Never Trust a Vegetable

Yeah, it creeped me out too.

Some sort of nasty bell pepper dwelling caterpillar was my first guess when I found it inside the pepper-formerly-destined for Kevin's stir fry.

It's something inanimate growing in the pepper. Probably harmless, maybe a seed that's sprouted. But who knows? Maybe it's some "harmless" growth spurred by a chemically induced misfire in bell pepper DNA. Possibly it's the vegetable equivalent of my over-abundant estrogen fueled cell rampage.

Whatever it is, the last time I saw something that creepy looking growing in what otherwise appeared to be a healthy happy place was two years ago when a doctor showed me photos of the tumor he had just found during Kev's colonoscopy.

And that happy epidsode resulted in major surgery for Kevin followed by almost a year's worth of radiation and chemotherapy.

The Misses Lorri have always blamed my meat loaf for that entire incident. I've suspected all along that it was the vegetables. They look all healthy and good for you but you never know what secrets they're hiding.

This is why I've avoided vegetables as much as possible throughout my adult life. You can't trust 'em.

The Third Day

Nurse Pam will be here this morning and Kevin will be relieved of the chemotherapy pump.

Day Three of treatment week is Kevin's Day of Deliverance.

Just coming off the week of Easter, thoughts of Jesus being raised on the third day were on my mind. Then I remembered there are a lot of "third day" events in scripture.

Jonah and the whale for instance. Jonah tries to avoid what God asks of him. He tries to run away, only to be caught in a terrible storm and thrown overboard. Jonah spends 3 days and nights praying in the belly of a big fish. He realizes God could have ended his life but has chosen to spare him. He's grateful and ready to do as God as instructed him--go into Ninevah to preach repentance. On the third day the whale spits out a shaken but intact and grateful Jonah who goes on to answer God's call.

To be honest, I think 3 days in a whale's gut would have left me pissed. And I know there are times when 3 days of chemotherapy treatment leaves Kevin angry and more than a little disappointed.

I know he often wonders if he chose the wrong path. Or thinks, "I tried to do the right thing--for my family, for myself--and THIS is what I get?"

If cancer is the storm in Kevin's life, chemotherapy is his whale. It's really not a great place to be but in the end the goal is for Kevin to emerge--shaken, true, but largely intact. And changed. We'll both be forever changed by these months.

I think I've established that I don't believe God "gave Kevin cancer for a reason." Nor do I believe that we can pray Kevin's cancer away. I don't believe God works that way. I don't literally believe a whale swallowed a fellow named Jonah and kept him hostage for a three day marathon of sea faring prayer before regurgitating him intact on dry land.

I believe God knew Kevin would develop cancer and He knows how cancer will play out in our lives.

I believe prayer delivers us the grace and determination to make good things out of bad as God has promised.

I believe there is a message of hope, willingness, gratitude and mercy in the story of Jonah and the whale.

For Kevin life right now is a chronilogical three day count down every other week. The biblical accounts of "three days" remind me that though this literal time of three days will eventually be gone from our lives, the meaning of "three days," of waiting for a sign that things will be well, will continue for years as Kevin goes into the observation period after treatment.

I don't think it is a coincidence that Kevin's treatment brings him to the point of misery and then relief on the third day. I think it is a subtle but real reminder that this, too, will pass. That there is deliverance and it's found in the mercy and compassion of a loving God.

Good News, Relatively Speaking

It's tough for Kevin to think of anything associated with chemotherapy as "good news." However, relative to how things go in that realm, there was good news this week. He is able to use a different chemotherapy for the radiation period.

He began chemotherapy again today in addition to the 5 day a week radiation treatments. He is taking Xeloda (Capecitebine) 5 days a week. Xeloda is metabolized by cancer cells (and some healthy cells too) into 5-FU, the intravenious drug Kevin was receiving last fall. Xeloda is supposed to come with fewer side effects.

Xeloda is taken as a pill. A fat handful of pills twice a day. For Kevin, it's 5 after breakfast and 5 more after supper. Lots of water throughout the day to help his body get rid of the drugs.

He's supposed to minimize the consumption of folic acid. Extra folic acid may encourage the Xeloda to stay in his system longer and, thus, increase side effects.

Check labels as you walk down your grocery aisle--folic acid is in a lot of foods. It's not easy to avoid so common sense is the simple rule. Don't eat 4 bowls of cereal a day, that sort of thing.

One of the side effects Xeloda is known associated with is hand/foot syndrome, a drying and peeling of hands and feet. It can become very painful very quickly from what we've read. There's some of that associated with the 5-FU Kevin was on before so he's already in the habit of moisturizing hands and feet a couple of times a day. The oncologist suggested slathering them up at night and wearing light weight socks and gloves to bed. Kevin's feet are cold and sensitive anyway so he's willing to go the sock route.

The gloves may take some talking.

The big plus with Xeloda is not having the constant infusion pump for 5 to 7 weeks of radiation treatment. 24 hous a day/7 days a week/5 to 7 weeks was going to be a physical and mental challenge for Kevin to endure the infusion pump.

And the hated port will not have to be accessed/used for this treatment period. It had become more itchy and sore throughout the weeks of treatment last fall. Kevin thinks it's partly his body complaining about the invasion and partly due to some leakage when the needle was removed each time.

So even though chemotherapy re-enters the scene, in the big picture the appearance of Xeloda is a good thing.

Chemotherapy II, a Primer

Chemotherapy Counting. Thought you might like an explanation of some of the terms/numbers we use when talking about Kevin's treatment. The terminology used by the oncologist made a lot more sense to me once I researched the whole idea of treatment "cycles."

Chemotherapy is usually counted in "cycles" which include treatment and a rest period. More about the treatment/rest theory on another day.

In Kevin's treatment, a cycle consists of 2 treatments, each two weeks apart. So he has a treatment period of Monday to Wednesday (his chemotherapy drugs are delivered over 48 hours--an IV drip consisting of 2 chemotherapy drugs at the clinic which takes about 2 hours, a "push" (larger dose injected through the IV over 5 minutes) of another chemotherapy drug, then 46 hours of the same drug infused through the portable pump). Then the infusion pump is disconnected and his body gets 11 days to recover. He has another 48 hours of chemotherapy drugs, 11 days to rest and the cycle is complete.

So a cycle is, roughly, a month for Kevin. More precisely, 28 days, 4 weeks, 2 chemotherapy treatments.

The cycles are recorded like this:
Cycle 1-1 (first treatment)
Cycle 1-15 (second treatment)

Cycle 2-1 (third treatment)
Cycle 2-15 (fourth treatment)

Cycle 3-1 (fifth treatment)...

A common plan for rectal cancer treatment, after surgery, is

2 cycles of chemotherapy (4 treatments)
1 month of no treatment (recovery)
5 to 8 weeks of daily radiation with continuous chemotherapy (through the infusion pump). "Continuous" can mean 5 days a week on the pump or, literally, 7 days a week on the pump, non-stop for the entire 5 - 8 week period--the oncologist decided which way to go.
The radiation period is given a little vaguely on purpose. There is a total amount of treatment that will be given. That total may have to be given in smaller increments depending on how his body reacts.
1 month of no treatment (recovery)
2 cycles of chemotherapy (another 4 treatments)

Something in the neighborhood of an eight month time span (5 to 6 months of active treatment with 2 months of recovery sandwiched inside), not allowing any periods where treatment is delayed because of illness or reactions.

Cancer has expanded our vocabulary. I'm keeping a growing list of word and definition--a cancer glossary--which I'll post another time.

I like lists. A list is almost as good as a plan.