On the upside...

This chemotherapy round was, as I expected, harder than the two before. I read somewhere the expression "chemo-tired" to describe the surprisingly intense fatigue. I often feel like I have weights attached to me and I'm slogging through mud. Between that and the swelling of the nerve-damaged foot, I've been fairly sedentary. It's a good thing I like to read! At the beginning of the year I had set myself my usual Goodreads challenge of 52 books. Following my mastectomy in the beginning of June, I spent more time than I care to think about lying on the couch. Watching movies, sure, but also reading. I hit my goal in early July.

And have not slowed down. I have read, for instance, 11 books on breast cancer. And another half dozen on nutrition and health. But I am careful about sources, and so I have read a few books on the scams in medical care. One quote stayed with me was from a former editor of the Journal of the American Medical Association, who said, "Of all the ghouls who feed on the bodies of the dead and dying, the cancer quacks are the most vicious and the most unprincipled."

I've been taking advantage of the library's willingness to send books I request from any branch in the system to my home library, and have gone off on tangents exploring cults, politics, autobiographies, evolution, and minimalism. I love walking into the library and walking out with the latest stack they are holding for me behind the counter.

But it's not all serious non-fiction, I've also read novel after novel after novel. Some silly, some gripping, all helping me pass the time. Most all, anyway - once in a while I get a chapter in and decide I'm not enjoying the book enough to continue. No matter, there's always another in the queue. So here we are at the end of October, and I just finished my 94th book for the year. I have another week of time off work for my next chemo round and later, ten days off following my scheduled ankle surgery - I think I will easily be able to hit double my original goal by year's end.

Weekend drive.

This actually happened the weekend before chemo, but I didn't have time to post it. I'm still crippled up because of my foot, so we decided to take advantage of the beautiful weather and go for a little drive down some back roads.

I loved this weathered but taken-care-of log cabin. Not enough windows for me, though - I need light!

If I had a small farm, I'd really have to give serious consideration to getting a pony. How sweet is he?

Several of the churches we passed had old graveyards attached to them. If I'd been up for walking, I'd have gotten out to explore.

Sadly, the Who Cares God Cares Restaurant was not open for business. I so wanted to go in and order deviled eggs.

Instead, we settled -very happily- for a grilled cheese sandwich (Gruyère, Gouda and avocado ranch dressing on sourdough) with sweet potato fries and a couple of pints at a beer garden. The sandwich wasn't actually on the menu, but if you know to ask, they'll make it for you. I'm still in the phase of post-chemo where things taste disgusting to me, but I'm looking ahead to venturing out again as soon as that passes.

It’s poison, I tell ya, it’s poison!

I'm one of those people who needs to know everything I can about my own healthcare. I have patients who tell me, "My doctor put me on a new medicine. It's a white pill. I'm not sure how many milligrams." That just blows my mind. How do you not know what medication you are taking? I'm home now after my third chemo round and waiting for the neulastin to infuse tonight. And bracing myself for the string of sucky days that will follow. In the meantime, I'll give you a lay-person's overview:

My own particular chemotherapy regimen is just two chemo agents once the pre-medications (antiemetics, corticosteroids, anxiolytics) are in. When I first told my younger son I'd be on Cytoxan and Taxotere he said, "Wow. Kind of scary when they include the word 'toxin' in the drug." Cytoxan is a trade name for cyclophosphamide and was named because it's a cytotoxic drug. Cells go through a cycle of growing, dividing (mitosis), resting, and then starting over again. Normally, cells know when to stop that silliness, but not cancerous cells. They are marked by out-of-control growth, rapidly cycling through the phases over and over again. That's where chemotherapy comes in. Cyclophosamides are alkylating agents that alter the cell's DNA and slow cell growth. They act on cancer cells particularly during their resting phase, leaving them unable to replicate. The more rapidly a cell divides, the more useful a chemo agent is. The downside, of course, is that they also go after other rapid-growth cells like those in bone marrow, hair follicles and the mucous membranes of the mouth and gut. Yay.

Anyway, there is an interesting history behind the development of these drugs that goes back to World War I and the use of the first chemical weapon, mustard gas, by the Germans. It was nasty stuff, able to be absorbed through the skin so that gas masks weren't adequate protection. The troops hit by sulfurous clouds of mustard gas liquid would, at high enough doses, become blind and develop ulcerating necrosis of the skin. If inhaled, hemorrhagic pulmonary edema developed. As you can imagine, death from mustard gas was a miserable affair. The soldiers who didn't die went on to experience nausea and vomiting, hair loss and suppressed immune systems. Sound familiar?

So during WWII, Nazis again used mustard gas. Because screw the Geneva Convention prohibiting chemical warfare. A couple of pharmacologists thought, "Hey, if this stuff can kill people, maybe we should use it to fight cancer!" You can't make this shit up. And it did work, to an extent. Unfortunately, it was also near-lethal and only temporarily effective. But chemotherapy was born and nitrogen mustards like the Cytoxan being infused into me every three weeks are still being used.

And then there is the Taxotere, one of a group of chemo agents called taxanes. The first was paclitaxel, derived from the bark of the Pacific yew tree (the genus for yews is Taxus, hence the name) in the late 60's. Apparently it's a relatively rare tree, and so twenty years of research later, another agent, docetaxel, was synthesized from the needles of the more common European yew tree. Docetaxel is more effective than paclitaxol but also more toxic. That's why on my first round it was infused very slowly to make sure I would not have a reaction to it. Taxanes work by binding to the  microtubules which control the communication within cancer cells, causing mitosis to be inhibited.

So there you have it, conifer needles and sulphur mustard. Kind of sounds natural and outdoorsy, doesn't it? Okay, no, no it doesn't - it is definitely no picnic. But with any luck the combination of a microtubule inhibiting taxane and and DNA-disrupting alkylating agent will do its job on any rogue cancer cells in me without taking me down in the process.

Who are the people in your neighborhood?

We live in an old neighborhood with a range of houses, both in style and price. Little post-war ranchers like ours, old brick houses from early in the last century, newer stone houses. I love the variety and much prefer it to living in a cookie-cutter suburb. But this house made me gasp when I saw it. We were on our way to meet up with two other couples right after it had been painted. It was the topic of conversation when we got to the brew pub: "My God, did you see that aqua house? What were they thinking?" and "It's too bright even for Jamaica!" and "Whoever owns that place HAS to be colorblind!" On the one hand, they have the right to paint their house whatever color they want. But I had to feel badly for the folks across the street trying to sell their house. Good look with that now.

My theory is the owners got stoned one day, found the paint on the clearance shelf, and just went nuts. Why else would they slap paint onto parts of the window frame and even the glass of the windows? And the benches are a weird mix of sage green, aqua and some dark green, applied apparently at random. There's also a bright blue bench on the other side of the house.

My favorite thing is that they've chosen to accent with bright yellow, including a Hotei statue (what some people call a Laughing Buddha), guarding the steps alongside a tiny American flag. I'll give the home's owners this - it's eye-catching. No one is going to miss this house. Except, of course, my color-blind husband. It looks normal to him.