Milestones in Here Be Dust

My celebration on Independence Day was somewhat unusual this year. On that day, exactly 100 days after my lumpectomy, the last of my surgical skin fell off.

Rather, my surgical skin from the lumpectomy fell off. My port insertion site continues to heal.

I still have a bit of a seroma at the lumpectomy site, which is another way of saying that fluid fills the area where my breast tissue and tumor had been removed. That lump will continue to shrink over time; it has already decreased considerably over the past several months. I see my surgeon again next week, so I should get a better idea of where everything stands as far as my surgeries are concerned.

This week I am scheduled to receive my last infusion of Adriamycin and Cytoxan. Most likely I will start on Taxol at the end of the month, for 12 consecutive weekly infusions. Depending on the dose (TBD), infusion should last between one and three hours each time.

My oncologist's assistant tells me that Taxol is "a walk in the park" compared to what I've been getting. I told him that what I've been getting has been a walk in the park compared to the severe dysmenorrhea that I had endured for 18 years. Even so, I will be dealing with a new set of unknowns in terms of side effects. That creates some natural apprehension -- but as with my current regimen, I expect to know the drill after my first Taxol infusion.

My infusions occur on the same day of the week as my organic produce pickup from the local farmers' network. If push comes to shove, I can pay a bit extra for home delivery, but I'm keeping my fingers crossed that I'll be able to continue my pickups while on Taxol. I've skipped pickups on the days of AC infusions, but have gotten those groceries on interim weeks, since my AC infusions have been three weeks apart. Taxol won't provide those breaks. Fortunately, the pickup location is close to home.

My blood work continues to be good, all things considered. Here's a slice of life that I posted on Facebook back on June 28:

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M finds me updating my data on PatientsLikeMe.com and wants to know what's going on. I show her the pretty longitudinal graphs generated from my blood test results. Now that I've had 3 chemo cycles, many (though not all) of the test results have formed predictable patterns. My hematocrit graph is particularly pretty and looks like a left-leaning range of almost-identical mountains. The valleys represent the week after chemo. The peaks represent two weeks after chemo, after my Neulasta shot has kicked in and put my bone marrow on overdrive. From there drops a gentle, roughly 30-degree slope, to the next valley.

M asks me, "Do you know what hematocrit is?" I know she knows, with her degrees in biochemistry and immunology. I quip, "Someone critiques your blood."

I use cheat sheets. A while back I had downloaded a couple of great charts, one detailing CBC (complete blood count), the other detailing CMP (comprehensive metabolic panel), because I get both. Hematocrit is part of the CBC and is "the percentage of red blood cells."

The chart gives the ranges for men and women. As expected, I'm a little low the week after chemo (in the valley), but not enough for concern. The charts also explain what low and high readings mean. A low reading on hematocrit means, "Iron, vitamin B12, or folate deficiency; bone marrow damage; leukemia or lymphoma; acute or chronic blood loss; red blood cell hemolysis."

I read this aloud, then turn to the high column: "Dehydration, renal problems, pulmonary disease, congenital heart disease, polycythemia vera."

That last item rolls off my tongue. M wonders if my pronunciation is correct. I assure her it is. (Original series Trekkies will know where I'm going with this.) She parses out the etymology and proposes an alternate pronunciation. She heads off to her copy of Dorland's Medical Dictionary and is back in a bit, to let me know the dictionary agrees with me.

I ask her if she wants to know how I knew the correct pronunciation. Then I tell her about "For The World Is Hollow, And I Have Touched The Sky," and Dr. "Bones" McCoy's diagnosis of xenopolycythemia as the episode begins.

They did their research back then. Trek rules. :-)
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Right now, my one side effect that really seems to hang on is the neuropathy around the site of my 1966 compound fracture. In addition to mild numbness and tingling I experience short bouts of intense tingling, as though I were receiving a mild but prolonged electric shock. These episodes usually last about a minute (one lasted for about three minutes). They can occur whether I am sitting or standing (usually when standing right after I've been sitting) and during the day or night (usually night). The intense tingling ranges across more of my leg, but is not painful.

I also haven't felt as much thirst at night. After my first two AC infusions it was standard operating procedure for me to have to sip water before getting out of bed, including for middle-of-the-night bathroom breaks. I still keep my water bottle beside the bed, but I haven't had to sip from it these past few nights.

All things considered, I've been feeling pretty good.