Week 11, Days 4, 5, 6 & 7

I accidentally bang my afflicted left hand against the sliding door of the West-Herr Toyota courtesy van Tuesday morning and it hurts like hell as it swells into a red welt. How long will I have this vein-inflamed side effect, I wonder? 

I just had a cancer talk with the shuttle driver, who went through four years -- four years! -- of chemo to beat leukemia. He had to retire early from his job, had chemo at Roswell Park every day all day at first and couldn't get a bone marrow transplant from his family because none of them were a match. Because of the chemo's effect on his legs, he walks with a cane, but he's cured and happy to be driving the shuttle three days a week. 

So I'm counting my blessings. I keep something close to a normal schedule, aside from ending my evenings a little earlier than I used to. There's that sinus condition, which erupts into sneezes and sniffles occasionally. And the zinging in my ears every once in a while. And blurry vision, which compels me to wear one of my many pairs of drugstore cheaters a lot and may or may not be related to chemo. And some lingering fatigue. And my hand. 

But chemo is over. No treatment Wednesday. Nothing but a month of recovery with some tests to confirm it before the surgery on May 4. Health care proxy Bill Finkelstein wonders how firm that surgery date really is. He's decided not to wait until my meeting with Dr. Guru on April 10 to get a confirmation.

Week 11: Days 1, 2 & 3

So Terry Gross is interviewing the doctor who wrote "Cancer: The Emperor of All Maladies," subject of a Ken Burns documentary series on PBS next week, and he talks about how intense chemo treatments used to be and how many of the advances in recent years have been in palliative care, with better drugs to reduce the side effects like nausea.

I can attest to that. Nausea is what you're likely to get with Gemcitabine, my final chemo infusion on Wednesday, and part of the prep before they hook it up is an anti-nausea pill, Compazine. I've been continuing the Compazine at home, lest those occasional little volcanic burps erupt into a Kilauea. So far, so good.

What I have mostly is the fatigue. More than once Wednesday night I settled down in front of a "Seinfeld" episode and next thing I knew, there was another sitcom rerun on the channel. I finished that off with 10 hours in bed, soaking up sleep. Thursday and Friday, out and about as usual to bridge, to lunch, to work Thursday night, I still dozed off in front of computer screens, slow-moving bridge hands and long stop lights. 

What else do I have? A fuzzy brain. Fuzzy vision, too. That zinging in my ears still crops up. Stuff still tastes funny. And then there are the sore veins, especially in my left hand, still swollen more than a month after that hand last got the Gemcitabine. 

Can you blame me for having an attitude about where to stick the IV for my final infusion? Right arm only. That attitude ran smack into a nurse I hadn't had before, Connie, a black woman who's been at Roswell Park Cancer Institute 32 years. 

Connie wasn't going to let me tell her what to do. She took her time sizing up my hide-and-seek veins, tied off my right arm above the elbow, had me flex my fingers a few times and then got out the alcohol swabs. Darned if she didn't nail it on the first try. She also got the doctor's permission for a simultaneous infusion of saline solution to keep the Gemcitabine from burning my veins. The fatigue started setting in halfway through the half-hour session. 

And that's the end of chemo. Hallelujah! Better days are ahead. Next: A CAT scan April 8, followed by a consult with the surgeon, Dr. Guru, two days later. 

Week 10, Days 1 & 2

Not much to say about Day 2, Thursday, except that as an alternative to naps (the first taken before noon), more exploration of how much sleep I could get in front of the big-screen TV in the living room. I had no energy for anything else.
Quite a bit of sleep, as it turned out, helped along by some seriously bland March Madness in the evening. The Purdue-Cincinnati basketball game, in which I had little interest to begin with (aside from my brother Tom being a Purdue alum), was a real snorer, since neither team seemed to have the will to prevail. By the time it went into overtime, I'd long stopped wondering which of them would.
More to say about Day 1, Wednesday, which was infusion day, and for my next to last chemo treatment at Roswell Park Cancer Institute, my main goal was avoiding pain.
No problem in the phlebotomy clinic (or "phleblotomy," as someone there was calling it). A bit of a problem a couple hours later in the chemo unit, however, where the nurse, Kim, graciously set us up in the best cubicle on the place, the big one with the two chairs and a bed that we enjoyed during the very first treatment two months ago. It turned out to be the best place for it, since health proxy Bill Finkelstein spent most of the next hour on two phones in the final throes of wrapping up the closing on the sale of his mother's place in Florida.
Meanwhile, Kim was having trouble finding an vein, especially after her first attempt in my chemo-afflicted left hand was unsuccessful. Her uncertainty after that was palpable. We asked if the nurse was on duty who found a vein a week earlier. Doreen. Doreen strode in, slapped my right inner forearm, spied a likely spot and hit it on the first stab. Did the doctor approve infusing the saline solution along with the Gemcitabine? No signature, just two red rubber stamps on a slip of paper that said I'd seen the doctor. Except I hadn't seen the doctor. Worked for the nurses. Worked for me. Just one more to go.

