appreciation of friends and family.

Thoughs and prayers to all going throug this, including of course caregivers and families. A request for thoughts and prayers to friends of ours that have a baby in neo-natal due to a premature birth, as well as a very good friend and his family whose son recently passed away.

Again, many thanks for checking in, and we wish everyone well!

John and Chris

Good news, clean bill of health, and the next checkup is 6 months out!

Thanks for all the kind wishes, thoughts, and prayers - and for checking in, we really appreciate it.

Activities:
- Colonoscopy/Endoscopy in October - clean results
- PET/CT on 1/28/08 - results were good. actually showed decreased activity where there may have been a cold or something evident last time. Blood counts all look good.

I found out that I'm now allergic to the contrast dye they use in the CAT scan. That means next time I have to pre-medicate with Prednison and Benadryl (prescription), to ward off the effects. I got itchy (lips, face), and had a feeling of asthma a bit; nothing too bad, but they monitored me and ran a saline IV and made me drink lots of water.

I also found out I have some early and minor cataracts. It's a possible side effect of prednisone, and my eye doctor noticed is when checking my eyes. From chemocare.com )http://www.chemocare.com/bio/prednisone.asp):
The following are less common side effects (occurring in 10 to 29%) for patients receiving prednisone:

Headaches
Dizziness
Mood swings
Cataracts and bone thinning (with long-term use)

It was great to see Dr. Goy, he's doing well, energetic as ever. He, and his nurse practitioner, Noel, said I need to get back on the exercies routine. My buddy Andy has been getting on me a bit as well, saying that it was my being in good shape when all this started, that really helped me get through it well, so I owe it to myself, and family to get back to a good condition. I'll be spending some more time on the bike (in the basement now), trying to shed some pounds, and get the cardio back!

I've mailed with Steve and Cory - and they're doing great, remission, doing well. Jim is going to start treatment soon, he had a little scare with acute diverticulitis, and a temporary colonostomy (my Dad had one too - colonostomy); no doubt he'll do well.

That's it for now, feeling great, working hard, and enjoying friends and family!

All the best,
John & Chris

I had my quarterly PET/CT scans, along with the review by Dr. Goy's office - all good!

Dr. Goy was traveling, so one of his associates reveiwed me. I thought this would be good, to get a 'second opinion' kind of thing; a review from someone not as familiar with my case. However, I do like having Dr. Goy review my case, and will hold out for him next time. He knows the whole story, and it's good to have that history.

The scans were clean, and the review good. After the next quarterly, they can move to semi-annually.

I'm going for a colonoscopy/endoscopy as part of an annual scan, and will have those results shortly. A number of friends are being scheduled for them now - as they're either 50, or nearing it, and my advice is constant - it's no big deal (sedation is a good thing). The fasting is the wosrt part!

The family's been doing well, just returned from a vacation to Florida to see some family, as well as Mickey and Universal. Family and work are good, and we're just doing our thing...

Thanks for checking in,
John

I had my PET/CT scans done yesterday, and met with Dr. Goy today.

A good checkup by the good doctor, and I was on my way. Not much to report, but that's a good thing!

I feel great, am working hard, enjoying summer, looking forward to some vacation, and life and the family are great. Thanks to all that read this, and for your support.

Again, best wishes to everyone involved with this, we hear Stephen's doing well, Jim's going to see Dr. Goy on Monday, and seems to be status quo, and I'm hoping everyone else is doing great.

Have a great summer!
John

PS. Alex has been busy trying to clean up the thousands of spam comment entries that have appeared. We'll see if we can keep it clean!

I had my quarterly visit with Dr. Goy, after getting the quarterly PET/CT's done. All is well!

I've updated my blood counts on the background tab, and they're staying steady. Everything looks good, and it was great to see Dr. Goy and everyone there. I even stopped on 5 PE (where I received chemo and excellent treatment), and got to see Mary, the head nurse, and a wonderful person. I got to catch up with her, and hear about the recent goings on. The nurses on an oncology floor are amazing, and I'm very happy to hear they're doing well, it can't be an easy job.

That's it for me, I'm busy with work and family, and still need to drop some of this weight! need more bike riding...

all my best to everyone checking in, and of course to those battling the disease. Steve, Jim, James, Corey, etc - keep up the good work guys, sounds like everyone's doing well.

All our best,
John and Chris

Good meeting with Dr. Goy.

My Father accompanied on the trip, as Chris had some other stuff to tend to, and it's good to get out with Dad! Thanks for the company Dad! (BTW, Dad turned 70 this past week!)

The feedback was good - no changes since the last visit. Things like that are good. You have no idea (or maybe you do), how good it is to be 'unremarkable' - they're great words to see on your scans. That, and 'physiological' uptake is a good thing.

Blood work came back good, it's posted on this site as well.

Had a great chat with Dr. Goy. He's seeing the most patients with MCL nationwide I believe, and Hackensack University Medical Center is treating a tremendous number of cancer patients - rivling MDA I believe. Not something you like to hear on one side, but they're doing good work. He's getting more help, and can hopefully get more involved in research, and finding a cure/cures.

I asked about Steve, Jim, and James - all patients of Dr. Goy's, and friends of ours - all are doing well. Much hope for continued good news.

It's ironic, it's great to see the group up there - Coleen, Jessie, Alex, etc - but - I do like keeping my distance! (Also got to hear about some of the 5PE nurses, and all are well.)

Also - a buddy is doing an amazing job chronicalling his battle with Cancer, having just undergone a SCT. His blog is: http://1speeder.com/tiki/tiki-view_blog.php?blogId=1
He has AMAZING resolve.

Happy Holidays to all!

It's been the normal (which is good!) Holiday fun here. Running around, seeing family and friends, lots of good stuff. Back for a little work before the New Years weekend.

I feel great (but then, always did!). I REALLY need to drop weight now! The holidays are cruel for that...

ok, back to work, but again, all the best, Merry Christmas, Happy Holidays, and the best of Health, Happiness, and Prosperity in the New Year!

John

Quick post - all went well with my recent Dr. Goy visit and assosicated PET/CT. I'll get into more detail, but pressed for time right now. But Aunt Joan gave me concerned grief (for which I'm appreciattive) for my lack of posting following the checkup.

I was scheduled for a PET/CT today (10/20/06), but the machine was broken, so they were kind and told me of the status this am. There was a chance it would be fixed for my 2pm appointment, but call later; it wasn't done, so we rescheduled for next Thursday at 7am.

I'm meeting with Dr. Goy on next Friday, and he of course gets the results, interprets, and uses that as the major input to the follow-up exam (so there will be a rush on reading those slides!).

Since last I posted, all has been well. The family is doing well, I'm going about my normal life - work is crazy, but I do try to keep a bit of perspective on that. i.e. - i will think 3x before missing out on some family event for work. I was pretty good with that before, but even more so now.

I had a bump on the back of my leg at the last Dr. Goy visit, and since then I've had it removed - a sebacious cyst (sp?) was the verdict. Benign - a wonderful thing, negative tests - negative is good... Heck, I was even happy to hear the doc say 'it's an adult pimple'. I'll take that.

I still haven't managed to take the extra weight off - but really want to. I worked too hard last time to have this stay! I went on a 50 mile semi-hilly bike ride about 2 weeks ago - the Twin Lights ride that originates in the Highlands, NJ. Nice ride, and we did a 17.2 mph pace. It's better than the pace I did it at 2 years ago, when I was about 30lbs lighter - and no, it's not 30lbs of muscle! I did it with my good friend Andy - with whom I used to ride regularly, but he's at a different employer, so we can't get out for our weekly 32 mile ride - but we did squeze one in about a month ago - after a work golf outing that we were both at. 18 holes of golf, beers, food, and then 32 miles of riding - and again - a better performance than i had ever posted before. Too many variables to determine the cause, or if cancer played into it at all before. Bottom line, it was a great ride.

All else seems well, I reached out to a few 'cancer' friends a while back, and all are doing well. Actually - I need to catch up with Steve to see how he's doing. We always ask about him when visiting Dr. Goy.

A friend of a friend is getting ready for a stem cell transplant, after having 2 relapses. He's an animal. He works out like you wouldn't believe - even when doing chemo. His site is: http://1speeder.com/tiki/tiki-view_blog.php?blogId=1
inspirational, and I wish all the best for he and his family.

That's it for now, all the best to everyone following this, and anyone undergoing it...

We had our quarterly checkup with Dr. Goy yesterday - all is well. I had the PET/CT done on Tuesday, and the results were available for Dr. Goy on Wednesday.

Dr. Goy is going out of the country for a couple of weeks, so he wanted to wrap this up before going away, and I had a pea sized lump on the back of my leg, just above where your knee bends, that we were concerned with. It was blue-ish in color, and about the size of a pea. At first I thought it was a mosquito bite when I felt it, but after it didn't go away, and didn't itch, I checked it out and told Chris. She relayed the info to Coleen, and she got us in about a week earlier than we were previously scheduled for, and with Dr. Goy, etc.

Dr. Goy checked it out, and didn't feel that it was anything (and they had done scans of my leg the prior day), but he had me go to the hospital to have a sample taken from it. There, a doctor used a very small needle ("smaller than the ones they take blood from you with" said the assistant) to remove some fluid from the site, to make slides, etc. There was no need to numb the site, as the needles to numb would have been as, if not more, painful than the needle to draw a sample. The doctor took the sample, and afterwards, there was very little left of the lump! His suspicion was that it was just a bruise that healed improperly and blood pooled there - but the test would determine things definitively.

Doctor Goy called us on the way home from the appointment to tell us that it was nothing and we were good for another 3 months! Great news indeed.

We also stopped at the hospital for a book signing by Sharon Parker, whom wrote a book on her battle with cancer (she had 2 different cancers at once). Dr. Goy wrote the forward to the book, as he was her physician at MDA. She's followed him to Hackensack, and she said she'd follow him anywhere in the world. She's an incredibly energetic and wonderful woman; she had pictures displayed of her with Howie Mandell, Gov Potacki, Tom Jones, and countless other celebs, as her family used to own a resort in the Catskills. I'll read the book and post the name of it later, or you can search Amazon on her name. She's doing a book tour currently, and wanted to know if we would host something in our home around this. More to follow...

Many thanks to everyone for the good wishes, prayers, and thoughts as we come up to these checkups. We really appreciate it - more than we can possibly express.

Happy Summer everyone!

Couple of comments:
(1) Dr. Goy tried to call us on Tuesday evening to let us know the PET/CT scans looked clear, but we weren't home, and he didn't want to just leave a message (however, that's the kind of message you CAN leave on an answering machine!). He also called our cell phone on our drive home on Wed to let us know all was fine. It's great that he understands the patient's concerns, and tries to accomodate/communicate/etc.
(2) The doctor that took my sample had obviously reviewed my case before seeing me. I imagine this should be common practice, but I was just there for a quick sample, and he knew how the initial diagnosis took place, where the initial slides were collected, and that Dr. Goy took the second set. He had a pretty good understanding of my case - in a short time, and for what I imagine is a pretty basic procedure.

I'm impressed at this level of detail and care, because I know there are other doctors out there that don't do this.

It's been a while since I've posted, and that's a good thing!

Doing the normal stuff, feeling fine. Summer's here (technically), and the calendar is filled with the normal events, leaving only a weekend or two open, lots of good stuff.

I need to check in with some of my old 'cell mates' (a phrase that was coined on one of the list servers I subscribe to. I've not spoken/mailed with Steve or others, but hope they're doing well. I see notes from Corey (he's the same age as me, out in Chicago - same treatment, etc), and he seems to be doing well.

That's it for now, hope everyone is doing well!

Best Regards, enjoy your summer!
John

Met with Dr. Goy today. Basic exam with him, and he had previously communicated that the results of the PET/CT were good. All feels good, he's happy, as are we!

PET/CT scheduled for 3 months from now, with another follow up. We can stop the blood tests, as the numbers are coming back (HGB, etc.), and we'll check that with the next review

Had a PET/CT scan done today as part of my quarterly reviews. I'll meet with Dr. Goy next Friday to review the results.

I feel great, and look forward to good news!

All else is well, we've just returned from a vacation to California, where we visited San Francisco, Monterey, and Yosemite. All great stuff! We saw our friends Claus and Claudia (and Francesca, and Christopher, and Theresa), who opened their home to us most graciously, and we had a wonderful stay!

I need to get back on the bike - as the vaca did not help with weight loss (up 2 lbs, thanks to lots of hiking for keeping that down to a manageable 2!).

Blood counts are looking good. HGB is still rising - hit 14 this week! (16 was the 'old' - pre chemo high.)

Feeling great! I'm training on a regular basis (on a bicycle mounted in a trainer - it's too cold out!). Still trying to drop some weight, it's not that easy... Seems gaining 15-20 lbs is pretty common nowadays with chemo - I suppose that's a good thing compared to the previous chemo.

Feel great. Going for weekly blood tests (CBC) just to see how the numbers are doing. The WBC's and PLT's are back to normal, the HGB's are getting there. 12.2 last week, seem to be going up 1 point per week. I was 16 back in June b4 chemo, etc, so I expect I should get back to that level.

I'm back on a more regular routing of bike riding. I'm doing in it on a trainer in the basement now, as it's too cold for me outside! I try to get at least half an hour about 4 times a week, and usually extend one of those to an hour on a weekend. It feels good, and now my legs are the limiting factor, not my heart/lungs, which I felt more of b4 (i.e. my legs felt strong b4, but I'd find my heart hitting upper ranges faster than usual, and I would get more winded earlier. Now it seems to be more of the burning in my legs than my heart rate maxing out!)

The Polar S720i heart rate monitor (HRM) that my brother and parents got me for Christas is great. I've enclosed a screen shot of a graphic it produces (by dumping the data from the watch unit to the PC). I'm just showing heart rate and cadence, as I'm stationary and altitude doesn't change (or shouldn't!), and speed is checked at the front wheel (wireless), and on a trainer that doesn't spin. It is great to check your progress!

I need to get in touch with Steven, and see how he's making out, post chemo, well I hope!

I talked to a guy a couple of weeks ago, he has MCL. He was trying to figure out which path to take: which protocol, doctor, hospital, etc. It's not an easy choice, and there aren't any definitive answers. It's good to feel like you've made an attempt to help someone, hopefully I have actually helped.

Work is good - busy as can be, but happy to be back!

It is great to be home with family and friends, doing the normal stuff! I'll get some pics of my current hair status, etc. soon. I have eyebrows, and hair is growing back. Seems to be dark brown (same as b4), not sure if it'll be curly or straight... Facial hair is a bit different. A goatee seems to be growing in a brown color, with some grey at the bottom - where I had it b4. But the rest of my face is blonde or something, and really not noticeable. We'll see what happens!

Many thanks to Doug, Esther, Ellie, and Hannah for a wonderful dinner last night! They had us over for a celebratory dinner - and the kids helped with balloons and a 'Congratulations' banner. We toasted to health and good friends - both of which this whole ordeal has put quite a focus on! Many thanks for last night, and all your support through this experience!

It was a great evening, and hopefully today we'll get some sledding in with them, as we've got about a foot of fresh snow on the ground!

Great day today, not just because my eyebrows are coming back though...

Intended to do the bike this am, but that 5 minute doze turned into an hour, and then the whole family was in our bed, so there's no way you want to leave that to pedal on a bike...

We had a light breakfast because we were going to a brunch with my parents and brother and Kristine for a belated celebration of their 40th wedding anniversary. After breakfast we played a bit, and then got ready, and headed off to the restaurant. I see my brother's truck and my parent's suv in the parking lot when we get there - that's good. We see the matre de, and he has a bit of a confused look as I ask him where they're seated, but Alex walks out and greets us, and escorts us into the room - where I see lots of yellow balloons, my in-laws, brother in-law and his wife, my Aunt and Uncle, my cousin and his wife, my mother, annd of course Kristine. Mind you, this was just supposed to be Alex, Kristine, Mom & Dad, and our family.

So... Yeah, turns out Alex and Kristine planned a celebration for me that was a complete surprise, very uncalled for, but very appreciated! It was very cool. Great to see everyone in one place and catch up. It was just awesome, and Alex and Kristine really outdid themselves. As you've seen throughout the site, Alex has been awesome with rides to the hospital at odd hours, helping out with any and everything around the house, and just doing anything he could. Kristine was of tremendous support, coming to Hackensack with and without Alex, playing games with me, bringing me puzzles, reading material (I still have to return her stuff), and general encouragement. She even brought her best friend Jenny to see me once (Jenny's a really nice girl that's got an amazing job that I don't even think I can talk about, but...) and Jenny has been very supportive as well - saying my name out loud at her local Synagogue when it's time for intentions. If you've gone through something like this, you know you can't repay people for what they've done to support you, but they should realize how much it means - I certainly hope you two do.

Yet another really cool thing though - I got a really neat gift from my cousin. I got a Tour of Hope hat, signed by 3 members of the 2005 Discovery Channel team, and a cycling jersey as well. There’s a whole story behind it, but it’s late, and I’ll need some time to try to capture the whole essence of the story as it was conveyed to me.

Awesome time, many thanks to everyone for coming, and looking forward to more family get-togethers - just for the heck of it though!
Alex and Kristine set this up!

Some of the festivities:

more festivities:

just cheesy...

how do you take a pic?:

Today was my follow up visit with Dr. Goy, to review the PET/CT results from a week and a half ago (I had meetings last week and couldn't get in for an appt, but Coleen was kind enough to consult with Dr. Goy and she did let me know that he said all was well!).

Great visit, blood counts are coming back. HGB was at 10, PLT's are up, and the whites are doing ok - they seem to be a bit low, but that's written off to coming back from chemo.

I've actually got a bit of a head cold now. It started last Thurs pm, and it's now Mon, and I'm feeling better, have a bit of a cough, but not too bad. Admittedly, I haven't exactly been nursing it, as we were in Atlantic City this past weekend, having quite a good time. I wrote to a buddy, it's actually nice to be 'normal' sick....

Thanks to Alex for arranging the rooms, Omi and Opa, Grandmom and Grandpop for watching the kids, and of course the kids for letting us get away!

We need to schedule the next CT scan for April, and I'll see Dr. Goy a few days later to review, checkup, get blood work, etc. We talked to Dr. Goy about PCR testing, and as usual he was very explanatory, drawing on the exam table paper, showing us how it checks the chromosomes, etc - great stuff! (The nurses on 5PE used to tell me how they loved how he explains things!) The test can help to tell if the cancer is in your blood. The interesting part is that it's one piece of the puzzle, you also need to check to see if it's in your body in other ways - CT, etc. MCL tends to inhabit the gut (stomach, colon, etc) so it's important to check that out along the way. The R HyperCVAD is a great one for this cancer, and we're obviously quite optimistic.

The posts will be slowing down, but thanks for following along, and we'll try to keep you posted with events as they warrant!

Got great news from Coleen yesterday, the PET/CT scans were negative - which is a great word in medical terms. No sign of cancer! We're quite happy as you can imagine.

Blood work was ok, Coleen want's me to get more red, as the HGB was 7.9, still under 8. So I went to RWJ's Cancer Center and got 1 pint today, and I'll get another on Friday. Apparently they don't have a big supply of what I need. I'm O+, but with CMV Negative, Leukoreduced, irradiated, and I think that's it, that adds some complexity. Intereresting, in Hackensack it's usually not an issue getting it - the Cross Type and Matching takes some time, but getting the blood doesn't take that long - I'm sure it has to do with the size of Hackensack vs. Hamilton. RWJ Hamiton has a great facility though, and it's much closer than Hackensack... My HGB was 8.6 today, so it is better, we'll see what it is on Friday.

Quick update - got on the bike on Sun and today for about 35 min each day. Alex, Mom, and Dad got me a cool Polar heart monitor that lets you program in an exercise set. So I have a 10 min warmup, 3 intervals that take me up to around 170bpm, then get me down to 140 as a recovery zone, then a 10 minute cool down at 140-150. Neat stuff - as it really lets you customize your workout and get your heart going as much as you want to. I'm a bit winded doing it now, which is part being out of shape, and part still low blood counts I'm sure.

I went for a CBC test at lunch today, and won't have those results until tomorrow. Regular day in the office, and then home....

Spent the day at the Cancer Center at Robert Wood Johnson in Hamilton, getting 2 units of blood and 1 of Platelets. It's a very nice facility where the outer perimeter infusion chairs face out to a garden, and the inner ones face each other, but it's a very bright airy setting. I took a chair off on the side where I could be on the phone and not bother anyone (hopefully). It wasn't too crowded (only a few of us), so that was good.

I got my blood and felt better. You really don't feel better immediately - only because you really don't feed like there's anything wrong - until you run up a couple flights of stairs, or do something requiring energy! Then you notice the boost when you've got more blood.... I was 6.8 when tested this am, so I needed some HGB.

Also got a big 'ol bag of platelets. Those are funny. Blood comes in pints, platelets come in units. Some bags are small, some large, it's the luck of the draw. I've been at 5.something, and got a small bag, followed by a normal size one. Today I got lucky and got a big one (my platelets were 37, up from 17 on Wed, but still lacking).

Headed home after and onto a normal weekend!

Got my PET/CT scan today. No results for a few days, and I'll review them with Dr. Goy next week, or the week after.

Stopped by at the doc's office as well to get my blood work, as (1) I'm still not that far out of the 'B' cycle, (2) I've been a bit winded when I don't think I should be, and (3) I was one town over, and they get the results in about 30 minutes as opposed to next day!

HGB wasn't bad - 7.8, but Coleen said that since I'm feeling the way I do, I should get 2 pints. There wasn't time today, so I'll get some locally (saves the hour trip up there!)

PLT's were 17 - not great at all. Explains why the gauze pad filled up quickly after the PET/CT scan when they took the IV out! I'll get a unit of Platelets as well!

WBC's were 4.8 - good stuff. I should be able to ward off the winter bugs!

So, I'll be going to the cancer center at Robert Wood Johnson in Hamilton to get the stuff on Friday. I have mtgs in NYC tomorrow, and since I'm not at critical levels, I'm going to make those and do the blood on Friday.

Doing well! Amazing, ran a 99 degree fever, and just took an hour nap. That seemed to knock it down to 98.8. I had ridden the bike for just over half an hour in the am (161 bpm avg, with a 177 max), so I did feel good, just felt a little tired in the afternoon. This could be from low counts - it is day 8 after all, or the light fever, or whatever, but I really feel good.

I have some mouth pain - doing soup for lunch, etc. Using Sodium Bicarb as a mouthwash, and got some 'magic mouthwash' perscription from the doc. They call it that in the hospital, and the prescription actually says it too! It's actually Lanocane, Benedryl, and Malox mixed together. You rinse with it, and it numbs your mouth a bit, and also helps with the sores that can form after the 'B' cycle. I believe they're related to the methotrexate. I'd gotten them b4, but even though I only have 2 black spots on the inside of my cheeks, my tongue and mouth is pretty sore.

