The Chemo – Cycle 3

Ugh. It’s been a long, tough week. Last Monday (one week ago) I started cycle 3, and it’s been a physically and emotionally challenging week, to say the least. This cycle really brought me to my knees – it has definitely been harder than the first two cycles. I mean I knew it was going to be hard but I didn’t realize this past week would be the hardest one yet. That’s the main reason I haven’t posted in a while, I just haven’t had the energy. But today I finally feel like I’m starting to turn a corner! I feel maybe 75% myself, but not quite at 100% normal. Hopefully in the next couple days that will happen.

I’ll start with the good: Saturday before cycle 3 started Lisa’s mom, Jevne, arrived to help! She was a key reason we made it through the week and has been amazing. Jevne even watched Elliot for us on Saturday night (her first night here!) so Lisa and I could have a date night! We had a nice dinner at one of our favorite restaurants in North Park, The Smoking Goat. Then Jevne watched Elliot during the day throughout the week so Lisa could take me to my all day infusion appointments. Clutch.

Easter Sunday we had a few friends over for dinner to celebrate. It was nice to have a normal gathering with friends before cycle 3 started, but I was still dreading the treatment that was going to start on Monday. I made the best of our time and enjoyed the food, but I’ll admit my mind was burdened with the weight of the week to come. I’m thankful for understanding friends who are willing to walk alongside me during this time.

A few other highlights of the week:

Monday night, our friend Philip and his mom Margie bought groceries and cooked dinner for us!
Our friend Nicole brought us a delicious dinner on Tuesday night even though her husband Joe, was away on a work trip all week.
My friend Jon took the day off work and drove all the way from Escondido to North Park and back to take me to infusion on Thursday so that Lisa, Elliot, and Jevne could have a fun half day at SeaWorld! Jon basically sat in traffic for me all day on Thursday, and I am so thankful for his help!
Our friend Kristen brought us our absolute favorite Thai food on Friday night!
Our friends Graden and Elle came over and cooked us dinner on Saturday night!
Our friend Olivia brought fantastic, deconstructed sweet potato tacos over for dinner Sunday night!
Several people from our North Park community group showed up for us in ways that we seriously can’t even wrap our heads around this week. You know who you are and you are incredible!
Our friend Adam Bartels happens to know Tyler Trent’s parents, so he shared my Purdue blog post with them and they graciously sent me a copy of Tyler’s new book! I started reading it at the beginning of last week when I still had energy and love it so far!

Tyler Trent’s new book. So far so good, this book has been a big encouragement to me!

There’s a lot to be thankful for here. The support we have been shown recently has been astounding and we couldn’t have made it this far without all your help.

Now onto some of the bad for the week. The veins in my arms are completely jacked up by the chemo drugs. The chemo has bruised the main veins on my inner forearms (yes veins do bruise and yes they hurt) and made it impossible for the nurses to start a new IV on any of those veins. I’ve said it before, and I’ll say it again: I HATE GETTING THE IV. It’s the worst part of each visit. I’m so stressed that the nurse won’t get it right and they will have to make multiple attempts to get a good IV (which has happened before). Thankfully, I had an amazing nurse that found an invisible vein on the top of my arm and started a good IV on Monday. I saved that IV for Tuesday (kept it overnight, which also sucks pretty bad but only slightly less than getting a new IV) and then got a new IV on Wednesday. The same nurse as Monday found the same invisible vein on the top of my right arm (previously it was the left arm) and successfully started my IV! Yeah that was a real stressor for me, but glad I made it through the week okay with the IVs. My arms look terrible now, but the worst is over.

Finally, I have just been super drained of energy this cycle. I feel like the chemo hit me harder this time. I’ve been zapped of energy and it really takes a toll on me both physically and emotionally. By Wednesday I’m basically reduced to a vegetable. All I can do is just sit around and space out. Everything takes an enormous amount of energy, even thinking, reading, and eating. As someone who spends a lot of time inside my head, you can imagine how horrible this is for me. To not even be able to think straight or read is very taxing and makes me really sad. So I just sit, and sit, and sit, and sit, …

Until finally I wake up with a bit more energy like today. Thankfully.

