Round #2

Well, today I began my second round of the four scheduled 4 day chemo treatments which are in conjunction with my weekly one hour treatments. So far the side affects have been minimal with no signs yet of fatigue or nausea. The only prominent side affect was the acne type rash that Dr. Kukunoor said 1 in 10 people get and of course I got it! I should be so lucky in the lottery! After the initial treatment I felt the rash coming on and when I went and had the nurses at the chemo center look at it I was told that I was just having a reaction to Decadrol and that it would go away by itself. This was on a Friday when I should have also had a second one hour treatment but lo and behold no one ever mentioned that I was scheduled for this treatment even though they went into the computer and wrote down the rest of my appointments for the rest of the month for me. By Monday my nose was peppered with with white pockets of puss and black dried scabs from where the skin had blistered and bled. My entire nose was a deep red as if it was on fire and the rash spread up above my eyebrows and across my forehead and into my scalp and also down onto my chest. I called the nurses station again on Monday and this time when they saw my face they now determined that I had the rash I had told them about three days earlier. I was also suffering from mouth sores mostly located on the inside front of my lower lip and my tongue was extremly sensitive to any kind of heat. Even luke warm water would make my eyes water as if I had bitten into a hot pepper. Well the nurse gave me three precriptions, one for my mouth and two for the rash, one oral and one gel treatments. When I went to the Pharmacy to have them filled I was told that the they were out of the Gel and would not be able to get it until the foloowing day. This put me 4 days behind where I should have been had they acted diligently when I first contacted them the previous Friday. Needless to say I was not pleased by this and then to top it off when I went for my treatment the next Friday they finally realized I missed the treatment on the previous Friday and tried to cover themselves by saying that they probably bypassed that treatment because of the rash. This was a bogus claim because if it were true than I would've gotten the prescriptions on Friday instead of the follwoing Monday. You don't deal with the same nurse on every visit but I made it clear to the third nurse who gave me my treatment the neither of the two nurses on the previous Friday or Monday visits ever made a comment about bypassing a treatment or even that I had missed one. It was nothing more than them trying to cover themselves for this blunder. I had an appointment with Dr. Kukunoor on this past Wednesday and I made sure Dr. Kukunoor was aware of this. By now the rash is about 90% clear of my face but I still have red splotches on my chest but they do not itch like the ones that were on my face. Dr. Kukunoor wants me to continue with both the oral and gel prescriptions for the ramainder of the treatments to make sure the rash stays under control and for that I am grateful.
Todays bloodwork, drawn before the treatment began showed the majority of my counts to be below the low end of normal but they decided to go through with the treatment and I will get a booster shot on Tuesday when the fanny pack is removed to get my counts back up in the normal range. My WBC (White Blood Count) was 2.25 and the normal range is 3.70 to 10.1 and my RBC (Red Blood Count) was 3.90 and the normal range for that is 4.06 to 5.58. My Neutropenia count, another form of white blood cells was 1.57 and the normal range for those is 1.63 to 6.96. These cells turn into white blood cells and because the count was so close to normal this was the determining factor in going on with today's treatment. My Lymphopenia counts were .431 and normal for that is 1.09 to 2.99. This is another type of white blood cell. All of these are critical in the immune system in fighting off infections. My hemaglobin cout was at 12.3 and the normal range for that is 12.9t o 15.9 so I was pretty close there and there were about 4 other counts that were in the normal range but I don't have a detailed description of what they are or what they do and because they are in the normal range I'm not to concerned about them.
So other than that my eating is good, swallowing is better and energy level is good too. Dr. Kukunoor said that if this is as bad as it will gets, he said "Ill take it!" to which I replied to him,
"You can have it"" :)
Dr. Kukunoor did tell me that he spoke with Dr. Rodriguez who did the axillary dissection and they went over the operative report and Dr. Rodriguez said the the lymphnode that he wanted to remove for the biopsy procedure was wrapped around nerves and capillary tissues which prevented him from removing the entire node thru surgery. He removed as much of it as was possible. Dr. Kukunoor said that this is why he wants to be as aggressive as possible with the chemo and if after the treatment is done and the subsequent PetScan comes back clean than radiation to that area will be the appropiate follow-up. I asked Dr. Kukunoor what he meant by the PetScan coming back clean and he said the PetScans do not pick up microscopic cells, so as long as there are no other masses found elsewhere within my body at the time of the PetScan than this means it is clean and targeted radiation to the area will be the protocol to follow. When I asked Dr. Kukunoor as to how he would stage this cancer he said that the cancer in my neck was staged as a Stage 4B and he would now classify this as a Stage 4C. When I asked him which was worse he said the Stage 4C was worse because it had moved.
So now I have my friend for the next 4 days and then hopefully I'll return to normal. No hair loss as of yet but this is only the second treatment so if memory serves me well I believe it was at least two treatments last year before I saw the hair begin to fall out, so as the Zen Master in "Charlie Wilson's War" said, "We'll see!" I will close with that as I realize this was a lengthy post and there are more things I can go into to but this is enough for now. I will update probably next week sometime after Tuesday's pack removal.