Still getting Neupogen shots, and haven't experienced any bone pain at this time. Still getting blood from the nose (again, not a nosebleed, just bloody discharge when blowing my nose). I'm sure it's from the low platelet count (should have gotten them checked on Friday - so I could have #'s on Mon, but...).

All is well..

Had an appt with Dr. Goy today. Regular post-chemo follow-up. All was good - he seemed pleased, I got all 8 cycles in, etc. My counts were ok, HGB @ 7.9, PLT @ 26 (so that was a bit low), didn't get the WBC's - have to check those. So, given that I'm still on the way down (day 5), and the 'B' cycle drops me pretty hard, Coleen (nurse practitioner) opted to give me 2 pints of red, and a unit of platelets. So I spent the afternoon in the infusion room. Chris stayed for a while, and then she went home, and Alex picked me up (THANKS). Alex and I went out for Thai food for dinner after.

For follow-up, I'll have a PET/CT scan next week, and then meet with Goy the week after to discuss. After that, I'll get CT scans every 3 months, and blood work at the same time. If there's anything that pops up, I'll get a PET scan. The CT scan is a broader based scan that will identify more stuff - while the PET scan is more detailed for cancer specifically.

We saw Steven in the waiting room (Stephen a great guy that I met the very first day of treatment in the hospital that has MCL as well). It was funny - we didn't recognize him at first - he has eyebrows, and he dropped off some of the chemo weight (mind you - Steven is thin as it is, so I dind't think he had any weight to lose, but as someone had noted in some newsgroup - there's a 'moon face' associated with chemo - I think it has to do with all the fluids that are pushed into your system). He's doing great, and it was really good to see him (even if we didn't get to see his parents!).

I feel good. The blood should help, as I was feeling a bit winded when doing some stuff around the house. Never sure if it's in my mind, or real, but given the numbers are on the decline, it's probably real. The platelets should help with the clotting of course, and I'm getting some purple coloring on the back of my arms where I'm getting the Neopogen shots.

DONATIONS:
I had some leftover dressing changes and Heparin, etc from my Hickman, and we asked the doc's office if there was something we could do with them. Sure enough, they were happy to take them, as there are poeple that don't have insurance, or insurance that's not so good, and they will pass the items on to those folks. Kristen, the nurse that gave me the blood - and whom I gave the items to, said she had a woman in yesterday that fit the bill - she would be extremely happy to provide this to her. So - if you have extra stuff - don't toss it, give it to your local oncologist and see if you can help someone.

Another great day, church, take down the outdoor lights, a little clean up outside (with Emily's help), lunch, around the block with the kids for a scooter ride, and then a bike ride to the park. Had a fire in the fireplace, etc. etc. - just a great day - a great weekend!

The number of posts will diminish at this point. I'll document the after effects of the last treatment, as I'm very curious to see how this will end up - with a fever or not specifically.

I know my numbers will drop, the 'B' cycle will knock my WBC, HGB, and PLT's down. I already have some light bloody nose spray - it's not a bloody nose, just when I blow, there's some color there - standard post 'B', as the PLT's drop I assume.

I feel great, went with John to a B-day party today (he got to ride a pony!), we cleaned carpets at night - thanks Alex, did some post Christmas clean-up, etc. Just a good day. Still have the normal, don't know what I want to eat, feel real bloated, a little nauseas not and then post chemo blahs, but overall I feel awesome.

We all slept in the basement - sleepover of sorts - as we wanted the carpets to dry fully, and wanted to have some fun with it!

Liking being at home...

Should be getting out today. Numbers look good. Methotrexate was .04 (has to be .08 to be released, but they also want you to have 4 or so doses of Leucovorin, and I'm only on like 3 - they also want a 48 hour reading, which would be around 1pm today - they can defer that or...).

Feel good, looking forward to release, but I have a day's worth of meetings to attend, so a later release would actually work better. Last one is 3pm, so that could time out well. Alex has offered a ride, and I'm looking forward to Pizza tonight.

Appettite is dropping, had the roast pork for dinner last night, had one little bite, and it just didn't do anything for me. Went to the vending machine and had a bag of fritos - the salt seems to do the trick! Some water, etc.

Finished up chemo early this am (hooked it up around 2:30am). Methotrexate levels were at .04, so that's good enough to go home (they want under .08). Need more Leucovorin at home, but that's fine (they want 8 15mg treatments). Got somore more fluids, got my triple lumen removed - no pain whatsoever there, and Alex came to get me around 4pm.

Said my goodbye's to the excellent nursing staff. Bittersweat - don't come back except for pleasure visits was the basic theme. Apparently (can't remember if I've typed this b4), many patients don't come back for visits, and I'm sure it's because of the treatment/memory. However, I would like to stop by with some donuts, coffee, see how the wonderful people that helped me through this are doing. The lack of visits often only leaves the nurses seeing those that come back for bad news, not those that are doing well. They'd like to see the good stories too! So, I plan on doing some of that!

Came home to balloons on the porch, and a great poster made by the kids and Mom! Really nice. We had pizza (my choice), and a great cake - make by the kids and decorated by mom - with Congratulations John on it! My Mom was over too - Dad's fighting a cold and didn't want to subject me to it.

So, today ends my chemo treatment for MCL. During the next week I'll monitor blood levels (where I expect my WBC's, HGB's, and PLT's to drop), and I'm hoping I won't fever, as due to the lack of catheter, there's apparently less chance of that happening. You can drop the WBC's etc, and still not get an infection - so that would be fine - a simple trip to get some blood, etc - without an overnight stay w/b nice!

After that, I'll need a follow-up PET/CT scan, and then those every 3 months or so, and blood work weekly I believe. I'll work out more of the details with the good Dr. when I see him on Wed.

For now, I'm very happy to be done, extremely happy to be home with the family, and very grateful to everyone reading this, everyone that's provided wishes, hopes, prayers, thoughts, visits, and any possible good will towards our family. It's been quite a journey, and I'll paraphrase Steve Meyer (note posted on 'Personal Notes'), I wouldn't wish it on anyone, but it's been an amazing experience. Hard to verbalize.

I/We can't begin to thank everyone for their help, but please know that without the support of our family and friends I can't imagine going through this as we did.

Good night sleep, was really tired by day's end yesterday. Not great sleep the night b4, and a long day. Was just wiped. Couldn't even sneak in a bike ride! Will get one today. Feel good, Creatine is at 1.0, PH is at 8, so the numbers look good. I'll get my weekly CBC summary at the end, I feel fine. Still expecting to be back here about 6-7 days out for neutropenia, but without the hickman and any infection that may have brought on, I'm not sure if I'll need antibiotics, ect. The neutropenia cold just have me here for low counts, get some blood and platelets, and no infection - just being wary of getting an infection (with my usual WBC's of 200 at that point). We'll see....

Good day of work scheduled, and hopefully a bike ride - rather - will be a bike ride!

Got on the bike, good ride - tried out the new heart monitor using the interval function. Pretty cool - makes you do a warm up, do a predetermined interval level - where you get your heart rate to a level for 5 minutes (you set the level and time), and then you recover (i chose to recover to a heart rate), then 2 more intervals and recovery, then a cool down. Was about 45 minutes all together. Felt good. Plottted it on a graph (part of the software).

Another good night's sleep. Got to bed around 12:30, a couple of bio breaks, a better bloodletting - didn't seem to be as invasive and I managed to stay asleep or semi-comatose through most of it. It was the weigh-in that's annoying - you have to get out of bed! But back to sleep after that. Up around 7am to check in with the family and start the day!

Pete and Chris came by for a short visit (I had a bunch of conf calls, and they had to get John from school and off to playtime. Great to see Pete, who has better blood counts than I do (when I'm in perfect health)! Chris brought me a care package from my Mom, some veal, and potatoes, and banana bread.... And that's after Chris's care package of Chicken Picata (sp?), rice, asparagus, and pecan pie! AND - hospital food isn't bad - it's just, what would you eat??!! I'll be doing the bike later tonight, after some work, and maybe a nap. After the ride I'll have dinner.

Ok, the schedule got a little mixed up. I pushed work longer than expected, usually happens, and then forgot that Andy was coming up for a visit around 5pm. Sure enough, righ on queue! Many thanks for coming up, great to catch up and clear up my decision on which heart rate monitor and headlight to go with (cycling talk). Andy was kind and hung around until darn near 9, so I grabbed a meal after that (Mom's veal chops and taters and banana bread - nice...), and then ditched the ride, as I was pretty beat and wanted to wrap up some other stuff, and then was really wiped out and went to bed around 11:30.

Medical
I got my morning checkover by my nurse and my Creatine and Bun are a borderline right now. They're impacted by the chemo, and they impact Kidney function so they check that closely - along with PH, which was 6 again, so 2 more sodium bicarb pills. They also increased my fluids last night (so that should help), and my fluid output has been good. Erin was saying they've been noticing higher Creatine and Bun numbers on the floor in general, and they're keeping an eye on it. It could cause the chemo to be stopped for a bit and then restarted. Not sure how long of a break - she was just giving me an overview, and not trying to scare me! Hopefully I'll see Goy today and talk to him about that. I haven't been tracking those numbers closely so I don't know what I've been historically.

PH is doing better - up to 8 now - good stuff! 3pm

Creatine is down to 1.1 now (from 1.3, was .9 when I came in, 1.5 is the high point where they start talking with docs - about suspending chemo), fluids are being pumped through, so that's good! Chemo is continuing!

Good night's sleep, up few times for bio trips; they pump you full of sodium bicarb during the Methotrexate admin. Even with that, they check your PH regularly, and I'm getting additional sodium bicarb pills. PH was 6 at last check. Then at 4am the overhead light came on for the blood draw. That's no fun! This is where I miss Denise who does the blood draw by light of a flashlight - sometimes you don't even wake up... (The blood's drawn from the catheter line - this time the triple lumen, previously the hickman.)

Good day working, bunch of conf calls, etc. Got on the bike for the first time in a while again. Did 25 minutes at an avergage of 168, max of 175. Maybe a bit much, but I felt fine, wasn't breathing too heavy, and I tried to knock it down a bit, but it kept up there pretty high. Part low HGB, part out of shape. I got a great new heart monitor for Christmas from Alex and my parents, so I'll program in an interval workout to try that out - that way it'll force me to keep to a reasonale level (I'll have to figure out what reasonable is!).

Last week of treatment... Talking to some of the nurses about that, and Gabby was saying that many patients don't even come back to visit, and the nurses wish they would. Me, at this point, when coming to see Dr. Goy, I'd like to visit, just to say hi. I don't think I'll have an aversion to this place, but I'm sure many do. The people here have been great, and it would be nice just to check in to see how they're doing. We'll see...

Checked into Camp Hackensack today (or my summer home, or whatever euphamism you want to give it!). We brought up a cheese/pepperoni/keilbasa/cracker platter for the nurses. They were really appreciative, and it was nice to give them something. Chris has made cinnamon bread before, but this was certainly a little bigger. They're a great group and it's nice to give a little something back. We're certainly not alone in that feeling - they've had so much food since prior to the holidays - the station where they keep it - right by the patient fridge - has been filled with cookies, fruit baskets, donuts, the works - since before Chrstmas. A testament to them.

Got checked in - nice window bed - looking out to the city (NYC) - nice for the last round! Got my triple lumen installed by Dr. Kline - she's awesome. GREAT bedside personality, and a good touch. The triple is a bedside procedure, confirmed by an Xray they do at your bedside - to make sure the line is in the vein properly. It's not really painful, but there is some pressure, and some weird discomfort as they push it into your chest. Gabby (nurse) was there to offer a hand to squeeze - it does help!

Pics of the triple lumen (and the marks from where the Hickman used to be):

They told me Steven checked out yesterday - he just finished round 7. They said he looked great and sent his regards. Steven, if your reading - glad to hear you're going for 8. Not that I want you to have more of this stuff - but I've always said I think I want to take as much as I can - to make sure I kick this. Likewise for you... Hope all is well with you, and a Happy New Year to you, Murray, Barbara, and the rest of your family!

I'm getting fluids now (3pm), and I'll get Rituxan as soon as it comes up. First a little benadryl, so maybe a nap around then. Chris headed back home, and Grandmom had taken the kids to see 'Cheaper By the Dozen 2' - so I'm sure that was a good time for everyone! (Thanks Grandmom!) Not sure if Uncle Alex went along or not....

Great HGB counts today - 10.5 - I can't remember when they were that high! No wonder I felt so good this past week!

FWIW, we saw about 11 NJ State Troopers with lights on today - having stopped cars along the NJTP. Half marked, half unmarked. Definitely out in force! (Vance J, I'm glad you're doing the managment/leadership stuff now, that TP stuff seems a wee bit risky!)

HAPPY NEW YEAR!!

Nice day at home. Actualy, Alex, myself, and the kids went out to a park to fly (1) a stomp rocket, (2) a pump up rocket, and (3) an air powered plane.

The stomp rocket is a simple setup with a plastic/rubber bladder that you step on that pushes air to a lunch pad to launch a plastic/foam rocket. A good step can get you about 150 ft.

The pump rocket is made by Estes (the model rocket company), and you hand pump air to a resevoir, and a guage let's you know when to stop - or where you are on a scale. A more elaborate plastic/foam rocket sits on the launch pad. That one goes up at least 200-250ft (they say it can do 300ft). (Safety feature - you can't tilt the rocket to aim it anywhere but pretty much strait up. So you can't aim it at your brother. Not that you would of course. You can aim the stomp rocket, but it doesn't have as much force.)

The air powered airplane is cool - it's a see through plastic plane, where the fuselage acts as the bladder, and there's a single piston 'engine' that receives the air pressure, and spins the prop. You pump it up with a small bicycle type pump (special for the plane). The wings and rudder are foam. This thing had to fly for about 300 ft. We had some wind, so we flew it into the wind, where it climbed, and then did a slow turn around to fly with the wind, and flew for a nice distance.

That, some playing on the swings, and some Razor Scootering by the kids and we had a nice time outside! Thanks for coming out Uncle Alex!

A pretty relaxing rest of the day, some shopping, etc (got 75% off of Christmas lights at Target - amazing - $2 for nice lights..).

Hung out around the house, played with the kids, did some shopping, etc. A nice quiet day for the most part. Watched Star Wars Episode 5 - The Empire Strikes Back. Everyone seemed to enjoy it. Only 1 more episode to go!

John III crashed around 10pm or so, BUT EMILY STAYED UP UNTIL 12:30AM She made it!! She was good too, not overtired or anything. She was happy she got to see the ball drop, as were we.

Quiet night, a little wine with dinner, and hot chocolate with some Bailey's during the movie, and that was our partying. Hanging on the couch with the kids, that's a good time!

Quiet day in the office - not many people in. Got some work done, still good to catch up. Had a few client calls - surprised to find people in, actually, working from home mostly!

Good day, still sleeping in a bit (till 7am - going to bed around 11-11:30) - I need to get back into a 6am schedule so I can get the bike training in!

The office is quiet this week - which is nice. Getting caught up on some stuff, having some client calls, but it's very quiet at the client site - which is also good for me! I can spend some time on stuff here, and catch up a bit with the folks in the office. Being away for treatment, and subsequent infection/fevers does take its toll; when you're in the office the time flies by.

S/b a quiet nite at home....nice.

Good day, went to see the doc. Nothing really new there. We brought in a platter (cheese, crackers, etc.) for the staff - so I got my blood draw quickly, as we set it up back in the infusion room where they usually have the goodies for the staff, and Dino does his blood draws there too - so he just told me to come over when I had a chance.

Waited about half an hour to 45 min for the doc. He did a once over on me, basic checks of the lymph nodes, blood work, and make sure I'm doing fine. Without PET/CT/etc results, there's not much to look at.

We chatted about some results that recently came out of MD Anderson - related to R-HyperCVAD - all encouraging. They're a continuation of previously published results I think, with just more data as the length of the study continues on. Mary - from Las Vegas was kind enough to send a PDF of the study to me. Her husband has done a great job of bouncing back from R-HyperCVAD and MCL, and is back to playing tennis and leading a normal life - which I am really looking forward to (ok, replace tennis with cycling).

On fitness, I got a really great heart monitor from my parents and Alex. I think it's a not so subtle hint that I need to get back on track with riding and fitness, as I started chemo strong with riding, but have been lacking lately. I'll get on the bike next week while in for the 8th round - figure I need to finish strong!

I spent some time following up on another blog; a friend (Cliff) of my friend Viraf has a lymphoma, and he's getting a stem cell transplant at Johns Hopkins. He's taking enough chemo right now to knock out his system, so they can transplant him. It's a tough route, and I wish him all the best.

Back to the office grind. Hopefully a quiet week!

The office was quiet, did some good work, and got caught up with the few in the office. Went to lunch with Mom, Chris and the kids, and Uncle Alex. Mom wanted to treat to this Indian buffet that's nearby. Just what we needed, more eating! It was nice though. Dad was feeling a bit under the weather, so he stayed back (I'm not sure he's that big of an Indian food fan).

Feel great, looking forward to the last round of treatments!

The day after Christmas. We played with toys and the kids and the kid's toys until around noon or slightly later. We were in PJ's and happy during that time! We ran some errands in the afternoon, and then had a reasonable dinner (first one in days), and Uncle Alex came over to watch Star Wars 3. Packed it in soon after and Chris and I said what a wonderful Christmas weekend it had been.

Felt great....

Merry Christmas!!!

Emily came in at 5am (Chris was in with John, as he had come in our room around 3pm, and she went to his bed with him). She was excited as Santa had come and left a small present by her bedside, and the reindeer had made a mess with the cheerios, tracking them into her room and John's! Chris was vacuuming that up later....

I told her she had to wait until at least 6am! She got into bed with me. I think she just watched the clock, because at 6am she was up again, ready to go. I sent her to Chris to see if it was good enough (I used to get up even earlier I think). Chris said 7am, as the kids had been up late the night b4. So, at 7am, it was up again, and downstairs to check out the goods! They were psyched, and we'll put up some pics soon. We went through all our stuff and then had breakfast, and then back to toys!

We went to Omi and Opa's at 1:30pm or so, and Peter, Karin, Derek, and Tyler were there too, so all the cousins had a good time, as did the aunts and uncles! More great eats, and we went home stuffed again. We watched Star Wars 2 with the kids, and Uncle Alex came over too - a nice way to end the day. (I got Star Wars 1-3 for my birthday, and got 4-6 for Christmas. So we're watching all of them in the order 1-6 to keep the story line straight. Emily seems pretty into it, John likes the light saber battles, but the other stuff seems to bore him. Alex and I are into it - as it's the first time we've seen it in this order, in close proximity of each episode too - really allows you to see what's happening with the senate, etc. geeky, yeah....)

Oh, felt great, and REALLY GREAT TO BE HOME ON CHRISTMAS!
Our hearts go out to all those going through illness, etc that can't be home on Christmas.

Happy Christmas Eve!

Kids are excited! I ran to do some errands with them this am to (1) get stuff done and (2) let Chris get some stuff done at home!

We went to 5pm mass, then to my parents for dinner and gifts, finishing up around 10pm, and the kids were beat, but did great. Lots of good food and drink - I had 1 glass of wine. That makes 3 for the whole time I've been going through treatment. I'm only a social drinker mind you, but it is nice to have a nice glass of red wine with a good meal. We left stuffed. The holidays have not been kind!

We put cookies and milk out for Santa, and some cheerios and water out for the reindeer. Santa had left a nice letter for the kids and Grandmom and Grandpa's, telling them how good they had been this year helping out Mom and Dad, and being good to each other. They're reallly been phenominal through this. Can't really tell that they've missed a beat. They've taken the whole thing in stride - including the Hickman, which has got to be a bit weird to see. They were of course happy to see it go!

Chris and I were up for a bit more, and then off to bed.

Doing great. Last day in the office b4 Christmas. Got out to lunch with some friends from the office, nice...

Got word from the doc (infectious disease) that I could stop taking IV Cipro and switch over to pills (750 mg). So, I took my last IV one (since I had it with me in the office), and then took out the IV (Nurse Kitty showed me how). No big deal, and it's great to be completely lumenless, and IVless. There are no ports attached to my body for the first time in about 5 months!

Nice night at home, the calm before the storm (Christmas eve and all...).

Slept at home last night! Always a nice thing...

Feel good, got up, took an early conf call. Tried to flush my IV (peripheral, on my lower arm, just above the wrist on the top), and it wouldn't take the saline, and wouldn't draw back, probably clotted. Called the home healthcare provider, and they can't get a nurse out until later. I'll deal....

Went to work, came home at lunch, and the nurse had me pull out the old line (ez), and she installed a new one - great touch - little to no pain, and she got a good vein right away. We then ran the cipro from this 'eclipse' thing. It's a little ball that's pressurized, and there's a regulator that keeps the flow the way it should be. Neat. Much better than hanging a bag.

Went back to work, finished up the day, and I'm having my second round of Cipro now around midnight.

Here's a pic of my new peripheral IV and the eclipse ball of Cipro, partially deflated. (Oh, that's a sock on my wrist. You use it to cover the IV and keep all the extra cord from getting in your way when not in use. Neat trick - thanks to Kitty our nurse, and it is an old Christmas sock from Chris, so it's quite festive.....)

Good sleep - I think I slept from around 11 am until the 4am - turn on the really bright light over your head to stick your arm and draw blood - followed by bp/pulse/temp and stand up and get weighed. Ok, no go back to sleep. Thank you very much. Makes you really miss Denise taking blood from the hickman at 4am and you didn't even know.....

Did some good work today, feel good. Met with the infectious disease doctor, and I can go home today. I'll get the IV antibiotics, and then check on my status on Friday to see if the cultures are still negative - at which point i can go oral cipro.

Got another pint of blood today, was high 7's. Felt like I could use it. That's 3 pints this week if you're keeping track. Curious to see how much I'll need after the B cycle. There definitely seems to be a cumulative effect of the chemo. Even the A cycle is causing me to need blood now. Platelets are down a bit, 75, but s/b back up soon since I'm at day 9, and should be rebounding soon.

Good sleep, except for when they now insert a needle to draw blood at 4am! (and then the weiging, and BP, pulse, temp, etc. No fever btw)

Doing some work, then hope to see the doc this am and get a feel for what's going on with the treatment of the bug. What is it? Can I take oral antibiotics? WHEN CAN I GO HOME?

The infectious disease doctors came to see me, and it looks like I can go home tomorrow. No fevers, feel good, seem to be reacting to the antibiotic and/or having the line removed.

