The New, New Plan

Well, at 6:30 AM, my Radiation Oncologist messaged me with a change to my plan. He reviewed my past lung CT scans and feels that they are growing too slowly to have priority over chemo. So, after brain radiation we’ll start chemo.

In theory, if we hit the right chemo, it should also affect the lung tumors, too. So, the liver starts getting treatment about 2 weeks faster under this plan, which is great, as they have also been my 2nd biggest concern (after brain).

I had a heck of a time getting out of bed and getting to work, today. The bed kept calling me back. But, I managed to make the drive (actually got to work about 30 minutes earlier than I normally do). I’ll probably be fighting sleep a lot today. Not sure why…I slept well last night.

Meanwhile, still very little appetite or capacity to eat. I didn’t weigh, today, but probably a little lighter. Tried a smoothie on the way home from work. Managed to finish about 16 oz of it (bought a 32 oz). Also had a ham and cheese sandwich. I am trying…

Well, better get what work I can get done, done. I’ll let you know if the radiation gives me any mental superpowers (or erodes those mental superpowers I already possess).

A New Plan

Well, the Radiation Oncologist’s report changes my treatment plan pretty dramatically. Because of the number and position of the brain tumors (some could not be reached by Cyberknife), they will be doing whole brain (avoiding hippocampus) radiation. Hippocampus is involved in memory, so avoiding the hippocampus should help to avoid memory issues.

The rest of the brain radiation can cause side effects. Basically anyything else the brain does could be affected, including speech, problem solving, vision, basic personality, motor skills, … well, you get the drift. But, they have started me on another drug that should help to reduce or even prevent these side effects.

So, 9 days of that, then another 14 or so days irradiating the lungs. Could cause coughing…nothing new, there.

Once all that is done, it is on to chemotherapy. No end date planned…usually it is when the patient can no longer tolerate the chemo or if they decide the chemo I’m on isn’t doing what it needs to do (which is kill the liver tumors). But, then they’d likely start me on a different chemo. It will be 3-week cycles, with treatment the first two weeks, the one week off. Not sure exactly what the nature of the treatments will be…whether it will be IV or pill and how many days treatment is given during those first two weeks of each cycle. I’ll find out when I next meet with my Medical Oncologist (early December, probably)

I asked when the next assessment (CT scan/MRI/PET or whatever) would be. Doctor said about 2 months. So, they expect me to be around for at least 2 months. Hoping for much, much longer. I am really ready to start feeling better and doing some things. I’ve just been too tired all the time to get out and do very much. Oh, and that reminds me. The main expected side-effect during both radiation and chemotherapy is … fatigue.

So, on top of being fatigued, I’ll be even more fatigued. I’m going to stake out a corner of the couch at my sisters’ houses for Thanksgiving and Christmas and just get up for food. If I doze off, let me sleep (but wake me if anything happens).

Official Results, Soon

Well, I got the MRI on Friday, but have to wait until this afternoon to get the official results. I know there are more than 2 tumors (well, if I’m looking at the scans correctly). I counted 8 or 9. One of the two that were visible on CT (the one in the left prefrontal cortex) turns out to be two that have grown into each other. So, 2pm appointment with the Radiation Oncologist to get results and make a plan.

Meanwhile, my appetite is about as bad as it has ever been. I’m back down to 122 lbs. Besides taking a long time to get hungry, I fill up fast. I’ve never been one who could eat after I fill up. Going to start buying and/or making smoothies to supplement…sweets are less of a problem to get down with low appetite than “real food.”

Otherwise, I do feel more fatigued/tired/winded. Not sure if that is due to not eating enough or another side-effect of the cancer. I’ve been off cancer meds now for nearly a month, so should be recovering from that. But, yesterday I got insurance approval for the next chemo in the drug chain (assuming nothing else changes): topotecan.

Got about an hour before I need to leave for the appointment, so going to try to finish the smoothie I got with lunch and try not to nap.

Now We’re Even Bigger, with More Locations!

That would sound great, if I was talking from the point of view of Costco. But, unfortunately, that is the latest word from my tumors.

Lung tumors have gotten bigger and are affecting nearby lymph nodes.

Liver tumors have gone from one of note with several suspect, to at least 9 (that even I can see on the CT scan well enough to count. In the featured photo, I’ve circled four. Since this is a 2D view, you can’t see the other 5 or 6 (I can by scrolling through the slices). You need to go to the page for this post to see the image…if you are viewing the stream, just click on the post title.

