CANCER FREE

This is the last post I'm going to write because ROBERTO IS CANCER FREE!

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The visit to the surgeon on Wednesday was full of great news!

First, the surgeon divulged some more tidbits about the surgery.  Another reason why the tumor was difficult to remove was because it was "hard" and "had cartilage" in it.  :\  The cartilage is actually normal for teratomas (teeth and hair have been found in some). 

Second, the tumor had NO malignant cells!  Hooray!  I'm guessing this means the teratoma was around for a while (maybe since birth?) and the seminoma was a recent development.  Also, the teratoma will *probably* not come back.  Roberto will have to follow up with the oncologist to periodically check for the seminoma.

Third (I told you, lots of news), the surgeon took the staples out of Roberto without any trouble and put some skin glue on the incision.  There's some tape on the incision now so Roberto doesn't burst open.  Oh yeah, the adhesive I mentioned in the last post is from all the bandages for the dressing and tape to keep the sensors on Roberto's body.  Yep, there's still bits on him because I've been lazy.

So, all in all, ROBERTO IS CANCER FREE.  FREE!

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Roberto is making really good progress and is slowly weaning himself off of the pain medication.  We are cautious because we don't want him to get to a point where he is "chasing the pain."  He's slightly more mobile now but it's still hard for him to move his arm around.  There's a part of Roberto's chest below the pectoral muscles that are numb.  The surgeon told us that when they spread his ribs during the surgery, there is a nerve that was affected.  Roberto might be numb there for a long time. 

I feel like I can finally breathe a sigh of relief now that the surgeon has told us that Roberto is cancer free.  It's almost strange to think that I won't have to occupy my thoughts with how sick Roberto is feeling or how to juggle Roberto's care with life's other activities.

We're lucky:  the doctors found the cancer in time to treat it effectively and the treatment only took up 6 months of our lives.  I know others who were/are not as lucky.  I said this already, but I'll say it again - I'm going to cherish every day that I have with Roberto now. 

Robostrong!!!

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 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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Robostrong Bracelets!

Roberto had a great couple of days.  I figured it wasn't worth blogging about another day of watching tv.  However, he didn't feel at 100% today.  I think he felt nauseated so I made him take some anti-nausea medicine.  Hopefully he did not catch some sort of virus or anything.  I'm going to keep an eye out for a fever, though.

Our roommate, Aubrey, bought a few awesome "Robostrong" bracelets!  It was so hard to take a picture of it.  We have a few extras to hand out, so claim yours today!

I found myself looking at upcoming events that I normally would coerce Roberto into doing with me.  Here are a few of the things I want/wanted to do!

Lost Sierra Endurance Run
http://www.lostsierraendurancerun.com/

Zombie Preparedness!
http://www.rei.com/event/45517/session/77681

Archer Live!
http://www.axs.com/events/244767/archer-live-tour-tickets?skin=goldenvoice

Missed Events.  :(

http://sacburgerbattle.com/

I could be trying to distract myself from the fact that Saturday was supposed to be our wedding day.  It'll be just another Saturday now.  Nothing special.  

Tomorrow, Roberto will have his blood drawn and analyzed so the oncologist can make sure Roberto is healthy enough to start the fourth round.  We are almost at the end!

Cycle 3 - Day 18

Arts and Crafts

Today was a nice relaxing day at home.  Roberto and the food he ate finally came to a mutual understanding: he eats the food and the food stays in his tummy.  I won't get into the incident with orange juice in the morning.  There was also a close call in the afternoon but we were able to calm down Roberto's stomach with some well-timed medication and him lying on the floor. 

The venerable Doug stopped by to simply do groceries!  I tried to talk him out of it, but he insisted that he was going to drive to Davis anyway.  It was really nice to see Doug again and it made Roberto happy as well despite him still feeling sick.  Even though groceries were wonderful on their own, Doug also brought lovely miniature roses!  Roberto is already making plans to re-pot them in a larger container. 

Roberto's been antsy since the end of the infusion week.  I think it might be a side effect of one or more of the drugs from the infusion week.  He has trouble sitting still and gets up frequently to walk around which is sort of challenging because our place is small.  Before Roberto's chemotherapy started, my mom bought him a bunch of artsy things to keep him preoccupied.  For some reason, today he rediscovered the bag of goodies and got to work. 

Below is the half-painted plywood tiger.  Rawr!