They've switched me to intravenous Cipro, and they'll be sending me home with that. I'll have a fresh, regular, arm or hand IV setup, and I'll get 3 days of IV antibiotics at home. This is a little different, as they usually use a PICC line, or the Hickman, but this s/b good as it will get me home, and the home care folks will show me how to maintain the IV as it's a little different than the Hickman. After that, I'll got to oral Cipro (750 versus the usual 500).

They'll then keep the cultures growing, and the goal is to have nothing growing at the 5 day mark, and then they're confident that they've got it beat. So I have to call them on Friday to check that out.

Pretty good night's sleep. Got 2 units of blood overnight, so the pre-treatment with Benadryl helps to wipe you out a bit! My HGB went to 6 something, therefore the 2 units... It's interesting, you get to sense when you're a bit low. I've been running in the mid 8's post chemo for the most part, and when I go into the low 7's, I can feel it when walking up stairs, etc. You get winded a bit, and just 'feel it'.

They took blood for cultures this am (have to get them via needle now that I don't have the Hickman anymore!). That'll help determine how I'm doing, and how long I'll stay. The doc came by this am and said he'd like to get me back home taking the antibiotics - I'd like that....

Got my vincristine push today. First time without a catheter. The intersting part is that Vincristine is a vessicant (sp?) - a drug that will kill your skin. So, when they run it through the catheter, no big deal, it goes right into your vein, and somehow causes no damage to your body. If they run it through a regular IV in your arm/hand, the nurse giving the chemo is usually ademant about being the one to put in the IV. They want to make sure they get a good vein, get good blood flow, that the patient doesn't knock the needle out, etc. If the Vincristine seeps out of the vein, or if the needle's not in right, it can leak out and kill the skin, and then there's skin grafts, etc. It sounds a bit dramatic, but I've heard enough about it to have some concern over it. It's to the point that since I had blood drawn from my right arm in the morning, they needed to watch where they gave the Vincristine, and the hole that was put in my vein to get the blood in the am, could become a leakage point when the vincristine is administered - and back to the skin issues. Neat stuff. The also administer it very slowly, mixed with saline, and they check for blood return every so often to make sure the needles still exactly where it should be. So, they mapped out where the blood was drawn from, found an unrelated vein, and then still picked a point above the blood draw site to add a measure of safety. (Ironically, I was on a conf call when the nurse - actually the nurse trainer was called in for this one - was inserting the IV and moving it around - when the client said 'John - can you take a stab at that one' - in reference to a question that was introduced. I had to tell them of the irony.... I know, it doesn't hurt much, but it's also not a pleasant experience - and trying to answer client questions at that time was not easy.) She found the vein, but even then had to move the needle/line around to get a good blood flow. Once that was acheived, she gave me the push, slowly, and kept checking with me to see if I had any burning, discomfort, etc. Of course, your mind plays a few tricks with you at that time, and any sensation you have makes you wonder. Mind you, they'd just been moving a needle around in my arm, placing and removing tape from my arm (pulling out arm hair, etc), and rubbing it with alcohol. So yes, there were a variety of sensations I was feeling - but none of them felt like burining, and it all went fine. that's pretty much it for the med stuff today, just getting antibiotics and fluids, still don't have an idea of when i'm leaving.

NOTE - Be an advocate for your own health. The docs and nurses are great, but you still need to stay on top of things. I was talking to the nurse about my meds, and she said something about my last Neupogen shot being tonight. That was only day 7, and I usually get it for 10 days post chemo, starting 24 hours after chemo. The doc can 'throttle' it, if the WBC is up to an acceptable level, you can skip a day, monitor, go back on, etc - nice way to handle it. So I raised the issue, we went to my chart, and for some reason there was a note that Mon w/b my last Neupogen shot. We called out to the doc to verify, and he said that it should go for the full 10. Important because my WBC was 2 on Mon am, and day 7-10 is really your low point, so I think I still need it raised up. Again - just make sure you, or your caregiver, or someone has an extra eye on these things. As good as your doc and nurses are, there's a whole lot going on!

Chris came up this am - GREAT to see her. And that's not just because she brought up food (quiche, chicken, rolls, birthday cake, soda)! We got to chat a bit, and then she ran off... Thanks Hon!

Alex and Kristine came up for a visit - Thanks! We played Bogle, and I even won one game. I think Kristine's still reeling from that one. She doesn't lose. (just trying to make me feel better, I know...)

I've got a great roomate - Frank, 70 years old. Tongue cancer. Apparently fairly common. He's getting 3 doses of chemo, then he'll get some radiation and chemo. This is better than the old treatment that used to involve surgery, and impact your speech significantly. He's in phenominal shape, but man, they have a hard time getting his veins. 9 attempts to do an IV last time, at least 5 this time. And he's got these sinewy arms, but apparently the veins roll.

Spent the night in an ER room. We got a private room, so that was good, and one of the nurses was great and got Chris a nice recliner (as opposed to the regular/hard chair she was trying to sleep in - with her head on the bed in front of her, or some other bad position). So we got some sleep from about 1:30am to around 6am when a doc came in, and then I think we zonked out again for another hour or so....

We played Scrabble, and I'm happy to say I won (despite Chris turning my 'funnel' into 'funnelS' and making it a triple value word worth 30 points!). We hung around in the am for a bit, then Alex came to give Chris a break around 10am, and Alex and I started to watch a scary movie...

And then the Docs came in to tell me they were going to take out my Hickman. They left to get supplies, I left to go to the bathroom, they came back, Alex told them I ran away! They said he'd have to step in and be the patient then... Removal of the Hickman was one of the things I dreaded the most. Had to do with reading Lance Armstrong's account of a similar removal, and a buddy in the office with something similar. Something about them yanking out this line that had become part of my body for the past 4 months or so. Mind you, I want to get rid of it - I want to play with the kids without having to worry about it getting snagged, want to NOT have to flush with heparin every morning, want to NOT have to tape it up to my body every am, and not have to wrap it every time I shower. HOWEVER, it did allow me to have blood drawn without getting a needle, did allow me to get chemo and IV fluids administered with a simple quick connect, and really wasn't that much of a hastle. I made out pretty well, I only have one more round of chemo to go through, and they can put in a triple lumen for that. I had one of those installed for my first round of chemo. It's an easy install (local anestetic), and it's good for about a week (longer than that risks infection). I had one for the first round because we were going on vaca to the shore the week after, and I wanted to go swimming - which you can't do with a Hickman. So the doc obliged and I did the temporary one for a week, got it out, and then on round 2 had the Hickman installed. Now, with 1 treatment to go, I go back to the temporary method, not bad.

The actual removal was no bid deal. Alex was in the room and watched the whole thing, and can tell you I was about as tense as can be, and there were wet spots under my legs (and pretty much everywhere), due to some nervous perspiration, my feet were pulled back in anticipation of pain, etc. (What a wimp, I know... but I did see scalpels come out of the kits...). The docs (1 regular surgeon and one resident that actually did the incision and some of the work) were great; very personable, yet very professional. Some lydocane (sp?) to numb the site (and extra shot or two just to be sure), out came the stitches - probably the worst part, then they identify where the 'cuff' is, how integrated it is (very - grows into the skin somewhat - which is what it's supposed to do), and they make the incision, clamp, cut, and remove. I didn't watch at all, just kept my eyes closed and felt some pressure, no biggie.

Then, instead of watching the scary movie we were going to watch, we decided to watch a sci-fi movie, as I was still a bit hyped from the hole procedure!

Not that long after we got word that I was moving to 5! Good stuff! The transport came around 3pm, up to 5, saw Gabby (one of the many great nurses there), and she apologized for not having a bed sooner - she new I was in the ER, and had made a bed for me on Sat, but scheduling just didn't work out. These guys really look out for you, it's great. Caught up with Gabby, got checked in by Sophia, and then got all settled in. Even saw Dr. Goy, Colleen and Susan. Dr. Goy's not sure as to what will happen right now. He feels the line was the cause of the problem, and IV antibiotics will take care of things, but they'll do more cultures to see how I am, and how long I need to get them. Without the Hickman, I can't get IV antibiotics at home anymore (another downside). I haven't been over 99 degrees since last night, so things seem to be responding (and I haven't had Tylenol since then either).

Getting caught up on the blog and mails since I haven't been able to connect at all while in the ER....

On 2 Antibiotics for Gram Negative something. Azactam and something...

We have a family birthday party scheduled for John's 5th bday today. We went back and forth on cancelling, etc due to my fever, but seems even if I have it, we know what to do (take 3 tylenol and it'll settle).

I talked to Goy in the am, and he said if the fever went over 101 to come to Hackesack. Seems it's not behaving like a virus, not like the disease, so he's not quite sure. He suspects the Hickman line, and seems like he'd pull that if it continues.

I took it ez in the am, and then around 11am I started to get chills. I took the Tylenol, got in bed, and got all covered up. Did some shaking, but not too much. The fever got up to 102.2, and then came back down again. We held off going to Hackensack until after the party, figuring, it's been doing this for 3 days now, 5 or so extra hours is not going to matter much (and it didn't).

We had the party, I came downstairs and grabbed some pizza and cake, and John opened gifts, and then Chris and I headed off to Hackensack! We got to the ER, got a private room in relatively short time (actually kicked someone out who was out getting tests I think!). Got blood work drawn for CBC's, cultures, etc. And then the waiting game. Wait for results, wait for a room, wait for attention, etc. I carry a thermometer in my briefcase so I can monitor my temp after chemo (as you're supposed to), and Chris would check my temp every so often (15 min intervals at some point). When my temp goes up with this, it tends to go up quick, and that's what the doc in Princeton said may lead to the chills, or Rigors (sp?), it's the body's way of reacting to a rapid ride in temp in a short time. Sure enough, it's good Chris watched, because nobody else took a temp while I was in that room, and I went from 100 to 102.7 in about an hour and 45 minutes. I had some chills, but nothing that big. I got Tylenol and everything started to come down.

Key thing - you need to watch out for yourself - the docs and nurses are good, but they're understaffed, busy, etc - and you really need to help yourself. Chris monitored and went out to tell the doc/nurse 'hey, he's 102 now, he might need tylenol'. That's huge. Leaving it all to the patient is not a good thing - we're not always our best advocates.

The rest of the day/night was uneventful; watched TV, relaxed, got IV fluids, and saw Dr. Goy briefly. He wanted to see results before making a decision about pulling the line. He seemed to be trending away from pulling it now.

Slept ok last night, got up a few times, either chilled or sweating. Seemed like the fever broke. I took Tylenol at 4am, and that seemed to be it - got warm enough, then got sweaty and thought I was done. However, at around 11:45am, I started to feel chilly, followed by the shivers, and about 15 mintues of that again. Took the Tylenol immediately, and that seemed to diminish the intensity of the chills. I went from around 98.4 to 102.2 in about half an hour.

The temps down a bit now, 101.5, and I feel fine, just a bit beat from all the fluctuation I'm sure. We've been on with the onc, etc., and there's not much to do, as all CBC's look fine, and they're waiting on the cultures to come back. Apparently, it would be ideal to take the culture while I'm actually at 102, but there's little chance of that unless you're under observation, as it does seem to go down pretty quickly once the Tylenol kicks in.

Will keep in touch with the Docs, and see where this goes, it's more annoying than anything else.

Is it related to the Hickman?
Is it simply a virus?
Is it a bacteria I can treat with antibiotics?
Will the Hickman get pulled?

We all watched Star Wars 1 (The Phantom Menace) at night - nice... The kids are into Start Wars - very cool! And watching it from the start is pretty neat - as opposed to starting mid way like 'we' all did.

Started out fine - working from home in case this thing acted up again, and then at about 9:30 the chills came on with a vengance. Put on extra layers, couldn't stop shaking (shivering), got in bed, put a heating pad under my back to heat up, was 99.5 b4 the heating pad, that raised it to 101.5. I'm going to the ER at Princeton, as the docs office wants to get me on anti-biotics asap, concerns about being septic (need to look it up).

I feel better now, not shivering, and we'll head off shortly. We'll get blood cultures taken, the works, just takes a bit of time. (don't want to get out of the bed though for fear of cold!)

Hung out at the hospital for a while, got blood tests (CBC - great counts, cultures), chest XRAY, EKG, all looked good. Nothing positive showed up, so hours later I was released, and Alex took me home (Thanks again!!)

Took 3 (325) Tylenol while at the hospital, and then 4 hours later 3 more, as I was starting to get chilled. The fever accompanies the chills... Started getting chilled at night again, and took more Tylenol at 9pm - helped. Called the on call onc just to keep him up to date.

Feel pretty good otherwise, just a bit tired, no doubt due to battling the fever...

NOTE - I appreciate the 'Comments' that are left on the Blog, and just want everyone to know that I try to respond with a little note on them after I read them. It's easier than e-mailing, and I can share more with everyone that's following.

Feeling a bit blah today. Seems I got a reprieve on the '2 days after chemo blahs' by a day. Usually, the first 2 days out of chemo, I have low energy, can't figure out what to eat, if I'm hungry, if I'm not, etc. Just a 'blah' feeling. No fever, no aches or pains, just not 100%. Still very doable, in the office for an 8am mtg, etc., but I opted out of a holiday dinner in the city tonight to keep my energy and not over-do it (and not get grief from any number of family members and friends).

So, aside from that, it's a good day, cold though! And I'm dressed for NY and not going! (I know, there are worse things.)

My buddy Andy is heading out to see another friend that just had surgery for colon cancer. A few years younger than me, and apparently it was emergency type surgery. Amazing this cancer thing....

One more thing - when I was getting my PET/CT Scan this past Monday as part of the possible 'lung biopsy procedure', I looked up at the donut type machine that I was going in, and sure enough, there it was, "Siemens". Immediately thought of Claus (and family)! (Our good friends that have hopefully only temporarily moved west, and who is employed by the same.) Glad you're still taking care of me!

Feel great today. Lots of energy, in the office, just a really good day. Had a great breakfast, lunch, dinner - appetite in general. Different than the usual day after chemo ends. I'll take it!

Good to be home too!!

Great night's sleep, last day of chemo for this cycle! Hooked up to Cytoxin, and I should get my pushes tonight a little early (s/b 12 hours after chemo ends) as they're great to try to get me home at a reasonable hour, and Alex has offered to pick me up.

Feel really good, there's been no sign of a temp at all, I have to get my CBC's for the week, I haven't been tracking them. I'll post them later.

Interesting on the CBC's, they trended up while I was in the hospital. I'll get them again on Thursday, so you can see what happens after chemo ends, and then again on Monday.

Got home, great to be home. Alex is great and picks me up, takes me out for a bagel, carries my bags, a good brother indeed. Many thanks.

Another good night's sleep - got up a couple times because of being a bit hot - the plastic mattress covers aren't great. And of course vital and blood checks, but good sleep overall.

Dose 4 (out of 6) of Cytoxin. All proceeding well.

Will get on the bike and do some work today. Should be a quiet day.

Got some good work done today (reviews that I needed to catch up on). Then Kristine came over and brought some excellent cheesecake that was supposed to be for Alex, but.... And she brought Dunkin Donuts coffee too - that was nice.... Then we played some game Bogle, that was appropriately named for me. Kristine beat the pants off me again, and again... She offered to lose, but I said that wouldn't be any fun, especially after I had become so good at doing that myself... Thanks for coming up!!

Got on the bike after that, did 30 minutes with an average heart rate of 165. It's the 2nd time on the bike in over a month, and it felt good, but hard. The resistance was all the way down, and the RPM's had to be around 65, and the heart was obviously still working pretty hard. Breathing was good, not too heavy once in my cadence. The legs felt it, but in a good way.

Great night's sleep - except for some poking and prodding in the early am.

Got on the bike today for about 20 minutes to get back into it. Also didn't have my heart monitor, and I like to see what's going on there. Chris is bringing it up today, along with the kids, with whom I'll get to have lunch! So that's a good day right there.

Getting Cytoxin, Mesna, etc. All standard stuff...

Chris and the kids came up, and it was great. We had lunch in the lounge, and then played John's Spiderman Match Card came, and then a 4 way game of war, where John won after being a card or 2 away from being out! Great to see Chris and the kids all at once.

Alex, Mom, and Dad came up after dinner, and that was also great. Alex and I started a game of Othello, but that got put away so we could all play Scrabble, where Mom won! Good fun had by all. Dad is looking good, and seems to be pretty much back to normal after his bout of fun this summer (kidney stones, etc.).

A very nice day....

Had a good night's sleep, no fever.

I've been given the go ahead for chemo today, so Rituxan should start soon.

It stopped snowing in Hackensack, but there was enough snow at home to close schools, so the kids have a 3 day weekend, and Mommy was going out to shovel the slush. Sorry Hon, I truly would rather be there shoveling than be here. UPDATE - Many thanks to Bill and Betty for shoveling the drive! Chris was taking pics of the kids, and when she went out front to shovel, Bill and Betty were almost done... Thanks again!!

Got Rituxan running at about 5:30pm or so, Cytoxin started (with Mesna) at 8:30pm - that'll run for 3 hours, and then 5 more times every 12 hours for a total of 6 treatments - which will go until Monday at 11:30am.

Leslie came up for a visit - many thanks, great to see her and catch up on our families, etc.

I think the fever may have broken last night. I was hot/cold during the night, but feel good this am.

Going to the hospital for chemo - or at least for observation before starting chemo! 10am reservation time.

Checked into the hospital, got setup, and they're going to wait on chemo until Friday - so long as I keep the fever down. Blood was drawn from each lumen of the Hickman, and also from an arm vein (peripherally) to get cultures started. I also got a nasal wash. Now there's a fun thing. They take a tube of saline and shoot it up one nostril, then you have to blow back into a container (repeat for the other nostril). They then culture that sample to see if you have any flu or RSV or related activity.

The nasal wash came back negative, as did the Hickman line cultures. Still waiting on the peripheral culture, but it should be negative. May have just been a simple virus that ran its course. If everything stays quiet, I'll get chemo tomorrow.

Ended up in the ER last night - fever got to 100.9, called the doc, and Colleen said to come in (want to make sure nothing's growing, etc.). So Alex gave me a ride there around 8pm, getting there at 9apm, a bit crowded so it took a little while, and then we waited in a hallway on a gurney. They took a chest x-ray (looked good), drew some blood, and talked to Goy. The fever had subsided to 99.4 by the time I had gotten there, and Goy was good with letting me go, just monitor it, and take Tylenol if it spikes again. I'm still scheduled for chemo tomorrow (a scheduling error bumped it from Wed to Thurs).

Many thanks to Alex for the trip - we ended up getting home arounnd 3am, but it was home...

It is kind of lame being in the ER for a fever, but it helps when you say 'cancer related' after to give it some credibility. (one of the conversatoins Alex and I had while waiting, and waiting, and...)

Weird. Started getting chilly around 1pm this afternoon, put on a sweatshirt (over my flan and t-shirt), and was still chilly. So I got in bed with the heating pad for my back, and to warm me up, and cranked up the heat in the bedroom. (Our master bedroom has separate heat since it was an addition.) Getting warmer, but sure enough, there's a temp, got up to 101.0, took a tylenol, and wait and see. It's pretty much the same story as yesterday, and since they drew blood then and weren't concered, it s/b the same today. If it goes much higher, I'll call. I'm still scheduled to go in tomorrow, so they'll have me under close observation.

Ok, the snow thing was a bust. There was snow, but not even a delay for school. Chris asked if someone did our driveway, but it just didn't accumulate on blacktop. So much for that...

Feel good, worked from home in the am, then headed into the office in the afternoon. Feel pretty good, Lana said I looked flushed, and my temp is 99.5, and I'm a little bit chilly, but I have short sleeves on. I'll put a sweatshirt on shortly. I do NOT want to delay chemo any more - confirmed that I have a bed coming tomorrow, just need to get the call from the hospital tonight.

Schedule to go in for some procedure to check my lungs to see what the 'opacity' in the pet/ct scans is. Most likely some fungus or bacteria that needs to be treated b4 getting more chemo to get it knocked down. Not sure of any details on the test, but I'll post once I get some. I think I'll be staying overnight, and not sure if I'll have connectivity (PC).

Finally got in to the hospital for the exam (some delays, confusion, etc.) around 12:30pm, actually in the radiology area around 1:30pm, and wheeled into the PET/CT room around 3pm. They do a scan of you to see where the 'stuff' is, and then they planned on giving me a local, and then inserting some scope in to take a biopsy of the 'stuff' to see what it is, and do pathology and cultures on it. Suspicion is that it's fungal, and not lymphoma (good of course - given the options). They did some scans - with me on my back, and then had me roll over and did another (a little different). The doc that was going to do the procedure then came in and said they weren't going to do it, as he had consulted with Dr. Goy, and the spots that had been there had dissipated considerably. We think it has to do with the antibiotic (Vanko) that I'm on. He decided not to do it as (1) they spots had shrunk, and (2) apparently it would be quite hard to actually get samples given how small they had become. I think there's also a risk factor involved, as when the doc was explaining the procedure to Chris and I, there's apparently a 10% chance that since they're inserting a needle in the lung, the lung can deflate. Sometimes it's no big deal, and it only partially deflates, and they effectively watch and wait, and it get's better, other times they need to assist and insert a tube and remove the air from the chest cavity, etc. etc. Regardless, seems to me that you need to weigh those risks with the chance you think you're actually going to get a good specimen with the fact that it seems to be getting better with current treatment, etc. I'm still interested in knowing if we should be treating it with something else as well. We'll talk to Dr. Goy tomorrow.

Still scheduled for more chemo on Wed.

Many thanks to all for the kind messages on the remission, we are very happy, and really appreciate all the support.

We're also getting ready for about 4" of snow tomorrow, and the kids went to bed with their PJ's on inside out and backwards - to help the snow close school tomorrow. (John's not in school yet, but he's helping sis as much as he can! - he even had his socks on inside out and upside down.)

going to bed, it's after 11pm, and i just saw that my lovely wife has her pj's on inside out and backwards too! oh well, gotta go with the flow!

It snowed last night!! About 3 inches of wet snow, but it covered everything!

While we were making breakfast, Chris mentioned that someone was on the driveway. Sure enough, someone was, and shoveling for us - Earle and Marsha - MANY THANKS!!

A great breakfast, church, some errands and then Chris tried to get a Christmas picture of the kids. That's always a fun time. John is pretty much Calvin of Calvin and Hobbes. Try to take a picture of him, and it's good for about 40 pics. Thank goodness for digital cameras. I think we got a winner though. I'll post it when we sort through the pics.

The kids and I played in the snow, and made a small snow fort. They wanted to do battle with Mommy, but I said she's not much of a warrior - try me out!! So we had a snowball fight. The kids had their fort, and I was unprotected on the other side of the driveway. Luckily, they couldn't throw that far. I got a couple of good shots in!!

