Sir John of the Chemo Ward

John had his second round of chemotherapy on Thursday and Friday. He has emerged in good spirits (so far as we can tell in a long distance call). He arrived at the hospital on Thursday morning (after his daily radiation treatment) and they told him he was a bit dehydrated (in spite of the cream-based milkshakes he had been downing). This meant that the chemotherapy would be delayed until they got his liquids back up.

The first part of Thursday, therefore, meant an IV drip on top of the other preparations made for chemo. The pleasant discovery of the process was the combination of ginger ale and cranberry juice: its lower acid level meant that it did not aggravate his throat as much as orange juice.

The chemo drip began later in the afternoon and coincided with a visit from Wilma who used it as an occasion to try out the Canada Line. John reported how lovely it was to see her.

Thursday night was a bit fitful sleeping so they gave him a sleeping pill. He was pleasantly surprised that the sedative didn’t mean that he would end up wetting the bed as the extra liquids made their way through him. Instead, he found he would still wake up for frequent urination, but he had no trouble falling back to sleep. He even felt that it had been a rather restful sleep by the time the morning came around.

John also discovered that he would be able to continue using the strong nausea pills he was given when leaving (on Friday). During his last chemo session he thought they had to be distributed over all 3 chemo sessions so he had cut back on them prematurely. This time around, he was assured they would give him a new set next time – so he is looking forward to a more comfortable time over the next few days.

Aaron passed on a few photos documenting John’s journey. The first gives you an idea what all the fuss is about – the lump in John’s neck (if you can see it!) – and the second is the attire that “Sir John” wears when outside in the sun.

Anticipating round 2 of chemo

Wilma came down from Sicamous to visit John and Dorothy for a few days. This will coincide nicely with John’s next hurdle: his second chemo treatment on Thursday (“a little bit scary” he reports). He will go in to the hospital on Thursday morning (July 29th) to get the usual prep and will stay overnight to receive the treatment and early recovery. This time, he says, he will be more careful about hydrating with calories and taking advantage of the wonder of laxatives.

At present, John reports that each day is a bit unpredictable. Some days it’s nausea (controlled by light medication), sometimes it’s morning headaches, and sometimes it’s constipation. So far his throat is not a major problem and can be managed by the aloe vera and apple juice cocktail. His strategy is to eat lightly every 2 hours or so.

Aaron continues to serve as welcome backup with the paper run and Dorothy’s support.

Dry Mouth

Having permission to eat comfort food loses its appeal when everything tastes dry. John reports that he has had to rely on memory to enjoy even cheesecake, steak, pasta, and homemade soup. I'm wondering whether it will be an orgy of new discoveries once the therapy is over and his taste buds are revived. Something to look forward to!

He says he has lost some energy, but was able to visit Bowen Island on Sunday, Dorothy on Wednesday, and even get in some personal shopping. Monday was a day to "take it easy". His weight is back up a bit (up 3.6 kg) and he has found that aloe vera has provided welcome comfort to his throat in the face of the radiation treatments. On Monday it was very sore but after he began taking aloe vera and apple juice it has become much more manageable.

He lives with nausea, but uses light medication to manage it. He reports that it means he eats slowly - constantly - in order to keep his weight up. Tomorrow is his next weigh-in so he will get the official word on how well he is doing.

His biggest concern seems to be Dorothy - not his own situation. Aaron has been her shopping and errand support and Wilma will be in town soon (on Sunday the 25th) so, along with John's occasional visits, it seems that she will be well taken care of. Wilma plans to hang out in Vancouver for a few days at the end of this month and then will return later in August.

We were pleased to hear how well John is doing - in spite of the corporeal onslaught he is facing. Each of the new challenges seems to be adequately met and his spirit seems high. He is looking forward to a trip to Bowen on Saturday for a change of sight and place.

Erratum: Aaron noticed that I had erroneously identified Gabriola as the destination for his weekly paper runs. It should have been Gibson's. Sorry John and Aaron! That's what you get for hiring a cheap ghost writer.

Samantha complained that she wasn't included in the photo of the chocolate eclair crew - so here is one of her and her uncle from Christmas 2004.

The Chemotherapy Quick-loss Diet

John reports that he lost 6 kg in 1 week! Looking in the mirror he sees JP (without the hair, I presume). He can even touch his toes. It sounds like a tasty diet as well - cream instead of milk, butter on everything, with extra cheese all around. John figures that his body must be a whirlwind of cell death and reconstruction - with all that activity sucking up energy wherever it can.

