The blogger's sacred oath

The last couple of posts have been kind of skimpy when it comes to photos, which means I have been failing to uphold the blogger's sacred oath to burden the world's bandwidth to the maximum of my ability.  So this is just a quick follow-up to upload a few pictures.  These were all taken on C's phone, so feel free to blame the hardware if the exposure is off.

We'll start with a picture from my last day at chemo.  To celebrate, I decided to brighten the room by pulling out the one Hawaiian shirt I own.  I actually got the shirt from my uncle after he passed away as a result of lung cancer.  This was the first time I have worn it.  Typically, Hawaiian shirts should be reserved for tropical themed parties in the middle of the winter.  And maybe, just maybe, they can also be worn while in Hawaii.  But I think chemotherapy gives you license to occasionally act outside the bounds of otherwise normal civilized behavior.

Goofy half-smile and crazy-eyes are almost certainly the result of the massive doses of Benadryl that accompanied each infusion.

The rest of the pictures are from the ski C and I went on last Friday, discussed in the prior post.

C was all smiles, glad to be skiing on a gorgeous snowy day, energy building in her legs waiting to be unleashed at the first sign of an incline.

I, on the other hand, spent my time desperately trying to fill my lungs with precious, precious oxygen.  This particular picture was taken at the top of short, but steep, climb.  I labored into position at the crest.  C was waiting, wearing the same smile pictured above, camera-phone at the ready, trying to get me to move into a better spot so she could snap a picture with the sun and mountains visible in the background.  I think I stared at her with an expression much like that she ultimately caught here.  "I can hardly hear you speak through the heaving of my chest.  There will be no more moving today!" I declared.  But, eventually I regained my breath and my perspective, and C got her way and coached out a smile:

All in all, a fine day to be on the trail in the low angled sun of an Alaska winter.

Rapid heart beat.

I suppose I've had a post-treatment aversion to updating the blog.  Perhaps aversion is the wrong word.  Its really more of an out of sight, out of mind phenomenon.  Hey, treatment is over!  Nothing to see here, people.  Just keep moving.

I also feel like I'm holding a basket of eggs and wondering how many chickens I've got.  In prior posts, I've commented on the fact that tumors previously obvious to the touch have long since disappeared, and that the doctor overseeing this whole health fiasco has every confidence that the R-CHOP regiment behaved predictably and did its job in an honorable and workman like manner.  Nevertheless, as also previously noted, I have a PET scan scheduled in about five days.  That will give us the internal picture and really be the driver to declaring a full-, partial-, or non-remission.  After meeting with the doctor on the 7th, we'll all know a bit more.

In the meantime, I am now officially in the longest chemo-free stretch of days that my body has enjoyed since July.  In general, I feel good, but I have a lot of strength and aerobic capacity to rebuild.  I really have no idea how long that might take.  I've been diligently going to the chemo-rehab classes... and pushing past the prescribed heart rate zone.  The nurses crease their brows, toss me questions about how I feel and how I've been responding to the exercise, and then give me a pass so long as I don't get hit with sudden fatigue or find myself catching colds (both signs that I've pushed my body too hard and it has given up the ghost).  Even so, I find myself on the tread mill shuffling along at 13+ minute/miles.  [If I stayed in the prescribed heart-rate zone, I'd be going at a fast walk instead of a slow run.]  Outside of the gym, I tend to run at between an 11 and 12 minute/mile pace.  My goal for last summer was to run a fast (for me) half-marathon, something in the 7 to 7.5 minute/mile range.  Clearly, that goal has been pushed back until next summer or later.  I'll just have to see how the winter goes and how my body responds.

To anyone curious about the Anchorage weather, you will be glad to know that Thanksgiving brought fresh snow, badly needed following a week of warmer weather and freezing rain.  The ski trails are skiable once again.  I went out on Friday, and again today.  If you have never had the pleasure of skate-skiing, it is a ton of fun and a ton of pain.  It is an activity that takes both technique and fitness, the more of both the better.  My technique is only passable and, as I have already complained about for a full paragraph, my fitness is not what it used to be.  That makes for some short skis, replete with frequent stops, my body hunched over poles for support and chest heaving (heart rate be damned!).  But both days brought low-angled sun, trees draped with snow, and good conditions.  It is beautiful to be out, and given the choice between the chemo-chair and an out-of-shape ski, I will take the later.

As an update to my international call of arms, I am disappointed to report that it now appears that the Google/Blogspot statistical tools only reports the top 10 countries from which my page has had hits.  I see we have added Malaysia and Georgia, and I would of course like to welcome them to the fold.  Are there others outside of the top 10?  Who knows?  Switzerland dropped off the list, so I know there is at least one country no longer represented on the statistics tools.  Its one page view could not sustain it with such fierce competition from eastern Europe and Asia.  Interestingly, the biggest gains in viewership have been in Russia, now fourth behind the U.S., Canada, and France.  How many of these people got here by accident?  How many were seeking information about cancer?  How many page views are simply the result of programs scanning pages for e-mail addresses in order to generate spam?  I may never know.

Enjoy the transition to December.

Rehab

This is just a quick update post, to fill in the details moving forward for those who are interested.  As noted in the last post, I had my last chemo treatment last Wednesday.  Tomorrow (Sunday) will be the last day I take the steroids, so starting Monday I wipe my hands of the drugs all together.  We have scheduled a PET scan about four weeks out.  As I may or may not have ever mentioned (I'm too lazy to read back through to find out either way), I've been getting a shot to boost white blood cell production after each treatment.  The activity resulting from the shot can register as "hot" on a PET scan, so we need to wait until it has worked its way out of my system before doing the scan.