Week 9, Days 6 & 7 (in progress)

What I learn Monday is not to trust my first impressions this week, especially the ones that feel pretty good getting out of bed. They don't last. The heavy feet and slow brain set in and, try as I might to shake them off, they prevail. 

Nevertheless, I go play bridge. ("We'll have our usual s**tty game," partner Barbara Sadkin promises on the phone). But we do better than usual, finishing among the winners (52%), despite my generally passive play. 

After a nap at home, my first impressions return and I call the office. I'm coming in, at least for a while. Then, when I get there, I'm so mentally listless that I struggle to put words together. I throw in the towel around 9 p.m., beating the big crowd that would exit an hour later from the Sabres hockey game in the arena down the street. 

Today, Tuesday, St. Patrick's Day, feels much the same. Just come out for lunch, bridge director (and health proxy) Bill Finkelstein says, after I tell him I have no partner lined up for either the morning or afternoon game. He's serving corned beef. Hard to resist.

Week 9, Days 3, 4 & 5

Don't know if it's the steroid pills and the anti-nausea pills or something else, but Friday and Saturday are near-normal days, packed with activity. 

Bridge both days (a winner Saturday with a 65% game, best score of the year so far), shopping, a couple fine Local Restaurant Week dinners (last-minute luck gets us into Coco over on Main Street on Friday, while Brioso in Williamsville on Saturday is the first place in the 10 that I called where I could get a reservation for six at a reasonable hour). All that without naps.

Sunday starts out just as perky, but soon gets woozy and wobbly again now that the steroid prescription has run its course. After picking up the Sunday Buffalo News and a stop at Target, the rest of the day descends into doubt. Muscles droop. The brain fogs in. After lunch, I want nothing more than a nap. But first a call the city desk at The News to tell editor Rod Watson I'm not going to make it in tonight. That's a decision that still feels right after the nap.

Week 9, Days 1 & 2

Thanks to bridge player, film buff and wine fancier Mike Silverman for coming up the best description of the condition I'm in on Thursday after I clumsily tried to explain it to him -- woozy and wobbly. 

Yes, the brain and the legs have become unreliable again, but not so much as to discourage what's turned into a full day. That's included trips to the post office and the car wash (yes, it's warm enough for that, finally), plus chipping away the remaining ice on the path to the back door at home (a six-foot long stretch, melted to a thin crust on the far edge by another day of glorious March sun). 

And now, after a nap, I'm at work.

Nor did it discourage my bridge game. Maybe it was because partner Florence Boyd and I were on defense most of the day. At any rate, I made fewer mistakes than usual and we came in first North-South. 

As for the chemo at Roswell Park Cancer Institute on Wednesday, it was more easily endurable than last month, thanks to a few discoveries that we've made along the way. 

First of all, you can request (and get) an expert phlebotomist in the Phlebotomy Clinic. Result: She hit the vein with little pain. 

Second, you can request (and get) one of the better vein-finders in the Chemotherapy Clinic. On Wednesday, after chemo nurse Katherine didn't spot one, it was Doreen. She found one halfway down my right forearm on the first try.

And third, you can request (and get) saline solution in combination with one of the chemo drugs, Gemcitabine, which reduces its vein-burning characteristics. 

There's still some confusion about #3. We asked the chemo doc, Dr. Saby George, if he needed to approve this, as the chemo nurses had told us. He replied that he doesn't need to and that he doesn't like to micro-manage. Then we got a contradictory answer from the nurse in charge in chemo. Oh no, she said, the doctor usually has to approve.

At any rate, I got the saline solution and the requisite veins are happy. Happier than the veins on my left hand, which are still sore from the Gemcitabine four weeks ago. 

During the Cisplatin infusion, which came before the Gembitamine, I felt no effects at first and wondered when they would kick in. Halfway through the two-hour process, I found out. The fatigue enveloped me and I could no longer stay awake to read. 

Later, after a hearty dinner at soon-to-close Torches on Restaurant Week specials (beer & cheese soup, mac & cheese wrapped in porchetta and a dessert -- I'd fasted on water, tea and crackers all day), I could hardly stay awake at all. I was in bed by 9:30 p.m.

My day also included a sit-down with a new (to me) member of the Roswell Park team, the social worker. By his request, it was without my health proxy, Bill Finkelstein. 

