Marshall's Cancer Updates

  Italian beef by Corrine It's been a week and a half since my second chemo-immunotherapy session and I have to say that this time has been much easier. The oncologist reduced the chemotherapy drugs (carboplatin and paclitaxel) by 20%, as well as one of the immunotherapy drugs (atezolizumab). The other immunotherapy drug, bevacizumab, he eliminated completely. The entire session ended up being a couple hours shorter than the first session. This time, I remembered to smear lidocain on my port and cover it with cling wrap, which made the poke much more tolerable. I passed the 8 hours or so doom scrolling. Crazy stuff in the news. John came in Monday evening after chemo, and then left late to drive a 3 hour round trip errand to pick up Greg at the Amtrak station in Grand Rapids at midnight. They chattered the whole way back and drove 30 miles an hour down the last stretch of HWY 10 dodging deer that were poised on the edge of the rode. Corrine was able to fly back to Chicago and drive...

Cashmere beanie by Cornelia. It's the only thing I can stand to have on my head. I'm feeling better today.  When I reported my side effects to my oncologist on Monday, he sent me to the infusion center on Tuesday for an IV infusion for hydration, and they sent me on to the ER for a CT scan to check for blood clots. Six hours later, I was discharged after they found no evidence of clots in my lungs. My BP was 100/50, which is a sign of dehydration. There was some disagreement between the ER staff and my oncologist over the interpretation of the CT scan. The ER staff consulted with an on call oncologist in Grand Rapids who suggested that there was evidence of disease progression:  Irregular spiculated mass within the right lower lobe is again noted. The dominant aspect measures approximately 42 x 28 x 32 mm, probably not significantly changed, however, there is progressive consolidative and/or soft tissue opacity seen extending inferiorly and laterally, possibly reflecting super...

It's been 2 weeks since my first chemo-immuno therapy session. There's just no way to prepare anyone for how awful this is. I have a lot of respect for others who've gone through this, and their caretakers who've borne witness and held space with them. It's a lot just to manage the medication and linens and bedclothes and meals and water and watching the pounds melt away. I've now dropped about 30 pounds, 10 pounds in the last 2 weeks. Generally, the first week, once the steroids wore off, I was sleeping 20 hours a day, nauseous, and fell a couple times from dizziness. This lasted through Monday of last week.  In the early part of last week, the side effects from the infusion seemed to taper off, but then they came back in a wave on Thursday after a PT session to work my arm.  I seemed to backslide with the fatigue and joint discomfort. By Friday, I had a pretty severe rash on both elbows, and light rashes on my knees, chest, and back, as well as some radiation ...

Monday (5/23) was my first day in the infusion bay. It was a long one -- 8:30 am to 6:30 pm with about 9 or so different medications combinations through the port in my chest.  Ouch-cha-cha! I'll remember the  lidocaine-prilocain cream on that port prep next time. The meds were a mixture of pain meds, anti-anxiety meds, Benadryl-type meds, steroids, anti-nausea meds, chemo meds, and immune meds. They kept me sedate and somewhat sleepy with no other adverse effects. I had brought my computer and some bills to process and other light plans, but never got to any of it. I'm not quite sure what i did for 10 hours. Corrine drove me to the infusion center and sat with me for a few hours until Laura and her husband Doug arrived.    BRIEF UPDATE (Friday a.m.): I felt great at first (from the steroids, I'm told), but the toxins from the chemo kicked in by Wednesday night and the past two days have been incredibly rough. I'll have to come back later to fill in the gaps. For now...

  The pain isn't nearly as bad now that we've found the right dosage of dilaudid and added on the fentanyl patch, in addition to a decrease in pain from the humerus starting to heal. I've had 4 days back-to-back of radiation on the humerus. It felt like each day was a quicker and easier treatment, but the med techs told me that there were no changes to the duration or intensity, I was just adjusting to them. However, I have been totally wiped out physically, sleeping late in the morning (until time for the treatment) and then returning home to sleep more in the afternoon and evening and then again through the night (with a little help from the dilaudid, fentanyl, Ativan, edibles, and cpap.) I feel like I've spent most of this week sleeping, but this weekend I've started perking up a bit. The pain in my shoulder has lessened a lot and I'm starting to taper off the dilaudid.  Thanks to neighbor Tim for driving me to treatment on Tuesday and an opportunity to wande...

Mom and Pris, August 2022, Old City Cemetery, Monroe, LA Happy Mother's Day. I'm fortunate to still have my mother in my life, though I know right now that she and the rest of my family are very concerned about my health.  This past week has been much better by far than the few weeks prior. The Dilaudid (2 pills every 4 hours) was doing a bit better than the Oxy, but I was still in quite a bit of pain and having trouble sleeping, moving from the bed to an arm chair to the couch. I met with Tim, the Palliative Care Coordinator, on Monday.  Tim appears to be about my age, a nurse with a great deal of experience in palliative care, with a grey chin puff and a Pride button on his lapel. That was reassuring to me that we would be getting care from someone a bit openminded and on the same wavelength. As a number of people have said, it's important to have a good match. If you ever wonder whether or not these signs or signals can put patients at ease, I can attest that they do. Pa...

Moon rise over Emerson Lake (5/5/2023) Reader caveat: Keep in mind that this information is filtered through a narcotic haze and may not be entirely accurate. Or discrete.  It's been a rough week, and I'm wiped from the radiation. I had three sessions targeting the mass in my lower right lobe, with surgery on Monday, and radiation on Tuesday, Wednesday, and Friday. And then a fairly humiliating bout with constipation on Friday morning. Thanks to Corrine for the fleet enema, if that's not too much information.  And on top of all of that, I've had severe struggles with depression and anxiety that have grown worse since surgery. There is a heavy mantle of guilt over causing grief and hardship to others, mixed with a sense of hopelessness and despondency, and some regret over a shortened career. I hope to return to teaching in the fall, but feel a need to explore early retirement options, possibly phasing in next summer. I am fortunate and grateful to have those options, as...