Round 3 Session 3 – completed

Today is Saturday, Jan 7, 2017, and all is peaceful outside with the sun shining over a cold (-24 C this am) Lake Bernard.  The crispy air and the stillness were disturbed by my early morning drive to Ottawa to consult with a CCAC nurse.  The drive to Ottawa was nothing short of winter magic.  There was a spectacular deep blue sky, the rising sun, the radiant visual effects of iced trees, the moist air with tiny flecks of snow caused by the river fog and a duel rainbow floating in front of my car showing me the pots of gold at the ends of the rainbow as I squinted into the rising sunshine.  All of these elements converged in my view along the highway and reminded me of the early morning drives with the kids to go skiing on a Saturday morning.  It was also one of those mornings that reminded me that my camera (not my phone) should be in the car at all times.   The trip was for a routine appointment but I am getting ahead of myself.

Earlier in the week I went to TOH to do my blood tests at the last possible minute to ensure that my WBC had done their thing and they were of sufficient count to allow me to go ahead with my 3^rd session for this round of Chemo.  After the blood tests I waited for the rest of the day to see if I received a call to cancel my Chemo session.  Unfortunately, as with most things today, only bad news travels fast and patients are left to wait and wait to see how their tests have come out.  Doctors in general work on the basis of: “if nothing is wrong, proceed and if something is wrong we will call you.”  The difficulty is that the patient is left wondering until such time as the patient losses interest which could be days later.  All that time the Dr. may be confident that all is well while the patient is still worried.  In my case the Dr. gets the results and decides if it is OK or not to proceed and goes about his business taking care of other patients.  However, I was left to think about it all day until I was sure that their office was closed and only then was I confident that my session would go forward the following day.   In this case, I waited all day and did not hear so ...... I went to the session at the Queensway Carleton Hospital in the Irving Greenburg Cancer Centre.

On Wednesday morning it was a cold post rain/snow storm that coated the city in an icy wonderland reminding me of the Ice Storm 1998.  The city traffic was limited to people who had to go outside.  The grounds of the QCH were beautiful with ice laden trees twinkling in the sunshine.  I parked in a series of spots designated for the Cancer Centre and made my way into the reasonably new facility.  The operational routine was very similar, if not exactly the same as the procedures at TOH.  Suddenly I felt comfortable as I had been feeling a bit on edge with this transition to the new location.  “Someone moved my cheese” and I was reacting to that change.  My session itself was informative as I queried the nurses about what they do, how they were doing it and about their views of the process.  This usually results in some casual conversation while they are working which provides me with a lot of information to bolster my confidence and knowledge of the process and the intended outcomes, reactions and ultimately the effectiveness of the process.  The team I had on that day gave me lots of support as I seemed to be feeling that I needed some extra courage with this session.  The session was the usual 3 hours and came to an end around lunch time.

I was feeling pretty tired after the session but I set about my small number of “chores” in the city before I drove to the cottage to rest up for the balance of the day.  Upon my arrival at the cottage I saw that rest was not as close as I would have liked.  There was a full 10” of wet snow in the driveway as a result of the storm the night before.  We had stayed in the city so the storm dumped snow for about 24 hours without any attention.  I was fortunate as the road snowplough guy had just completed our road but he is not contracted to do my driveway.  To add to the fun, there was no power at the cottage.  We had been alerted of this situation earlier in the day but it still meant some work to get some electricity into the house.  I chose to do the driveway first and then I could move my car off the road.  Thankfully my snow blower started without the usual power assist and I started the task of cleaning out the driveway.  Approximately 1.5 hours later the driveway was a deep gouge out of the level snow across our property.  I parked the car in the garage after I disengaged the power lift for the garage door.  I then turned to the task of getting my generator started and connecting the pony-panel to provide power to essential parts of the house.  That is usually done in the dark as the power usually goes out in the evenings but this time I was lucky to have daylight to work with.  It started with a couple of pulls and power was restored inside the house.  At that time the power had been out about 14 hours based on detective work with clocks in the house.  I checked with Hydro Quebec and their automated system gave me hope that the failure would be reconciled in an hour or so from my call.  They were right and the power came on long enough for me to switch it back for full operation and think about settling down to rest.  Unfortunately, after a brief 45 minutes of operation the power stopped without even a flicker.  I restarted the generator and decided that I had better get some gas as this could last a while.  A run to the Low gas station  fixed the lack of gas and a call to the Hydro proved that we were in a long time without power.  Once I got all that running again I sat down and it was 5 pm.  Where had the day gone and where did I get the energy to get through all of that.  We managed to jury rig the toaster oven to cook up some grilled cheese sandwiches and we heated up a great soup that our friends had dropped off a few days before.  It turned out to be a great meal as we enjoyed a quiet evening at home in front of the fire.  The power returned at 2 am the next day.