We had another fire in the fireplace, played Old Maid, and then watched some home movies.... A good day.

Still not sure when my appointment is tomorrow for the lung scan thing - or what exactly the procedure is. I called the hospital, and the group that does it is the 'special services' unit of radiology, and they're not in on Sundays - so I'll be calling them at 7am tomorrow.

My nephew's 1st Bday part was today! He's doing some walking, so that was great to see - gettting more of a personality, all the good stuff. A great time was had by all, thanks Peter and Karin!

Came home from that, had a fire in the fireplace, and then Uncle Alex came over and he, Em, and I watched Harry Potter and the Sorcerer's Stone, and John and Chris watched Scooby Doo and the Headless Horseman. John came in and out to watch parts of Harry Potter, but it was a bit intense!

Back pain started up again today. Ironic - a couple of days after the PET/CT scan, same as last time. I tried not to do anything wrong when getting off the table, but maybe I swung my legs wrong, dunno. I'll talk to Dr. Goy and my family Dr. about it.

Had a 10am appt with Dr. Goy today, which meant that I got in to see him around noon.... I think this is fairly common nowadays with any specialist. I did get my blood draws prior to that, including vanko levels, cbc's, etc. All from the port, so that was painless!

Then we did get to see him and got the good news - Remission! So, 2 days after my birthday!!(Almost as good as Cory's news on his birthday of his MCL remission!) Many thanks to all our friends and family whom are as happy with this news as we are! 2 more cycles to beat the heck out of anything that remains hidden, or just to make sure everything's been beaten down. I liken it to the horror movies when you want the hero to make sure they 'take care' of the beast/creature/maniac/etc. - use the extra 8 bullets - make sure it's gone. 2 more rounds of chemo, do it - just make sure you beat it down.

The PET/CT did reveal some 'mutifocal opacity' in the lungs, which 'may be infectious in etiology' (direct from the pet/ct reading doctor's notes). Seems there's some stuff showing in the lungs that doesn't look like cancer (no activity on the PET, but more visual through those tests. It showed on the previous PET/CT round, and it's there again on this one. Goy suspects fungal, or bacterial activity - could be from the hospital, etc. He had a pulmonologist (sp?) check out the slides, and I have an appt on Monday with one. There will be some testing performed to see what it is, and get it treated. My chemo (Round 7) had been scheduled for Sunday, but Goy wants to back off on that a few days to get this identified and treatment for it underway. Makes sense. No need to reduce the body's immunity through chemo while you know there's something going on - that you haven't identified yet. He's not 'that' concerned with it - it's a bit of funk that needs to be treated, and then we move on. He's setup my chemo bed for Wednesday, so that's encouraging. (I will miss my work end of year meeting/party, but a small price to pay....)

Seems part of the testing may be the insertion of something into the chest cavity to check the lungs - done with a local, and promised to be less painful than the bone marrow aspiration. Now, there's a good barometer of discomfort. For those that have had them (bone marrow aspirations), they are NOT that fun. 'Discomfort' is a good term for it, and frankly, anything involving 'discomfort' and 'you'll feel some pressure' is not good. But, since it's less than that, I'm sure it will be fine... All in all, I'd rather have a general, but I'm sure that's not gonna happen.

Also - good luck to Allison, who's on a tough diet this week of Lamb, rice, and water to rule out some allergies. And nice job to Mom and Lauren who are doing the same diet to hang tought with her! Good luck guys, it'll be over soon, and then you can get back to some good eats!!

Another good day. Feel good, still taking Vanko.

Went to an allergist today to see if I'm allergic to penicillin (PCN). All tests were negative - so it looks like I can get PCN next time instead of Vanko, which should be more effective for fighting B Cycle infections. Good stuff.

Another warm, sunny day. Hard to believe it's almost December!

Good day, did the Vanko in the office again.

PET/CT Scan tonight, no eating after 12 noon!

Good day, feel completely normal. Good day at work.

I've been taking my vanko while at work in the am. It takes an hour and a half to drip, so doing it at home when I have 8:15am conf calls just doesn't work out, so I bring my pole, bag of vanko, and associated stuff to the office, close the door, and do my thing.

Slept at Mom and Dad's again last night - thanks! Got up early and headed off to Hackensack for a blood draw (CBC's, Culture, Vank levels, the works). CBC's were good, Platelets are at 43, coming back. All the rest are fine. Want to get the culture results so I know if the line can stay in or not.

Went to work right after, and hooked up my Vankomycine. Did some conf calls, and it was a pretty good day!

I'll be heading home and sleeping home tonight. Chris is doing better, and I really miss being there! Mom and Dad's is great, but there's no place like home!

Made a Dr. appt for Thursday to get checked for an allergy to pennicillin. I'd like to be able to get that for the next neutropenic fever (which will happen in January).

This week I have a PET/CT scan on Wed, Allergist on Thurs, and Dr. Goy follow-up on Friday for the results of the PET/CT scan.

Good to be home! Stayed at Mom and Dad's at night, as Chris and Emily are a bit ill, but I went home about mid-day and we put up a Christmas tree (artificial) in the kitchen, put lights on, decorated, etc. John and I did some "fixin'" of some of his toys (dead batteries) - always a good time in the basement shop. Had dinner together, hung out a bit, and then headed back to Mom and Dad's. Hung out with Alex and watched some family videos that I had copied from 8mm tape to DVD. Good stuff.... Did a bit of work and packed it in.

Great night's sleep last night - the 10mg Ambien may have had something to do with that! ; )

Feel good, fever has been under 101 for a while - 99's, and one 100.1 last night when playing scrabble, so it looks good for release today. Just need to get all the Dr. signoffs.... WBC's are 8.something, so they're nice. Not sure of the other numbers yet. Want to see the PLT's jump up a bit, but they were coming along. Platelets were still low (19), but I looked at the log, and they take a while to come back, and then they tend to come back strong.

I'll be back here in just over a week for the next round, so I'd like to get out and spend some time at home! I'll be wearing a mask at home, as Chris is still under the weather with a bug, and Em's got a little something, so caution there.

Temp has stayed down, and I got the go ahead for discharge around 4:30. Disconnect, new caps and dressing, flush, and get dressed for home! Alex and Dad are heading up to pick me up, stuck in Thanksgiving weekend traffic, so it'll take a little bit.

Stopped by to see Steve, and his Mom and Dad were there too. He's making an incredible recovery from the pneumonia, etc. I'm sure I'll get to see him during one of the next few sessions!

Did not sleep well last night. Woke up around 2:30am, and tossed and turned for the rest of the night. They stop giving out ambiens at 2am, so that was out of the question. Temp was 102 when they took my vitals at 5am. Not sure where that came from, my temp had been good (under 101, and really in the 99's) before that. Maybe it just broke....

Dr. Goy stopped in this am, and he wants me to stay one more day due to the 102. The cultures were still positive, so he still hopes the vanko can kill them in the hickman, but if not, the hickman will have to come out. If I get more fevers, he wants cultures drawn. He also wants me to come to his office on Monday to get blood drawn for counts and cultures. So close, but yet......

My WBC's are 3.7 - so they made a huge jump up. All the Nuepogen helped, along with the fact that it's now day 10 post chemo, and that's when you're supposed to start back upward. I started to get some bone pain yesterday - in the knees and hips - normal stuff towards the end of the Neupogen cycle for me. Platelets are at 19, coming up, so that's good.

I feel fine, decent energy, etc - great looking day out - blue sky, etc. Chris said it's in the 20's though, and there was a really strong wind yesterday that blew some of our stuff around! Chris is stil under the weather, and will hopefully be turning the corner on hers (and not prove positive for mono!). Tonight's the local town Christmas parade, and the kids should get to go see that.

Alex and Kristine stopped by tonight, we played Othello, and Scrabble. I beat Kristine at Othello, and she kicked Alex and I in Scabble (Luis, don't ask, it wasn't even close! - she opened with all seven letters.). Thanks for the visit guys, very nice. (Alex has become quite a fan of the hospital's grilled cheeze sandwiches.)

Looking forward to going home tomorrow - barring any weird fevers.

Our most sincere wishes to everyone that's looking at this for a Very Happy Thanksgiving to you and your families! Lot's to be thannkful for. If you've not read it, I'd encourage you to read Steven Meyer's write-up that I've posted on the Personal Note Tab titled 'Note from an MCL'er' http://fightingmcl.com/index.php?blog=11. I'm sure you can apply it to many things in life, and it certainly puts things in perspective.

Medical
Counts are still low - Platelets were 5 this am. So, 2 more pints of blood, and 2 more units of Platelets. I've not kept close count, but that has to be either 10 or 12 units of red I've gotten over the entire course. Goy stopped in this am and said, the chemo gets to the bone marrow, and that's what it's doing, impacting my bodies ability to make blood cells - temporarily. And it does seem to have a cumulative effect, which we expected. I had a tough time with the 2nd B cycle, but bounced back relatively quickly, this one's taking a bit longer. To be expected...

The kids both made great Thanksgiving projects that Alex brought up last night. Emily made a really cool looking turkey that's hard to describe, but all the nurses have complimented it; and John made the traditional hand turkey - and it looks really cool! Both are proudly displayed on my window sill!

Alex and Mom came by with great eats for me - turkey, stuffing, sweat potatoes, pumpkin pie, some apple thing, all excellent!! It wasn't the same as being at home, but it sure tasted good!

They left, I watched a movie and went to sleep early...

Slept better last night, so I'm very happy about that!

Medical
Saw Dr. Goy this am, and my WBC's are still .2, HGB 6 something, PLT at 11. Goy really wants to get me home for Turkey day, but he also doesn't want me to have to come back here by way of the ER. The ER route usually means about 20 hours of moving from a general ER booth, to a private room, to some other room, etc - and then to the 5th floor - hopefully. So, it's smarter to stay here if my counts are low, and they are. However, they could turn (upwards) and he'd be happy to let me go. He'll be making rounds tomorrow, so if I'm good, he'll get me out. My temperature seems to be down, more in the 99 range than the 102 it's been.

Goy has me on Neupogen, which is normal, and he's giving me another shot that's got a similar use (raise the WBC count), and Mary (nurse) just told me he prescribed 2 Neupogen shots for me today! So he's really trying to get my WBC count up! Gotta love him.

I'm getting 2 units of Platelets today, as well as 2 pints of blood. He's trying to boost me up on all fronts so that if I can go tomorrow, I'm all set! At the least, he doesn't want me to have to deal with the blood pressure cuff on all the time during Thanksgiving. You have to have your BP monitored every 15 minutes while getting blood - and it keeps you tethered for the most part. You can walk around with one pole with the pumps and bags of stuff, but 2 poles is more than I can manuever!

Just saw the infectious disease dr. They drew blood for a culture this am, and if that's negative, that's good. if it's positive, the hickman may have to come out, as the bacteria would still be active in the catheter, and that's not good.

Overall a really good day, a Joisey boy turned country bumpkin named Vinny stopped by for a visit - great to see him and catch up! He hasn't picked up a twang yet, but I'm waiting. My brother came up at night with some steak and keilbasa (sp?) that we had cooked up at home earlier in the week - and Chris packaged it up with some baked potatoes and veggies, so we feasted on that. Amazing, Alex wasn't hungry, but managed to devour his portion in no time flat.... Watched some Seinfeld, and re-watched a movie called the Princess Bride. Neat movie - lighthearted, but really cool. Fred Savage, Peter Falk, Billy Crystal, Andre the Giant, and those aren't the main characters - interesting cast. Famous line - 'My name is Enigo Montoya, you killed my father, prepare to die' with a heavy Spanish accent.

Interesting hospital fact - they have a decent menu, but there are specials every night (which I knew, and ask about), but they also have specials at lunch! (Hey, if you're stuck in a room for 4-5 days, little things make you happy - and we all know, meals are one of the key highlights of the day - right Andy?) They also have things like Gatorade to drink - that's not on menu. Bottom line - ask... They apparently do try to be a bit more flexible for our floor (5), and 8 (stem cell transplants), as we tend to have longer stays.

Had a so-so night sleep. I was running a fever around 102 last night, so they'd wake me for tylenol, various checks and drugs, and... I'll catch a nap today.

Medical
The antibiotics I'm on are Vankomycin and Azactam. I need to get tested to see if I'm allergic to Penicillin, as the doc would rather give that than the 2 other ones. Apparently, Penicillin is a better broad spectrum antibiotic, and does a good job on this kind of infection. (I had a reaction to Penicillin when I was a child.)

WBC count is still .2. HGB went up to 7.2 (2 pints of blood yesterday). Saw Dr. Goy and Phyllis (Nurse Practitioner), and Goy will try to get me home for Thanksgiving - so long as my WBC counts are up. If they're too low, I'll just end up back here... There is an infection, some strep.. or staph... thing that they'll treat with Vankomycine (I'm allergic to Penicillin), and that should clear it up. The infection is in the Hickman, and in my body, so it needs to be knocked out of the Hickman - which should happen with the delivery of the antibiotics through the Hickman. Otherwise the Hickman has to come out - and I don't want that, not with 2 treatments to go.

fwiw, Phyllis was not as optimistic about release date, she said the WBC's usually come up around day 15-17 (counting from the start of chemo), and that would put me at day 12 right now, and 15 w/b Friday. However, I'm still getting Neupogen, and Goy was going to bump up my dose I think. It'll be what it is....

Medical:
Feel fine this am, a little beat, so it could be the effect of the temp I had last night. I should also note that after the B cycle specifically, I tend to get a bit of a nosebleed. Not running blood, but when I blow my nose, there's usually light blood in the tissue. I talked to the Doc about it after the first time, and he wasn't concerned. I've looked online and it is one of the other side effects of Methotrexate. Again, it's just when I blow, so it's not a big deal - more reference for anyone else that experiences it - but check with your Dr. as always.

Going to work from home today. I have some meetings I have to dial into, but I'll need to get blood drawn, and I may run a temp in the afternoon, so I'm better off being here.

Chris said it last night, this fever, then one more (cycle 8 - if I get one then too!), I can deal with that.

Went to the Dr's, numbers were low, WBC .2, HGB 6.8, PLT 20, so in to the hospital - a private room on the 5th floor - nice.... Getting some blood, some platelets, and some more blood, and then some antibiotic. Hope to be healed up by Thanksgiving.....

Saw my buddy Steve - a fellow MCL'er that I met on my first day of treatment. He's recovering from a battle with pneumonia, that had him in ICU for 8 days. He looks great, sounds great, and has his usual energy - so you'd never know he was hurting recently! Got to see his Mom and Dad (Murray and Barbara) as well, and they're just great people - really nice family.

Another great day outsdide. We're waiting for Emily to come home to hear all the news about camping!

I feel good, just a little winded after doing stairs, etc - so I'll bet blood taken tomorrow, and I'll have results on Tuesday, but it'll be good to see what the trend is this time. Probably take it again on Wed, as Thursday's Thanksgiving.

I'm still not exercising, taking it ez on the back, which is about 95% better, I just don't want to do anything stupid to it. It was way too sore last time!

Emily came home and had a great time, and we all played in the basement for a while with Pirates!

Medical:
I took an hour nap at some point - again, trying to keep healthy. Went to my parents for dinner, and after dinner someone felt me head and that led to a temp taking, and it was 99. Need to watch... Before going to bed I was a bit chilly, after getting in bed and warmed up, took the temp, 100.8 (subsequent temps were the same or 100.9). Called the doc, he said I was reaching that point again - 5 days out - where the numbers s/b dropping. So long as I wasn't shaking, which would mean an infection that I wouldn't be able to kick on my own (I'm still taking Cipro, etcc - so I'm on antibiotics already), I could take a Tylenol, and call the doc in the am to see what he wants to do. Most likely blood tests to check levels and maybe a culture. Probably have to go to Hackensack to get those developed quickly, or maybe at the Hamilton center, not sure. Got good sleep overnight, got up a few times and checked the temp, was usually at 98.8 or 98.6 - so it came down. I expect it'll go up again on Monday - that's the usual pattern. Avoiding the hospital w/b nice though!

Beautiful day out! Alex came over and helped us clean up for the season - re-arrange the stuff in the shed, put some firewood up by the porch, store the table, etc - MANY THNANKS! (I'm stil trying to take it ez on my back, and I'm not supposed to expose myself to too much bacteria, etc.)

Emily went on a Girl Scout camping trip, her first one without Mom, and we got a call from her at night - where she sounded like she was having a great time! (They're in cabins with heat and electricity, so it wasn't that cold....)

We watched 'Iron Giant', a 1999 Disney/Pixar type movie that was really neat - great story/message, and John is HUGE into it.

Feel good, energy level is good. Took a nap during the day for about 45 minutes to try to stay on top of things.

Went to see the Dr. today. Good stuff - he's happy with results. My blood counts are good (for post B Cycle). I'll get a PET/CAT next week, as the last one (after the 4th round) still had some 'shmutz' on it. Endo/Colon and Bone Marrow are clean, so it's just the PET/CAT that we need clean now. We talked about follow up PET/CAT scans every 3-4 months after treatment ends in Dec - that'll be great! (We'll do another PET/CAT after the 8th treatment as well.) This was record time for the Dr. appt btw, only in the waiting room about 10 min b4 blood draw, and then about 5 min after that got to see the doc - amazing.

So we're pretty pshyched. Hopefully after the next PET/CAT it'll show complete remission. Aside from that, I feel good, and again, hope not to go into Neutropenic fever this time.

Pete and Lisa watched the kids while we were out. Chris and Pete cleaned up leaves in the am, then Pete and Lisa did more in the PM, and then Pete did the lawn, finishing just after dark fell! MANY THANKS FOR ALL THE HELP!! I can't wait to get back to doing that stuff...

Another good day - even if it is 30 degrees colder than it was yesterday! (Mid November, go figure.)

Need to keep taking the mouthwash to make sure the mouth sores don't appear. It's baking soda and water, but helps to keep the mouth from getting mucositis (sp?), which can be brought on after chemo as your mouth can't fight the basic bacteria that's there. The baking soda helps to neutralize it I suppose.

Feel good - still a little bit of funk, but not bad, getting good work done.

Glad to have slept in my own bed last night, and to be back home!

Feel good, just the usual day after chemo funk. Heard that I sounded a bit out of it on 2 conf calls in the am, but I felt fine, may have just been a bit groggy.

Not too hungry, but eating well enough. Put on too much weight. A lot of it seems to be fluids - still drop about 8-10lbs overnight. The 'B' cycle is the one you really need to drink a lot with to flush out the methotrexate. Not exercising has hurt, but the back is getting better, so once that's back to normal, I'll be back on the bike. Taking a muscle relaxant for the back, and using the heat pads still. No pain killers needed.

Highlites of the day - parent teacher conference, classroom observation, and a PTO meeting at night (with some work inbetween!). It's good to get back into the swing of things.

Ironically, was wiped out at night, but took a while to fall asleep - hate when that happens!

Last chemo finished up around 4pm (Ara-C), so now it's just monitoring Methotrexate levels to make sure I can leave today. ETA is noon-ish, but that may be optimistic. It never seems to go that smoothly. And I need to work out a ride home!

Feel good, on conf calls all am. Another good night's sleep!

Talked to the doc about the timing of Neupogen, and general 'B' cycle effects. (The 'B' cycle is harder on me, and I may end up with Neutropenic fever - where your white blood cells (WBC) are too low to fight bacteria that normally live in your body, and you get a fever.) He said there's really nothing you can do to prevent it, and getting the Neupogen a bit earlier (24 hours after chemo as opposed to 48 hours after) will probably not help. It seems it's a matter of your body being beaten down by the chemo, and there's not much you can do about it. If it's gonna go low, it's gonna go low. You obviously don't want to stress it, but.... I had previously gone with the idea that I'm going to end up in the hospital with the fever - since I did after the second 'B' cycle, and the first one saw me with a mild fever, but I've recently taken a more defiant attitude and I'm determined NOT to end up with the fever! (Mind over matter? whatever, I'll do what I can!)

Great night's sleep. Feeling good, back is feeling better.

Chris came up and let me beat her at 'Spit' the card game! She's too good to me...

Good day, did some work, etc.

Aunt Joan and Uncle Jim came up and hung out for a while (thanks!), and I went to bed around 9pm, was beat!

Counts look good, actually going up - seems to be due to the steroids. Looks like I should get out on Tues, my Methotrexate level is at .18, it needs to be under .1 for release.

Great night's sleep. No back pain to wake me up. It's still there if I move the wrong way, but feels much better. I'm on a muscle relaxer (Flexoril - ap?, 3x per day) that I started on Wed pm, took all day Thurs, then only took one on Friday (due to checking into the hospital, and having them check out the meds), and I took all 3 yesterday. I can't take an anti-inflamatory, as you can't have anything that thins the blood while on chemo. Regardless, good night's sleep! just woke up at 4am for the blood draw, and then at 5 for vitals and weight check.

Doing some good reading (trade rags, bike magazines, medical stuff), and on the pc of course. A laptop is essential for these stays. Even if it is connected via dial-up, it's a wonderful thing to have. FWIW, I don't even turn on the TV when I'm here. Just watch the occassional DVD.

Chris and the kids came up, we had lunch in the lounge, and then spent some time outside - great weather! Great to see the kids, and of course Chris - a little quality time like that goes a long way!

They left, and about an hour later Alex, Mom, & Dad came up. Everyone looked well, and they even brought a care package - pecan pie and ice cream! So we had some of that, and I got a slice for dessert later! Good stuff. Another great visit. They left and I nodded off for a bit - after some pre-med I got.

Medical:
- Finished the 24hr Methatrexate around 11:30
- Delayed getting hte Ara-C until after Chris and the kids left so I could go outside. They don't let you off the floor it you're hooked up to chemo. So I got pre-meds for that around 2pm (mostly for anti nausea - apparently Ara-C is known to cuase it.) Got Solumedrol, A..., and....
- then the Ara-C starts for 2 hours, and you get that on a 12 hour cycle for 4 cycles. So it should be (1) Sun 2pm, (2) Mon 2am, (3) Mon 2pm, (4) Tue 2am. They then need to check my levels and get me on Leucovorin to knock the Methotrexate levels down. That determines when I can leave. Hopefully Tuesday evening.

Feel great though!

Saw Pedro leaving today. He just finished up this 2nd cycle, his first 'B'. Looks good! Looks like he did a bit of a haircut, as would follow from the 'A' Cycle, where about 2 weeks after you notice a bit of a thinning taking place, or I did. Best to he and his family!

Woke up around 3am with more back pain, bot more meds, and that seemed to roll into the 4am blood draw, that rolled into the 5am vitals and weight check. I'll nap today...