I haven't seen Roberto sit and focus so intensely except for when he plays Starcraft.  :P  He'll probably be done with the tiger tomorrow.  I kinda hope this doesn't catch on as a hobby; I don't particularly want tons of these around the apartment. Believe me, I've seen it before: polar bears and elephants invading a household with pieces hung on the wall and others hidden all about.  It was terrifying.

Roberto has taken the dangerous path of taking some of his medication on his own without looking up the side-effects.  He was already banned from taking medication on his own, but I guess today he decided that he knew better.  The wonderful anti-nausea medicine that helped him in the afternoon also causes drowsiness.  What better than to use the same drug as a sleep aid!  *rolling eyes smiley*  Well, unbeknownst to Roberto, the drug also causes twitching.  Sooooo much twitching.  He's "dancing" in bed!  :( 

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Now that Roberto is on the other side of the infusion week, he is happier that his body is slowly returning to normal.  It's hard on him to stay strong during the week because it's simply torture for him and makes it difficult for him to remember that he'll be back to normal at the end of the week.  After the next two weeks of recovery, there will be one more cycle.  We all have to try to keep him Robostrong!

Cycle 3 - Day 7

Chemo - Cycle 3 - Day 3 - Hump Day

A cliche title for another day of Roberto feeling terrible.  I had a really busy day, so this post will be super short.  Roberto did slightly better today in that he kept down most of the food he ate.  His diet consisted mostly of fruits.  Hopefully tomorrow we can get him to eat some protein.  We'll see if the new anti-nausea medication does the trick.

Robostrong!

Shake Shake Shake

Another uneventful day.  The night, however, was not.  Roberto had difficulty sleeping; it might stem from last week when the chemo drugs would make him sleep during the day and he had to wake up at night to go to the bathroom.  So, he took half an Ambien but it made his arms and legs shake as if he were dancing.  :\   We'll see how tonight goes. 

Eric sent us a great poem.

Cancer is so limited...
It cannot cripple love.
It cannot shatter hope.
It cannot corrode faith.
It cannot eat away peace.
It cannot destroy confidence.
It cannot kill friendship.
It cannot shut out memories.
It cannot silence courage.
It cannot reduce eternal life.
It cannot quench the Spirit.

Robostrong! 


Cycle 2 - Day 9

Chemo - Cycle 2 - Day 3 - A Tough Day

Today was very tough on Roberto.  He spent the day either sleeping or throwing up.  I would go into details of the day but they are messy and not necessary for the blog.  I thought we were pretty good at giving him the anti-nausea medication on time, but it might be more than that.  The oncologist told us last week that patients typically vomit the entire week when receiving the chemotherapy drugs.  This might be the norm for Roberto for the other cycles.

I first speculated that the smell of the medicine would induce vomiting because Roberto was complaining about the medicine smell all the time.  Also, the smell is strongest in the bathrooms of the Infusion Center and his quarantined bathroom at home; those were the locations in which he usually threw up.  But after the last two days, it might just be him moving too fast and not knowing what feeling nauseated is like. 

With all the vomiting, Roberto didn't eat much today.  We sort of prepared for this over the weekend with Roberto eating as much as he could on Saturday and Sunday.  He lost a bit of weight from the first cycle and he didn't quite gain it all back.  Hopefully he won't lose too much more weight.

On a lighter note, I've started taping up the cards Roberto has received in the mail.  If I could tape emails and text messages, there would be a lot more on the wall.  Here's a picture:

We're over half-way through the week of chemo drugs.  The next two days will be hard.

Chemo - Cycle 2 - Day 2 - Fedoras Are Cool

Just me and Roberto today at the Infusion Center.  We wanted to give Adam a day off since he's been so great about helping us out.

Here's a current picture of Roberto.  He's so cute in his military hat.  It's not a real military hat, by the way.  We just picked up a hat from Target.  The choice was between the military hat or a fedora.  Coincidentally, we had just finished watching "White Collar" whose main character likes wearing fedoras.  Alas, I could not persuade Roberto to mimic Neal Caffery.

Here he is sitting pretty in his comfy chair.  We decided that driving the 20+ minutes to Sacramento was worth it instead of going to the Davis Infusion Center because the Sacramento chairs recline and have the seat warming option!  Now that Roberto is bald, the cool air of the Infusion Center makes him colder than before, so he's using the beanie from Tasia!

The Infusion Center has brand new medicine pumps!  They seem to be more convenient for the nurses to keep track of the drugs with the digital library that the pumps contain.  So far, the nurses have had to spend a lot more time pressing buttons in order to find the correct drug name.  Also, they've started a list of drugs that are not in the pump!  Totally convenient.  Well, at least they are shiny and new.

