Time flies, but is standing still...

How quickly, or slowly time seems to go by....It seems like I just had my second treatment, yet this week I found myself back at Huntsman for Infusion #3 and while I am happy to be moving forward, checking one more treatment off, I honestly dread the few days post-treatment and how it makes me feel.  Time seems to come to a grinding halt over these days.  I have found that doing something that makes me happy the morning of my treatment sets me up for a much more positive day. For me, the easiest thing to do to make me happy is to ride my bike.  So, for the seventh time (yes, I have now had seven chemo treatments over the past two years) I rode my bike to chemo.  I arrived with a smile on my face, ready to conquer the day.

Shannon was at Huntsman with car, non-bike clothes, and food to greet me.

I had another uneventful infusion day.  My veins are holding up beautifully and it looks like I will get through my entire treatment without requiring the surgical implantation of a port.  My lab results indicate that my Red Blood Cells, Hematocrit, and Hemoglobin are holding steady which doesn't surprise me as my energy levels have overall been pretty good.  My White Blood Cells and Neutrophils have dropped.  They are not in the dangerously low range...yet...but low enough that we are going to postpone my next and final treatment by at least three days.  My oncologist feels that over the long run, this little bit of extra recovery, will be best for my body.  As she pointed out, my body has had a s##t ton of chemo, my current regimen is hardcore, and thus far my body is holding up remarkably well.  (Well, I may have paraphrased a bit, but that is essentially what she said).  It does seem as though my bone marrow may be a little bit "sleepy" and slow to replenish white blood cells, not surprising at this point.  In addition to the few extra days of "rest" I am hitting the nutrition, supplementation, and visualization hard!  From a nutritional standpoint, I will be focusing on lots of Vitamin C which helps protect White Blood Cells from oxidative stress.  That means lots of peppers, strawberries, kale, etc.  I will also be trying, despite the warm temperatures, to consume bone broth, which helps protect the bone marrow.  From a supplement standpoint, I will increase my intake of Astralagus and from a visualization standpoint, Shannon and I will visualize my body making loads and loads of White Blood Cells.  And of course I will continue with acupuncture.

Here are my labs from before my third infusion:

Blood Counts	Target Ranges	Chemo#1	Chemo#2	Chemo#3	Chemo#4
WBC	4-8	4.18	3.43	3.17
Lymphocytes	>1 in treatment	2.5	1.6	1.3
Neutrophils	>1 in treatment	2.5	1.6	1.4
Monocytes	<.56	.3	.4	.4
Eosinophils	<.24	0	0	0
RBC count	3.9-4.5	3.94	4.18	4.14
Mean Corpuscle Volume	<98 in treatment	94.6	92.2	93.6
Platelets	150-300	168	276	262
Protein Status
Hemoglobin	13-14	12.9	13.6	13
Albumin	4-5	4.0	4.3	4.4
Total Protein	>6.6 in treatment	6.6	7.1	7.2
Electrolyte Balance
Sodium	140-144	140	138	141
Potassium	4-4.5	3.5	3.4	3.6
Chloride	100-106	108	104	106
Kidney Health
BUN	13-18	15	9	11
Creatinine	.7-1.1	.63	.72	.65
Calcium	9.2-10.1	8.8	9.1	9.5
Oxidation
RBC Distribution Width	<13	13	13.2	13.8

On a positive note, although I have had some significant fatigue the past few days, I have had less nausea and acid reflux than after my last treatment.  Perhaps this is due to the ear acupressure treatment?

Regardless, it is nice and a lot more comfortable to be a bit less burpy.  Additionally, my cravings have been a bit different this time around.  Instead of craving that delicious NadaMoo ice cream, I have been craving sweet potatoes.  Although this journey is difficult, I am thankful for all of the good, and even GREAT days I had after my second treatment.   Many days were spent on the mountain bike, running with Dizzy, working a job I enjoy, and spending time with friends.   I am hopeful that round 3 goes similarly well.

Feel free to join me and Shannon in visualizing my bone marrow producing LOTS of healthy White Blood Cells (Lymphocytes, Neutrophils, NK Cells-your choice)!

If you need help visualizing my bone marrow producing white blood cells, here's an image:

Weekly photos can be seen here and workouts here!