All looks good, and they hooked up my methotrexate (1st one is a 2 hour dose) around 8:30am, after some pre meds (cortiosteroid and kytril - both IV). They hooked up the next bag of methotrexate (24 hour one) around 10:30am. So that'll run until tomorrow, then the Ara-C starts.

Chris came up and beat me at Scrabble. But she also brought me home-made chili, corn bread, and iced tea - and of course she was here, so I can take the beating at a board game! The kids are coming tomorrow, so that'll be nice - maybe it'll get warm out and we can venture outside - wishful thinking.

All else is well, just doing the PC thing, some reading, and trying to stay off my feet to heal up the back.

Went to bed around 10:30, no back pain - hopefully a good night!

Headed off to HUMed at around 9am, got there at 10am, got to my private room - yes private room - on the 5th floor (just worked out that way). I'm just happy that I got in for chemo - they're still backed up with beds, and sometimes have to push people out for several days.

Got my fluids running, and then they hooked up the Rituxan - that finished around 5pm. Methotrexate starts tomorrow.

Did some mails, etc, then watched a movie. Back started to act up towards the end of the movie. Not sure why, but got a pain killer and that kicked in eventually.

Great day, the kids had off from school, so we went to the beach and took a walk along the water, played on a playground, ate some pizza, and had donuts and coffee (ok, i had coffee), and headed home. It was cool and windy, but just a really nice day, and great to get some fresh ocean air.

Did some stuff at home, and then we watched the Incredibles, the kids love it, and I think Chris and I were pretty glued to it as well (even though we've seen it b4).

A quiet day. Did some work on the PC in the am, got some paperwork done - taking it ez on the back. Ironically, time spent sitting it tougher than standing!

Went to the doc for the back, he thinks it's a strain, the muscles are tight on the lower back, and it seems to involve the psiatic (sp?) nerve as well - shoots down the legs a bit. He said the remedy is being horizontal - so 5 days of chemo should do the trick! Also gave me a script for muscle relaxers and Davocet (sp?) for pain. Did the muscle relaxers, and that seems to help, and I'm using the Therma-Wrap - disposable 8 hour heating pad - helps!

Aside from that, all else is well. We may go to the beach tomorrow, as the kids have off, and that's not too bad on the back!

Back's still sore - made an appt with the family doc to have it checked out, that's tomorrow. Tried one of those disposable heating pads today - gets warm just by taking it out of the foil packet. Has a bunch of 'discs' that get warm. Seemed to help.

Chris and her father put a coat of driveway sealer down today, as I was not allowed to do it. THANKS!!! They also did some leaf blowing, but I got to help there.

Good otherwise - still scheduled to go to the hospital on Friday - if there's a bed available.

Good day, nothing major. Day of vaca, so chores around the house - need to get caught up on some lost weekends!

Another good day. Did get on the bike this am. Only for 20 minutes. Did 157 avrage heart rate for the 20 mins. Want to got back on tomorrow. My legs felt it today! Weight is still almost the same (204 vs 198), but there's definitely been a bit of a shift. Jeans are a bit tighter, not as strong, etc. I haven't been on the bike as much as I had been early on. Part of it is work, part having a fever etc and not wanting to stress that, part laziness I suppose (not getting up early enough). I need to get back on it. Fall usually takes a bit of a toll on training, so that's part of it.

Had family breakfast (great to be home), church, John had a b-day party to go to so Emily and I dropped off Mom and John, and we went to do some shopping and then had lunch at Friendly's, picked up Mom and John, then went home. I went to Home Depot and the auto parts store to pick up some supplies for this week's chores... Dinner and hanning out with John in the evening (Emily and Chris went to a Girl Scout sing-a-long). Stories in bed with the kids, and then relaxing...

What a great weekend....

Delayed entry - busy weekend! Another good day.

Was going to get on the bicycle this am (for a trainging ride), but opted to stay in bed with the family for a great morning of four of us in a queen size bed. You just can't beat that.

Went to an open house for John's nursery school, then to Lamberville to the Flea Market to try to find a toy dealer that's supposed to specialize in McDonalds toys - no luck, but there were some other big events that some of the dealers may have been at. So we stopped in Lambertville to check drive by Joe & Michelle's house - very nice!! They weren't in, but we left a v-mail... Then we ate lunch at the Full Moon. The decision to eat ther was partly based on the fact that they served grilled cheese sandwiches for the kids! Good place though.... Then home for some chores.

Finally we went to Alex's to try out his new chimnea - really cool! It's a steel one that provides 360 degree access to the fire (through a grate). Made smores, had hot chocolate, etc. Great time, and then back home. The kids got to bed too late... I took the bike there (as I went early to help put it together), and it was a bit chilly on the way home. That, and some fog had settled in, and the deer were out, so a very alert ride home. That, and my back's still bothering me, and the bike was NOT the most comfortable. Need to get the back healed up before taking it out for any rides...

A great day!

Delayed entry - busy with work. Another good day. Feel back to normal, but still going to bed early to get lots of sleep. Looking forward to the weekend, and some vacation next week!

Delayed entry - busy with work. Another good day. Feel back to normal, but going to bed early to get lots of sleep.

Delayed entries, busy with work... Good day - back to normal for the most part, just a bit tired at night, so I go to bed early. Must have done something to my back again - it's sore a bit...

Back in the office - and good.

Diwali (Indian feastival of Lights). GREAT home made treats, good to come back on a day like that! Bunch of meetings, catch up with some friends on activites, etc. Felt good all day, just a little tired at the end.

Can't believe it's November already!

I've posted all my CBC counts under 'Background', as I don't know where else to post them. I'll try to keep them updated on a fairly regular basis. You can see there's a downward trend, where the average is getting lower - all to be expected. The next 'B' cycle should test the limits again, and I expect I'll be getting some more blood after it. I've had 8 pints of red so far (6 after the last 'B', and 2 after this past 'A').

There's a fellow MCL'er in Chicago - Cory, that's 39 (1yr my senior), who's body seems to be taking this a bit better than mine. He had some blood after 5, but I don't think he's had as much as me. So - again - results vary by individual. Still - I was on the stationary bike during the last 'A' cycle for 3 of the days - so even though the body needs some help, you can still work it pretty hard!

In the Hospital with a fever.

Fever's been down since yesterday am (nothing over 99), so I'll be getting out today. I may get another pint of red depending on the CBC's from this am, and I'm hoping to get my chemo push today (Vincristine). I should see my doc (Dr. Goy) in the am, as he has rounds. Hopefully I'll get out in the afternoon, and get home for the evening's activities!

Feel good, GREAT day outside, I'd like to get out to take advantage of some of it. It's weird being inside for several days straight.

Fever stayed down, got my Vincristine push, another pint of blood, and I'm all set to go home. Will hopefully meet up with the kids to go trick or treating while they're still out.

Got home as the kids were coming in - so they were still in costume! Checked out the candy, and may have sampled a bit.... Hung around for a while to see them, and then stayed at my parents to stay away from some of the germs bouncing around the house - need to stay healthy.... It's tough, want to see the family, but also want to stay out of the hospital.

Many thanks to Alex for the trips back and forth to Hackensack.... and for getting me home in time to see them in costume!

In the Hospital for a fever.

They feel it wasn't really Neutropenic fever, as that's when your WBC's are .5 or lower. Mine were alway at least 2.5, and I'm at 4.6 now (Neupogen shots helping). So it was probably some bug that I got, and either the antibiotics are helping, or I'm just fending it off. The cultures came back negative, so it seems there was nothing bacterial going on.

My fever seems to have broken, I had a 102 last night, but at the 4am vitals check today, it was 98.4, and 99 when I woke up - but I had too many blankets on when I woke up, and was hot.

My other counts are dropping still (still going through the Nadir - day 8 today), so my HGB is at 6.8, and Platelets at 94. I'll be getting a unit of blood today to boost the HGB, so that's good. Ironically, I feel better today - not that I felt bad before, I just feel better - more energy, more alert, etc.

I need to see if I can get my chemo push while I'm here, and what the determining factors are for that. I think I'll probably be here until tomorrow, to make sure the fever is gone, and that'll hopefully enable them to give the chemo as well. hopefully....

However, I need to be home to see Halloween tomorrow!

At the Hospital for 'Neutropenic Fever'.

Feel the same - actually feel pretty good, it's just the chills that kick in towards the evening, and then I get a bit tired. Aside from that, all else seems well.

I was supposed to get my Vincristine and Adrimycine pushes yesterday, which obviously were held off, so I'm hoping I can get them while I'm here - if my counts are good, etc. Not sure what the other qualifiers will be.

Since I'm on the 5th floor, everythings good - comfortable with the care/staff, and know my way around.

At the Hospital - for 'Neutropenic Fever'.

Got to the ER around 1am, the doc had called ahead, so they new about me. Regardless - they're really good with getting you from the waiting room into the ER. The waiting room is virutally empty, but the ER is a very active/swamped place. Got a separate room in the ER - nice... Got blood taken (from a new IV they inserted - the onc nurses tell me the ER's really not good with the central line catheters - it would be much nicer if they could just take from there instead of sticking you again!), chest X-Ray, etc. They started the Vankomycine IV antibiotic almost right away, and another one that I need to get the spelling of. I moved from that room to another room in the 'expansion' area of the ER (private room again), and we stayed there until around 5pm, when I got moved to the 9th floor for about 5 minutes, and then to the 5th floor (yes!). We got all setup on the 5th floor and felt at home (unfortunte/fortunately....).

Alex was great, staying the whole time, sleeping upright in a chair, etc - making sure I was getting good care. Many thanks... Chris was at home with the kids, and now sounds a bit like Mickey Mouse, as she has close to no voice. She did go to the doc, and they think it's either allergies or a virus, but she has some stuff to help clear it up.

I went to sleep around 9:30pm, just beat from the day... Slept pretty well, had a fever on and off, complete with sweats, etc. Got Tylenol at 4am or so as I was over 101. I seem to be having a tougher time kicking the fever this time, but then, last time I may have been getting a lot of Tylenol as a pre-med for the infusions I was getting, and that would have helped knock the fever down.

Woke up a bit later than usual, as planned - to try to get rid of this fever. (Also got up about every 2 hours last night, so needed to rest up a bit.) Felt pretty good, going to work from home today to take it easy and not subject myself to too much (but like I've said, there's illness at home, so... I'll wear a mask when needed).

Temp seems to be staying at the 99 range (but was 98 when I typed this!- good, as I'm usually low) - I'll just watch it (as you're supposed to do for the 10 days following chemo anyway.

Have a Dr. appt tomorrow to get my 'pushes' anyway, so I'm hoping I still get those, and of course I'll get a once over, AND I'd like to hear how the PET/CT/Colon/Endo tests look - to the Dr. I've read the Colon/Endo, and it says there's no sign of MCL, that it's in remission. Just need to get the same from the PET/CT!

Started to get chilled in the afternoon again (around 3pm), and the temp went up some more. Ended up just over 100, so took 2 Tylenol to do the same thing I did on Wed. They didn't have a reducing effect, but seemed to keep it at that level. Rested up on the couch, keeping warm (as I was chilled). At some point, the temp was 101 and change, and we called the doc. Given we had an appt the next day, he said we could do the Tylenol every 3 hours, but if I started to shake (overly chilled), or feel bad, to call back. The temp slowly crept up, and hit 102.3 around 11pm. Called the doc again, and he said to come on in... Called Alex, he came over and we left for the ER just b4 midnight.

Update on everyone else with infirmaties:
- Dad seems to be doing better - more energy, apparently rated himself a 7.9 out of 10 the other day.
- Chris is still fighting some bug, having a rough time getting rid of it.
- John III is almost done, just an annoying deep cough
- Emily seems good - just a little cough
- Kristine had ACL surgery and is recovering quite well! (Pain killers are good food.)
- Alex doesn't know which way to go.

Good day, stomach's still not quite right - more annoying than anything. Just had some cheese and that was good! Dropped some weight last night (yeah, up every 2 hours or so.....) They pump you so full of fluids in the hospital to flush you out that you're pretty bloated when you leave. My face has been fairly puffy, despite only being up about 5 or so pounds. (202 this am, usually around 198)

Working away...

Got a great note from Chris (my lovely wife) in the comments section today. It's all hooey, she's the one really keeping this all together (scheduling, motivating, etc), I'm just going throught the paces! Love ya hon...

Got my CBC results, WBC 34, HGB 8.9, and PLT 299 - so that's all good.

Ended up with a slight fever in the office, 99.2, no biggie, but after going home and taking a nap (feeling a bit tired and chilled), it went up to 100.8 - while under lots of covers... Rested some more, took off some covers, lost some of the chill, and it went downt to 100.5, so we called the on-call (Dr. Shu). Based on my good cell counts it doesn't seem like Neutropenic fever (from what I understand of it - my WBC counts are fine - I should be able to battle infection), however we are battling sicknesses in the house - normal fall stuff....

So.... Take 2 tylenol, watch the fever, if it goes up, call back/come in. Watched it, and it finally went back down to 99.3 after about an hour, and stayed there most of the night - without any more Tylenol,

Feeling better stomach wise today. It's usually 2 days that it takes for it to wear off (how much of that is mental, I'm not sure).

Will get CBC's today to see what the levels look like, but won't know for a day or so.... Always curious to see where they're at. Feel good though. Haven't been on the bike since Sat, but felt good huffing it in NYC yesterday, only did a flight of stairs at a time.

Went to NYC for meetings all day. Still feeling the stomach thing where I don't know if I'm nauseas, hungry, etc. Just annoying, no big deal. Took an anti-nausea pill at some point, and ate just fine throughout the day. Did not want to drink any water (and I usually love water), but drank quite a bit of hot tea, etc. trying different things seems to help. A friend tells me it seems like I'm pregnant....

Held up well, took a nap on the train for about 15 min on the way home, and just took it ez in the evening. We've got some colds floating around the house right now, so we're watching that.

All else is well! Good luck to Kristine on her knee (ACL) surgery tomorrow!

Good to be back home... Feel good. Stomach's questionable - just don't know what I want... usual stuff. Church, chores, a little tired, spend some time on the PC...

Good day!

Had Denise last night, she took blood at 4am, and I didn't know... The vitals and wieght from the nurses asst was a different story, and Pedro's pump kept beeping, and he felt bad - nothing you can do, just like a doze on an alarm. Such a nice guy - we had a great conversation this am.

Feel good, should get out tonight - last chemo finishing now, vincristine and adriamycin push tonight. Need to have the Mesna complete - protects the kidney/bladder - and it's time sensitive, so it can't be rushed. Looks like an 8-9pm release. At least I'll be in my own bed tonight, and at home in the am for Sunday breakfast, etc! Thanks to Alex for the ride home!

Did the bike for 50 minutes, 159 average. Did 153-158 for most of it, and spiked to 170 for a couple of sessions. Went for more distance...

Went to dinner at an all you can eat meat place - nice... Wasn't sure if I'd have an appetite, but I did well!

Medical:
During the A cycle specifically, I tend to lose my appetite towards the end of it. Same thing this time. Cereal for lunch yesterday, pizza for dinner (but not that hungry), Cereal for breakfast this am, no appetite for lunch, just skipping it. (ok, alex brought a snickers, and i'm snakcing on that.) We'll see what's up for dinner. Not really nausea, but a bit of that excessive saliva/swallowing thing going on. Not making me feel like I want to go on the bike - but I really do - maybe that's what I need.....

Good 'night' sleep, then of course the 4am blood draw - with full lights (Denise - on tonight - comes in without any light and does it - she's awesome!), then at 5am, weight check, then something else at 6am, vitals (??), dunno. There's gotta be a be a better way!

Medical:
I realized I really haven't posted anything about my treatments this week... Just another day - really nothing special. You're just tethered to 'the pole'. Feel completely fine. Realized that Kytril is awesome again - I think they brought it in about 2 hours late for some reason, and I hadn't noticed, except, that my stomach felt a bit off. I thought, hmmm, had a light lunch, maybe that was it, or whatever. Then when they brought the meds in, I looked at the clock, and.... It's a great drug! Lasts 24 hours, not much more!

GREAT NEWS - Path report on the colon/endo biopsies came back clean! So it looks like it's working. Not sure what this means in terms of a CR yet, but once we get PET/CT results, etc, we'll see.... Regardless, it could mean I get a pass on the next round of colon/endo tests, bummer.... ; )

Conf calls, work, mails, Chris came in and we synched up our schedules for the rest of the year. We're cancelling a trip to disney that we had planned (pre-cancer), for November. Just figured it wasn't the wisest thing, even though it was post A cycle - which isn't bad. However.... We were there last year, and we'll do something in the spring instead!

So now we moved the chemo schedule around for the rest of the year, and it looks like I should be home for Thanksgiving (barring neutropenic fever), John III's bday, and Christmas! And s/b done by New Years!

Did the bike for 37 minutes (had to stop for a conf call - that got delayed - bummer), avg of 159. Did 155 for most of it, doing 173 for about 10 minutes. Again - feels great to do. Legs actually felt it a bit - too out of practice - it's been about 3 weeks since this session...

Good night's sleep! Crashed around 10:30pm....

Feel good, getting my meds, etc. My roomie (Pedro - almost 75 years old) is starting R-HyperCVAD too, so I created an entry under 'Background' that has a 'what to do/expect' entry for newbies. It's based on MY experiences, but it's something.

Doing work, etc.

Did the bike for 30 mins, avg heart at about 168, and avg rpm around 76 or so. I have the resistance all the way down on the bike, and I focus on heart rate for training. I got up to 187 at the end - just for kicks, but kept it at the 168-174 mark for the most part. I want to get on later if possible, at a lower rate, longer duration. Had to cut short this am for a conf call. Thanks to Pat McGeever for his comments on the blog about my numbers! Still feel good doing it, and I do like spiking those numbers a bit - but I'll do it in more of an interval pace than I've done previously....

Alex and Andy stopped by - great to see them - thanks... alex brought candy - good and bad. oh, the candy tasted good, it's just not what i should be having.... no complaints though!

Back feels better today. Spent some extra time in the shower with hot water on it - stretching it a bit.

Got to the hospital around 9:20am, got right to the floor, got a window bed with a great roomie - Pedro, he's from Argentina. Real nice guy that had CLL that morphed into Richters (not sure wha tthat is - I'll look it up later). Heck of a nice guy though, practicing my Spanish a bit with him, and he's tolerant - maybe even appreciates the attempt.

Very happy to be back on the 5th floor. The other staff was good, but I'm much more comfortable on 5...

Dr. Goy was making rounds, so he gave me a quick once over, was aware of my trip to the ER last time, and seemed pleased with the results of the endo/colon tests - may not have to have a test after round 6, depending on the path reports this round. Yes, you can imagine how upset I'll be if I don't have another colon/endoscopy. Well, I'll try to make due....

Met with one of the infectious disease docs today - I honestly don't remember seeing her last week, must have been Friday when I was in a fog big time - sleeping most of the day... She told me the bug I had was the 'corny bacterium' - a nothing bug. Even if it was in in the catheter, they don't remove it for that one. They treat it with antibiotics to the catheter, etc. When I took the Vanko, I would switch ports on the catheter, to treat each side...

Medical:
IV Meds today:
Rituximab (with Benadryl and Tylenol as a pre-med)
Magnesium Sulfate
Potassium Chloride
Decadron
Mesna
Cytoxin (7:30 - so Wed 7:30pm, Thur 7:30am/pm, Fri 7:30am/pm, Sat 7:30am)

Pills:
Kytril (Anti-Nausea)
Cipro (Antibiotic)
some others... (the usual anti-fungal, anti-viral)

Doing mails, etc. beautiful day out - at least I can see it... It is weird going into the hospital, and then not getting outside for 4-5 days. Nice when you finally do. (They do have an outside area that you can go to if you're not hooked up to chemo, and I will take advantage of that if the opportunity presents itself. Do a little reading, etc....)

Heard a teleconference (for about 2 hours) from John P. Leonard, M.D., associate professor of medicine, Weill Medical College of Cornell University; and Steven H. Bernstein, M.D., associate professor of medicine, University of Rochester School of Medicine. The website for info on it is: http://www.lls.org/all_page.adp?item_id=65748. They talked about advances in lymphoma treatment, talking about Rituxan, Zevalin, etc. targetted treatments, etc. It was pretty good. Nothing too intense, but there's good advances being made, and targetted therapies are quite interesting. That's the stuff that attacks the specific cells, as opposed to just killing everything. One thing that was intersting was that Rituximab - a wonder drug of sorts (a monoclonal antibody - I think), helps to kill cells, but they're not sure exactly why. It may help to tell the cells to die (cells have a timer telling them to die, and cancer cells have a broken timer), or it may create pores in the cell, causing stuff to get in them, and them to bloat and die, or some other 3rd way that I forget.... regardless, it seems it works, but they don't know the exact mechanics of it - interesting...

Good day, early meetings, out to lunch with a couple of 'old' friends from Merrill (Thanks for lunch Walt and Bob!). Funny watching the over 40 crowd read menus without glasses - from 2-3 feet.

There's a fun time for you - take someone (over 40, that's never had Thai before) to a Thai place, making sure they don't have their reading glasses, and have them order something. Sure, the name of the dish is big enough, but the description is wayyyy too small. And you really can't make heads or tails out of the title..... Yeah, we all got Pad Thai - love those noodles!

All else is good. Back's still sore, a few tylenol today, and even a percocet tonight - but I did some stuff outside; nothing major, but may have just been enought to annoy it. Yeah, never learn...

Hospital tomorrow for round 5 (A cycle), which is a piece of cake compared to the B. The cycles themselves aren't bad really, it's more the after effects of the B that get me. Wanna get in, and get out - hopefully on Sat (4 days). Want to get on the bike in the hospital, the last time I was on was the last time in the hospital! I'll talk to the doc about the back, and of course see what he thinks about the PET/CT/Endo/Colonoscopy tests!

Woke up hungry! ok, not that bad... no coffee, no nothing, not allowed drinks even after midnight prior to the colon/endoscopy.

Had the procedure. Different anestesia this time. Had Propofol at the last one, Fentanyl and Versed at this one. Propofol is like a switch; one minute you're awake in the OR, the next minute you're awake in the recovery room. No drowsiness at the onset, nothing - just out. Fentanyl and Versed on the other hand leave you awake, but in no real pain. I could see the pics on the screen as the Doc performed the procedure, but really didn't have any pain. Minor discomfort if anything, and seeing the pics seemed worth it! I was even talking to the Dr., can't tell you about what, but I know I was talking. That's the weird part with Fentanyl and Versed, you don't remember everything - leaves you with a bit of amnesia. I had it once b4, for my colonoscopy in 2000 - same effect. Not sure which I like more. I really like being out, but then, seeing the pics real time is kinda neat. Had this one at St. Francis hospital, the staff was nice, and everthing went well.

