He Earned It!

Cycle 4 - Day 6 (Saturday)

I'm still keeping track of the days of the cycle because the two recovery weeks after the infusion is technically part of the chemotherapy treatment.  

Our (last???) visit to the Infusion Center today came with a reward! 

Roberto got a special certificate for completing his chemotherapy treatment.  The nurses signed the certificate at the bottom.  The certificate has a special place at the top of the card wall.  Roberto is definitely happy that he doesn't have to get the chemo drugs pumped through his body anymore.  He's focusing on regaining his strength and getting ready for the surgery. 

In addition to receiving his certificate, Roberto also had his PICC line removed (as promised).  The nurse simply pulled the PICC line out of Roberto's arm.  It was amazing and disgusting.  There was even a countdown as the line neared the last 10 centimeters.  The nurse sort of cheated at the end because Roberto was getting a little freaked out by the whole process (I was definitely squirming).  I have no idea how well you can see it in this video, but here it is:

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Overall, today was okay.  Roberto, I think, wants to recover faster than his body will allow.  The morning started off well with him eating some fruit.  Then he wanted to go for a quick walk around the block.  After the trip to the Infusion Center, I made him my specialty of "egg in a hole" - an egg fried inside a piece of bread, but then threw it up later.  Then Adam made him some nice soup.  I think that's where Roberto should have stopped but he couldn't refuse the rice/bean/veggie thing that Adam made for dinner.

This post is going up late because Roberto wanted to go on a nearly midnight walk because he was having trouble sleeping.  Not even 10 yards from our apartment, Roberto threw up his dinner.  I was so surprised because it had been so long since he had eaten.  Roberto was going to keep walking but I dragged him back home and got him back into bed with some ginger ale.  He's finally sleeping soundly.

It's always so hard to see him so sick like this.  Let's hope that tomorrow is better. 

Chemo - Cycle 4 - Day 5 - No More Icky Chemo Drugs!

No more chemo.  NO MORE CHEMO!  Wooooooohoooooo!!!  Finally!  I'm so tired, though, that I can't fully process it.  I think it's partly because Roberto is still feeling super crappy and because I haven't been getting much sleep every night this week.  Hopefully Roberto can start bouncing back in the next week.  The fourth cycle was much much better than the third cycle because he didn't throw up most of the time - just a few times. 

Tomorrow, Roberto's Mesna sack is taken from him, he gets a Neulasta shot to promote white blood cell growth, AND his PICC line is removed! 

Okay, time for rest.  We don't have to wake up early to get to the Infusion Center at 8am. 

100% done (I'm not counting the recovery period now)!  Weeeeeeeeeeeeeeee!!!  I'm processing it!!!

Chemo - Cycle 4 - Day 4 - Final Countdown

Roberto spent some of the night dry heaving and started the morning with throwing up.  :(  Luckily, that was it.  We were able to get to the Infusion Center without problems.  The nurse got Roberto started on the amazing anti-nausea medicine (the same from Monday) and that seemed to do the trick.  He still had some issues with dry heaving, but that's something we can live with nowadays.  I'm just glad that he can eat a small peach and *not* throw it up 30 minutes later.  It's a vast improvement over cycle 3. The thing is, I've gotten used to the weird, disgusting burping/heaving noises that Roberto makes.  :\

ONE MORE DAY!!!  Then Roberto can slowly start building his strength!  We confirmed with the oncologist's nurse that we'll have to wait at least a month before consulting with the thoracic surgeon.  While we want to jump right into surgery, it probably *is* best for Roberto to rest a bit in case he needs to have the open chest surgery (which seems like a strong possibility from how the doctors talk about it).  This also means we get to enjoy a "normal" life for an extra week or two.  But, anyway, ONE MORE DAY!

Chemo - Cycle 4 - Day 3 - Three Down, Two to Go!

Well, it seems that the anti-nausea drug from Monday is wearing off like I feared.  He spent the morning dry heaving, and it continued until we got to the Infusion Center.  I made Roberto take sips of ginger ale and the nurse got him started on his pre-medications early.  Both of those combined seemed to do the trick; Roberto stopped dry heaving as frequently and was able to get some rest in the morning.  The dry heaving still continued but Roberto successfully remained vomit free by the end of the day! 

I'm going to keep this post short.  I gave you guys enough reading for the past two days.  Go out and play some board games for me!