This week has been hard on our entire family. Lisa has had a lot of work to take care of with two busy projects going on, all while juggling Elliot duties and my daily infusion visits. There’s also the emotional component she’s been dealing with of seeing me sad and without energy and not being able to do anything about it which I know isn’t easy. She has been INCREDIBLE and is my ROCK!

BABY STEPS. I can make it through today. Tomorrow I’ll be a little better, and a bit better the day after that. Baby steps. Less than two weeks to go with cycle 3!

-B

The Chemo – Cycle 2 Begins

Day 1 of cycle 2 is complete, and I’m feeling good! I know that the chemo is going to hit me harder this week since I go in every day Monday through Friday. By tomorrow night I will probably be napping in my ugly ass amazing recliner!

I wanted to fill you in on my chemotherapy regimen and give you a little bit more info and what my treatment is like. My oncologist prescribed three cycles of BEP chemo, where each cycle is three weeks, or 21 days. BEP is short for Bleomycin, Etoposide, and platinum, or as it is commonly referred to now, Cisplatin. These three drugs in combination are HIGHLY EFFECTIVE at curing testicular cancer. BEP chemo in combination with the surgery I might need afterwards has a 95% CURE RATE. That’s the highest cure rate of any type of cancer. Pro tip: if you have to get cancer, choose testicular cancer, it’s the best. Sorry ladies!

Three chemo drugs in total on a 21 day cycle. The infusion schedule based on the day of the cycle for these drugs is as follows:

Days 1 through 5: Cisplatin and Etopiside (Monday through Friday every day during the first week of my cycle)
Days 2, 9, and 16: Bleomycin. On day 2 Bleomycin is an additional infusion along with the Cisplatin and Etopiside.

I just completed the first cycle yesterday, Sunday March 31st, and today, April 1st, I started cycle two. Today was cycle 2, day 1 so it was only Cisplatin and Etopiside and the side effects haven’t quite kicked in yet, hence why I feel so good.

So how do these chemo drugs kill cancer you might ask? Great question!

Basically, Cisplatin – a chemical composed of platinum, ammonia, and chlorine – is the heavy hitter in my treatment. Cisplatin works by interfering with DNA replication, which effectively kills any and all fast growing cells in your body. Obviously that includes cancer cells, since they grow fast, but also includes things like hair, white blood cells, stomach lining, the outer layer of skin, and taste buds. Hence, many of the worst side effects of this drug. Also, Cisplatin has the potential to damage the kidney.

Fun fact about Cisplatin: the use of this drug to treat testicular cancer was pioneered in the early 1970’s by Dr. Lawrence Einhorn, a researcher at INDIANA UNIVERSITY!!! BOO, IU SUCKS! Note for those who didn’t know me in my Purdue days: Purdue and IU are bitter rivals and generally dislike or hate each other. Purdue hates IU so much they chant “IU SUCKS!” at home football games, regardless of the opponent. This past season though, for Tyler Trent, they changed the chant to “CANCER SUCKS!” I like to think they were chanting for me even though I didn’t know I had cancer yet, haha.

Before Dr. Einhorn started using Cisplatin to treat testicular cancer, the overall survival rate was only 5%!!! An article on the IU website summarizes his groundbreaking achievements and contributions to cancer research:

” Dr. Einhorn minimized the extremely toxic side effects of treatment; shortened the duration of two years of therapy to nine to 12 weeks; and established a model for a curable tumor, which has served as a research roadmap for generations of oncologists.”
Marking a Milestone: Dr. Einhorn discovered testicular cancer cure 40 years ago”, https://cancer.iu.edu/news-publications/Einhorn.shtml

Anyways, Dr. Einhorn was the dude that discovered that Cisplatin works really well when treating testicular cancer and I am ETERNALLY GRATEFUL for his discovery despite the fact that he is (still) at IU. That means 50 years ago this cancer would have probably ended up killing me. Thanks IU! Just so you know, I will probably still chant “IU SUCKS!” when Purdue plays them but I will try to be nicer now.

