Round 3 Underway

I'm Well set Into the third treatment cycle now. My counts were good, so We continued the dose escalation another 20%, such that I'm receiving a dose 40% stronger than the first cycle. I'm feeling lucky, sentimental, retrospective and introspective, and generally blessed. For these reasons, each of them at least loosely attributable to, I expect a multitude of posts over the next few days. Keep an eye out!

Chocolate Chip Muffies: The Best of Two Wonderful Worlds

 What do you get when you bake chocolate chip cookie dough in a muffin tin? Well, muffies, of course! I saw this idea in the AllTheCooks app that I use somewhat religiously and immediately had to try it. You have all the taste of a perfect, homemade chocolate chip cookie, with the added pluses of a crisp, almost caramelized edge, and a moist, gooey interior. It's the best of every chocolate chip dough world! Here's the recipe if you want a luscious treat:





CHOCOLATE CHIP "MUFFIES"
(Recipe courtesy an AllTheCooks app user)

• 1 c. butter
• 1 c. white sugar
• 1/2 c. firmly packed brown sugar
• 2 eggs
• 2 teaspoons pure vanilla
• 2 1/3 c. all-purpose flour, unsifted
• 1 tsp. salt
• 1 tsp. baking soda
• 12 oz. chocolate chips (1 bag)

1. Preheat oven to 375F.
2. Cream sugars and butter until light and fluffy.
3. Add eggs and beat well.
4. Beat in salt, baking soda, and vanilla.
5. Add flour a cup at a time, mixing well, but just enough to incorporate.
6. Stir in chocolate chips.
7. Spoon batter into greased cupcake tins (do not use cupcake liners) using enough batter to fill each cup approximately halfway.
8. Bake for approximately 20-22 minutes, or until lightly browned on top.
9. Makes about 18 "muffies."

Steroid Dependency: A Serious Conversation I Think I Might Be Having Soon

Prednisone is a steroid used to treat everything from asthma to colitis. It's also used frequently in chemo regimens because it depresses immune system responses thus allowing for the cytotoxins (chemo drugs) to do their job without interference. A typical dose is between 5mg and 20mg, taken on and off at regular intervals. And put simply, it makes you feel like could clean your entire neighborhood in one day. Now imagine that, while in the hospital, I'm on 240mg of the stuff EACH DAY! Oh my god, my family. At the very least, they've eaten well, because I've been inspired to make some off-the-wall down-right-gourmet meals while on this stuff. But for all the benefits prendisone offers, it is similar to nearly every other prescription-only drug in that you run a high-risk of developing dependence on it.

If you are on prednisone for longer than a week or so, as I am, your body begins to shut down production of its own natural corticosteroids, and if you stop taking prednisone suddenly, you can develop serious kidney problems. This is why you are usually tapered off the steroid over the course of several days. But because prednisone introduces such a rush of corticosteroids into the body, eventually your body might just stop producing them anyway, leading to steroid dependency. If you taper off the drug while you are steroid dependent, get ready for a bumpy ride. On top of it, because I have colitis at the moment (and perhaps permanently), I almost always get a flare-up on the last day or two of the taper, and afterwards I basically have no digestive comfort until I go back on the prednisone. If it turns out, after my chemo is completed, that I still have colitis, I will likely be on prednisone on and off for the rest of my life. But if not, I'm a bit worried at the moment about how I'm going to manage getting permanently off of it. Thus, I will be having a serious conversation with my doctor soon, and if you begin to notice symptom development around the time of your own taper, I'd suggest you consider having this conversation too.

Ouch: Hurting in Places You Didn't Know Exist

Cancer produces a unique type of pain. Candidly, I thought (as I'm sure so many others did) that I would be immune to cancer pain, and my general well-being after my first treatment gave me no reason to suspect otherwise. Then a few days before round two, chemo and I met in a dark alley somewhere, and chemo won. The most common type of cancer pain is called neuropathy, which involves any number of symptoms relating to sensation or control of the limbs and extremities. My legs hurt constantly, and what began as impaired control of my right arm has now progressed to the most annoying, dull-ache sensation I have ever felt. It's as if someone is constantly pulling my arm outward from the socket, and there is little to no reprieve from it. Neuropathy is a serious issue that should be addressed with your doctor. She or he is not likely to worry about it, as long it goes away, but if it becomes more persistent, then it must be treated. Moreover, the symptoms will likely continue months to even a year after your last treatment (oh yay me!). My experience with neuropathic pain has led me to the following habits or suggestions for anyone else who is just starting chemo or who is dealing with this fabulously annoying and often very disconcerting pathology:

