Not Out of the Woods

Roberto did not have a great day despite me throwing at him all the possible anti-nausea medication I could get my hands on.  Only one meal was able to stay in his stomach today and that was a single Asian pear.  He tried eating many other fruits and soups, but those didn't stay down. 

When he was awake, he wanted to do something so I gave him the other wooden puzzle toy my mom bought (a dragon!) but apparently it was super complicated with all the scale parts.  Then Roberto and I played the board game Formula D which simulates formula 1 racing.  Roberto was still scarred from the fiery crash he suffered the last time he played so he was conservative with his car.  I, on the other hand, went wild around the turns and won!  I don't mean to disparage Roberto when I say that the game was pretty simple in that one rolls a die and moves a tiny race car; playing the game totally wiped Roberto of energy.  That's when we moved into the session of watching a Starcraft tournament.  I've come to realize that I've learned an unpleasant amount about Starcraft from watching these episodes with Roberto.  Banelings!  Pylons!  GG!!!

Besides the above activities, we spent the day going upstairs and back downstairs depending on Roberto's comfort level and desire to sleep.  I say "we" because he doesn't want to be alone. While he is sleepy, he doesn't quite stay asleep and I think he's becoming anxious since he is not recovering very quickly.  He kept telling me that he wished he didn't feel so terrible.  Right now, I think my presence is helping because he is totally snoring.

I hope tomorrow is a little better for him.  Robostrong!

Cycle 4 - Day 7

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 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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Bread and Butter

Roberto is still sick.  :(  The effects of the chemotherapy drugs seem to be lingering much longer than any of us have expected.  He has more energy but he is still throwing up his food and has the weird twitches.  Our current plan of attack is to have him drink lots of water so he can flush out the drugs from last week.  Also, small food portions.  The teeniest food portions.  And no more self-medicating!

He finished the tiger!

I mentioned this to my mom and she's now planning on buying more kits. :-P

At night, we went on a short walk around the neighborhood to get rid of Roberto's jitters so he could sleep later.  It was also a nice opportunity to just talk about what's going on.  I think it was good for Roberto to some things off his chest.

Hopefully Roberto will be inhaling In and Out burgers by the end of the week.   :)

Cycle 3 - Day 8 

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!

Chemo - Cycle 3 - Day 2 - More of the Same

I can't believe it's only been two days of the infusion week.  Roberto still has difficulty keeping food down and the anti-nausea medication seems to have minimal effect on him.  However, I don't know how must worse it would be if he wasn't taking the anti-nausea medication at all.  The oncologist stated that patients on similar chemo drugs as Roberto would vomit the entire week of infusion.  That seems to be more and more true for Roberto as we continue with the chemotherapy.

Roberto also had trouble sleeping last night.  A few of the anti-nausea medications make him restless.  His leg starts twitching and I think he wakes himself up.  At least, it wakes me up when he lightly kicks me and then I let out a little grunt or cry and *that* probably wakes him up.  It basically becomes a chain of sleep-inhibiting actions.  I gave him a quick back massage before bed today - we'll see if that does the trick.

The nurse told us in July, at the beginning of chemotherapy, that it might help to set goals for each day so it felt as though something was accomplished.  I used to set goals of eating a certain amount of food but that doesn't even seem feasible anymore with Roberto unable to finish half a pint of smoothie.  Tomorrow (Wednesday), Roberto will be given new anti-nausea medication.  I hope that it will allow Roberto to eat more than a single pear and two crackers. 

Chemo - Cycle 3 - Day 1 - The Start of a Long Week

Today did not start off well.  In the morning, I could tell that the anticipation of vomiting was weighing on Roberto's mind as he somberly organized his bag of medicine, candy, and other sundries for the infusion week.  He was almost dragging his feet as we went to the car. 

We arrived at the hospital and settled in at the Infusion Center just fine; going to the Infusion Center is becoming so routine now that the valet parking attendants recognize us.  Things seemed to be going along as normal as the nurse cheerily hooked Roberto up to the infusion machine and discussed the changes to Roberto's chemo treatment with him.  Adam graciously got an In and Out lunch for Roberto and me, which we happily scarfed down.  Roberto semi-prognosticated when he said, "I hope I only taste this once."  I left shortly afterwards to run some errands and get some work done at home.

Later, I learned that Roberto *did* throw up at the Infusion Center about 30 minutes after eating, and a second time once at home.  :\  Vomiting this early in the week does not bode well for the rest of the week as he usually does not eat that much food once he has vomited during treatment.  The oncologist is putting Roberto on a new anti-nausea medicine on Wednesday, and we are hoping that will do the trick and prevent any more vomiting during the last half of the week.

Roberto's diet for today consisted of cereal, half a peach, and 8 oz of a homemade smoothie.  That's actually more than what he usually eats when he's not feeling well.   Usually he can only stomach half a yogurt in the morning and a couple of tiny bowls of soup for dinner.  One good thing is that he was awake and mostly alert when he was home and didn't take long naps.  Hopefully that means he'll get a good night's rest.

Flowers!

Cycle 2 - Day 6

Friday night was probably one of the worst nights for Roberto.  He had difficulty sleeping, so we gave him an ambien.  About an hour later, he came downstairs and declared that the sleeping medication wasn't working because he kept thinking his pillows were part of some (video game?) mission.  I think that was sleeping but I'm sure that's not the type of sleep any one really wants to have.  Also, one of Roberto's anti-nausea medicines may be giving him restless-leg syndrome and general restlessness because his leg would twitch a bit at night as if he was dreaming about playing soccer and then he got out of bed and wanted to walk around the living room.  Soon, Roberto will be off the medication so hopefully he (and I) will get a full night's rest. 

