Round 2 of Chemo

THE WEEK THAT WAS:  This was a TOUGH week.  As I write this, the Wednesday following the Cisplatin infusion last Thursday, I feel wonderful.  I had actually forgotten how bad the first five days after Cisplatin Chemo would be since during the first round, after the first five days, it was relatively easy.  I take a two drug nausea regime which mostly keeps the nausea in check - but it is always right there in the pit of my stomach letting me know it can arrive at any moment.  On the very few occasions where vomiting won out it came quickly, left quickly, but was surprisingly powerful.  Not to be gross, well kinda gross, but it was otherworldly strong.  Nothing came forth (dry heaves) but in the midst of the throes I was weirdly fascinated by the sounds and the force I have never experienced before.  But gone quickly.  Yesterday, Tuesday, I woke up feeling pretty well but that went away right after breakfast and I took by two drug regimen and they quickly put me to sleep and ended the day for me.

ABOUT NAUSEA MEDICINE:  During the first round I took one drug, Promethazine, every 8 hours and another, Zofran, every 8 hours as needed.  Taken together, I am in a semi-conscious state; which is how I like it those first days after Cisplatin.  My stomach mostly feels empty?  I use a question mark because I am eating well, but the feeling might be just the effect the chemo has on the cells lining my stomach.  That empty feeling is my stomach's way of letting me know to keep taking the Zofran because overwhelming nausea is always just a step away.  The only time I truly get nauseous is when I begin to feel better about days 4-5 and stop taking the Zofran until "as needed".  Sometimes I'm off by a half hour but its pretty fast acting, within minutes actually.

During this round I used a patch, much like a nicotine patch, that lasts one week and slowly keeps Zofran continuously in my blood stream.  Two things.  First, Zofran in pill form costs $40.00 for a 2 week supply.  The patch form costs $1,400 for one month supply.  My insurance, BCBS, paid for almost all of both types, which is ridiculous to me.  Why should BCBS pay 17.5 times as much for the convenience of me not having to pop a pill every 8 hours?  Secondly, the patch didn't work nearly as well as the pill form.  I got sick a few times with the patch and had to pop a pill for extra help - which causes extreme constipation.  After a couple days I took the patch off and went back to the pills.  They are fast acting and if taken timely, better for me.  I guess that's a waste of $1,400.  Sorry about that BCBS.

AFTER THE CHEMO:  I didn't realize I was supposed to be embarrassed about the cancer I have, otherwise I might not have started this blog.  Come to find out, it is very hard to find famous people who have had bladder cancer because most don't like to admit it.  Bladder cancer is the 4th most common cancer, but the most expensive to treat by far.  I guess the issue that causes celebrities to hide the fact they have this cancer is "The Bag".  With this cancer, the bladder must go and you have to decide which diversion method to use to remove urine from the body.  All methods use some portion of the intestines to create a conduit for the urine to leave the body.  The most common currently for people my age I understand is the "Neo-Bladder".  That is cutting out a section of the intestine, forming a "bladder" like balloon, attaching the ureters from the kidney and the attaching this new bladder to the urethra to pee through the penis as usual.  Upside is you most likely will pee normally, though not guaranteed.  Downsides are many, such as this new "bladder" will only hold pee for about 3 hours and you will have to urinate every three hours for the rest of your life.  Even during the night.  Plus there are infections, and catheterizing and generally about 50% of the time, serious complications requiring hospital stays and further surgeries.  Another form is the Indiana Pouch.  Pretty similar except this pouch is attached to the inside of the abdominal wall with a little hole.  Again, about every 3 hours you put a little straw in the hole to drain out the urine.  (Now you understand why famous people don't tell a lot of people they have/had bladder cancer?)  Lastly, the tried and true Illeal Conduit.  This take a section of the small intestine and creates a "stoma", or hole,  in the abdomen that a bag attaches too to collect the urine.  Very unsexy, but less much less complications.  Another benefit of the "bag" method to me is that the other methods take a lot of time, energy, work, follow up treatments for complications to finally get it right.  If the cancer comes back, and my cancer has a pretty big recurrence rate, I'd hate to be dealing with all that in the last months of my life.

I have  about two months to decide.  The surgeries are pretty major.  About 2 weeks  in the hospital and about 6 weeks recovery time.  I'm trying not to think about that honestly, and just focus on Chemo.  I imagine surgery will be in early October - an incredibly busy time at work.

On a personal note:  I'm looking forward  to ending chemo just in time to celebrate my 30th wedding anniversary with my beautiful bride Janice.  Throughout all this I can't escape the knowledge that I have been incredibly blessed.   I have been in love with her everyday since I first met her and have been completely satisfied with the life and family we have created.  It is very hard to have a pity party for yourself when you are in a period of  reflection of 30 years together with another person and know that the the life you have led with her has been one that has exceeded any possible hope when you exchanged those vows.  1,2,3.