The really good part - the pics looked MUCH better. No polyps that the doc or I could see. She took lots of biopsies (I remember her taking those - watching them on the screen). And we'll have those results in a week or so. But the pics looked really nice (sorry, not gonna share those on the site - although you'd easily mistake them for a trachea or any other internal pics).

Got home and ate. Had a cheese steak and chips - and some pumpkin pie. Much better now....

All done with my anti-biotic, so no more of that. Which is nice. It wasn't that bad, just has you hooked up to a bag/pole for just over an hour - which isn't great. The back's still store, but maybe getting better.

Back to work!

Prep day for colonoscopy, so no breakfast, lunch, or dinner to speak of... Not fun. The prep is by far the worst part of the whole procedure!

Went on a Hayride and picked pumpkins, etc at Windsor Farms - great day for it, and a great time! Took the kids over to Grandmom and Grandpops, and Alex was there doing the lawn, so we got a chance to all catch up - nice.... Chris meanwhile did the lawn, and did some fall prep work (taking in some of the ornaments, etc.) - thanks hon!

Did some more Halloween decorating, and Chris and the kids are making cookies (which I WILL eat tomorrow).

Have the colonoscopy, endoscopy tomorrow, and then work from home (depending on sedation!). Seems like an extra long time between cycles, as I'd normally go in today, but since Dr. Goy is in Europe, I don't go in until Wednesday. Enjoying the extra time....

Good day, back's still sore. Taking Tylenol to help that. Still feels like I just pulled something.

Went to my nephew Derek's Bday Party - had a great time! Then Sat night mass, and stuff around the house. A good day!

Good day... Back pain is still there, but the pharmacy doesn't think it's related to the antibiotic. I probably did something to my back. I haven't excercised in a couple of weeks, and I really need to get back on that - may have weekened the trunk and opened myself up for something there - that'll teach ya!

Still taking the antibiotic, only bummer is that it drips for an hour, which of course means I sit by the PC and do mail, etc for an hour in the am (usually do them for about half an hour, this cuts in a bit). Suppose I could get them while on the bike...

Have a consult today for my endo/colonoscopy. Ironically, I've had a number of these (tests), and each with a different doctor, due to oncologist preference, insurance coverage, etc. I suppose I would have liked some consistency so one doc could do a compare, but the reports will have to do. FWIW, these tests are no big deal. They put you out, and when you wake up, you're in the recovery room. Prepping is the worst part (no eating) - so that'll be Sunday. Which means Saturday will NOT be a day to eat lightly! Consult went well, all set for Monday.

HUGE Bright spot today. Had a breakfast meeting today with Andy and Guy (2 good friends and of course collegues - it was a working breakfast!). Guy got me a signed picture of Lance Armstrong, via the LAF (Lance Armstrong Foundation). It's a great picture, with Lance bearing down on the bike, grimacing in pain - just awesome! Many thanks, truly an inspirational picture. Guy and Andy have been incredibly supportive, and I'm truly appreciative...

Went to NYC today, felt better doing the stairs - no doubt due to the 6 new pints of blood since the last visit!

Still have lower back pain - like I did something to it, but we're going to check with the pharmacy to make sure the antibiotic doesn't have anything to do with that. Better safe then sorry.

Chris contacted the Infectious Disease doc's at the hospital that got involved when I was at the ER - he need to sign off on me b4 I can go for the next round of chemo. They found that the culture may have been something topical, and the antibiotic should take care of anything and I'm good to go for the next chemo round! - good stuff, didn't want to delay that. Current schedule has me finishing this year, and I'd like to keep that schedule!

Got great news today from friends or ours that had triplets (Guy and Tracey), and Tyler and Arianna are at home and cute as can be, and Peyton will be home soon! Thanks for the great news!

Taking the antibiotics is not that bad - have to allow an hour+ sitting around waiting for them to go in, so that's a bit annoying, but beats a fever!

Feel good, today s/b an uneventful med day (no Dr. appts, etc), so I'm happy to get caugh up on some work during normal hours. Chris has been great scheduling a host of Dr. appts, and given my work meetings, that's no easy chore (Thanks Hon!). It's probably one of my greatest points of frustration - trying to make all my meetings, while trying to get on the calendar of doctors that obviously have limited time - as they're all specialists. We inevitably clash on schedules, and Chris reminds me that health is the first thing I need to worry about. I know this, but you sometimes get wrapped up in all the other stuff. The other stuff I also feel is a tremendous therapeutic benefit.

Good rest of the day, lots of work to do, etc. I can do lots of work away from the office, but it's definitely not the same as being in the office!

Have some lower back pain, feels exactly like I pulled my hurt my back by lifting something incorrectly. Can't recall if I did - don't think so, but... The Neupogen s/b wearing off, so not sure that that is. Ironically, another guy in the office has the same pain - and said his brother does too! Not sure what that's all about.

Doing the IV antibiotic thing, etc. Have NYC meetings tomorrow.

Got up, showered, doing the Antibiotitc Drip, Alex s/b here soon to take me to get my PET/CT scan done (thanks!). Didn't get up early enough, so I think I'll be finishing it in the car, but I don't think that's an issue - it's pretty convenient - probably hang the bag from a coat hook - that'll work!

Have a quick Dr. appt after the PET/CT with another onc from the practice as a follow up, with a CBC to see how I'm doing.
PET/CT went fine, that's a fun one - you get to watch TV for about 45 minutes while you drink some Crystal Lite and let a shot and the drink run through you. Then you lay on a table for another 40 minutes or so. Hardest part is staying still while you start to fall asleep. (Really. Because if you start to drift off, you move a bit, wake up, and think 'shoot - how much did I move?') Test went fine, no results yet. Trip to the Doc was good, nothing major. Just CBC's, and I need to check with the Infections Diseases group at Hackensack to OK me for the next round of chemo. They're the group that checked me out first at the hospital over the weekend - I guess due to the fever and the nature of it - bactierial. I got the ok for my endo/colonoscopy next Monday (yeah).
Blood work is better:
WBC 27.9 (no doubt a result of Neupogen - last shot was last night)
RBC 2.86
HGB 9 (Nice!)
Platelets 75 (Coming along nicely, 150-450 is the desired range)

Feel good. Temperature's been fine. Eyes have been a bit dry - that's a side effect of chemo, just starting to experience it though. Got some Murine eye drops for that.

Thanks to Janna and Carlos for a cool blanket from Rituxan (one of the newer wonder drugs that's been used on me to fight MCL). Janna and her Mother did a cancer walk recently and they got a blanket as one of the event gifts - and she passed it along to me - I'll be sure to use it in good health! She and Carlos also sent along a really nice framed inspirational message (I'll post part of it under Personal Note later) that we have up in the kitchen now. Thanks for the messages guys, you two are awesome.... Looking forward to some good get togethers in the new year (when I can try to keep up with 'Los!).

Glad to be back at home - much better night's sleep....

Got up, got some breakfast and ate that while getting my antibiotic IV drip and doing a conf call. The drip ran for just over an hour (you apparently want it to be an hour+, not under, or you can get some side effects).

Feel good, will work from home today, just to get back to normal. Have a PET/CT scan tomorrow, and a visit to the Doc's office to check levels, etc.

Had some bone pain last night in the knees, from the Neupogen presumably. A couple of Tylenol took care of that. Tood other than that.

Alex and I watched the Guns of Navarone (never saw it b4), good old war movie. (Thanks to Alex for hanging with me into the evening..., Chris got to spend a good evening with the kids - everyone in our bed!)

Got more antibiotic this am, and I'm waiting for Dr. Rowley to do rounds and check me out. There was no order for CBC's this am, so they'll have to draw blood, run CBC's, and then see if I should be released. I'd like to go home today, even if it means an antibiotic IV pump for a couple of days. I can deal with that.

GOT THE GO AHEAD TO LEAVE!
WBC (4.5 - 11) 5
RBC (4.6 - 6.2) 2.59
HGB (13.5 - 17) 8.3
HCT (40 - 54%) 22.3
platelets (150-450) 33
glucose (68-122) 90
Bun (5-24) 14
Creatine (.3-.1.5) 0.9
Neutrophils Abs (2.5-7.0) 4.1
MG (1.8-2.4) 2
K (3.5-5.2) 3.8

WBC's are looking much better, HGB's are back where they seem to live during chemo. Platelets are still way low, but should bounce back. I need to setup an appt with the dr on Tuesday following my PET/CT scan, just to review numbers, etc.

Had a nurse come to the house to show us how to hood up the IV antibiotic (the Z one). Pretty ez. Comes with a pole to hang it on, bags of antibiotic, tubes to use (you use a tube 2x), give the antibiotic every 12 hours, etc. 8 days of treatment, normal antibiotic course (plus the couple days in the hospital).

One thing we've noticed, the 5th floor oncology unit is awesome. They all know what to do with cancer, etc, I have the utmost confidence in them. A couple of the nurses I've had on this floor were really good, but some I wasnt' as sure of. You need to watch what's going on. One nurse was going to flush my line with Heparin first, then Saline. We paused her (because I had enough heparin in me at the time - so we didn't need it), and she just used Saline, but I asked another nurse what the proper order is. It's Saline - to flush the line, and then Heparin to prevent clotting. You need to watch what's going on, and you can question them doing their jobs. (I later found out that the flushing of a triple lumen is different than the double lumen that I have - but still - question!) Also, I'm not sure of the term for the unit I'm in, but I assume everone's pretty sensitive to exposure (private rooms, etc), but there's tremendous discrepancy as to how people come into the rooms. Some come in with masks, gloves, and protective gear each time, and won't leave the room once they've donned the gear, others walk in with no mask, gloves, or gown. I don't know if the first group is overly protective or if the latter is too lax. (But the first docs from the ER were very explicit about keeping me away from any possible infection - this may have relaxed as my numbers are increaseing, but I still have the initial words in my head...) This could all be minor stuff, but it makes you wonder a bit - and it certainly makes me want my 5th floor!

Feeling much better today - great sleep (Benadryl induced!). Chris slept over, by my side, on a pull out chair bed that she said was reasonably comfortable. Thanks hon.... Alex s/b coming up later to check in. Dad's doing better - talked to him today, and he's in no pain, and should be going home. His potassium levels are low, so they're monitoring that.

Back to me:
Fever is gone, temp at 97 & 98 which is normal for me.

CBC's show:
- WBC at .6 (600)
- HBG at 7.2

Talked to Dr. Rowley (another doctor in the practice, he's the chief of stem cell transplants) today, and he's optimistic that I could be out of here tomorrow. He seemed generally pleased with my progress.

I had cultures drawn on Thursday evening to see if there's infection in me, one culture from the Hickman line, one from a hand vein. One of the cultures seems to be growing something, so that could mean more anti-biotics, but they could be administered at home, via the Hickman. They have small pumps that fit in fanny packs and you can be mobile with them.

I'll be getting one more pint of red today, just to bring me up a bit more (he said I'm a big boy, one's needed for one leg, one for another....). That will bring me up to 6 pints for the week - half of my blood! Amazing....

The obvious question is, will this happen again next B cycle? More than likely. Seems that the cumulative effect of the B is pretty strong, and if it continues, I'll get low levels again next time. There's not much you can do to prevent it, just keep an eye on things, etc. Chris was concerned about hours in the office, NYC, etc. and the docs really don't feel that's a contributing factor. It's more the chemo, and how my body reacts to it. Obviously, I need to keep my exposure to infection down, and be smart, but I don't need to live in a bubble.

Hey, it's been good so far, so a couple of tough B cycles is doable!

Saturday I got:
- 2 pints of Red Blood
- 2 units of Platelets
- Solumedrol
- Vancomycin
- Neupogen shot

Started off the day (12am) in the emergency room of Hackensack University Medical Center. Went from one of the standard curtained rooms, to a small private room (where Chris got to sleep in a dentist-type chair). We were there from aroun 1am-5am, then to another private room down the hall - a bit larger and nicer, then to another even larger private room down the hall - and finally to the promised land - the 9th floor. Floors 5 & 8 are the oncology floors, with 5 being standard onc, decent rooms, usually double occupancy, and in need of some updating. The 8th floor is for Stem Cell Transplants - where you can be there for 25 days or so. I've never been there, but they tell you there's flat screen tv's, internet, etc. However, you really don't want to be there... The 9th floor is the same, but it's not dedicated to oncology - its general purpose, but it's the same setup as 8. Flat screen TV (42" I think), internet connectivity through the TV, but it's a cludge, so I'll use the PC. Generally nicer accomodations.

Chris stayed all night with me, Alex stopped in last night to check in, and then returned to day to spell Chris. He's still here wit me now, and then Chris (after getting some sleep, etc) will come back and stay the night. She likes to make sure she's here to monitor me, etc. She's the one that noticed the hive from the platelets first - so there is definite benefit to here being here (aside from the obvious).

In related news (pun intended), Dad got the rest of his kidney stones removed surgically today (another 12 or so), and he's staying over at the hospital one for night for observation. His levels (potassium, etc) were low, so he's getting taken care of for that as well. Emily mentioned something about the men falling apart - she has something there....

Medical
I'll probably be here until Tues or Wed. Dr. Hsu said it usually takes around 15-16 days from the start of chemo for the levels to go back to normal (taking last monday as my start, that would run to into Tues or Wed.

While on this floor either I need to wear a mask, or my visitors do; visitors also need to wear a yellow protective gown. All to keep the possibility of infection down. I'm not to touch anyone, or have anyone touch me. Surgical gloves are used, etc. Serious stuff to keep the risks down.

I've gotten 3 pints of blood so far. I'll be getting 2 units of platelets (i started getting 1 b4, but developed 2 individual hives, so they stopped it, and they were going to check to see if there was anything that should be causing an allergic reaction.

I've gotten 2 types of antibiotics so far (Vancomycin and another). I get pre-medicated with Benadryl (IV) and Tylenol 650mg by pills orally.

My temperature is back to 98.4, with is pretty normal for me - I tend to run cooler.

I just need to get my numbers back up. At 12 noon today they were:
- WBC .2 (200) (s/b 4-11)
- RBC 1.95 (s/b 4.7-6.1)
- HBG 6.2 (s/b 14-18)
- LYMPH (Abs) 0 (s/b .7 - 3.5)

I have a couple of sores in my mouth, one on each side of my tongue - they're small black spots, nothing major, but a bit tender - make talking a little annoying. And there were some others, but tongue ones are the ones that are I don't like! They gave me something to swoosh around in my mouth that helps to numb them a bit, nystatin or something. That's all part of the mucositis (sp?) that can take place post chemo, especially on the B cycle. The mouth has lots of bacteria, and the chemo breaking down the bodies ability to fight infection can cause the mucositis.

I feel good overall. I slept most of today, partly because I didn't sleep well last night, and party from the Benadryl IV. Felt great to sleep. Right now I feel almost 100%. I have a slight cough now and then, more of a tickle. I had a chest x-ray overnight, and that was clear, and all breathing checks they do are fine, so it's probably just that, a tickle...

Bottom line - Chris says now we know why this is the B cycle, the B is for Boss, it's the Boss. I had a fever last time, it went to 100.4, but went back down. Given that chemo is a bit of a cumulative effect, it makes sense that this one would be tougher. Ironically, I had felt quite fine prior to today. The cycle itself was a piece of cake, no hiccups like last time, etc. However, the after effect was pretty intense this time. I talked to the docs about whether or not my activities (trips to NYC, etc) played a part in this, and they felt they didn't. It was more likely just the chemo lowering my levels. However, I know next time that I may want to take some more care to keep myself less exposed to anything, etc.

Friday I got:
- IV Antibiotics (Aztreonam & Vancomycin)

- Aztreonam (AZ-tree-oh-nam) is an antibiotic that is used to treat infections caused by bacteria. It works by killing bacteria or preventing their growth.

Aztreonam is used to treat bacterial infections in many different parts of the body. It is sometimes given with other antibiotics. This medicine will not work for colds, flu, or other viral infections.

- 1 pint of Red Blood
- Platelets (but stopped after hives appeared)
- Solumedrol (cortiosteroid)
- Benadryl and Tylonol as pre-meds for any blood/platelets

Went for a cholesterol check this am. It's something a group of us do quarterly or so - we started it when we started doing Atkins about 3 years ago, and wanted to see the impact. During Atkins (not on it anymore), my cholesterol got better. HDL (good) was up, LDL (bad) was down, Tri's were great, all good stuff. We then go out for a big breakfast at a local diner, omelletes, usually with lots of meat, etc. Did that this am, ended up just being Bax and me, then went to Bob Evans. I had my best scores ever. I have to thank whomever gave the blood, as it obviously wasn't my work. I've not been excercising as much, I've been eating whatever works - weight's basically flat, and my total number was 200, but good was 71, bad was 116, and ratio was 2.8 - which is really good. Maybe chemo impacts it? Dunno, there's too much going on right now to make a good study I'm sure, but bottom line, it was good - and I'll take the good news!!

Medical

The day started to turn a bit. I felt a bit warm in the afternoon, checked, and the temp was 99.5. It stayed there for a bit, so I went home early (left around 4:30 or so) and then took a nap at home. Temp got up to 101 and change into the evening, so we called the on-call (Dr. Segall) and he suggested we get to the ER, as neutropenic fever seemed to make sense, given how many days away from chemo I was, etc.

The term neutropenia describes the situation where the number of neutrophils in the blood is too low. Neutrophils are very important in defending the body against bacterial infections, and therefore, a patient with too few neutrophils is more susceptible to bacterial infections.

Neutrophils (pronounced NEW TROH FILS), which surround and destroy bacteria in your body; and

Lymphocytes (pronounced LIM FOH SITES), which are the key part of your body’s immune system, and defend against viruses.

A third kind of blood cell, the platelet, helps your blood to clot.

What is Neutropenia?
-NEUTROPENIA, Causes, Consequences, and Care, Provided by The Neutropenia Association Inc.1993

Neutropenia is a blood disorder that can affect anyone. Some people are born with it. It can happen after a viral infection. In some cases the cause can be a side effect of a drug, or exposure to certain poisons. People can get neutropenia when treated for cancer with chemotherapy drugs. Sometimes it happens for no known reason.

Blood is made up of billions of cells. There are many different types of blood cells, but most of the time you hear about two kinds - red cells and white cells. There are more red cells than any other type of blood cell. They are very important as they carry oxygen from your lungs to all parts of your body. White blood cells are just as important, but for a very different reason. One of their jobs is to protect you from infection. There are several kinds of white cells. Each has a special function. The most common ones are:

Neutrophils (pronounced NEW TROH FILS), which surround and destroy bacteria in your body; and

Lymphocytes (pronounced LIM FOH SITES), which are the key part of your body’s immune system, and defend against viruses.

A third kind of blood cell, the platelet, helps your blood to clot.

The term neutropenia describes the situation where the number of neutrophils in the blood is too low. Neutrophils are very important in defending the body against bacterial infections, and therefore, a patient with too few neutrophils is more susceptible to bacterial infections.

Everyone has been sick with an infection at one time or another. That’s because it’s easy for bacteria and viruses that cause infections to get inside the body. Healthy people don’t often get infections even though bacteria and viruses are all around us, even in the air we breathe.

The body protects itself against the constant risk of infection by making a lot of neutrophils. They are your main defense against infections.

People with neutropenia get infections easily and often. Most of the infections occur in the lungs, mouth and throat, sinuses and skin. Painful mouth ulcers, gum infections, ear infections and periodontal disease are common. Severe, life-threatening infections may occur. Often the child or adult must be hospitalized and receive intravenous antibiotics. Your doctor uses blood tests to find out whether you have enough neutrophils.

The level of neutropenia may vary considerably. In general, the blood of healthy adults contains about 1500 to 7000 neutrophils per mm3 (1.5 - 7.0 x 109 /1). In children under 6 years of age the neutrophil count may be lower. The severity of neutropenia generally depends on the absolute neutrophil count (ANC) and is described as follows:

* Mild neutropenia, when the ANC falls below a lower limit of 1500 per mm3 (1.5 x 109 /1), but remains higher than 1000 per mm3 (1.0 x 109 /1).

* Moderate neutropenia, when the ANC falls between 500 per mm3 and 1000 per mm3 (0.5 x 109 /1 - 1.0 x 109 /1)

* Severe neutropenia, when the ANC falls below 500 per mm3 (0.5 x 109 /1)

Mine were .1, so Severe would be the classification....

A decent site about Neutropenia is: http://www.neutropenia.ca/about/index.html

The basic thing is to get a CBC (complete blood count), and if your neutrophils are too low (don't recall the level) you have to check into the hospital, and get IV antibiotics until your levels come back up. So the initial test is a CBC, and if that's good, you probably just have some infection and maybe an antibiotic change will help (I'm currently on Cipro). However, of you're neutropenic, you're just too low, and you can't fight anything - even bacteria in your body that you normally handle quite well can become an issue - so you get high dose, broad spectrum antibiotics. I'm allergic to Penecillin and Clindamycin - two of those broad spectrum anti-biotics, so they'd have to use something else).

I tried to see if I could get all this checked out at the local hospital (Princeton, about 20 mins away, versus the 1 hr drive to Hackensack. I called my local oncologist in Princeton to see if that was an option, as you need to have an affiliated doctor. They were not that receptive, given that treatment was administered elsewhere, and for continuity of treatment, they suggested I go to Hackensack, bummer... So Earle and Marsha watched the kids until Omi and Opa came to sleep over (many thanks to both families!!), and off we went to Hackensack (ER). We got taken very quickly - about 15 minutes from when we signed in - amazing - and they were very busy.... We got our curtained room, got some blood taken, chest X-Ray, etc.

Thursday night we got:
- Blood cultures from the hickman line
- blood cultures from a hand vein
- chest x-ray (clear)

The rest is on tomorrow's entry...

Decided to work from home today after getting some grief from Chris (wife) and Alex (brother) about over-doing it with my NYC trips, etc. My WBC's were 1.5, and my HGB's were 5.8, so cutting back a bit was probably smart. If I can do it from home, and reduce the risk of infections, colds etc (it's getting to be cold/flu season), why not. Work has been great with accomodating, so that's good.

Scheduled a transfusion at a local cancer center - Robert Wood Johnson in Hamilton has a new cancer center, and it has a great infusion center. On the first floor, with all the chairs pointing out to large windows that look out to trees, gardens, etc. Since you're there for a few hours, it makes it a lot nicer. They provided a great boxed lunch, had sodas and juices, coffee, etc - nice setup - and really really nice staff. I did work for the almost 4 hours I was there (1.5 or so for cross typing the blood and then 2 hours for the transfusion, plus some admin time, etc.) doing conf calls, etc. You're just sitting there, what else are you going to do, watch TV?