We went back to the Infusion Center this Saturday afternoon to return the medicine bag he has to carry around for the duration of the chemo week.  Also, because he's been vomiting so much, he got a liter or two of saline for hydration.  It's standard practice to take stats of his vitals and we found out that he lost about 10 pounds this week.  That's not terribly shocking news since he hasn't been eating but still disconcerting. 

Roberto is already showing signs of recovering from the chemo drugs.  There was some dry-heaving action happening today, but that was in the morning.  Later in the day, he ate a whole peach, a cookie, and two tiny bowls of broth!  I'm more cautious about the soup since most of the time he will throw it up, so I gave him just broth.  Since he was not given the chemo drugs today, he was awake for a good portion of the day. 

Unfortunately, Roberto is still plagued with restlessness from Friday night and couldn't stay still for the nap he wanted to take.  He found a cure in the form of Halo.  Yay for Halo!  So we definitively know now that Halo also cures restless leg syndrome.  Basically, Halo is the cure for everything.  As I type this, Roberto is sleeping now, however, I can hear the sounds of kicking coming from Roberto.  I might move to the couch tonight.  Oh my, he's rolling about the bed and flinging pillows around.  Um, when you see Roberto, just pretend that I never wrote this on the blog (i.e. don't mention this).  I think he's making a pillow fort!  ...

Anyway, we got a wonderful surprise on our front door in the evening!

Aunt Patti and Uncle Doug sent us beautiful flowers already potted!  Roberto wanted to start a flower garden and all we have is a dahlia plant that refuses to bloom again (and a bunch of sad pepper plants, but those are my fault).  Roberto was soooooooooooo (yes, I need that many o's) happy when he saw the plants, he immediately watered them and tended to our other plants. 

This concludes the chemo drug infusion portion of cycle 2.  I'm going to be throwing so much food in front of Roberto's face this week.  I talked to Roberto about what he wanted his first meal to be and he enthusiastically said, "Burgers!"  My jambalaya never had a chance. 

Chemo - Cycle 2 - Day 5 - Survival

Day 5 had ended and, thus, the chemo portion of Roberto's second cycle has come to an end.  Now he has 16 days of recovery to enjoy with rest and lots of food.

Roberto still struggled with feeling nauseated today and it continues to stymie our attempts at getting Roberto to eat.  At the same time, we don't want to push him to eat and then have him throw up the meal a few minutes later.  The oncologist prescribed a fourth anti-nausea drug to help with the nausea.  Since he's been home, he's only thrown up once, so maybe it's starting to work.  The nurse also commented that since Roberto's nausea is worse than the first cycle, his symptoms might be psychosomatic.  There might be some truth to that speculation because Roberto was getting a bit anxious before the second cycle started.  I think I'll try to get Roberto to talk to me a bit more about how he's feeling about all of this once he is more lucid.  He already does not want to do the two remaining cycles of chemotherapy.

On a lighter note, Roberto received another card in the mail today!  Aunt Patti has been in almost constant contact with us since the beginning, and it brought a small bit of sunshine into Roberto's gloomy day to read her supportive words.  I also read to Roberto a couple of texts and emails.  I think such messages are so wonderful and they definitely uplifted my spirits today.

Tomorrow, Roberto gets to hand in his fanny pack of drugs and be done with the chemo infusion!  The first meal he craved after the first cycle was In and Out.  Of course, right???  That guy lives and breathes those burgers and fries.  We'll see what he eats this time around.  Any bets on my jambalaya?  Believe it or not, it's a strong contender.

Chemo - Cycle 2 - Day 4 - Tiny Bowls

Well, chemo is a huge pain in the ***.  Roberto spent the whole day fighting the urge to throw up.  He was successful a majority of times but was miserable the entire day.  It's hard watching Roberto suffer each day and be unable to mitigate his nausea.  Roberto's oncologist and nurse decided to give Roberto a third anti-nausea drug to take at home.  Hopefully it will do the trick.  So far, in the evening, Roberto has been doing well.

We're also trying portion control with Roberto.  It seems even while sick, he will finish all the food that is placed in front of him. so we've resorted to tiny bowls of soup.  Roberto is definitely not eating enough food, but there's just one more day of chemo drugs for this cycle and maybe on Saturday he will be able to eat more.

During Roberto's low points, he'll say, "Chemo sucks," and "Why did this have to happen to me/us?"  There's certainly no easy or comforting answer to that question.  Is it reassuring to know that your body is predisposed genetically to have cells that would go rogue by multiply out of control and murder you?  Another perspective of the same idea: was this part of a grand plan for Roberto's life? 

I have difficulty answering such questions.  I can't even begin to imagine what Roberto is experiencing and what could be said to make him feel better.  I'll say the usual, "You're strong and will get through this," and "You're going to be awesomer after this over," because it's the truth and it's easy to speak such truths.  Instead of attempting deeper answers, I focus on doing everything I can to help Roberto physically get through this ordeal.  Everyday I hope that my and Adam's presence at the Infusion Center and at home gives him a little bit more strength to get through the day.

Roberto is already dreading the next two chemo cycles and it's becoming harder to be Robostrong. For now, though, let's get him through tomorrow.

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.