The down side (besides the cancer, of course) is the necessity for plenty of laxative medicine. It took him a while to work out the appropriate levels to overcome the constipation, but it sounds like he has figured it out for now. He also experienced some ups and downs with nausea as he finished off the first set of heavy meds, spent a day or so suffering with the resulting nausea, then restarting them again - with positive results. This has meant beef tenderloin last night and lamb tonight.

He has an appointment with the chemo doctor tomorrow - not for more treatment - just for a chat, checkup, and to ask the many questions that have arisen since the first round of treatment.

It was lovely to hear him back in such great spirits - and with an obvious rejuvenation of energy.

Here's a photo of the goal we are setting for you, John. Who cares if it was 1975?

Withdrawal

John reported that today (Monday) was not as good as yesterday. He figures it was partly because it was the first day without the "major nausea medications" that he was given after the chemo treatment. He went to the hospital for another dose of radiation around noon but discovered that his energy level had dropped so much that it was difficult to get off the couch.

This is quite a contrast to the previous day when he prepared his usual Sunday breakfast for whoever turned up. Not only did he eat his fill, but did the laundry, and spent the afternoon eating cherries on the back porch.

Aaron took over his Monday visit and shopping trip at Dorothy's so all is well with his other obligations. Frankie (his nurse friend) passed on some tips about massage points to help with the nausea so he is making good use of this technique. John added that he is still eating and drinking okay in spite of the occasional nausea.

He will be in for radiation treatments every day this week - the first full week of this therapy.

Here is a photo of Uncle John leading the chocolate eclair crew on New Year's Day - 2010.

First round of radiation and chemo

John had his first round of radiation and chemo-therapy on Thursday and Friday (8^th and 9^th of July). He went in to the hospital on Thursday, received radiation treatments (about 15 minutes to set up and receive the radiation), and stayed overnight to receive the chemo-therapy. The chemo is delivered intravenously overnight. He was released from the hospital on Friday. I had a chat with him today (Saturday).

He reported that his nausea is not as bad as he expected. It seems to be well managed by the medication. He couldn’t eat on Friday, but slept well, and had a regular breakfast today. He even forgot he was on therapy a few times during the day. Apparently alcohol is not off the list of foods – and they even recommended Guiness since it has calories. He told me that he doesn’t like the taste of Guiness, but since his taste buds will be out of commission in a few weeks he figured that at least it will provide him with calories!

He will go in for radiation therapy 5 days a week (Monday to Friday) – with weekends off. It is only for a short time each day so he will likely be able to keep his activities up while his energy lasts. He was warned that he should not go into new environments, however, since his immune system will be severely weakened and shouldn’t expose himself to any new “bugs”. This means he will be able to visit Dorothy but not take her shopping.

Here's a photo of John with Charlie (John was trying to be a ventriloquist, but Charlie wasn't fooled!

Background information

John received a diagnosis of metastatic squamous cell carcinoma in early May. He had gone to the doctor after Wilma insisted that the lump on his neck was getting bigger. It took 2 biopsies to confirm the diagnosis but once it was established a team of specialists was quickly assembled. It took about 3 weeks of tests to determine there seemed to be no identifiable source of the cancerous cells and to establish the best course of action.

Since the cancerous cells were concentrated in the lymph nodes of his neck then radiation treatments were the proscribed approach. At the same time a series of chemo-therapy treatments were added to deal with any other cells that might have migrated to other parts of his body. They felt that the chemo-therapy might also deal with the source of the cells if they had missed it in their earlier scans.

It is very difficult to anticipate the effects of these therapies on John's body and life. Each person reacts somewhat differently. Chances are that he will experience pain in his throat as the radiation treatments have their effect. This will mean that he will have trouble eating solid foods a week or so into the treatments. He will also experience nausea along with the chemo-therapy. In general he will be very uncomfortable for the next few months. The 2 therapies are scheduled to take place over 7 weeks.

John has been concerned not only about the his personal situation but how he might manage the other obligations on his plate. Primary among these are the weekly times he spends with Dorothy (his mother), both for the social visits and for the shopping, cheque-writing, and other errands that need to be done on her behalf. Aaron has offered to step as much as he can – including some of the weekly paper runs to Gabriola that John makes. Dorothy insists, of course, that she is able to manage all of the shopping and other activities for the duration of John's treatment.

We know there are many of you out there who share our concern with the difficulties that John will be facing over the next few months. Part of that concern can be managed with up-to-date information on his progress and a method of communicating on an ongoing basis. It is for this reason that I have offered to set up a blog to keep you informed. I will add to it as I learn of John’s progress.

You are all welcome to join in with your own comments or best wishes as the events unfold. We hope that this will not only keep you informed, but will serve as a support to John over the next few months.