After asking me how I felt about things, he got to what seemed to be the real purpose of this conference, the picture-taking of me and a health care worker last month, the one that prompted a sit-down with a hospital security officer.

I told him that I had consulted with a lawyer about this (didn't invoke his name though -- your anonymity is safe with me, Mickey) and we have every right to take pictures as long as the health care worker doesn't say no (which she didn't) and that I would fight this if they tried it again. The social worker then suggested that Bill was abrasive and that we would get better results if he was more diplomatic. He then showed up for the conference with Dr. George, but said nothing. Apparently just an observer. 

Week 8: Days 1, 2, 3, 4, 5, 6 and probably 7

A week without a chemo treatment and I'm feeling good. There are longer intervals between trips to the washroom and no naps in the afternoon. I start getting sleepy mid-evening, but that's it. 

I've played bridge almost every day (last Friday in St. Catharines, Ont.), gone shopping in the afternoons and worked each night (except Friday and Saturday, of course). I've been to the dentist and the dermatologist. 

Now that the temperature is finally peeking above freezing, I've chipped the ice off a path to the garage. I've had wasabi with sushi and Tabasco with soup without digestive backlash. Alcoholic beverages, on the other hand, I'm still avoiding. 

This lovely grace period comes to a halt on Wednesday, when I go back to Roswell Park Cancer Institute to start the third round of chemo, beginning with the double infusion of Cisplatin and Gembitamine. Will I be flattened by fatigue again for a week or more? Could be. This time, at least, I know it's coming. 

So I've stocked up on bottled water and Tuesday I'm getting my hair cut, figuring that if it doesn't happen now, it could be two or three weeks before I'm up to it again. By then, if I'm lucky enough to not start losing my hair, I'd look like a mountain man. 

Week 7, Days 5, 6 & 7

This is as good as I’m going to feel in this cycle, I tell the bridge players when they ask how I’m doing. Still a little tired, still a little fuzzy around the edges. A bit more pep and I’d be almost normal.

Yes, I’m back at the bridge tables, but my game is nothing to brag about. In fact, it’s been costing me my naps, thanks to a late start Monday and a stop for lunch Tuesday. I’m sleepier than usual as the evening progresses at the office.

Keeping my blood percolating each night, however, are what’s become my specialty these days – obituaries. Major ones for notable folks, both beloved. One is former WKBW deejay Don Burns, who became the godfather of the rave scene in Toronto. The other is local author Margery Facklam, a woman who kept snakes and porcupines for pets and who wrote some 30 books on natural science, very successful ones, for children. 

Week 7, Days 2, 3 & 4

On the upswing, but not as far up as last month. Back then, I could go to my bridge game, drop home for a nap, then go to work and maybe wrestle a couple bears or wildcats. I can't handle that much now. 

This time, the trip to the office is all I can muster Thursday. It turns out to be a full evening, minus bears and wildcats, but not without computer lock-ups. 

On Friday, I make it to bridge, but don't have enough energy to go out to lunch afterward. It's straight home to bed instead. I rally for Vietnamese food with friends Marti Gorman and Jim Jacobs at the Niagara Seafood Restaurant later. 

On Saturday, Boris the cat has a check-up at the vet at 11 a.m. During the wait to see the doc, I duck across the street to the hardware store and buy a new snow shovel, which I use back home, along with the ice chipper, to attack the crusted snow and ice on our treacherous back stairs. 

After a warm-up and a bite, I set off on a short round of errands which once again test my energy levels. More ginger molasses cookies from Carla's Crumby Creations at Horsefeathers Winter Market before closing time at 2. Prescriptions and fizzy water and a few other supplies from Tops Market in Black Rock. And I'm flagging. At least driving is vaguely restorative, because I need more of that fabulous artisan yogurt from the Farm Store, which is just a couple blocks from home, and it's only open on weekends. Worth the stop. I score the last four jars of their Fig Tea flavor. 

Greeting me back home is an extravagant and unexpected gift -- a huge bouquet of flowers worthy of a wedding or a funeral or, in my case, somewhere in between. It's a get-well wish from old friend and former Buffalo News freelance critic Pat Donovan, an extremely funny lady with whom my contact is usually just e-mail and Facebook. I'm overwhelmed. Boris likes it too. Especially the ferns. 

Then I crawl into bed and nap. Deeply. 

Revived a couple hours later, we join friends Dan and Susanne Sack for dinner at Marco's on Niagara Street, a restaurant chosen for its promise to be well-heated (Niagara Seafood Restaurant was frigid Friday night, despite its newly-installed vestibule). Marco's other promise -- you shall not be underfed. All of us take home big packages of leftovers.