Ok, moving on. The second drug, Etoposide – a partially synthetic drug made from the mandrake tree rhizome – is more complicated, but basically screws with the DNA sequencing of cancer cells. I’ll just quote wikepedia because it summarizes how Etoposide works better than I could:

“Etoposide forms a ternary complex with DNA and the topoisomerase II enzyme (which aids in DNA unwinding), prevents re-ligation of the DNA strands, and by doing so causes DNA strands to break.^[8] Cancer cells rely on this enzyme more than healthy cells, since they divide more rapidly. Therefore, this causes errors in DNA synthesis and promotes apoptosis of the cancer cell.”
“Etoposide”, Wikipedia, https://en.wikipedia.org/wiki/Etoposide

Yeah, more cool science bro, it’s saving my life here.

Finally, the third drug, Bleomycin, is some really crazy stuff. It’s a “nonribosomal peptide,” which is essentially a chain of amino acids that are produced by bacteria and fungi. Researchers don’t fully know how this drug works, but it basically causes cancer cells to split, then the Cisplatin and Etoposide attack and kills these cells. I’m not gonna quote wikipedia here because the article is too intense. You can read it if you’re interested though.

The side effects of Bleomycin are different than the last two drugs. Bleomycin is the drug that gave me a fever during week 2 and sent me to the ER. It also causes scar tissue to form in the lungs that might make breathing difficult and potentially cuase long term lung damage. The Oncologist is closely monitoring my lungs to hopefully make sure this doesn’t happen. So far I havent’ had any issues with my lungs from the Bleomycin. I read tonight that Bleomycin causes a long term increase in toxicity to Oxygen, so I will need to tell that to any doctor if have surgery and need general anesthesia. It also means I probably shouldn’t ever scuba dive again. Bit of a bummer but I’m not a huge scuba diver.

That’s the summary of my chemo drugs and how they work. All of these drugs are given intravenously, which means I have to get an IV every day I have an infusion, or try to keep the IV from the previous day (or days) overnight. I HATE getting the IV. It’s probably the worst part for me. One nurse had to poke me three times on the third day of cycle one and then my arm was all bruised up. Ugh. But keeping the IV overnight presents a different challenge: I can’t get it wet, so showering is problematic. I ended buying some arm cast bags today on amazon so I can try and shower and keep my IV dry.

The benefit of the IV though, is that they give you the chemo drug slowly over the course of an hour so it doesn’t all immediately hit your bloodstream. If taken orally, the 45mg of Cisplatin I get every day would likely cause me to barf my guts as soon as I digest it and it enters my blood. So that’s the benefit of the intravenous infusion. I have to sit there all day but side effects are minimized.

I also get an extensive cocktail of drugs to manage the side effects: kytrol, steriods, and amend. These are given intravenously prior to the first chemo drug (usally Cisplatin). Additionally, because Cisplatin can mess up my kidney, they give me a full liter of intravenous hydration (basically saline solution) at the beginning and end of each infusion on days 1 through 5. On these days my schedule at the infusion center will typically look something like this:

Arrive at the infusion center, check in, and wait (depending on how busy it is).
Take my vitals: blood pressure, temperature, oxygen level, weight.
Get called back to the infusion center, start an IV if I don’t already have one.
One liter of intravenous hydration over the course of an hour.
Pre-meds (the three drug mix above for side effects above) for half an hour.
Cisplatin, typically 45mg dissolved in a liter of saline, for one hour.
Etoposide, weight based, somewhere around 1mg per pound of body weight, dissolved in a liter of saline, for one hour.
Bleomycin (days 2, 9, and 16 only), for 15 minutes or so. I don’t remember the dosage. I also get tylenol to help counteract fever and also Zyrtec for some side effect, not sure what that is, ha.

