Round 4/"Magic Mouthwash"/Eyebrow Update

I completed round 4 of infusions this week. There's not much to add as it all went as it usually does. I'll have the usual after effects as I've described before. I'm really hoping I can get past the nadir next week without going to the hospital. Now that four rounds are done, I've got just two remaining. It makes me so happy to think that, next round when I finish my three days of infusions, I'll be able to say to myself, "Just one more round!"

I had a CT scan and saw my medical oncologist last week. The scan revealed no additional cancer, which is a great result. It also showed that the tumor I do have is about the same size. The doctor told us early on that it wasn't common for tumors like mine to shrink very much, so it wasn't unexpected. He recommended we continue with the chemotherapy treatments. Once I've completed all six, then we'll assess next steps for other possible treatment, including surgery and radiation.

During the last round of chemo my mouth got pretty sore. This is a common side effect of chemotherapy. The chemo drugs target fast dividing cells and, as it turns out, that applies to the cells in our mouths. During the first two rounds, my mouth got a little sore but it wasn't significant. With round 3, the soreness was definitely more pronounced, and made it a little hard to chew and swallow for a couple of days. When I reached out to my care team to ask for help, I discovered something informally known as "Magic Mouthwash." (I don't think the pharmacists call it that.) 

Magic Mouthwash is a mixture of lidocaine, Maalox, and Benadryl. The ingredients are meant to numb the mouth and give protection before eating and/or to give pain relief after eating. My mouth soreness resolved on its own before I could get this concoction, but I now have a bottle at the ready. If the soreness gets to the point that it did last round, I'll definitely be swishing and spitting with this stuff for a day or two. I sure hope it lives up to its (informal) name, "Magic Mouthwash."

Finally, what you've all been waiting for: Yes, I still have eyebrows! They have thinned, but they are definitely still there. My hirsute ancestors' genes are robust, apparently. (It's strange. The hair on my head, except for the eyebrows, is gone. I haven't shaved my face in many weeks. The bit of hair on my hands is gone, but not my arms. Same for my feet/ankles, but not my legs.) I just may get through this with my eyebrows intact!

The Nadir Strikes Back

On day 10 of this round of chemo, which is when I would expect to be in the nadir with very low blood counts, especially white cells -- I developed a fever. This isn't necessarily a problem unless it gets too high for too long.

It got too high for too long.

After that initial fever increased and dogged me all night long, my care team told me I needed to go to the hospital. I also had an infection on my right ear, near the top where the cartilage curls over. I went to the hospital and was admitted. 

I started on IV antibiotics, the doctors took care of the infection on my ear, and my fever finally started to come down and my ear began to heal.

I spent two and a half days and two nights in the hospital. My white blood cells finally rebounded. However, my hemoglobin and platelets were still low, so I had a blood transfusion and platelet transfusion.

A huge shout out to all of you who regularly give blood!!

So now it's time to both recover from this and begin to gather my strength for round 4 which starts in a little over a week.

Round 3 Wrap Up - plus chemo theology

I finished round three of chemotherapy infusions last week. That means I'm almost halfway there - 3 of 6 rounds done.

I'm learning the pattern of how the whole cycle plays out. I receive the first infusion on Monday, and I feel OK, for the most part. Infusion two is on Tuesday, and I'm definitely feeling it by Tuesday afternoon. Infusion three on Wednesday, and I feel lousy. There's fatigue, the nausea that lurks around the edges even when under control, the fogginess and lack of energy. That lasts into Friday morning, and then once the infusions are 48 hours behind me, I slowly start to feel a bit better. By Sunday, I'm off almost all of the drugs to control nausea and side effects, so I'm a little clearer, less fatigued, and generally feel a lot better.

Then a few good days before the nadir hits (see below and above). And then, if I'm lucky, a good week before I go back and repeat the whole process all over again.

I have a CT scan scheduled for the first week of February as well as an appointment with my oncologist. Hopefully that will allow a mid-treatment assessment of how it's all going.

Finally, I've been using this space to share information and how I'm experiencing all of this. Though I am a pastor, I haven't offered up any theological or spiritual reflections. I may get to that later. You never know.

But I was struck with my colleague and friend Brian's comparison of the nadir to "the depths" in Psalm 139:8. That happens to be my favorite Psalm. It's all about our inability to escape God's loving and gracious presence...even when we make our bed in "sheol" (the Hebrew); that is, in the depths. 

That's exactly what the nadir is...the depths, a pit, a place that we sink into and imagine God can't or won't follow. My experience has been that I feel the ordinary, daily sense of God's gracious presence (nothing flashy!) through all of this. That presence is always there. It follows me wherever I go, even when I descend into a chemo-induced nadir. And it's there when I go for a walk around the block. And it's there when my hands are twitching from the drugs. And it's there when I send emails, or make the coffee in the morning, or go to the bathroom for the upteenth time. Nothing dramatic. Just there. Gentle. Present. Steadfast. Strong. 

God's gracious presence -- always, eternally present.