Good news/bad news on the neck scan. The neck is clear. Yea! But the front of my neck has a lot of scarring and “odd” tissue that might be pre-cancerous. So, going to treat it with a fluourocil ointment (Carac). But that isn’t the bad news. The bad news is that that scan showed two probable tumors in my brain: One in my left prefrontal cortex and one in my cerebellum.

So, MRI brain is on tap. Neck CT only included partial brain scan. And, brain shows up better under an MRI than CT (contrast does not cross blood/brain barrier very well). Medical Oncologist sounded pretty confident that the brain tumors can be easily excised with radiation, so going back to my Radiation Oncologist on Thursday to discuss.

Also, chemo changing to topotecan. Oncologist is also looking into medical trials, especially RadVax, and the Stanford Cancer “Vaccine” to see if I would be a candidate for either. Both of those use a small amount of drug(s) injected directly into one tumor. RadVax then gives that tumor a small dose of radiation to cause it to have a larger T-cell response. Both, then, result in your body creating a large amount of T-cells targeted to that specific tumor type…and the T-cells attack all the tumors in the body, not just the one that was injected.

Oh, the Floaters, too!

I suppose “floaters” could also refer to the steatorrhea, but in this case, not. A few weeks ago, I started getting little black dots that I could only see with my left eye. The dots would move with my eye (so, since they were off-center, whenever I tried to look right at one, it would scoot out of the way).

Went to an ophthalmologist who checked out my eyes and told me I have detached vitreous of the left eye, which is a normal age-related degeneration. The main concern with them is that the retina could tear when the vitreous detached, but I was spared that complication. Prognosis: It will never really go away, but will become easier and easier to ignore. As I did in my previous post.

Just saw the neighbor who took my universal gym to the door…took him about 90 minutes to disassemble it. He looked ready for a nap. Now, waiting for the appliances to show up…they gave me a time window of 11:30AM to 3:30PM. Well, sitting here, now, I’m about halfway through that window and they are not here, yet. But, the only thing complicated to install should be the overhead microwave, since I don’t have one of those right now. The other appliances (refrigerator, dishwasher, oven) should be slide-in, plug-in, connect to existing water and drain connections, and done.

Supposed to go to dinner with friends at Reata, tonight. Surely appliances will be completed by 6:30 so I have time to not rush. Maybe even a nap while I wait. Yes, a nap sounds pretty good. Listening to the guy doing all that work disassembling the gym has really worn me out.

Early November Update

Well, it has again been a while since I’ve updated my status, so here goes (I’ll try not to ramble on too much). Actually, have not been a lot of changes.

Chemo

I’ve finished my 4th round of chemo last weekend. Chemo rounds really affect me the most in the first week after treatment…I am pretty tired every day. But, by the second week things are getting better and by the third, I’ve almost (but not quite) recovered to my pre-chemo state. Of course, then it is time for another round, so as long as I’m in treatment I never really fully recover. But, unlike the first major chemo I did, the drop each round is much less…that first time I don’t think I could have taken another round of chemo and continued to be able to walk. But, that chemo was much harsher on my system than the cocktail I’m on, now.

Last weekend was my last scheduled round, for now. That could (and likely will) change after next week. On 11/7 I’ll have a CT scan to see how the lungs/liver tumors look and also see if anything else is cropping up. Once we get those results, decisions will be made as to how to proceed with treatments. I really wish one of the “cancer vaccine” trials fit my profile. Many of those are showing amazing results in clearing tumors throughout the body without systemic impairment. What I’m on now, while somewhat targeted to only the tumors, still knocks down my entire immune system and does a number on my red-blood cell count.

Voice

I ordered a hands-free speaking valve and assorted accessories from a medical supply company. They implied in email that this would be covered by insurance, so I went with a brand that I’m not that fond of. They did say I’d have to file the claim myself. Should have been a clue. I spent nearly $1,000 on supplies, only to find it was all out-of-network (thus out-of-pocket). Also, it doesn’t work very well…still having to use a hand to my neck to get the voice (such as it is) to work. Basically, the device has a little flap that closes when you exhale hard…which makes the air go into the little valve going into my esophagus instead of out my neck.

So, I’ve just ordered my preferred brand, knowing that it also will not be covered by insurance (and around $600, but I’ve tried it in the doctor’s office and it seems to work much better). Seems that routine supplies (basically air filters that snap onto an adhesive base over the stoma and certain types of those bases) I can get w/insurance coverage. Of course, those are also the least expensive components.