Went home, spent some time with the family, and then finished up the work day...

Feel good as a result of the transfusion, not sure if I really feel any better - the test will be when doing stairs, etc. I'll get my CBC's on Friday to see how I'm doing. Not sure how long it takes for the fresh blood to impact your counts.

In NYC for meetings, felt winded when walking between buildings, coming up 2 flights of stairs out of the subway really winded me. Had to stop at the top to catch my breath - which was really gone.

Went to the Dr. for a regular checkup, and blood work showeed HGB at 5.8. Off to the clinic for a transfusion. It's neat - interesting to see what the impact of the HGB is on your daily activity, etc. Got a pint put in me, and I get another tomorrow (it was too late in the day to get both pints today). It takes almost 2 hours to get 1 pint put in you! Feel better - not that I was feeling bad, just too winded with basic activity. I was apparently looking a bit pale too - I hadn't noticed that. I have some color back now.

Aside from that, all is good.

Going to NYC for meetings today, and possibly a dinner after - depends on the energy level. Don't want to push it too much. I have a follow-up appt with my onc (Dr. Goy) tomorrow, where I'll get to see my CBC's (real curious).

I need to get the detailed results of my last PET/CT/Colon/Endoscopy tests. I realize I never got a copy, and I like to see them myself, as opposed to just hearing 'better' or 'good', etc. from the doc. One thing you hear repeatedly with treatment is that you are your own best advocate. You kneed to know as much as possible. Going to symposiums, reading NG's, learning about what's out there is tough (too many options), but it's essential to knowing what's going on, and having intellegent conversations with your doctor. The flip of that is - everyone says you do need to put your faith in your doctor, as it is a major part of the process. Just a guarded faith I suppose!

Feeling good!

Another beautiful day. We've had tremendous weather in NJ, with little rain, and just great temps and blue skies. I really think that can help your outlook!

Nice relaxed morning, breakfast, church, chores around the house, etc. Just a good day.

I am feeling the effects of the lowered HGB though - carried something from the basement to the 2nd floor, and when I got to our bedroom, I was really winded - really winded. Amazing. Makes sense, I have about half the oxygen carrying ability of what I did previously, and that does something... (Heard a similar story from Cory - 39 year old MCL'er - who said he saw stars after he and his wife carried a new TV upstairs - I understand! He got a transfusion during his 5th cycle, and felt better. Could be in my future, and again - it's all part of the treatment cycle.).

Had some Thai food for dinner. I know you're not supposed to eat anything too spicy (and this really wasn't), but I had cravings for spice. Gotta do what ya gotta do!

Quiet evening...

Got up and went to a symposium at Hackensack – where I have my treatments, and Dr. Goy (my onc) spoke, as did the chief of transplants. My brother went with me (hopefully he’d be a match), and by the end of the presentation – I thought ‘I need one of these’. Then I talked to Goy after, and he said he doesn’t feel there’s conclusive evidence that it really benefits MCL’ers. Similar to the discussions that have been taking place on the NG’s and Listservers. The kicker on SCT is whether it’s more effective first time around, less effective after a relapse, etc. I also asked about Rituxan maintenance, and he’s (Goy) not a believer that it’s that beneficial. This ia all part of the fun of this disease - it's not set in stone yet, so nobody knows exactly how to treat it. We'll see...

Ironically, there's another MCL'er in Chicago that's 39 (Cory), who's just finished up cycle 6 of RHyperCVAD, and he's having good success - but also going through the same SCT quandry, as are several people on a newsgroup and listserver that I subscribe to. There's some time - we'll see. I'd rahter not do it - as it really beats you up a bit - but if needed, I'll certainly do it.

It was a great day, and after the presentation, we (Alex, Kristine, and I) went to Houston's for a great steak lunch! Excellent time. Then home (Alex drove and let me sleep!).

Feeling good - particularly good for a 'b' cycle, that I thought was going to be harder than my post 'a' cycles. Go figure!

Went to NYC today for a presentation, and finished the day out there. Took my Leucovorin, eye drops, etc. Felt good overall, a little tired on the train back home, but the first couple of days after chemo are always a little off. Had pizza for lunch, and couldn't get 2 slices down - just not hungry enough. Dinner was some mozzarella cheeze and crackers. Chris made meatballs, but I just wasn't hungry enough. Again - seems to be part of the pattern. S/b back to normal in a day or so.

Going to Hackensack for a symposium tomorrow that Dr. Goy's speaking at - his is on lymphomas, and then another Dr. is talking about stem cell transplants - which are an interesting topic right now - needed or not, benefit or not, etc. Jury's out on them. We'll see. Alex is coming with me.

My Dad's going through a bit of a spell with Kidney stones right now, having about 12 of them queued up, and getting them blasted to make them pass easier. He's doing better today, but good luck to Dad!! Thoughts and prayers... (and stop drinking the soda!)

Scheduled to go home, finished up the last of the chemo, now it's just flushing the body out, getting the methotrexate levels down. They look good, so it was around 3pm that I was released. Got all setup with the meds to take at home (Cipro, etc...), and off I went.

Felt good, real good to get home. Half way done.

Drinking lots of fluids at home. Mom made cheese-steaks - nice...

Again - lost appetite towards the end of the hospital stay, and it's weird what you have cravings for at home. Some say it's like being pregnant. Dunno on that one!

Great night sleep!

Didn't ride last night, as I opted to turn in early. Was feeling beat around 10pm, around the same time I was going to ride, so I pickeded up a bicycling magazine instead, read for about 15 min's, and out. Didn't feel Denise draw blood at 4am, didn't hear them fix a couple air-in-line beeps, etc. Did get up to go to the bathroom a few times, and there's always weight and vitals and stuff, but I was able to go right back out... So up at 7:30 and feel great.

8am conf call, etc. etc...

Have I mentioned how nice the nurses are? Sweetie, Cutie, Love, and that's what they call us! Tellin' ya, they know how to make you feel at home. All with the professionalism and understanding that you want. Great mix.

Medical
More chemo today (Ara-C), eye drops every 6 hours, drinking, curious as to CBC's, wanna know my methotrexate level. Hickups have not been bad, curable by the 'concentration method' each time.

Did the bike for 40 mintues, between 160 and 180 bpm. Felt good.

Put on some weight (about 5lbs), so I got lasiks (sp?), it's a diuretic. I'm drinking quite a bit anyway, trying to flush out the methotrexate. Lots of cranbury juice and water mixed. We'll see what tomorrow brings!

The pre-med for the Ara-C does a number on you - makes you a bit sleepy for a while. Gave in today and caught about an hour's nap. Felt good.

Mom and Alex came to visit - and bring food - a nice change. Chicen parm from the local diner. good, could only eat half, not that hungry again. Had 2 rasin brans at 10am, and that's it - aside from drinking, and drinking....

Hopefully tomorrow will be release day! May be getting a BT (Blood Transfusoin) as i think HGB was in the 7's today. We'll see. again, to be expected with this.

gonna catch a funny movie, get my pre-meds, and crash... g'night all.

Better night sleep. Made the room a bit cooler, so I slept better. Vinnie suggested brining my own pillow (hels always been pretty bright), and the nurse said it's allowed (just keep an eye on it so it doesn't walk!).

Early conf calls, full day with work, grabbed lunch around 4pm, Chris and the kids came up around 5:30 with dinner - a stromboli - nice! Had a 'small' lunch, so I managed to eat dinner, but was stuffed. Chris also brought up a big bottle of cranberry juice, that i cut 50-50 with water, and I can drink that a lot - s/b good for getting rid of the methotrexate. My initial level was .14 - which isn't bad, as it was .14 later in the cycle last time, and it has to be under .1 to leave. Shouldn't be an issue.

I'll attempt to do the bike later. My HGB was 8.0 today, 8.6 yesterday, so I'm on a downward trend - expected to get lower tomorrow, so that could mean a transfusion. Each bag can get you 1 to 2 upticks. I expected more for some reason, but... I'll go slow and steady tonight - keep the heart around 155 or so.

Feeling a bit beat, just tired. But it was a long day, and not much sleep last night. Still feel good though!

HICKUPS - started up a bit. Great cure from a site (not sure if I've posted b4 but, after a hickup, concentrate like crazy on when the next hickup will come. Wait for it, expect it, think about when it will come. Keep thinking, no distractions, just focus. You'll find your breathing slows a bit, and it's regulated - but I've had them stop each time - with no, or 1 more hickup. It's from a web site Chris found. It means you don't have to drink water when you're bloated from all the bags of sodium whatever, and whatever water you're taking to swallow your pills and.... and the fact that you get these hickups so frequently requied you to drink like a fish....

Had a decent night sleep, hospital beds are NOT that comfortable. I think it's mostly the fact that they're wrapped in plastic and make you sweat a bit! (The pillows too.)

Medical:
Just getting pumped up with sodium bicarbonate to prep for the Methotrexate. That started at 8am, and will run for 2 hours at a high level, then a lower level for 24 more hours. Then the Ara-C, and Leucovorin to counter the Methotrexate after. Also got Solumedrol last night - a cortio-steriod I believe.

Schedule:
- Sunday - Rituxin, Sodium Bicarb
- Monday - 8am - 10am Methotrexate (high dosage)
- 10am -... Methotresate (low dosage)
- Tuesday - (Mon) - 12noon (approx) Methotrexate (low dosage)
- 1pm - 4pm Ara-C (1)
- Wednesday - 1am - 4am Ara-C (2)
- 1pm - 4pm Ara-C (3)
- Thursday - 1am - 4am Ara-C (4)
** Monitoring of Methotrexate levels begins at some point - to make sure I can be released. Drinking fluids is essential to get me out, as the level s/b below 0.1. I'll be taking Leucovorin at some point too - not sure when that starts.

Also getting pills for:
- acyclovir - anti viral
- cipro antibiotic
- flucanovole - anti-fungal
- aluproinal - anti-gout (removes uric acid)

Get Solumedrol (a cortiosteroid) as a pre-med. It's stronger than the other cortio-steroids (Prednisolone, Decadron)

Decadron helps with nausea too.

All is well, just hanging out doing mails/reviews/calls/getting chemo...

Banner day! Not only did I get to spend some quality time with Chris this am, but got visits (at the same time) from Viraf, John, and Danny - perhaps 3 of the nicest people you'll ever meet (and that's with even with V being a past World Stick Fighting Champion). Great to see everyone - many thanks for the visit!

Did 40 minutes on the bike, moderating the pace from 85 to about 65, to keep my heart around 170 for the most part, peaking at 180, recovering around 155 for some spells at the end. Felt good!

Note - the nurses here are great. Really make you feel at home. All of them are friendly, helpful, and very professional. Need to write-up a letter for them....

Got the word that we have a bed, and 10am's check-in. Grab breakfast, Omi and Opa came over to watch the kids, and we headed out to Hackensack. (Opa's going to mow the lawn, so he got a quick overview of the tractor operation - thanks Opa!)

Got to the hospital around 10:30am (we left a bit late...), checked in, got the window bed this time! (good stuff - it's worth asking for it when you ask for a room.)

Turns out I'm allowed to go outside to this nice garden area that's on the 3rd floor, so long as I'm not actively taking chemo. And there are nice chunks of time where I'm not getting chemo - so that's good. Seems you have to ask all the questions, they don't give you all the rules up front. And it's little things like being outside on really nice fall days that can make a huge difference (not that the oncology floor isn't more fun that being outside...).

Going to get caught up on some mails, and the blog (was about 4 days overdue), and maybe catch a movie - a comedy of course! (Sattler says Dangerfield, Unkee says Python, etc, we'll see what the magic bag holds!

Seems like it's been a while since I was in the hospital. I think it's because I didn't have any tests inbetween the last visit and now - just a regular dr. visit and the regular blood work. Felt like a nice long break! And now, I'm happy to be getting to the halfway point.

My schedule may change somewhat, as the Dr. will be in Europe for a conference or something - when i'm supposed to get my next cycle, and he wants to be here when I get it (he's very hands on, and I like that). So that could shift things around a bit - which actually may work out better for a vacation we had planned - that we're still debating going on! I don't want to be foolish - but if I'm good, and my counts are good, I want to keep doing as much as possible!

Medical:
Got started on fluids (sodium whatever, some bicarbonate) and Rituxan. I was done with the Rituxan by 4pm, and Methotrexate starts on Monday at 8am. The Methotrexate starts with a high dosage over a few hours, and is then followed up by a slower dosage over the next day - for a total of 24 hours. Then the Ara-C after that.

Talked about Flu vaccinations, etc - and it is strongly recommended that the family get flu shots in October - or when they start offering them, to keep everyone healthy around me (Jacquie - good point - thanks for raising it!).

Jeanine posted a note about 'Airborne', and I need to talk to the Doc about that. Her note was:
In terms of avoiding colds coming home from school...all the teachers I know swear by this product called "Airborne". Basically an alka seltzer-like tablet that you dissolve and drink (OTC, can get it at CVS and Wal-Mart). Has high doses of vitamins, maybe some Echinacea (?), but supposedly keeps the body's immunity working top-notch. Obviously, check with your docs (not sure what the vitamins would do with chemo), but might be worth a look!
We'll be checking it out! (Thanks guys... - and for the Italian American heads up - would have been nice if you guys were up here to enjoy it with us...)

Relaxed am in bed with the kids - always a great time!

Breakfast, then off to Michael's (craft store) to watch the kids make a craft - a cool plastic Prowler-type model. Esther, Ellie, and Hannah were there; great to see them, then off to Petsmart to look at all the shelter animals and have the kids ask if they can take everything home...

Alex came over and then we went to Joe and Michelle's to pickup some items that they were selling/giving to Alex (Joe and Michelle are 'downsizing' from a beautiful home in Hopewell to another beautiful home in Lambertville, and won't need some item, and Alex just bought his first house - and needs everything). Joe was great and helped Alex move a dining room table and chairs, speakiers, etc, while I chatted with Michelle (I'm trying not to over-do it, so....). Heck, Michelle even made me come out of the sun a few times so I didn't burn my head, etc. Always the Mom.... So, we left Hopewell with a full truck/trailer and went to casa de Alexandro, unpacked, and went home.

Went to 5pm mass with Grandmom and Grandpop, and then we all went to the Italian American Festival at Mercer County Park. Amazing. TONS of people, TONS of food. Lines at least 15 deep at each vendor, and lots of vendors. Sausage and Peppers, cheese steaks, calzones, zeppoles, funnell cakes, pizza, penne vodka, etc. etc - we had our fill, and then some. Then the kids did some rides, John a game, and home we went. It was quite cool - and my lack of hair does impact how cool I get. I tend to run hot, and usually don't need much by way of jackets, etc, but I was chillier than I wanted to be (had shorts on - legs were not the issue, and a sweatshirt). A hat probably would have done the trick.

A great day all in all, and I felt much better than on Friday.

Got to work early, as we had a special 'consultant breakfast' to celebrate breaking 300 billable consultants on the account! A group organized a breakfast for everyone, and managers got to serve the employees (the committe that pulled it together also served). We had pancakes, bagels and topings, hash browns, waffles, cinnamon and cheese bread (from Mastoris - excellent!), sausage, omellete stations (3) - withe the works (peppers, cheese, real bacon, onions, mushrooms, etc. etc.), fruit, and juice. The room was decorated nicely, with roses and vases, nice tablecloths, etc. Everyone that came in was truly impressed, and very appreciative (and of course wanted it to be a weekly/daily event). The group that coordinated did an excellent job, and spent a lot of time prepping. (I was admittedly skeptical of this event, but I have to say - I'm amazed at how well it went, and how beneficial it was.)

Back to work after eating too much - we did get to sample, and there were leftovers....

Felt pretty wiped out Friday night - not flu like but definitely beat. Not sure if it was Wednesday's ride, Thursday's activities, and Friday's early am thing, but fell asleep while watching Charlie Brown with the kids, and felt pretty tired when putting them to sleep. Also had about a 99.5 fever, so I went to sleep around 10pm, and over the course of the night it dropped.

Went mountain bike riding last night. Actually, rode mountain bikes on a tow path in Princeton - the path is packed dirt, quite smooth, not aggressive at all - just a nice quiet ride. We did about 18 miles total, keeping the speed between 15.5 and 17. My heart rate was around 168-186, averaging around 180. took about 1.5 hours, counting a couple of quick breaks. Felt really good to do it. Thanks Andy and Ajay for your patience. Stopped out for Starbucks after, very nice...

Thursday was a good day - nothing major during the day, went to work, we had an event in the eveing in NYC, so I took the train in around 3:40pm, went to a 'cocktail' hour (sans cocktails - just soda, etc), and then our new head of North American Operations spoke. Good session, energetic, etc. Got to see some of my NY compatriots, and it was good to catch up with them. We went to a bar after, but it was too crowded, so we opted to make a dash for Penn Station and catch the 8:07 express - made it!

Grabbed dinner with a buddy from the office at On the Border back in Princeton, and then home. Got in around 10:45pm or so.

Back to normal fully.... No ride this am, planning a mountain bike ride after work - on a tow path, nothing too aggressive, with some friends from the office. Maybe even a trip to Starbucks after!

Got blood drawn at lunch - they lost the results of Monday's tests, so i have no idea what the numbers where - and I really would have liked to...

Getting setup for the next round of tests (endo, colon, pet, ct, maybe bone marrow - hopefully not - I really don't like that one!). Hospital on Sunday for round 4. It's the 'b' cycle, which i think is a bit tougher, but whatever... want to get past the half way mark!

Seem to be putting on a few pounds - need to cut back! That, and of course not excercising as much... Expecting to lose a bit in the hospital, as my apettite there does seem to drop.

Did a little bike ride this am (did too much e-mail and had an 8:15 conf call, so had to cut it short). Need to keep training - feeling better, but need to keep it up.

Feel good, nothing new really. Last Neupogen shot was Monday, so bone pain is going away - getting back to normal.

Had a percocet last night - the bone pain wasn't bad, but enough to warrant a pill.

Got up and did some mails, then got on the bike. Another tough day. Need to keep at that. Did about 25 minutes with an average of 160bpm, but felt winded. Will be out tomorrow on it - if it doesn't rain.

Back in the office - good stuff, great day! Got blood work done at lunch, curious to see where those numbers are. Lower back and hips, and the knees are a little sore. Just moving a bit slow, kind of like I overdid it, but it's just the Neupogen. Took a Tylenol, helped a bit - again, not bad. Also had some soreness from this am in the back of my neck, arms, shoulders, etc. Had it last time too I think. Not like flu sore, but more like work-out sore.

Emily's got a low fever, so I need to keep a distance there. This will be the tough part. School's back in, meaning colds come home, and I need to stay clear of infection!

Got up and HAD to do a bike ride. I'd not been on the bike since almost 2 weeks ago in the hospital, and I really feel the need. When in Halifax - where it's fairly hilly, I had to hustle from the office to the hotel to meet up with a friend for dinner. The walk was brisk, and I was winded. Yeah, I was carrying my laptop, etc - but it was a sign that (1) I need to excercise, and (2) yeah, my RBC/HGB may be low - we'll see on Monday's blood test.

Tried the trainer in the basement, but due to one of my front chainrings being too shot (skips like crazy), I'm forced to go to a higher gear - more than I wanted to - and stressing the heart too quickly - shot up to 170 too fast. So - out on the road - and it's a beautiful day anyway! Did about 40 minutes total, around 160bpm average. I felt that 170 was too high - breathing too heavy. 160 seemed to be good. I'd obviously drop to 150 for some recovery, and shoot up to 170 for some stuff, but tried to keep the rpm's around 85 or so. Felt good - and bad; I'm outta shape afte 2 weeeks, or I'm a little low on HGB, or both. Bottom line, I'm getting on the bike tomorrow, and Tues, and.... Firm believer that keeping this up is key to success. Also - just read an article in Bicycling magazine that stopping regular excersice can make you irritable.

Off to church, Alex's etc.

Experiencing some bone pain today - lower back, hips (Neupogen related). Seems just about on time - I've done 8 shots, 2 more to do. Don't know my WBC counts due to the Halifax trip, so I may be good - or it could just be the body reacting to the overproduction of cells. Took a Tylenol, felt a bit better - may do Percocet tonight.

One think I thought of during church today. A friend of ours, Deacon Pat, gave us good advice when he administered Rights prior to my going into Hackensack for my first treatment. He said to be sure to thank God for helping me to make it through this - succeeding in this. NOT to ask Him to help me, but more pointedly to thank Him ahead of time for making it through. It's a tough one. Lots of faith, optimism, etc. I do keep thanking Him for all the help, and for making my treatments successful. It's a significant mindset.

Ok, fun day. Got to sleep around 12:30am or so, and the flight out is at 6:35 - so up at 4am. Hurricane Ophelia is expected to come to Halifax later Sat, so there's some urgency to get out of town - never mind wanting to get back home and see the family! Got to the airport on time, got out of Dodge, and was running errands back home by around 10am! Got home and crahsed! (The family was out for a bit.) They came home, I caught up, and then crashed a bit more.

I'm being more careful to listen to my body and not push it where I may have otherwise. If you know you're low on sleep, and heck, if you're tired - take a nap. There's enough stuff going on in you that you don't need to push for the fever or worse.

Got up, and went to a local fair (Septemberfest), where we met up with Doug, Esther, Ellie, and Hannah. We went on some rides, had dinner, played some games, and genereally had a great time. Back home and the kids got into bed - fully wiped out. Did some stuff, and then we crashed. A good day - great to be home!

Over to Uncle Alex's tomorrow to check out his new pool, and maybe even help him out a bit...

Up in Halifax, Canada, having a good time. It's work mind you, but good to see people that you usually only mail/speak with. Trips like this are too darn short!

Nothing spectacular during the day - watched the temp a couple of times, looks good (97-98 - I tend to run cool). Felt good, a little tired here and there, nothing major.

Had a great meal with John Mac and his lovely wife Nancy. (John was off on Friday but was kind enough to accompany me to dinner - truly appreciated, and of course, quite a pleasure.) Went to the 5 Fisherman - highly recommended - where they have a great Blackened Halibut with some sausage, jalepeno bread, veggies, etc - nice stuff. I know you're not supposed to go too nuts on spice on chemo, but you have to live a little!

Took a great stroll from dinner to the hotel to (attempt to) work off some of dinner, and then did some mails, and tried to get to bed early, as I have an early flight out. Oh yeah, another Neupogen shot - I still like when Chris gives them to me better, but I'm getting used to it in the leg.

Got up early (5:20am), and headed to the airport, and off to Halifax. Uneventful trip, noticed that nobody on the plane was coughing or sneezing - so I was happy. Lots of hand washing for me anyway!

