Wednesday, May 6, 2015

Treatment #3: The Liver Protests

Treatment number three happened on the last Monday of October, 2013.  Patrick and I arrived at the clinic on a bright, sunny morning.  After the routine pre-treatment tests, my liver enzymes were found to be "five times more than normal".  Because of that, the new drug (Avastin) was delayed again.  The doc decided also to omit from today's "recipe" the drug she suspected as the cause of the liver toxicity, oxaliplatin.

FOLFOX is the short-hand way of referencing the chemo regimen I was on.  "FOL" for folinic acid (leucovorin), "F" for fluorouricil (5FU), and "OX" for oxaliplatin.  My time in the infusion chair would be shorter that day, since the oxaliplatin would be skipped.

An order for an ultrasound of the liver was written and presented to me with the instruction, "Please have this done as soon as possible".  I tucked away the order and made a mental note to call the hospital later that day.

Off to the infusion room.  BP was taken, port accessed (no drama!), and meds started to drip.  Once I was settled, my oncologist came by to discuss my liver.  It was an unsatisfying conversation.  Unlike the fields I had worked in (programming and engineering), medicine is not at all cut-and-dried, especially when it comes to cancer treatment.  Human biology plus pharmacology equals...well, we would have to just wait and see.  The hope was that my liver enzymes would stabilize after a two-week break. 

"Maybe oxaliplatin could be added back in next time..." the doctor seemed to be thinking out loud when she suddenly stopped short and called out, "Can someone get a tissue?"  She spied a nickel-sized, hairy spider (!!!) on my sweater, just above where the port and its connected infusion hardware sat.

After a second or two of no response to her request, the doctor whacked the beast away with her prescription pad (Yikes! Don't forget the harpoon there...).  It was a jumping spider, and it disappeared to who-knows-where.  We briefly tried to find it, but it was well-hidden.  Just then, the requested tissues showed up.  We resumed our liver conversation and as that was wrapping up, the little monster crawled back onto my arm.  GAH!  "There it is!" declared the Good Doctor as she scooped it up, tossed it to the floor, and crushed it under her venerable shoe in one fell swoop.

I squeaked, "Spiders are good luck, right?"  

"Yes, I think that's right," she laughed.  The lady in the next chair over, who witnessed the whole scene, congratulated me for not trying to dart out of the chair.  I then remembered last week's iron infusion, and was glad that I had stayed put this time.

Hours later, I was disconnected from the infusion pump, and attached to the portable one.  We were sent on our way.

Oxaliplatin's absence was immediately obvious.  There was no sensitivity to cold, no shards-of-glass feelings in my fingers, and no numbness!  I even imagined the possibility of ice cream, sweet bliss.

Once home, I collapsed onto my bed.  As I lay there, drifting off to sleep, I had a conversation with my liver:

Me:  Liver?  Haven't I been good to you?

My Liver:  Yeah.  I guess.

Me:  Barely any alcohol, ever.

My Liver:  mmm-Hmmm

Me:  No smoking.  No illicit drugs.  Hardly any meds until now...

My Liver:  Yep

Me:  I guess chemo is no picnic...sorry about that.

My Liver:  You don't know that half of it, lady.

Me:  Good luck, Liver. [Yawnnn]  I hope you bounce back.

My Liver:  Stop talking to me, you freak.

Me:  zzzzz

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