Shoulder

The good news on my shoulder is that the accessory nerve that enervates the trapezius muscle is coming back to life. The bad news is that it was “down” for so long, my trapezius is severely wasted. So, I’m going to Physical Therapy every week and getting a set of exercises to help restore normal shoulder function. There are about 12 different exercises, most of which I am supposed to do while laying down. Right now, if I lay down, I go to sleep. So, my at-home exercising is not as frequent as it should be. But, even with that, I can tell a positive difference. Pain in the shoulder is less. And, I can see a bit of muscle tone coming back (albeit very slowly). Hopefully will be able to do more as my post-chemo stamina returns.

Weight

My weight is definitely up from the low dive to 121 lbs after that first chemo round (and week-long hospital stay). I got up to 131, but this week have dropped back down to 127…but a drop the week after chemo seems to be normal. I expect I’ll gain a bit more over the next two weeks. Main issues is just not being hungry. I’ve avoide outright nausea, but have never been one who could eat when I don’t feel hungry. Dronabinol is helping with appetite. Also, the steroids I take for a few days after chemo probably keep me from losing even more. All I can do is eat what I can. Trying still to stay low on the sugars and prioritize proteins, but some things (those things usually being proteins) just taste aweful, even with the lactoferrin supplements (which have definitely improved my sense of taste…but not to perfection).

Steatorrhea

Steatorrhea (fatty stools) continue with maybe a slight improvement. I’m beginning to wonder if it might not be associated with the liver tumor(s). Bile (which digests fats) starts out in the liver, moves to the gallbladder, then is purged into the intestine when you eat. Hopefully treating the tumor in the liver, as we’ve been doing, can help to resolve this. Mostly it is a concern for fat-soluble vitamin absorption (Vitamins D, E, A, and K).

Remodel

Hey, something unrelated (mostly) to health issues! My contractor finished the remodel on my kitchen and baths. I’m digging the full-sized shower in my master bath…so much nicer than stepping into a tub to take a shower. Also looks so much better. Tomorrow, new kitchen appliances are going to be installed, which will almost finish the domestic re-organization. What is left is to put everything back into the cabinets where they belong (didn’t want to do that until I got the new appliances in and considered what other changes I might want to make).

Well, I’ve also been too fatigued to really do much on the putting stuf where it belongs front, and up to a couple of weeks ago my shoulder really limited my ability to lift things into the upper cabinets (even lightweight stuff).

Next up, I’m disposing of a home gym that has been in a front bedroom mostly unused for a couple of years. I think it will be gone, tomorrow. Then the plan is to clear out the other stuff stored in that bedroom (which is mostly going to the curb). Then, take the hall bedroom and clear it out, using the first bedroom to put stuff I want to keep. Tentative plan is to put some photo studio stuff into that bedroom. Next will be to clear some things out of the living room into one of those bedrooms to unclutter the front of the house. Then, I should be finished (I’m guessing some time in 2022).

I’ve been in the house for 35 years and have way too much old, useless stuff sitting here and there. Not a hoarder…I have no issue getting rid of this stuff. But, things I see every day tend to become invisible to me over time…occasionally I’ll look with fresh eyes and “oh, crap, I need to clear some of this stuff out.” We recently had an electronics recycling day at work, and I think I would have won the prize for most stuff recycled…big CRT TV, computer monitors, and old PC components, some over a decade out of date.

Work

I am still coming to work every day. The week after treatment, those days are a bit shorter…I can get here early, but if I wait to late to leave, driving home becomes dangerous. I have fallen asleep at a stop light one time when I pushed it a bit far and woke up to horns honking and a green light. I’m sure they assumed I was texting.

Productivity is not up to par. Hard to concentrate when fighting drowsiness. But, still effective enough. My main concern is staying away from sick people as the flu season progresses. I did get flu, pneumonia, and shingles vaccines this year, so have some protection. But, chemo knocks down the immune system overall, so unsure exactly how much protection I will have. Have already had a few people in the office come down with what was probably the flu, but I stayed well away from them (and they me).

When I was going through chemo last year, I worked from home nearly the entire month of January to avoid getting sick. Trying to keep as much office time as I can this year, having missed so much due to hospitalization already (nearly 3 months in the hospital this year).

Finally

Well not that short of a post. But, at least I gave you headings so you could just read what you might find interesting. Really next up for me is wait and see what the CT fairy brings next week. Try to eat more. Try to do my therapeutic exercises more. And maybe post a bit more often so that these are shorter.