Did some work in Halifax, and then off to a Thai place for dinner, and gonna crash in a bit. Feel good. Have to give myself the Neupogen shot tonight. Did it once b4, just to try. I do it in the thigh, not bad. I do like when Chris gives it to me better!

Had a nice meal at night with some of the team (Patty, Jose, Monica, and of course Sammy), and then back to the hotel for some mails.

Good day... just a bit tired. I think I overdid it a bit yesterday (golf and soccer...). Ended up with a bit of a fever - just 99.8, but seems to happen when I do bit much during the nadir.

Met with the doctor today. He's happy with the progress. He'll re-test me after 4 cycles just to verify progress. If it's not progressing, we'll adjust somehow - not sure how, but.... The MCL is still in the colon now, but not as much, and seems to have retreated from everywhere else. Hickman site looks good, blood counts were good. HGB was 8.6, still lower than I want, but not that bad - no transfusion this time! Gave me the go ahead to travel, so off to Halifax for Thurs/Fri! Also got the vincristine push, and the Dexamethasone (I think), and I start the Dex... pills tomorrow for 3 days. 10 pills, all at once with breakfast.

Did some work, and then had a great meal over at Earle and Marsha's to celebrate back to school! Karen and Stu came over for dessert - and it was great to see everyone!

Had a 'work' golf outing today. I'd like to say the chemo impacted my play, or maybe the hickman, or maybe even the cancer, but alas, I have to suck it up as my own ineptitude at golf... I didn't hit any woods, in an attempt to keep myself from straining too much - specifically concerned about the Hickman line. Everything felt good the whole day. The tape I use to secure the Hickman to my chest got a bit loose by the end of the day, but that was it. No alcohol of course, just gatorade and water... (Best ball format, we finished 1 over par for anyone that's interested - great day of golf with an awesome foursome.)

Played a little soccer with the family at night, and now to get caught up on e-mails....

A dressing change as well for the Hickman, as it's needed after today!

Doc's tomorrow for a general checkup, and blood counts to see if I can to to Halifax for a trip Thurs/Fri.

Great day. Had to go to NYC for training/meetings, and despite catching the 6:51am (a bit earlier than my days in the local office), it was a great day. Got some work done on the train, had a good training session, followed up by about 3-4 more formal meetings, and a few impromptu ones. It was my first time in the city in a while, and good to be back. I'm not much of a city person, but it's nice to visit, and I really felt 100% today, so it was good to be there when I felt on top of my game. The weather was great as well, so that helps!

I got to meet up with what I really consider to be some good friends from the office, and it was great to see them in person and catch up. Really good people, and very supportive. Again, it's the people and support that really hits you when you go through this. Got a great inspirational story from one friend, and truly helps to put things in perspective - attitude is huge. You really need to keep the right focus, and just go at it. I'll do all that I can to do that.

Golf tomorrow (work outing ), so a 7am breakfast/practice range. I'll be taking it easy, as the Hickman line really doesn't allow for heavy swinging, etc (that's ok, I didn't have a drive before, so this is just a good excuse to give my drive to someone that can....).

Blood counts from Friday came in - WBC's at 6, HGB at 10. Good news! (HGB was 8.6 in the hospital, so it went up - that's the one that would indicate anemia, or a possible need for a transfusion.) Wed is the real test, and it should probably be down a bit by then - as it should be dropping (again, 7-10 days post chemo is the nadir - or low point), but I'll take the good numbers inbetween.

Great Sunday morning - opted to stay in bed (with the family) versus getting up to cycle. Don't know how that won out... Sunday pancakes (for the kids - chocolate chip), bagel for me... Church, shopping, car washing, yard chores, etc. A good Sunday indeed.

Felt better today, more energy, less stomach uneasiness (not nausea before, just uncertainty with eating, what to eat, etc.). I tend to be eating more, but my weight's staying the same(someone on one of my ng's said during chemo you can eat more - body using more energy?). I think some muscle may be attrophying! I know I'm not as active as I was previously, trying to take it easy on the Hickman, and in general. Need to cut back on the eating a bit!

Going to NY tomorrow for work, will be watching what I touch, how ofter I wash my hands, etc. 2nd Neupogen shot (of this cycle) tonight.

Talked to my Uncle Brian (the other Unkee) tonight - brought up a great point - the value of comedy. When in the hospital for chemo, I usually watch about 2 movies during the week. I tend to go with drama/suspense. He asked if I saw any comedies. I enjoy them, but I hadn't. We talked about the benefits of comedy, and I don't know why I hadn't thought of that b4. I think there's a lot to be gained by watching Young Frankenstein or the Meaning of Life - and will look to do that next time. Instead of being 'stressed out' by some movie, just let loose and watch a hysterical movie, it's gotta help.

Good day! Really nice out... Got up and had cereal (Honey Nut Cherios) right away - just made the stomach feel better. Wasn't that hungry, but... Pre-lunch, had some tostitos - salt seems to do the trick, and some lasagna. We're going to a picnic today, so it was just a couple of bits of lunch. Feeling not quite 100% yet - a little tired. Had blood drawn yesterday, so I won't know until Monday from the dr. what the RBC/HGB counts are, but I'm sure that may have something to do with it. They were expected to drop a bit, which can bring on anemia - or a feeling of tiredness - from what I get. Not overly tired, I raked the leaves on the playground area with the kids, cleaned up, etc. Jsut feeling a bit peekid. (sp?)

Hickman site still has some pink to it, I'll do a dressing change today, as the perspiration under the bandage tends to soften up any stuff under there, and it just seems prudent to change it today. The last change was on Tuesday.

Another 8:30am conf call, again - good to be back in the office! Took the car again, stuff to do, want to make sure I have enough wits about me before taking the bike.

Getting up regularly at night due to lots of drinking b4 bed (flushing the kidneys works), about every hour. However, seems I get back to sleep pretty quickly - the body adjusts.

Last night - woke myself up with a burp. Pretty big one, not a bad one (no stomach issue), but I pretty much never burp. Another smaller one occurred later. Just a data point. Stomach feels 'fine'. -- Just realized, I'm not usually a soda drinker, and I've been drinking a lot a lot more of it than usual - could be related.... (duh).

Still in a bit of a funk (Feel good overall - it's just the post chemo funk I've come to expect) - appettite especially. Not sure what I want to eat, if I want to eat, when I want to eat. After the first cycle, I found that being more full actually made me feel better. Not sure now. Playing it by ear. Have food nearby - crackers, peanut butter, etc - never know if you'll need it. Keep drinking - find a fluid that suits you. I love water for the most part, but right now it does nothing for me. Having more diet/non caffinated soda.

Hey - my brother's closing on his house today - Good Luck to Him!!! Huge step!!

Medical Stuff:
Good news from the a friend in the office (Myla), who coordinates our blood drives (that I used to take regular part in). Hackensack Hospital is part of the blood network that our donation center takes part in, so if I need blood, I'm covered there. Insurance should cover it anyway, but if there's any issue, we have that as a backup - good news!

Should get CBC's tomorrow to check, then on Monday, then the Dr. on Wed for more and a decision on travel. Wed will also be the vincrisine push, and the Dexamethasone pills after. Neupogen shots start this Saturday to boost WBC's.

Back at work.

Did an 8:15 conf call, followed by another at 8:30, etc... Full day of meetings, etc. Took the car instead of the motorcycle - despite a beautiful day, as it seems the first 2 days after chemo I'm usually a bit 'off'. A bit out of it, stomach not quite right - not sure what to eat/not eat. Want to drink a lot to flush the kidneys (required to keep the chemo from hurting them), yet, you still feel bloated from all the IV's in the hospital. It's a weird transition time. Don't know if it's the chemo from the week taking its toll, etc.

Regardless, lots of meetings, etc - good to be back at work and seeing people, calls, etc. (Different than being in the hospital doing it.)

Nice to be at home, have dinner, etc. Did bills, caught up on some paperwork, etc - up until around 11:45 or so, and crashed.....

BTW, talked to a good friend Guy, who just had triplets that were a bit premature and underweight. Helps to put things in perspective. I've got my battle, and Guy and his family have thiers. Thoughts and prayers to you guys... We know how tough Dad is, I'm sure they've all picked that up, and Peyton's quite the fighter!

Good nights sleep.

Good news, the night nurse - Maureen (aweome, not sure how she has that much energy overnight), was pushing to see if I could get out today, as opposed to Thursday. My last Cytoxin was at 5am today, and in speaking with Goy today, he's going to go for a 4pm Vincristine and Adrimycin push - which will get me out tonight!

My HGB levels went up to 8.6 (from 8.4), but Goy expects them to drop, and he we'll watch them to see if I'll need blood next week to boost them.

Interesting discussion around iron this am and RBC/HGB production. Goy said that the Iron I have is fine, the low levels are more a result of the chemo beating them down (or beating down the precursors to the RBC's). He had been involved in studies in Europe where they were giving Procrit (sp? - an iron booster I believe) to people to super size their iron to help production, and there was no benefit. So back to iron supplements or multivitamins, it doesn't seem they'll really benefit me that much.

Meanwhile though, I'm still going to cut back on milk, and keep eating my iron fortified cereal! (I had cereal for breakfast, lunch, and dinner yesterday.) My appetite is not good right now. No taste for meat, etc. Lance wrote in his book that during his chemo he started off eating well, and by the end of his treatments corn fritters (not even sure what they are) were the only thing he could stomach. I am lookig forward to sphagetti and meatballs at home - they really seam to do the trick when coming back! Thanks to Carol Anne (sp?) and Michelle for making some of my favorite dinners!

Hickman site looks good to me, have a fresh dressing on it from yesterday, new caps, etc. Still looks a bit pink, but much better, virtually no puss, and any slight swelling has receeded.

I'm home! It's 10:43 and I'm home! Kristine picked me up, and handed me off to Alex at the Menlo Park mall, in exchange for 2 cats and a laptop. not sure who got the better deal, but i got home. Chris had spaghetti and meatballs for me - which tasted great! (All I had at the hospital today was 2 containers of raisin bran.) Somethin' about the spaghetti and meatballs... Real happy to be home.

No bike riding today, a bunch of work, a little nap, and then ready to go. Julie gave me my Vincristine and Adrimycin pushes - nice and slow. She's very methodical. The Vincristine is apparently the one that kill skin quickly - it's one of the reasons they don't want to use a typical IV when doing this chemo. If anything happens when admininstering it, it kills the skin, and you have to get a skin graft. Slow administration through the hickman, with her pulling pack some blood now and then to stagger the administration is the preferred course of action I suppose. Works for me.

off to bed soon....

good night's sleep...

Met with Dr. Goy this am, and here's the key points:
- Lab Results are in. Bone Marrow was clear - so that's great, but the GI tract showed signs still. So it's 8 treatments and not 6 - which is what I expected, and partially what I wanted (beat this thing down!), however, ask me again at 5 treatments
- My follow up meeting will be on Wednesday, and I'll get my Vincristine push at that time. I'll get CBC's done locally on Monday.
- My Hemoglobins are still at 8.4, and Goy expects them to go lower, so we're anticipating needing a transfusion before leaving - just to head it off. I regularly dontate to a local blood bank through work, so I'll check what the rules are there for getting blood. And I'll be reaching out to all those kind enough to offer to donate if needed! (I'm particularly interested in Zorastrian blood - that would be cool!) Not concerned about this at all. Initially it sounded a bit scary - needing blood - but it's pretty simple, chemo does knock down the RBC/HGB count, among other things, and you sometimes need a little help. I'm also eating iron fortified bran flakes for breakfast, meat as much as possible, and dark veggies - all good for iron. Also cutting back on milk, that I recently added back into my diet after not having milk for about 2 years on Atkins. Milk apparently reduceds absorbtion of iron, so away it goes.
- I'm scheduled to go to HX next week, and we need to watch the levels before there. Goy's interested in my platelets primarily. WBC's he's fine with. I'll be calling up there to identify a hospital just in case.

Amusing anecdote - I use my passport as ID when travelling (as my license has no pic on it), and the passport photo has me about 55 lbs heavier than now (result of Atkins and excercise), and I've since shaved my head and face. So - that should be interesting.

Doing conference calls, mails, etc. Want to be on the bike later today, etc. etc.

Did the bike for 26 mintues today, with an average heart rate around 167. Cut at 26 as the 'rents and Alex and Kristine were coming up and I had to shower to be kind... Felt good.

Good rest of the day.

GREAT NIGHT OF SLEEP! (hey, it's the little things that count when you're in the hospital!)

Did some work until around 11:30pm, was getting sleepy, didn't get the Ambien as I was pretty tired. Went to sleep quickly, got up around 4:30 for the vitals check - that one has the overly happy nurse's aid saying 'good morning' etc. etc. Can't you do it without trying to really wake me up? (She was kind and didn't make me get on the scale, as I checked in yesterday and she'd use that result!) Denise - the great night nurse - came in around 5am with the Cytoxin, and she understands sleep. She REALLY tries to do it withough waking you, and if she does, she talks to you in a very soft voice, just great... Got up around 7:45am after that.

Feel great, good breakfast, some work, and Chris will be up soon. Need to get on the bike today, as it's been almost 2 weeks since I've last been on it for the 30 mile ride. (Had some minor fever during my nadir right after the ride - not associated, just part of the normal 'course of action', and then the tests last week just left me short of time and energy (lots of not eating for colonoscopy, PET/CT, etc - doesn't leave you feeling like you want to excercise!)

Good day still, had lunch, Chris came by, played Othello, got beat bad on one game, and I won the 2nd! Joe and Michelle stopped by (THANKS) and were kind enought to share some of the pics of their recent trip to Germany and Prague - many thanks for coming by!

I've been having some hiccups today, not sure if it's the meds, or... I dind't get them on the first A cycle, did on the B cycle, we'll see.

Had a late lunch, and had some nausea kicking in - then the nurse comes with the Kytril. Like clockwork - that stuff is great - seems to last 24 hours.

I'm getting on the bike shortly. Need to excercise!!

BTW, talked to a good buddy today, and he asked if what I'm posting here is me being honest, or putting on a bit of a good face for the benefit of family and friends. It's honest. I'm not holding back. One of the purposes of this blog is to act as a data point for anyone that has to go through this, and I'll post the good, the bad, and the ugly. I'm hoping for obvious reasons it's more good than bad, but I'll post it. So far I've been lucky. Do I expect it to be a bit more taxing as the cycles continue, yes. Do I intend on cycling and doing work in the hospital, yes. I think the latter is a very important part of recovery. He also commented on the outpouring of support that I've been receiving (posts, visits, etc), and I said again - it's by far the most amazing part of this journey. Thanks to all....

Had a great talk with one of the nurses - Dana, who's big into CBC's (blood counts) and what they mean:
- WBC (White Blood Cells) are for fighting infection. You should be between 4 and 11 (which is actuall 4k and 11k). Anything under 1k and you should be wearing a mask around to keep yourself from getting sick. I think she may be a bit hard core, but it's something to think about. I'm scheduled to fly to Canada for 2 days next week, and she gave me a bunch of masks to wear - and some heavy duty (T ones to wear on the plane! I may just do it. Better safe than sorry...
- RBC (Red Blood Cells) carry oxygen, and should be between 4.7 and 6.1 (4,700,000 and 6,100,000 I believe).
- HGB (Hemoglobin) - it's a component of the RBC's that's really responsible for carrying Oxygen. This is the number she watches. The range is 14.0 - 18.0. If it drops to 7.5, the doctor begins to think about a transfusion to bring them up. Mine were at 8.4 yesterday, so I'm curious to see where that goes.
- PLT (Platelets) are for blood clotting. Range is 135-430. Anything under 100 s/b watched, and avoid anything that may cause you injury, under 50 is really watch it... Mine were at 440 yesterday, so I'm good! (I'll take the good numbers where I can!)
- Those are the numbers she watches closely, and you can see why..

I did 40 minutes on the bike, alternating my heart rate around 170-155, mostly in the 170-165 range. I dropped it down a bit based on Dana's discussion with me, where my HGB is a bit low, and I really shouldn't stress the system more than needed. A good 40 minute ride, keeping about 84 cadence - except when I wanted to drop the heart down - felt really good.

Hope everyone's enjoying the long Labor Day Weekend, our best to you and your families!

Heading to the hospital for my 2nd 'A' cycle, or 3rd cycle alltogether. Curious to see what the results are from the tests last week.

Headed off the the hospital around 9:30am, getting there around 10:30am, got checked into my room right away - same room and bed as the very first time I checked in! (couldn't change over to the window view bed this time, as I have a roommate that seems to be staying.)

Got hooked up pretty quickly, got the sodium drips running, then the Rituxan (with Tylenol and Benadril before) this time. That was followed by Decadron (cortiosteroid), and then Cyclophosphamide (chemo).

Had the oral meds, Kytril (anti Nausea), antibiotic, antiviral, antifungal, etc.)

Had the admission review with the on-call doc. The doc is happy with the hickman site - the lack of pain and minimal discharge is what makes him pleased.

Feeling good, glad to be plugged in and getting everything running.

Schedule for this week s/b:
- Sodium solution all the time
- Rituxan from 1pm-4pm
- Mesna all the time (bladder protectorant)
- Cytoxin (Cyclophosphamide) from 5pm-8pm (for 3 hours, for 6 cycles)
(1) Sun 5pm
(2) Mon 5am
(3) Mon 5pm
(4) Tue 5am
(5) Tue 5pm
(6) Wed 5am
- Vincristine push 12 hours after Cytoxin - Wed 8pm
- Adriamycine push 12 hours after Cytoxin - Wed 8pm

Good day, just did some chores around the house. Alex was kind and cut the lawn for me - thanks! Played with the kids, and generally had a good Saturday!

The Hickman site still has some oozing by it. Not much, but I'll probably change the dressing tomorrow - I think it's better to change it at home than in the hospital (?). I'm sure they'll do it there too anyway....

Feel good otherwise.

It's Friday, beautiful out, left 2 smiling (but still somewhat sleepy) kids on the couch, Chris made me a great lunch, took the bike to work, life is good!

The Hickman site looks pretty good - but it looks like there may have been a little discharge - not sure from where. Not much, but I'm surprised, as I thought it was all done. The next dressing change s/b in the hospital, and I'll have them check it out, and I'm sure they can do a more thougough job than I can. Of course, I do have some concern that there are more airborne 'things' in the hospital than in the house. And certainly more 'things' that my body is not used to - I think that's one of the worries people have about Hickman's in the hospital.

The hip's still a bit sore from the Bone Marrow Aspiration, but that site looks good, I keep a band-aid on that one just for cleanliness.

Went for PET/CT Scan today. PET scan only took 25 minutes - which was better than the last time (took 50 minutes). Problem is, you can't eat before it, and you have to drink 3 glasses of water, then some stuff they give you to drink, etc. And - the room is cold. Bottom line, I guarantee you that you feel the need to get up before the test is over - and you have to lay perfectly still....

All in all a painless series of tests, and went into work after.

I'll be changing the dressing on the Hickman site later today - to try to keep that clean(er).

Ok - stop reading here if you're squeamish. This is really for the benefit of anyone with a Hickman.

Pulled the old bandage off, I still hate doing that. It stuck a bit at the site, where there was some dried, well, puss I guess - kind of crystalized material. Most of it pulled off with the dressing - which was good I suppose, just took a little bit, and I didn't want to upset the site. (I saved that, in case the doc wants to see.) The site looks better - the stitch spots are not as pin/red, and look to be better. The entry point for the cathater looks pretty good, but it's hard to see, as the opening points down. Had Chris look at it, and she said it looks fine. Cleaned the heck out of it - as much as possible - keeping to the rule of starting at the site and rotating around withouth doubling back (with the alcohol swab). Used the larger pad (not betadine, but some other cleaner) and did the final cleaning, let it dry, and on with the new patch. Looks good.

Up until around 12:30 doing work and some pleasure reading.

Showered, let the shower water help get the Bone Marrow bandage come off - didn't want to pull on that scab. Bandaid over it after - looks good.

Do some conf calls b4 the scoping, head up to Hackensack for the test, some calls after, and work from home the rest of the day.

Looking forward to the end of exams week! (Tomorrow - Thurs - is PET/CT scans.)

Test went well, initial results show improvement - need the oncologist to review all the info, that'll take a few days.

Results of the culture from the Hickman site show there's no internal infection, but there's some strepto-something on the outside. More frequent dressing changes, and we'll see. The site looks pretty good today.

Happy to be able to eat again....

Work from home day - prep for the colonoscopy on Wed.

Pretty quiet day overall - feel good.

Hungy and have a headache by the end of the day. I think the hunger is mostly because you know you CAN'T eat, which is just annoying. But then, you get to anticipate gorging the next day!

Have my endoscopy this am. As the doc doesn't have current blood work, and I'm too close to my nadir, he won't do any biopsies (fear that bleeding won't stop if the platelet count isn't high enough), but that's not really what I'm interested. I just want to see what's in there compared to before.

The endoscopy went great! Still a weird sensation to be in the OR with the docs and nurses, final prep taking place, then you wake up in a room and it feels like 5 minutes later, but you're in a different room, and none of the stuff is attached to you anymore. But - I like it. Initial results looked good. He took a couple of biopsies.

Called Dr. Goy's office regarding the redness and puss by the Hickman site, so they saw me. Got blood drawn for counts, they checked the site, and changed the dressing. Some concern, so the doc that installed it checked me out later. In the meanwhile I got my bone marrow aspiration. He did a great job, but I still hate getting that done.

The doc that installed the line said it looked pretty good - she didn't want to take it out yet. They drew blood for a culture from the hickman, and they'll check that. If it's positive for bacteria, they can treat with anti-biotics, or take it out. The infection seems to be very minimal, and just at the site of the stitches. She couldn't even get any puss to come out. So we'll go with more frequent bandage changes, and watch it. I'd like to keep it in, as I don't want a PIC line, and having a triple lumen installed every chemo treatment doesn't sound like fun. Wouldn't be that bad - as it would free me up between treatments! Any way it works out, it'll work out...

Finally left there around 6:30pm or so. Got home, ate breakfast, lunch, and dinner (had to fast before the endoscopy, and there was pretty much no time for lunch, etc - except for a starbucks coffee and some pastry on the way home....). The kids came back home, and all was well.

I gotta get some work done, and tomorrow is prep for the colonscopy, there's a good time!

BTW, WBC's were 36 I think, and Platelets were around 55. I need to get a copy of the CBC

Chris had a shower to go to, so I hung out with the kids for most of the day. I tried to take it easy, not wanting a repeat of the fever thing from Sat. Mom came over about mid-day to cook a turkey for dinner, and later Alex and Dad came over. Good stuff, as Alex went outside to play with the kids, which I had been trying to stay away from (fever thing). The kids were happy...

Just took it easy for the m