Around lunch time, Jim stopped by to keep us company.  He brought a card/board game with him called "San Juan."  Players slowly build plantations and buildings in order to colonize Puerto Rico.  I ... yeah, that seems like a sort of terrible theme.  Don't get me started on "Archipelago."

I thought that Roberto's appetite would have started to wane but after listening to the nurses talk about the restaurant Tres Hermanas, he sent me out to get a burrito!  "It's within walking distance," he said.  "It'll be really convenient!"  >_<  So, I had a lovely walk today through mid-town Sacramento. 

Two days down!  Three more days!  We're almost half way through.  Robostrong!

They See Me Rollin'

Today was full of interesting things.  Yes, that's the best intro you're going to get from me.  I've been grading finals.

First, Roberto's friends Greg and Gabby are visiting from LA!  I'm having fun getting to know them and hanging out with nice people.  We've taken them to the "hot" eateries of Davis - Cafe Bernardo and Burgers and Brew - and for a quick stop at the Ye Olde Beer Shoppe.  They are the first in a series of friends we are going to see this weekend.  Honestly, I thought that having so many people visiting was going to be a pain. However, it's been nice having the distraction.  The anticipation of the second cycle is rattling Roberto.  Well, as much as Roberto can be rattled which is not much.  So with friends around, Roberto and I can focus on them instead of the possible horribleness of the chemotherapy.  But, seriously, I just watched the Top Gear Bolivia Special again and I don't know how many more times I can see it before my brain implodes.

Second, we saw the oncologist to touch base and discuss the progress of the chemotherapy.  The oncologist listened to Roberto's breathing and could hear that the right lung is now taking in air!  Hooray!  No more collapsed right lung!  Also, one of the cancer indicators in Roberto's blood has decreased dramatically.  It's count was in the 1000's and has dropped to the 200's.  :)  Roberto may not need to have a CT scan after the second cycle because the CT scan would be needed to determine if the chemotherapy is doing its job and clearly it is.  

Third, Roberto is losing a lot more hair now.  It hurts when he brushes his hair against the grain.  Normally this is not a problem, except that he has to wear a hat now to protect his head from the sun.  Roberto now looks like he played with fire - and fire won.  Roberto got so fed up with his hair that he took the sticky roller he was using to clean the pillow and took it to his head!  This is the result:

I helped him out and we got a good 10 sheets of hair off his head.  I had bought a Bounce brand of roller which leaves a fresh Bounce scent behind so Roberto's head smells like Bounce now.  After a while, he took a wet towel and started brushing his head in the bath tub.  I was going to get a picture of all the hair in the tub but Roberto was too quick for me and washed the tub out unintentionally.

If you can, please send Roberto a quick message and tell him to be Robostrong!  We need to gear up for the second cycle.  Also, if you want to send a card or anything, message me and I'll give you our address.

Cycle 1 - Day 19

PICC Line Pics

We visited the Davis Sutter Infusion Center today to get Roberto's PICC line cleaned out.  He also had to get some blood drawn.  The PICC line is a catheter that is inserted in Roberto's vein and goes all the way to his superior vena cava (main vein to the heart).  I have the pictures below. 

Just a warning, the pictures might not be for the squeamish.  They are, however, totally for people who like seeing odd things sticking out of arms.




I warned you!










Still here?





The PICC line in all its glory!!!  One step closer to the Matrix.

Usually, it's not just hanging out all loose like that since it could get caught on something and be pulled out of his body (yikes!).  The nurse had taken off all the tape and gauze pads that were keeping the catheter snugly in place.  This way, she could clean up the arm.

Action shot of the nurse placing new tape and this special bandage with a window on Roberto's arm.  The window allows nurses to see if there is anything wrong with the PICC line such as blood seeping out or an infection.

Kinda blurry picture of the PICC line.  The PICC line splits into two other lines.  From what I can tell (and I might be totally wrong about this), one is mainly for administering the chemo drugs and the other is for drawing blood when necessary. 

Speaking of drawing blood, here's the PICC line in action!  Just attach the syringe to the PICC line and pull.  The advantage of the PICC line is that Roberto doesn't need to be pricked again and again when he needs blood drawn and when he receives the chemo drugs.  Also, one of the chemo drugs is very harsh on veins so the PICC line avoids the drugs interacting with the smaller veins of his arm. 

 Finally, the PICC line all nice and snug in gauze pads and tape.  They place an extra mesh thing around it for added security. 