Throat Blog — Poor Taste

Ok, maybe you though I was going to talk about my sense of humor. A good guess, but no, this post is about how chemo has altered my sense of taste.

Around the end of round 1, I started having altered taste, and now it is pretty extreme. The altered taste falls into one of three categories:

  • Taste is modified to something usually bitter or bad in some other way.
  • Taste is muted to neutral “mush” taste.
  • Taste is amplified.

Example, most Mondays I go to a favorite Italian restaurant and get a cup of clam chowder and a Lance Armstrong (that is a side spaghetti with one meatball).

The noodles tasted fine. The marinara tasted metallic, and the meatball tasted like it had been soaked in acetone after the acetone had been used to clean engine parts.

Sweets and salts tend to be amplified. Umami flavors (mushrooms, cream, etc) tend to taste OK.

So, that, combined with a general lack of appetite and early satiation have me fighting to maintain a bantom weight of 121.7 lbs. As a point of reference, I weighed about 134 before the first cycle started on 8/23.

Doctor prescribed Dronabinol which is a man-made form of THC. It is supposed to help with appetite, and does not get you high. I’ve been trying it since Saturday and it might be helping a little…my weight has plateaued at 121.7 lbs. Hopefully it will stop dropping, now. I’m getting “crepe paper” skin all over.

I don’t feel particularly great, but also not particularly bad. Somewhere in the “meh” zone. No real nausea…but I’m sure if I kept eating after my “full” signals started firing that could quickly change. So, also trying to spread out the calories. Going to switch to some other side pasta (maybe Fungus Fettuccini). And, keep on keeping it down.

Last Week Really Sucked

Going into the Labor Day weekend with a kidney stone was bad enough, but starting in the middle of the night on Sunday, my backside actually did start hurting. Bad enough that I drove to UTSW ER at 7AM with intense (level 7-8) pain. They diagnosed as a thrombosed external hemorrhoid. ER team tried to cut it open and remove the clot, but all they were able to do was cut it open. The clot was too deep to reach. Sent me home with instructions to sitz bath every few hours with assurances that, while this would make it bleed a bit, it would also flush out the clot.

Four sitz baths later, and there had been no bleeding. And, pain had progressively gotten worse instead of better. So, around 10pm, made the drive back to UTSW ER. This time, at triage, they found I had a temperature of 102.2 F. Something they were much more worried about than my buttache. But, they did re-examine to make sure that the area had not become infected. What they found was a 2nd thrombosed hemorrhoid. They admitted me to the hospital, not for what I drove there for, but because my blood work showed that my neutrophil count was 0. Neutrophils typically make up over 50% of your white blood cells, and are the first line of defense against infection. 0 is bad.

They also found a little fluid in my lungs (not enough that they would normally worry about) and wrote me up as at risk of having pneumonia. I really didn’t feel any other symptoms that might point to pneumonia, but with the other pain going on (peaking at 9 if I coughed) it could certainly have been masked.

The main blessing of moving to a room was that I got to start on painkillers. I am not normally a major painkiller consumer. But, this time, I took both the Narco and the Dilaudid as often as they would give it to me.

Tuesday was not much better. Colo-rectal team came around and tentatively scheduled minor surgery to directly address the hemorrhoid situation. Urology came by to tentatively address the kidney stone (it had not passed, but was no longer hurting…they were concerned that that kidney might have been infected and would need a stent put in to drain away infected fluids so as to keep it from spreading (sepsis).

In the end, both procedures were nixed because of the whole neutropenia (low neutrophil) situation.

Meanwhile, I do need to cough pretty strongly to keep my airway clear of mucous. If I don’t I really wheeze. Alternatives are swabbing it out or using suction to clear it. But, both of those options really make me cough uncontrollably and deeply. Respiratory Therapy came in and decided that we should try suction. I warned them that making me cough hard resulted in agony. What I did not warn them about (because I did not yet know this) was that coughing hard would also make me loose all control of my hemorrhoid-ridden zone.

Sure enough, they poked the suction line too deep and I started coughing, probably crying, and most definitely pooping. It is the only time (well, that I know of) that I have been grateful that I have no sense of smell (well, the sense is there, but since I have no airflow through my nose, odors never make it to the sensors). Oh what fun. Well, at least it allowed me a trip to the shower (while the nurse and tech took care of the aftermath). Came back to clean bedding, and another dose of Dilaudid.

