On My Last Cycle
Quick update, as I haven’t provided one in a while. Overall, things are good, and I felt better in cycle 5 than I did in cycle 4. The last of my 6 planned chemo + immunotherapy cycles in this phase of treatment started on Wednesday, 3 August, with the last infusion scheduled for next week. Once those are completed, we will go through another round of seeking opinions for the next phase of treatment, starting with a trip back to MD Anderson (Houston) from 14-18 August. We’ll consider the opinions of both MDACC and UCM and to decide on the next phase of treatment.
As far as how I’m feeling, fortunately, my fears that the cumulative effects of the drugs would make cycle 5 rougher were not realized. Cycle 5 was more like cycles 1-3 than cycle 4. By that, I mean the nausea and fatigue I experienced in days 3-5 were more similar to the first few cycles than cycle 4. After that, I started to feel better and got back to normal before the day 8 infusion. This was quite a relief, as the fatigue throughout most of cycle 4 was a challenge. My energy and appetite were normal throughout the cycle. I have managed to maintain my weight and eat and taste normally.
There are a few ongoing side effects, though. Again, these are relatively mild and manageable, so overall the treatment is going about as well as can be. First, the fullness in my right ear has persisted. It’s the same feeling as when the pressure doesn’t equalize after a flight. My hearing isn’t equal between my left and right ears. It sometimes feels like I’ve left an AirPod in my right ear but when I reach to take it out, there’s nothing there! I’ve now had this for about a month, so perhaps I’m getting more used to it. I did see Dr. Roxbury, my ENT, who did an exam and did not find anything concerning. He believes, as other doctors have stated, that the Eustachian tube is small and has been through a lot during the treatment. They believe that the ear fullness, especially since it’s only on the right side, is treatment-related and expect it to return to normal eventually.
The second impact is the loss of stamina. Throughout treatment, I’ve been trying to get the gym regularly (though not going as much as I had hoped). The last week or two I’ve noticed that I’m having to take more breaks or do less intensive reps/intervals. It’s still good to do a HIIT or cardio-based class, but I have to regulate my effort. For yoga classes, more gentle / restorative classes may be what I seek the next few weeks.
In addition, the cumulative effects of the drug treatments is reflected in my blood counts. I’ve been taking Zarxio injections to help boost my white blood cell count (WBC) and my absolute neutrophils. This helps to increase my ability to fight infection. These need to be above certain levels in order to receive treatment. I’ve been out of range for other items, as well, but these can’t be managed by drugs or diet / lifestyle. For example, in cycle 6, my carboplatin (chemo drug) dose was reduced because of low platelet counts. All of these impacts are common and not concerning, and they should return to normal post-treatment, according to my care team. I don’t feel any different based on the blood counts. However, I do need to be mindful of them, as I could have elevated risks when they are out of range.
Finally, as the there is only one more infusion left to complete the 6 cycles of systemic treatment, I asked the care team if the alcohol prohibition can be temporarily lifted, at least between the end of this phase and the beginning of whatever the next phase may be. They first asked me whether I had in mind a rager (“boys night out” in their parlance) or a celebratory glass. So I had to downgrade my expectations. I asked if I could have wine / cocktail with dinner. They asked me how much that entails - usually no more than 2 for me. They want me to limit to 1 (for the day, not the hour). They also suggested that it’d be a good wine, so I guess my planned purchase of Two Buck Chuck or the best boxed wine will be be for another time. Any suggestions on what I should drink instead? In Houston, we’ll be ordering cocktails or wine off the menu, but back in Chicago with access to my locker, I’ll have more choices. Champagne? White Burgundy? Dessert Wine?
Hopefully I’ll provide a more timely update next time. We’ll have some news to report from Houston, both the treatment plan and the eating adventures.