BOOM, that’s it folks! Today the above treatment (no Bleomycin today) took just under 5 and half hours. In addtion to the standard treatment above, I had to get blood drawn to make sure I was healthy enough to start cycle 2 and also visit the Oncologist to check in on me and make sure everything is ok. Turns out everything was fine so I started cycle 2! The blood draw people were running behind by an hour, which pushed everything else back today. My infusion ended at around 7:20pm and we got home just in time to see Elliot before his bedtime.

Even though today was a long day and ran late it was a really good day, much better than day 1 of cycle 1 where I was emotional wreck. Now I know what to expect so it was easier mentally and emotionally. I felt great and full of energy all day so I got some stuff done (still writing this blog post as of 11:50pm!), but better yet I had VISITORS! Five of my co-workers drove half an hour from the office to see me! Peter, Jon, James, and Scott stopped by for an hour and a half to chat, see what my typical day at the infusion center is like, and lift my spirits. It was a great visit. I’ve gotten nothing but love and support from my company during this time, they are really taking care of me well! I’m thankful I have a good job and work for a company that’s supportive and just wants me to get healthy.

These are some really awesome dudes that I work with. I work with some other really awesome people asd well who aren’t pictured here.

My good friend Philip also came by infusion center later to hang out, shoot the breeze, and give me crap. That’s how Philip loves on me, by teasing me. I have other friends who do this as well. YOU KNOW WHO YOU ARE. It was also great visit with Philip and I was glad he got to come by and experience my new normal.

Anyway, I’m up to over 1700 words now on this blog post. Kudos to you if you’re still reading! I’ll post another update soon with details on my brother and sister’s trips and some fun photos with them. Until then stay tuned!

-B

The Chemo – Days 11 Through 18

On Friday of last week my sister, Ashley, arrived in San Diego, and on Sunday my mom, Carroll, flew back to Indiana. It was great to have my mom’s help and I’m thankful she was here for the first two weeks. My sister has also been a great help since she’s been here the past week or so. And today my brother flew in from Indiana for the weekend! It’s great to have him here as well – it’s his first time to San Diego since we moved here.

I’ve been feeling quite well as of late, likely because my chemo schedule hasn’t been as intense. On Tuesday I had my last infusion (Bleomycin) of cycle one. No fever this time, which is great. My sister Ashley went with me to the infusion center this time so she got to experience all the fun of sitting around while I receive my chemo drugs intravenously.

Day 16 at the infusion center was uneventful

On Sunday we took my sister for a nice walk to see some more wildflowers down in Chula Vista. The wildflower bloom was off the charts and I got some great photos on our walk!

Wildflowers Near Mother San Miguel Mountain

My sister, Ashley, Elliot, and Lisa all enjoying the view.

I’ve been feeling so well this week I even went to work on Monday and Wednesday! It was really good to get back in the office, get some things done, and see all my coworkers. I’m thankful that the past week or so I have been doing well enough to have some semblence of normal life. It gives me hope that I can potentially return to work full time earlier than expected, and work a bit more the next two cycles.

Also, final update for today: my hair is starting to fall out. Yeah, I knew this time would come but it doesn’t really make it any easier. It’s mostly still on my head and beard, but anytime I touch my hair or beard a lot of hairs end up on my hands. I’m guessing it will likely be complety gone in the next week, possibly earlier. My brother and I are visiting my barber tomorrow together and I might just have him shave it off entirely, but we will see.

We still have some dates available for meals in the upcoming weeks if anyone would like to volunteer! You can check the available dates on our meal train site here: https://www.mealtrain.com/trains/lmwm36. Thank you for the continued support!