1. When possible, arrange to be driven to and from wherever you need to be. You just never know when neuropathic pain is going to change, and getting a sudden spasm or losing control of your arms or legs while driving could... well, let's just say you might not need chemo anymore.
2. Always have pain medication handy, in the original bottle to avoid issues with law enforcement. ALWAYS!
3. Consider alternative/holistic treatments (within reason and after consultation with your doctor). I, for one, am a big fan of Reiki massage, which involves only the lightest touch to help stimulate healing. It sounds a bit coo-coo, I know, but after one session, trust me I'm hooked. And I'm a man of science!
4. When having a neuropathic episode, such as losing control of a limb, talk to it. (Yea I know, coo-coo.) Okay, don't do this in public. :) But seriously, talking to your limb, almost willing it to move, is actually neurologically sound, as it forces the brain to send impulses to the limb and may help stimulate recovery. Visualizing your limb moving while you're doing this can help too. For that matter, neuropsychologists and medical researchers have suggested lately that "seeing" yourself getting better during treatment seems to actually improve the efficacy of the treatment. (My we are complicated beings.)
5. Finally, massage or lightly caress the affected limb while your having pain or loss of control. This helps stimulate bloodflow to the area and can improve mobility and ease the pain.

Sit Down for This One, Cuz' It Might Make Ya Faint...

I have been very, very lucky so far. Because my white cell counts have been normal, I have not required any supportive care, but just mention the words "supportive care" to an experienced cancer patient and she is likely to cringe. This is because "supportive care" is just a fancy way of saying, "you need to get Neupogen or Neulasta." No, we don't cringe because it is given in syringe form, nor because it hurts, nor because it has any particular side effects; rather, we cringe because Neupogen costs $3,000.00 PER INJECTION! It gets worse: Neulasta costs more than twice that. The decision between the two is a consideration of your particular progress and exactly how compromised your counts might be. Chemo wreaks havoc on your immune system and if your counts get too low, you might require the more costly injection, which involves a larger molecule of the main active ingredient, filgrastim, thus allowing the body to process it over a longer period of time. Either way, you're stuck up the proverbial estuary, without means of locomotion. And don't think insurance gets you off. Mine and many other plans are not exactly crazy about the cost of this, so don't be surprised if you get a bill anyway. There is hope, however. If you qualify, at least, a group known as The Safety Net Foundation offers assistance to people who are prescribed medications from the Amgen pharmaceutical company (yes, they have a bit of reputation for way overpricing their drugs). Aside from this, you just have to hope and pray that your counts stay good, and I'd recommend consuming lots of orange juice or other Vitamin C-rich products to give your immune system a hand where you can. For now, this issue remains highly controversial, and I consider myself very lucky to have avoided it so far. Nonetheless, I may have to receive this medication at some point, and I am sympathetic to those who receive it on a regular basis. Consider this: 6 round of chemo X $3,000.00/injection = $18,000 alone! By comparison, adriamycin (a common and powerful anti-cancer drug) costs between $25 and $75 per cycle. Something is majorly wrong here.

A Must-Have for the Technologically-Inclined Chemo Patient

If you are like me, and addicted to your smartphone, you understand the epic battle that occurs between the "need" to have constant access to the world of social media and the reality of a limited phone battery. Aside from this, I normally am on the road several days a week, and it is important for the mental health of my family and friends that my phone be always available. I recently discovered the ZeroLemon battery (I'm not a paid spokesperson), which I can personally attest to being able to keep a phone alive for upwards of three days on a single charge. I believe these are mostly for Samsung/Android devices, but the general sentiment here remains. If you use a smart phone, I recommend purchasing an extended battery so that while you're in the hospital you can enjoy phone access readily and without the frustration of having to find an outlet that works with your IV stand (I hate those things). It's not something you would normally think about, but trust me, it will make treatments (and your life) a lot easier, and almost all of them are very affordable at around $40 or less!

Happy Memorial Day

In memory of my grandfather, Carmen N. Veneziano, who fought bravely for our country during World War II, and in memory and honor of the countless other veterans who have made the ultimate sacrifice for God and country, a heartfelt and blessed Memorial Day, and thank you.