This might be the last post for a while.  Roberto is doing well although he has some back pain.  He has some special configuration with a bunch of pillows when he sleeps at night.  Other than that, his appetite is back and he doesn't sleep the entire day but does go to bed relatively early  The second cycle starts August 12th and I'll definitely start updating regularly again by that date, if not before.

Robostrong!

(Cycle 1 - Day 12)

 

Might Contain Microbes

I can finally say with confidence that Roberto is back!  He took his two precious cars out for some quality time and even gave them a good wash.  I'm not jealous of the cars!  I'm not!  *sigh*  Playing videogames and working on his cars - classic Roberto.

Today, Roberto got two cases of Spindrift soda from Shelly!  I got to try one today and it was pretty tasty!  This is a good time to mention, before we possibly get more goodies (hey, I can hope!), that Roberto has a somewhat restricted diet.  Chemotherapy weakens the immune system, so he cannot have foods that might contain microbes.  Basically, no unpasteurized foods, raw fruits or veggies unless they have peels or can be cleaned well, and no sushi or rare steaks.  Finally, I was able to stop Roberto from binging on sushi every day (just kidding!).

With all the focus on returning to some resemblance of normalcy, I got a small reminder of the upheaval our lives have taken; I had to speak with the florist for our wedding and explain why the wedding is postponed.  At least this was better than the email reminder I received from the caterer to setup the dinner menu (this was *after* I had already spoken with the caterer!).  My biggest worry a month ago was picking the bridesmaids' shoes. 

We've had an enormous outpouring of love since Roberto posted a note on Facebook about his treatment.  The positive energy has been truly uplifting.  Please, keep sending messages and emails.  They will be most important when Roberto starts the second cycle on August 12th.  Aubrey had the great idea of making "Robostrong" bracelets through http://www.reminderband.com/ .  I'm gonna try to look into this when I get a chance.  

(Cycle 1 - Day 10)

Comparing *Old* CT Scans

First, Roberto is doing great.  He's awake the whole day and joking around like his old self.  He's even lamenting about prematurely buzzing his hair since it hasn't started falling out yet.  

Second, I worked my computer skillz and made .avi files of the CT scans.  These are scans from June 13 and July 19.  Roberto has NOT had a CT scan since his chemotherapy treatment started.  I thought the movies would be a good way for everyone to visually see what happened inside Roberto in one month's time.

Let's set the scene.  It's early June and Roberto has a small-but-chronic cough.  He complains about feeling liquid inside his right lung but still managed to run 18+ miles with Pedro and Chris for a Western States 100 training run the previous weekend without incident.  I finally convince Roberto to see a doctor who orders a CT scan.  The scan shows there is a large mass in the space between his right lung and his heart.  The large black spaces are the lungs.  The right side of the body is on the left of the image (trust me).  

In the following weeks, Roberto sees a thoracic surgeon, gets a needle biospy, and finally consults with an oncologist who recommends chemotherapy immediately.  At this point, Roberto is having difficulty speaking without coughing up a storm.  Roberto gets a CT scan on July 19th, right before chemotherapy starts on July 22nd. The CT scan shows us that his heart and bronchial tube have shifted to the left and there doesn't seem to be much remaining of his right lung.

Here's another view (at the end is the same scan but with less contrast):

What does the tumor look like now that Roberto has completed one cycle of chemotherapy drugs?  We don't know.  The next CT scan will be some time between the second and third cycles.  The doctors were right about Roberto improving quickly; I do notice that Roberto has stopped coughing as frequently, he can talk now without coughing and has an easier time walking up stairs.

We've come a long way after a single week of chemotherapy drugs.  Let's stay Robostrong and finish this!

ROBOSTRONG!

Cycle 1 - Day 8

Roberto is practically back to normal.  We did some gardening (we moved pots around, it was not labor intensive) and he did some handy things around the house like fixing a chair.  He also played a bunch of video games in the afternoon.  That's the more typical Roberto behavior.  :P   Amanda stopped by for a short visit today.  She's been hanging out randomly during the past week when she can which is awesome! 

Roberto also got a nice care package in the mail from Tasia!  Take a look at the goods:

Now I don't have to look for hard candy because Tasia found some Queasy Drops.  No more scary Ginger People for us.  And yes, that is a T-Rex.  It's a known fact that T-Rexes are the best dinosaurs for fighting cancer.  We are definitely going to have to play some of those Mad Libs in the future. 

Eric made up a great word that I love:  Robostrong!  Reading and saying the word brings a smile to my face.  Roberto likes it too.  We're going to stay Robostrong for the rest of the year!