By way of background, and based solely on my limited understanding, a PET scan is one of the more precise tools for diagnosing and staging cancers.  I will be injected with a sugar tagged with some radio-nuclide.  Cancer cells metabolize the sugars at a much higher rate than healthy cells, meaning they take up the radio-nuclide in greater numbers.  I then lay beneath a camera, my cells emit radiation, and the film records the hot spots.  I had a PET scan following the original biopsy, and as is apparently typical for NHL patients, I lit up like a Christmas tree.  The expectation is that that is no longer the case.  We'll meet with my oncologist following the scan to discuss the results.

Assuming everything is a-ok, I'll continue on a routine of maintenance drugs, in which I'll get a dose of Rituximab twice a year for two years.  Sprinkled throughout will be regular checkups with the oncologist, once every three months to start.  We'll do additional scans on a 6 - 12 month basis, and over time the appointments and scans should get fewer and further in between.

In other news, I've signed up for a rehabilitation program that the local cancer center offers.  It basically amounts to personal training.  I had my first session last Friday.  They start off pretty conservatively, and try to keep your heart rate at about 50% of maximum.  So instead of diving right in to speed work, I spent 20 minutes on a tread mill walking at about a 17 minute per mile pace.  I've lost something between 10 and 15 pounds over the course of chemo, a fair bit of which is probably muscle mass.  The program also includes some weight training, which should be beneficial.  My intent is to quickly but safely rebuild.  I have lots of ideas for fitness goals for next year (so called recovery races), but will hold those in abeyance pending a better understanding of where I stand now and what goals are realistic.

Throughout treatment, I have at least managed to get a few runs in towards the end of each cycle (some more than others).  The fifth cycle was the hardest hitting, but C and I were still able to run hilly terrain at Kincaid for 3.5 miles last weekend.  I can't help but think that having maintained some level of activity provided a base which it is now time to strengthen.

So, kind of a dry post, but I thought some of you might be curious as to what the end of treatment means. Enjoy the weekend.

Statistics

This was supposed to be an update pre-my last scheduled treatment, but work got in the way.  So instead, it has turned into a post-treatment update.  For those counting, I went in yesterday for treatment number six.  That is six of six, so until someone tells me otherwise, I'm done.  I've had a number of questions along the line of: "So, you're almost there.  Are you excited?"  The truthful answer is, "no, not exactly excited."  Grateful, that I won't be sitting in the leather chair three weeks from now.  Tired of chemo, for sure.  Anxious, perhaps, to see the results of the next schedule PET scan and get the picture proof of remission.  Cognizant that we are talking "remission" and not "cure."  But not really excited.  Not in the way you are excited about an upcoming trip or an upcoming loaf after smelling the bread baking.  Just relieved and ready to rebuild.

Part of the power of administering your own webpage is access to the statistics tools.  The tools largely reveal the expected.  Most of you are in the U.S., and most got here from various mail sites (i.e., someone probably e-mailed you a link to the page).  As of today, there have been 2,116 page views.  I suspect half of those are me, maybe a quarter of them my Mom (unless she got scarred away by the topless pictures some time ago), and the rest are spread amongst those of you who came here deliberately and those who stumbled here by accident.  And there are a few people who stumbled here on accident.  One person Googled "chemo shave" and took the time to read (or at least follow the link).  Whoever you are, I hope you learned something!  A couple (or one person multiple times) got here from a Google search of images on the .ru version of the search site, looking for images of "Alps fog."  I suspect they did not find exactly what they were looking for, but hope they were entertained nevertheless.  Other Google searches were all either looking for this blog specifically or looking for information about the northernmost cobras in the U.S.  The later is a possibility, I guess.  I used to think that there were no snakes in Alaska at all.  Recently, I've read a number of different places that Maine is the only U.S. state without any poisonous snakes.  That suggests that not only is there a snake somewhere in Alaska, but that it is poisonous.  I suspect it is somewhere in SE Alaska, but highly doubt it is a cobra.

So far, I've had visits from the following countries:  United States (2,038), Canada (36 - Hi A and fam!), France (22 - Hi T and A!), Netherlands (4), Belgium (3), China (3), Germany (3), Russia (3), Poland (2), and Switzerland (1).  Of course, this is all just a drawn out request to any of you traveling: Take a laptop or find an internet cafe and dramatically expand the international scope of this blog!  I want to see hits from Burma!  Colombia!  Zamiba!  A Pacific island of your choice (other than Hawaii, which won't register separate from the U.S.)!  We've made good in-roads in Europe, but surely can do better!  Consider it a call to arms!

Of course, statistics can be applied in fields far flung from merely recording website traffic.  Try getting cancer and attempting to learn something about your disease.  It is a little humbling to think you have something that compels people who write on it to develop five-year mortality rates.  Luckily: (1) those numbers are good for NHL patients; and (2) for a disease with an average age at diagnosis of 60, I think a lot of the folks on the bad side of the 5-year bell curve probably had other issues going on as well.  Statistics don't tell you but so much.  Nevertheless, they draw you in, and I've been poking around at average remission rates.  It just creates more questions than answers, though.  Primarily, were the statistics developed using patients undergoing the new post-chemo maintenance regimes?  I guess it doesn't really matter.  I'll just aim for outlier status in any case... on the right side of the curve.  Permanent remission, anyone?