In The Red

October 18, 2018 Leave a comment

Before I get the go-ahead for each life-extending, bi-weekly, Opdivo immunotherapy infusion, the infusion nurse draws blood while I’m in the chemo chair. She/he then sends the sample off to the on site lab and they perform a series of blood tests right there at the facility. They look for gross anomalies, but the main metrics of interest are the white and red blood cell counts. If the counts are too low, they turn the patient away and actions are taken to bring up the counts before bringing the patient back. So far it hasn’t happened to me, but sadly, I’ve seen people who’ve driven from substantial distances get turned away on the spot.

The table below shows some of my blood test results as measured over the last two months. I have no before-cancer baseline to compare the table with, but I’d find it hard to believe that I’ve (or you’ve) ever had a clean slate of no out-of-range measurements.

Except for my TSH (Thyroid Stimulating Hormone) level, all of the “reds” in the above table are either just barely too high or just barely too low. We’ve been continually upping the dosage of levothyroxine I’ve been taking in an attempt to bring my TSH level waaaaaay down into the normal range of 0.4 milliunits per liter (mU/L) to 4.0 mU/L. I’m currently on 100 mcg of levothyroxine.

The sheer number of quantities they can measure in 15-20 minutes of analysis is amazing, dontcha think? Imagine trying to do this just 10 years ago?

Categories: Cancer

Fire Extinguisher

October 5, 2018 1 comment

Given that your feet are on fire due to chemo-induced peripheral neuropathy, here is the best way I know of to extinguish the fire….

Hell, I’ll bet it works for diabetes-induced podiatric nerve pain too.

I’m not a podiatrist, but I play one on the internet.  Going forward, just call me Dr. Dozer.

Categories: Cancer

Fire And Rubber

September 29, 2018 Leave a comment

As I write this, my feet are on fire and my right leg feels perilously like rubber when I walk. Oh, and someone has turned up the volume on the ringing inside my cranium. Those are the symptoms associated with the inflammation caused by my brain tumors. In the worst cases of inflammation, my sense of balance also deteriorates and I experience small, fleeting headaches in the back base of my head.

These symptoms have been ebbing and flowing over the past couple of months. They are more annoying than painful, but the worse they get the less mobile I become. They are less annoying in the morning when I get up and then they seem to get worse during the day.

The first time I experienced these symptoms my oncologist put me on steroids. The steroids alleviated the symptoms by decreasing the inflammation but they came with their own uncomfortable symptoms (crazy sleep patterns, anxiety, puffy pie face, huge appetite). When I stopped the steroids, things returned back to “normal“.

Since the symptoms of brain inflammation have returned yet again, my oncologist has given me the now familiar choice: I either go back on steroids for the umpteenth time to suppress the inflammation or I become sedentary and wait till the inflammation (hopefully) subsides.

For now, I’ve chosen to stay off the steroids and remain mostly sedentary. If I start getting headaches and a decreased sense of balance, I will go back on steroids. Do you think it’s the right choice?

Powerful And Dangerous

September 22, 2018 Leave a comment

Like many cancer drugs, Opdivo is very powerful and potentially dangerous. It changes your immune system forever. In addition to killing cancer cells, Opdivo can attack any organ in your body during treatment, or even after it’s discontinued. One of the more well-known and common side effects of Opdivo is that it can kill your thyroid gland.

The main job of the thyroid gland is to make the hormone thyroxine, also known as T4 because it has four iodine molecules. The thyroid also makes the hormone triiodothyronine, known as T3 because it has three iodine molecules, but in smaller amounts, explains Cathy Doria-Medina, MD, an endocrinologist with HealthCare Partners Medical Group in Torrance, California. “The thyroid gland makes mostly T4, [and] the T4 has to be converted to T3, because T3 is the part of thyroxine that actually does the work,” she says.

The pituitary gland at the base of the brain controls hormone production in your body. It makes Thyroid-Stimulating Hormone (TSH), which tells the thyroid gland how much T4 and T3 to produce. The TSH level in your blood reveals how much T4 your pituitary gland is asking your thyroid gland to make. A normal range for TSH in most laboratories is 0.4 milliunits per liter (mU/L) to 4.0 mU/L. If your TSH levels are abnormally high, it could mean you have an underactive thyroid, or hypothyroidism. – everydayhealth.com

With that 1D, sequential, textual intro to the pituitary/thyroid/TSH/T3/T4 feedback control system in our bodies, here’s a simple, 2D visual representation:

Ever since William L. Livingston introduced me to the brilliant, but underappreciated, work of William Powers I have a tendency to think of the human body as a wondrous, hierarchical, interconnected, aggregation of thousands of little negative feedback control systems. Ah, but once again I digress. Time to kick out of enginerd mode and back into C-patient mode.

The graph below shows how my TSH level has varied over the past few months. Starting in May, my TSH level zoomed off the chart. The symptoms I started feeling were increased fatigue and increased sensitivity to cold.

Levothyroxine is a synthetic substitute for the T4/T3 hormones produced by the thyroid. Sometime in June, I started taking 25 mcg/day of Levothyroxine.  Since my TSH level is still way above the maximum “normal” level, my dosage has been bumped up to 75 mcg/day.

Part of the “fun” of having cancer is learning all about how different subsystems in the body work. Every time a new complication pops up, I research the subject in order to understand better what to expect and how to resolve the issue or ameliorate the symptoms.

Categories: Cancer Tags: ,

The Exact Dates

September 17, 2018 Leave a comment

As to be expected, whenever I tell people that I have the big C, they typically ask what type and when was I diagnosed. I could never remember the exact dates so I tell them “March of 2016” for lung cancer and “a year later” for the brain metastases. However, I recently found out the exact dates. Those dates will live in infamy!

Every two weeks when I get “infused“, the nurse prints out the Opdivo infusion order from the doctor:

The order clearly states the diagnoses dates as:

  • 3/1/2016 Primary C34.31 Malignant neoplasm of lower lobe, right bronchus or lung Active
  • 3/28/2017 Secondary C79.31 Secondary malignant neoplasm of brain Active

So now I know the exact dates, and so do you 🙂

 

Categories: Cancer

My 29th Birthday

September 2, 2018 Leave a comment

On Monday 8/27/18, I underwent a “routine“, tri-monthly, CT scan of my chest and abdomen. At the follow-up appointment with my oncologist a couple of hours later, he summarized the findings with: “everything is still under control“. On top of that, the troublesome lymph node that had shown growth for two consecutive scans did not show any further growth between the last scan and this current scan. Whoo hoo, another 3 month reprieve!

On Wednesday 8/29/18, I underwent my 29th, bi-weekly, Opdivo infusion. Since the Opdivo has been preventing the big C from “progressing“, I consider each infusion day a birthday to celebrate!

Categories: Cancer

An Unlikely Duo

August 30, 2018 Leave a comment

In a pseudo-creative twist on my “Wardrobe Addition” post, I decided to reposition the faux jewelry I wear on my wrists to illustrate what two topics are of utmost importance to me these days.

I can picture people who see this for the first time saying to themselves….

Damn, that bloke has some bitcoin AND cancer? I hope he’s still around when bitcoin hits $100,000/BTC.

Oh, in case you were wondering what the hell the Fitbit is doing in the picture, it was there already and I was too lazy to take it off.

Categories: bitcoin, Cancer
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