Chemo - Cycle 4 - Day 2 - Life Mimics TV

It's great knowing that the end of the chemotherapy treatment is soon.  The next steps will be getting a CT scan, consulting with the oncologist, and then consulting with the thoracic surgeon.  We still have no information about the surgery since it depends on how much of the tumor is left over from the chemotherapy.  The uncertainty about the surgery is a little scary, but at least it means Roberto is one step closer to being cancer free.

Speaking of Roberto, he had another great day!  The new anti-nausea medication might be doing the trick.  It only lasts for three days, so tomorrow might be a little rough.  The good news is that Roberto will get a second dose on Thursday.

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Here are three fun things I learned in the last couple of weeks: 

1)  Roberto's finger tips are darker than the rest of his skin.  This is because of the chemotherapy.  Skin cells are one of the faster growing cells and so they are affected by the chemotherapy drugs (the drugs target all fast growing cells).  I have no idea the ways in which the skin is affected.  I just know that Roberto obsessed about his skin for a good couple of weeks until we could talk to the oncologist about it (it's normal and will go away).

2)  Some of the nurses at the Infusion Center have Grey's Anatomy (TM) brand of scrubs.  Who knew?

3)  It's really hard to get the word out to people.  Roberto is still getting messages from people who have no idea that he's battling cancer right now!  Either we missed a few key people when getting the news out or Roberto really has a ton of friends.  I guess people don't Facebook stalk like they used to.  *sigh*  Those were the days.

4)  I've been watching a bit of Scrubs lately, and I've started recognizing the drug names.  I don't know if that's a good or bad thing yet.  :-\  Also, I'm very scared of residents now, more than ever.

Okay, keep your fingers crossed for Wednesday!  Hopefully we'll have a strong and healthy Roberto again soon. :)

Chemo - Cycle 4 - Day 1 - Juicing

He's doing good, so far!  Roberto didn't vomit the entire day!  That means we don't have to worry about him not having enough calories for the day and being dehydrated.  The oncologist moved one of the anti-nausea medications to the first day.  It might have made the difference.

We also got a mini-laugh today because Roberto's nurse's name could be interpreted as a stripper name.  hehehe  Any guesses?  No, it's not Krystal.  Try again.   Is it a fact that nurse's with stripper names help people heal faster???  Stripper nurses?  Wait, I'm taking this in a bad direction.

Anyway, Roberto finally understands the benefits of small portions and hydration despite his usual mode of inhaling all food products.  Yesterday, he went to the Latino grocery store in Woodland to get some special carbonated apple juice that is good for nausea (purportedly).  The icebox we use for infusion weeks is packed with the special apple juice, Powerade and plenty of fruits and yogurts.  Thank goodness for the super Safeway sale on Powerades!

This cycle already feels different from the others.  I feel the optimism returning!  I'm super happy that Roberto is starting the week off well.  I'll just have to ignore his twitchy leg that keeps hitting me. 

Only four more days to go!!! 

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I know that it's the end of the treatment, but I wrote this out a while back and decided that maybe it'll be good to just throw out there.  The stuff below is part of the "Hidden Side" stuff I was writing earlier.  We learned about all the drugs in one day for "Chemo Education."  

There are three main chemotherapy drugs that Roberto gets during his infusion week (the first week of each cycle):  Ifosfamide, Etoposide, and Cisplatin.

Roberto has seminoma with elements of teratoma cells.  Seminoma is a type of testicular cancer and it can occur outside of the testicles; this is what Roberto has.  The good thing about seminoma is that it responds well to chemotherapy drugs. 


Ifosfamide
Good:  Used to treat testicular cancer.
Bad:  Destroys the lining of the bladder

This is the drug that requires Roberto to carry around the fanny pack during the chemo week.  The fanny pack administers the drug Mesna to protect his bladder but it must be given continuously.  Usually Bleomycin is given but it causes lung toxicity.  Since Roberto practically had only one lung at the beginning of chemotherapy, the oncologist replaced the Bleomycin with Ifosfamide. 

Etoposide
Good:  Used to treat testicular cancer.
Bad:  Damages vein tissue.

This is where the advantage of the PICC line is apparent.  Since the PICC line goes almost all the way to the heart, it bypasses the smaller veins and the Etoposide doesn't have a chance to damage them.

Cisplatin
Good:  Used to treat testicular cancer.
Bad:  Damages vein tissue; causes kidney toxicity.

*This* is the drug that induces the most vomiting.  Apparently, most people do not handle Cisplatin well, and I guess Roberto is one of them.  Also, partially to combat kidney toxicity, Roberto gets some saline solution at the start and end of the infusion (so before and after all drugs are administered).  The IV fluid is also part of general hydration for Roberto to help him flush the chemicals out of his body. 

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