This happened twice more (with a bit more control, so a lot less mess) before I learned not to mess with my airway until about 10 minutes after a shot of Dilaudid to moderate the pain and cough. I had an idea that the doctors allowed…provide me with a numbing spray (benzocaine, in this case) that I could spray into my airway before messing with it. The caveats were that, a) since the area would be numb, I should be very careful not to injure myself, and b) if I did injure my airway even a little, I would likely have a horrible extended coughing fit when the numbness wore off. Believe me, I was very careful. This worked! I had no further problems after doing this.

Wednesday all departments finally decided that any surgical intervention of any kind was definitely off the table. So, I should have been allowed to start eating. But, one of the teams insisted that I have a swallow study before being allowed to eat. I asked why. The reason was, they didn’t read my entire chart (which, admittedly, must be novel-sized at this point). They were worried about risk of aspirating my food. What??!! I calmly (well, maybe not so calmly) explained that there was no connection between my mouth and my airway. The only way for me to aspirate food was for me to uncap my airway, take a bite and chew, then let the chewed food dribble down my neck into my stoma. I hope I am years away from being in that condition.

So, then they said I could have soft foods. Again, What!!??. I’ve been eating any- and everything for a month, now I need to start eating pap? They relented and allowed that I could eat whatever I wanted.

So, I ordered food. But, nothing tastes good, I seem to fill up quickly and, honestly, didn’t feel that much like eating in the first place. Appetite is in the basement. But, I tried to get down what I could several times a day.

Late on Wednesday, they decided that I should get a catheter, to be sure that urine wasn’t stranding in my bladder (which could have also caused the possible infected fluid behind the kidney stone to back up and cause sepsis). Fine, what is one more hose at this point.

Throughout, the hemorrhoid situation, basically left untreated, didn’t get any better. After each trip to the toilet, I had to use the shower for hygiene. Now, I say “basically untreated” but I did have 2% Lidocaine and a steroid/lidocaine mix (could only apply every 5 hours) to use to apply to the area. They helped, some, with the pain.

On Thursday, they started giving me shots to boost my neutrophil production. By Saturday, neutrophils were back to being on the low side of normal, and I hadn’t had a fever in a couple fo days.

On Friday, I talked them into stepping the Lidocaine to a 5% strength. That was a bit more help. Biggest trigger for the pain (other than cough) was going to the toilet. I would warn the nurse so that she would have the Dilaudid ready to shoot when I got back to the bed.

Anyone who has seen me in the hospital knows that as soon as I feel well enough to move around, I put on street clothes and move to the couch. It is telling, then, that this trip I never sat on the couch. And, because of the potential for accidents, wore only my hospital gown with nothing underneath. This, up to the hour before I was discharged.

Which brings us to Sunday. The hospitalist came in fairly early and let me know that I would be being discharged because labs and fever had both been good for a couple of days. I estimated 3pm. Sure enough, got the final paperwork at 3pm and they wheeled me down to the curb. But, before leaving they also had to remove the catheter, which they did around 11 AM. When I had my first bladder void (maybe 2 PM) I also passed the kidney stone (which, oddly enough, was about the size, shape, and color of an uncooked kidney bean). So, one less thing to worry about.

Driving home was painful, but getting home was good. Was able to sleep, uninterrupted by anything other than the cat (who was not nearly as manic as he had been after my two-month absence). And, in the days after coming home, my achy-brachy parts are no longer so achy. Not back to normal, but I’m able to sit at my desk for a major fraction of the day. Actually made it fully through the day on Monday, but Tuesday had to take off a bit early (pain, tiredness).

Back to being in a state of “I can sleep at any time…just let me close my eyes for a minute.” Although I sleep through most of the night, I must not be getting very deep sleep…I’m just flat-out sleepy. And, no pain meds (other than the topical ointments) since Monday, so can’t blame feeling dopey on dope.

Long post ending. While I had my laptop with me, I was never “with it” enough to write coherently. Chemo round 2 (for this treatment cycle) starts Friday. Stay tuned!

A Real Pain in the Back Side

No, not my backside, the left side of my lower back. Started last night, but was tolerable until about 7AM, when it started spiking. Managed to get up, showered, dressed as the pain level climbed 6, 7… still rising.

So, took the long (40 minute) drive to UTSW Emergency Room. I could have gone to Medical City, Arlington (10-15 minutes), but nearly all my recent medical history is at UTSW. Pain peaked, then disappeared, of course, just before I walked into the ER. Considered, briefly, going into the office, but from past history I figured that this was another kidney stone and that the pain would be back.

