Saturday, September 26, 2009

I Decided to Decide

I still feel weird writing these. It seems so ego-driven or self-centered to think that others would want to know about my situation, but I guess "it's the thing to do." At least lots of people in my boat do it to keep friends and family posted on progress. For those who do want to read it, I thank you.

I had another monthly blood test a few days ago and it showed my white blood cell count had risen again, this time from 69,000 to 77,000. That compares to 32,000 in May, 68,000 in June, and 69,000 in July. "Normal" would be less than 10.

Even if the blood test had shown an increase of only another 1,000, as it had last time, I knew it was time to take action. The sleep-upright idea had run its course. It wasn't working any more. The lymph nodes are continuing to swell. The green tea extract has undoubtedly slowed the growth of white blood cells somewhat, but not enough. I can see it in the mirror. I hardly recognize myself when I look in the mirror. Some days I can even feel my eye lids and eye sockets closing in around my eyes.

I remembered some advice given by an ROTC instructor at URI in 1966. I was taking as wide range of courses as possible, avoiding the notion of a "major" completely. I was trying to keep as many doors open as possible. Major John Leach said to me: "You have to decide to decide." He was right; I knew it. And I know it now.

So I decided to decide. I have decided to start chemotherapy. Swine flu on the horizon or not.

Probably it will start about October first.

I have three basic choices: Rituxan (a monoclonal antibody) alone; "FCR"--which is a cocktail comprised of Fludarabine, Cyclophosphamide, and Rituxan; and "FCR Lite", which is the same as FCR, but given at a different strength and over a longer period of time to reduce the strain on the kidneys caused by all the medicine-killed white blood cells running through it.

FCR is the strongest and most stressful on the body, but statistically is shown to produce the longest and deepest remission most often. Also, the first treatment administered in one's lifetime is the most important one.

So, I have decided to hit it hardest and try to do it most thoroughly: FCR.

The schedule is three consecutive days of treatment every month for six months . . . if you can stand it.

So, that's the news from Lake Wobegon (d.b.a. Duane Lake).