Utah Cancer Connections Fall Magazine

Ginger Johnson, founder of HappyChemo and publisher of Utah Cancer Connections magazine, wrote a nice article on some local cyclists who also happen to have undergone cancer treatment.  We all have very different stories, but cycling has had such a positive impact on us all as we have gone through and recovered from treatment.  It is a good read!

Chemo #2, numbers, and radiation....

Last Tuesday's treatment was uneventful.  That is always a good thing.  Despite it being an "uneventful" infusion, it was still a long 5.5 hour process.

For those wondering, here's what a "typical" infusion day looks like:

-Arrive to hospital (via bike of course:)
-Shannon meets me there with car
-Secure bike on car

-IV placed, blood drawn

-Vitals taken by Medical Assistant

-Meet with Oncologist who does a physical exam and reviews lab work

-Get cleared for treatment

-Oncologist orders medications

-Wait for medications to be prepared

-Receive ~one hour of anti-nausea IV medications

-Chemo starts

-1.5 hours later go home

That's it.  Honestly, just typing it makes me a little sick to my stomach, but perhaps that is because I am still a little sick to my stomach!

Anyhow, as I've mentioned before, the first week after chemo is the hardest and this time was no exception.  It pretty much went exactly like last time.  However, I was prepared with toast, applesauce, NadaMoo dairy free ice cream, and pumpkin protein cookies.  The good news is that I seem to be rebounding from chemo #2 similarly to chemo #1.  Sometimes the effects can be cumulative, so I'll take the same!

Being a numbers person, I have been closely tracking my blood counts.  I even made a nifty chart with some of the more significant values.

Blood Counts	Target Ranges	Chemo#1	Chemo#2	Chemo#3	Chemo#4
WBC	4-8	4.18	3.43
Lymphocytes	>1 in treatment	2.5	1.6
Neutrophils	>1 in treatment	2.5	1.6
Monocytes	<.56	.3	.4
Eosinophils	<.24	0	0
RBC count	3.9-4.5	3.94	4.18
Mean Corpuscle Volume	<98 in treatment	94.6	92.2
Platelets	150-300	168	276
Protein Status
Hemoglobin	13-14	12.9	13.6
Albumin	4-5	4.0	4.3
Total Protein	>6.6 in treatment	6.6	7.1
Electrolyte Balance
Sodium	140-144	140	138
Potassium	4-4.5	3.5	3.4
Chloride	100-106	108	104
Kidney Health
BUN	13-18	15	9
Creatinine	.7-1.1	.63	.72
Calcium	9.2-10.1	8.8	9.1
Oxidation
RBC Distribution Width	<13	13	13.2

The "ranges" on my chart are the ideal ranges that my Nutritionist and I are targeting.  "Normal" ranges are a bit more lax.

Here's my interpretation:
-My white blood cells are a bit low, but still in the "normal" range.  This is despite not getting a Neulasta shot to help support immunity.
-Oddly, my red blood cell count, hematocrit, hemoglobin, and platelets all increased after my first treatment.  I am taking whey protein and chorella to help support my red blood cells, however I still find this odd.  Regardless, I'll take the little boost!
-The one value that I find a bit concerning is my BUN (blood urea nitrogen), which is an indicator of kidney health.  It is lower than what we are targeting, however it is still in the low "normal" range.  Other kidney health indicators look good, however from what I understand this value can also drop if your body is using more protein than it is getting.  I suspect this may be the case with me as chemo significantly increases your protein needs and I have been exercising routinely.  I will continue to focus on improving my protein intake.

In other news, I met with my radiation oncologist today.  I really like her.  If everything stays on track, I will meet with her again on October 1st where I will get measured and molded in preparation for radiation.  Even though I am going to get a crap load of radiation-boooo-they are extremely precise with their target areas.  My doctors typically have a hard time surprising me as I usually go into my appointments very well researched, however today I was surprised to learn that they will create a mold around my body that I will lay in for each radiation session so that I am in the exact same position.   Actual radiation will start the week of October 7th and will be daily for 5-6 weeks.  I was so psyched to "get out of" radiation back at my original diagnosis in 2011, however I know that it is 100% indicated this time around, so my plan is to move forward optimistically and see where the chips (i.e. how it affects my reconstruction) fall!

Photos from the week can be found here and weekly exercise here.