-B

The Pre-Chemo Prep

I had just over a week to prepare for chemo after I received my diagnosis and made a decision on the treatment plan. What I’ve now realized is that preparing for chemo isn’t all that different from planning a vacation, except instead of a getting to fly to a nice beach in a faraway spot you just get to drive to the infusion center! Ugh. So I bought some new sweats and comfortable lounge clothes to channel my inner Dude (the Big Lebowski) for 9 weeks of chillaxing. I also took this excuse to buy a new Cubs spring training hat since my hair is going to fall out.

Far and away the pre-cancer purchase I’m most excited about though is this AMAZING RECLINER! As you can see, the new recliner really ties the living room together:

Lisa’s and Sophie’s and Elliot’s favorite new chair.

This is how I know Lisa loves me deeply. She let me buy this ugly ass but insanely comfortable recliner for my 9 weeks of chemo. It’s now sitting in the middle of our living room and has totally messed up Lisa’s beautiful and meticulously planned space. But seriously, this thing is powered and has built in USB charging ports! It will be great when I’m really feeling crappy.

Another thing I wanted to do before chemo started was to get one last haircut and shave from my barber, Rene. I’ve been going to Rene since I moved to San Diego and he’s the best. The thought of losing my hair has been pretty scary for me and makes me sad to think about. I really love my red hair and it’s such a big piece of my identity as a person that it’s going to be a challenge for me to give that up during chemo. So anyways I went to see Rene one last time and he hooked me up with this bad ass haircut:

Super fresh new cancer haircut (at least until my hair falls out)

As you can see I went all out, and Rene added the cool lightning bolt for some extra pizzazz! You can follow Rene @kleanshaven on Instagram or book an appointment with him on the Freshly Faded website.

Finally, I had to get some good eats before chemo started. The chemo drugs mess up your taste buds and I’m now on the whole 30 diet so I knew I wouldn’t be able to eat a lot of my favorite foods for 9 weeks. It’s been a whirlwind of crazy good food the past couple weeks including:

IN-N-OUT BURGER
Ramen
Fried chicken at Fernside in South Park (thank you Travis!!!)
Indian Food from Himilayan Curry & Grill
Lisa’s amazing white chicken chili
Lisa’s amazing baked ziti
Hawaiian food from Chris’ Ono Grinds
Regent’s Pizza
Homemade biscuits & gravy
Curry & Noodles from Bahn Thai
Burgers & Pizza at THE FRIENDLY
Best steak of my life at Born and Raised with Lisa, my sister Ash, and bro-in-law Chad

Processed with MOLDIV — All the tasty things I love that I’m no longer allowed to eat or drink

Yeah that was some darn good eating and drinking. Last night I attempted to eat two entire boxes of girl scout cookies and failed miserably! Sadly I only made it through a half box of samoas. But now I’m going whole 30 and eating clean and not drinking so I can help my body HAMMER DOWN CANCER these next 9 weeks. We’ve even enlisted the help of a Nutrition Therapy Practitioner that specializes in helping cancer patients. Her name is Karianne and she is super great. She’s a cancer survivor and has been through chemo and knows how to help her clients both beat cancer and minimize the negative side effects of chemo including nausea. If you’d like some excellent Nutritional Therapy (even if you don’t have cancer, she can still help!) check out Karianne at her website: https://inspirawellnesscollective.com/.

Enjoyment of food has been a pretty big part of my life so it will be interesting to see how I do during chemo without some of the foods I really enjoy. Not that I won’t enjoy food at all, but priority #1 right now with food is to eat as healthy as possible to help my body as best I can the next 9 weeks. Up until this point my food choices were made primarily on what tastes good, whereas now I’m choosing foods that will work with my stomach and help me beat cancer. This is a good transition. Healthy eating has eluded me most of my life so maybe I can form some good habits now that will stick after my treatment is done.

Anyways, that’s it for now. It’s been a crazy week and a half prepping for chemo. Tomorrow I’m going try to post about chemo day 1 (which just finished!!!) so stay tuned!

– B