Almost at Baseline -- For Now in Here Be Dust

My side effects report is boring now. That's a good thing.

Wednesday marked my return to my accustomed energy level and also marked my first excursion away from the house following my Neulasta shot the preceding Friday. I took M to her dental appointment (and caught up with the staff there), then made stops at the post office and the market.

My energy return also marks the time when typically one's immunity from chemo infusion is at its lowest. That means I need to avoid crowds, and especially people with colds or flu or who have recently been immunized. Normally a trip to the dentist means a visit to the nearby mall, but I didn't want to take that chance -- especially since my blood wouldn't be tested until Thursday. Compared to my days of deep fatigue I felt great, but I also knew that I was immuno-compromised.

I did up this badge for myself:

I've attached it to my shirt with paper clips because I need to also avoid cuts and scrapes to the best of my ability (and treat them immediately with antiseptic and a clean bandage if they occur). I don't want to mess around with pins if I can help it. I can point to the badge when I back away from my usual hugs and handshakes.

My edema and constipation are currently history and I've returned to my baseline weight. My appetite is back to normal. I still feel occasional queasiness (especially after just awakening), remedied with sips of water. I still need to drink scads of water (at least 10 cups a day) because dehydration remains an issue, especially dry mouth.

My second chemo infusion occurs in about two weeks if all goes well and will ramp up my side effects again. Lather, rinse, repeat. Or in my case, lather with a mild soap, rinse with warm rather than hot water, and pat rather than rub dry.

I am waiting for my hair to fall out, which is pretty much a certainty with the type of drugs I'm getting. I estimate that will start to happen within the next two weeks. I last had a haircut about three months ago, so I'm pretty shaggy at this point. Electric shavers rather than blades are recommended -- again, to avoid the possibility of any cuts -- and since I don't have an electric shaver (and don't want one) I am giving my facial hair free range. Hair loss tends to mean all hair, so any excess growth should be short-lived. I'd have my head shaved, except that I've had a sebaceous cyst on my scalp for decades and don't want to risk that getting cut. The little kid in me fidgets: Are we bald yet? Are we bald yet? Are we bald yet?

My blood work on Thursday was pretty good, all things considered. Preliminary results show almost every reading still within normal range, though skewed away from baseline. (I expect more results to be available in a few days, which I can then access online.) The one outlier is my white blood cell count, which was a little low prior to chemo and which remains generally unchanged. At this point, it's not a cause for concern.

My understanding is that in general, chemo infusion decreases immunity to a lowest point that occurs about a week after infusion. By that time, the Neulasta shot kicks in sufficiently to build immunity back up. Each patient is different, and I'll receive a graph of my own immunity curve once enough data are in. As it is, I enter my lab results over at Patients Like Me, which generates graphs for the so-far 33 tests performed on me for which the site has categories. My blood work includes an additional two tests that the site doesn't currently cover.

Yesterday's appointment at the cancer center was with the ARNP. My 9-page, color graphics-enhanced side effects report for Chemo Cycle 1 Week 1 was a hit, and the nurse told me that the oncologist's assistant loves that kind of data. (The oncologist's assistant is terrific -- he is very enthusiastic about his work and I think he is surgically attached to his laptop. I bumped into him while waiting for my PET scan two weeks ago and he immediately accessed some info for me. Then we chit-chatted about cancer research.)

While at the cancer center, I learned that Humana has dropped the facility. This does not affect me personally; I have a different insurer. But it makes my blood boil. I asked the staff if patients not insured by Humana can still sign the petition and was told I could, so I added my voice to the protest.