On my second day of Chemo I was determined to stay calm and get some rest.  I managed to stay at the cottage for the day and I did indeed rest as the night was filled with hours of being awake with no ability to close and lock my eyes.  The steroid used in the chemo process on the previous day has that effect for about 24 hours.  I had some serious bouts of nausea that resulted in me reaching for my meds to combat such things.   The meds helped with the nausea but I still found it difficult to actually close my eyes and sleep.  I read for some of the day, invested some time in a proposal effort for Lightning Tree and watched some daytime TV to try to lull me to sleep.  The proposal effort was difficult as there were many variables, a need for concentration and we were working with a new organization that was unfamiliar with GOC processes.  I managed to get something out that made some sense – at least to me.  In the evening we enjoyed a nice light dinner, watched some TV and I went to bed early to try for that sleep that was eluding me.

Then, on the third day (Friday), I drove to Ottawa to visit with CCAC to have my bottle removed.  I had a new nurse who was very direct, informative and helpful with my quest for understanding of all the ramifications and impacts that my chemo treatments could cause.  I also asked her if there was a time I could get some assistance with my WBC fighting unit, known as Neuprogen, since the method of self injection was quite different from my experience with Neulasta from earlier rounds of Chemo.  She scheduled a morning appointment with her the following morning.  I was taken by her thoroughness and appreciated her attention to detail.

After my appointment for the bottle removal, I ventured to the Superstore for supplies, Luciano’s for some specialty items, the bakery for some cheese jalapeno and chive bread that I had a craving for and then to the gas station for gas and a car wash.  While in the car wash I ripped a piece of cheese bread and enjoyed its intense flavour.  However I had never felt the impact of the jalapeno as much as I did with that bite.  I had read that spicy food would be a challenge but I had not experienced that effect.  I stopped at one and would wait until I got home and could toast the bread and add some good old peanut butter to it.

Once home I decided to do some snow cleanup outside with Ranger.  It was cold but the exercise felt good.  The snow was no longer wet and heavy as the cold weather had made it hard and difficult to work with.  After a short while doing that I gave up and went for a walk with Ranger.  He was happy to have me throw his stick, run after it and slide down the road as he approached it and then pick it up and run away with it.  This was repeated several times during our walk.  It was fun to watch his friskiness as I froze my ass off.  The balance of the day was whiled away doing email, Facebook and mindless searches on the Internet.  Dinner that evening was a simple spaghetti and meat sauce feed with some great garlic bread.  It was appreciated as my appetite had been crushed by the Chemo treatment.  The only side effect I encountered that day was to pay attention to my bowel and to start the Imodium process for the next period.  Once again, I went to bed early to try to catch up on some lost sleep.

Earlier today, Saturday, I had that great drive to Ottawa and met with the nurse from CCAC to get my instructions on how to manage the self injection process to benefit from Neupogen.  She straightened me out on many sides of this story.  With Neulasta I had received a small pre-loaded needle that was simple enough to extract from the package, shoot up and then dispense with.  I kind of liked its simplicity.   In this case the box from the pharmacy contained 10 small bottles of prescription Neupogen to be taken at 10 different times.  My Dr. Instruction was to self-inject this drug into my stomach with three daily doses after each Chemo session.  So my investment in this drug was actually good for slightly over 3 sessions of Chemo.  This realization made me feel a lot better as the thought of the personal outlay of greater than $400 (representing only 20% of the total drug cost) for one session was not sitting well with me.  With that cost being split over three sessions I was relieved and I was able to accept it more readily.  So the nurse was able to explain all that to me and then she started on the process.  That included washing my hands, opening the three packages, assembling the needle, cleaning the bottle surface, loading the needle with the content of the bottle, checking for air locks, positioning the needle for injection, the injection of the contents and finally the disposal of the paraphernalia.  It certainly was not difficult but having the process described clearly made all the difference in my confidence to do this to myself two more times over the next 48 hours.  In addition, knowing that this may help to keep me on schedule for my next Chemo session was a strong motivator.

Following my informative CCAC visit I managed to get a couple of outstanding tasks off my ToDo list as I made my way back to Lake Bernard.  My physical health was better than in previous sessions as the nausea and other side effects seemed to be abating.  That is the signal that things will progressively improve over the subsequent days.