Last time I went to UTSW ER I waited hours to get into an exam room. This time, I was ushered straight in. Slow morning, I guess…there was only one other person in the triage area when I got there, and he was taken back to an exam room about 5 minutes after I got there. They started an IV, took some history, took some blood, and sent me to get a CT scan.

About time I got back from the CT, another wave of pain hit. Spiked up to a 9 and held there. Doctor ordered some IV pain meds which couldn’t get there soon enough. It knocked the pain back down to a 3 or 4, then it was just waiting for the test results to come back.

CT confirmed a 5mm stone in a ureteral duct on its way from the kidney to the bladder. Had to wait for blood tests to confirm no infection (if there had been an infection, I would have been admitted). Then, cut loose around 2:30pm.

Hadn’t eaten all day, so grabbed a late lunch and went to the office for a little while. Well, a very little while…long enough to pick up some things I wanted for the weekend and check to see if there were any emergencies. I’d kept up with all my emails while at the hospital waiting for the test results, so knew that there wasn’t likely to be anything hugely urgent late on a Friday the day before a 3-day weekend. Still, I have 4 or 5 hours of work to do tomorrow to get some things out that really need doing before Tuesday (main thing needs to be done before Sunday).

Speaking of eating, after 4 days or so of little to no appetite, it has come back. I think that the long-acting anti-nausea meds might be what killed my appetite…one wears off in 2 days, the other in 4 days, and I got the last Friday. Around Tuesday I started feeling very hungry, so have been eating normally (or maybe a little more than normally) since then.

Meanwhile I did find an effective treatment for my insomnia, albeit one that I would not recommend. The combination chemo cocktail I had last weekend (carboplatin, atezolizumab, and etoposide) has resulted in my insomnia going away, at least for this week. Every day, I manage to grab dinner, but as soon as I get home, I’m out like a light. Doesn’t matter if it is 7pm or 8pm…I’m out (other than getting up occasionally to take care of pressing bio issues) until I drag myself out of bed the next morning.

So, such fun going into a holiday (sort of) weekend. In addition to my work-work tomorrow I also need to clean up/put away some stuff in preparation of my nephew and his family coming over to help on Sunday. Nothing horrible, but I do have too many pill bottles out in the living room (where I’ve been sorting my meds into their daily doses) and need to lock up my weapons. Then, need to empty some of my storage bins so that we can use them to pack up the kitchen. Then, Sunday they’ll be here early and will work until lunch with my Mom. Hopefully the work-work I do tomorrow wont’ generate any emergency corrections and I can actually relax on Monday.

A Little Wiped Out

Well, maybe more than a little. Chemo 3 days in a row (Friday / Saturday / Sunday) and now a couple of weeks off to let it do its thing before the next round. Friday wasn’t too bad, other than lack of sleep from the night before. Saturday, I went home and took a long nap. Sunday, an even longer nap.

Monday I had early morning follow up appointment with my throat surgeon, then went into the office. Around 4 I realized I’d better leave if I wanted to stay awake for the drive home. Stopped by and got some soup for dinner, then on to the house. In bed by 7 pm. Barely crawled out of bed a little after 7 am. I could have stayed home, but then I would have just veg’d all day. Came to the office and am able to get some work done, but not up to my stellar productivity standards.

Biggest side effect is fatigue. But, I’m also not very hungry and the lymphedema (fluid build-up) in my neck seems to be a lot worse than before treatment. Don’t know if that is a side effect of the chemo or a side effect of not being very active the last few days. But, I’m still spared nausea.

I had ordered some accessories for my car (roof rack and other similar) expecting to install them when they got here. Well, I can’t even get them out of the back of the car, now. Rather than wait a week or two to feel up to it, one of my nephews is going to come over this weekend and put them together and on the car for a bit of walking around money. Also a few house tasks (all my kitchen cabinets need to be emptied in advance of a remodel that starts in a couple of weeks) so tapping him for that, as well.

Didn’t expect this big of an effect so quickly. Hopefully that means the tumors are getting kicked just as hard…or harder.

Thursday I have planned to have the feeding tube into my stomach removed…I’ve not used it in a couple of months and it is a constant irritant. Unless my mouth/throat develop sores (a possible side effect) my eating should not be affected (well, other than the loss of appetite, which I hope comes back during the pause between treatments). Actually, I could remove it myself, but the doctors really frown on that (you just deflate a balloon and pull). But, after that I have a complete break from doctors for a whole week!

Well, about ready to take a nap…but since I’m still at my office as I finish this up (started writing it yesterday), I’d better get a few more things done before heading home, where I will really try not to go to bed too early.