September 14, 2015

Blood Counts and Smokey Skies

Yes, I have been blog absent for much too long. To make up for it, I wrote a long blog. My apologies... For one or the other or both.

I have always associated the end of summer to be the start of September. Our weather is cooling. The days are noticeably shorter. The leaves are already changing colour. Unfortunately, the start of fall here means winter is just around the corner. But I can't complain because I am grateful for a wonderfully eventful summer and with my current treatments, which seem to be working, I was fortunate enough to enjoy that time.  My latest CT scan results from the end of July, after chemo #3 was "good". It was nothing spectacular because the radiologist compared it to the wrong "previous scan". I am either stable or a little better than stable...  Either way, I still consider it good news! Based on how much better I actually feel, I am going to say there's definitely some major shrinkage going on inside of me ;).

I now have 5 chemo treatments under my belt--a decent achievement considering all the scary stuff you hear about chemo. That's not to say I haven't had my challenges. The biggest concern has been my blood counts.  Carboplatin, along with other platinum-based chemo drugs, are known to knock out bone marrow function.  Your bone marrow produces platelets, red blood cells and white blood cells.  With each blood test before my chemo treatments, I saw these counts drop more and more.  After chemo #3, my hemoglobin count was low enough that my oncologist suggested I get a blood transfusion or delay the next treatment, which was not an option since I got into the habit of making travel plans between chemo treatments.  The drop in hemoglobin and, consequently, necessity for a blood transfusion was a surprise to me, I guess because I had adapted to the anemia and thought I felt "normal" although I did look somewhat pale. This was in contrast to my next, more severe episode of anemia just before chemo #6, which has been delayed a week. I'll get to that later. Anyway, with the second occurrence of low hemoglobin, I knew something was wrong. I was really pale, hypotensive, chronically fatigued, easily short of breath and I often felt like fainting... Ok, I actually did collapse once but I didn't pass out. My first blood transfusion after chemo #4, was a neatly arranged 3 hour stay at the hospital. Easy peasy, and came out warm and rosy :).  After I got over the chemo fatigue, I noticed and enjoyed the added bounce to my step! It also helped to improve my appetite :). Thank you to the two people who generously donated their O+ blood so that I wasn't at risk of complications from anemia (eg. heart failure). Unfortunately, borrowed blood doesn't last forever. And my bone marrow was still getting hammered by carboplatin. The "fainting" episode occurred on a Friday evening, which was 5 weeks after my first transfusion. We had to contact the on-call oncologist. By the time I spoke to her, I had regained some strength... as long as I didn't move or do anything. We agreed I should get some bloodwork done over the weekend and she would call with the verdict. A few hours after I got my bloodwork done on Sunday, the on-call oncologist called and told me my hemoglobin was once again "quite low". This time, I needed to go to Emergency for the transfusion. We "strategically" planned the trip to the ER in hopes of shortening our wait and stay; we had supper and packed snacks so we didn't need to worry about food and we waited until the posted online wait time was not ridiculous. Unfortunately, our hospital of choice was short on beds:(. We spent 10 hours, from admitting to more lab work to two bags of transfusion (thanks again very kind blood donors!!) to discharge, with a lot of waiting in between, at the hospital. We were discharged at 430am on Labour Day. Needless to say, despite the much needed hemoglobin boost I received, S and I needed a few days to recover from sleep deprivation.  We discovered later that, even though my hemoglobin recovered nicely, my platelets were also severely compromised when we reviewed the blood tests with the oncologist, who was subbing in for Dr. B while he attended the World Conference on Lung Cancer. We all agreed that a week's break would do me some good. So here I am, feeling a ton better after a great weekend of cycling and an easy hike in the Rockies, waiting for my last combo treatment with carboplatin. 

Dear Carboplatin, 
Thanks for helping me feel better by hopefully annihilating lots of cancer cells. I really appreciate it :). However, I don't appreciate what you are doing to my bone marrow. Sorry to tell you that I can't wait to be rid of you... Hopefully for a very long time. 


P.S. Please try to be nicer to me if we do meet again. Thanks. 

Regardless of the chemo challenges, I have learned to savour the good times between treatments.  Anemia issues aside, I usually have two weeks of no debilitating side effects, of normal taste buds, of being free to do what I please :). 

So after chemo #3, we took a road trip through British Columbia, stopping in Fintry (near Kelowna) and Vancouver.  The guesthouse we stayed at in Fintry was exactly what we needed! It was secluded, comfortable, quiet and so peaceful... Despite the real threat of evacuation because of a forest fire down the road! 
Note water bomber in the upper left, in contrast to elderly couple in the lower right of photo happily biking by despite the proximity of the forest fire.

Even though we lost power and then water, we still enjoyed our stay... Thanks to the facilities at the provincial park next door and the bicycles that came with our accommodation! We "glamped" under smokey skies for two days. It was then onto Vancouver! We always love being back in Vancouver: the ocean, the mountains, the plentiful organic and vegan friendly options. Unfortunately, We were only there for two days also :( -not much time to visit and eat!  Vancouver was unusually hot and dry, at a level 3 water restriction when we arrived. What's with the brown grass?? (Un)Fortunately, it downpoured the day we left but, because this was Zoey's first trip to the west coast, we insisted on taking her out for a walk along the sea wall in Stanley Park before leaving.

A wet but lovely stroll along the sea wall at Stanley Park.

I don't think Zoey cared much for the sea wall. She didn't look pleased that we dragged her out there when it was raining cats and dogs.  

Wet Zoey... but why does her tail still look fluffy and dry?

After getting over the funk of chemo #4, and blood transfusion, we, with Zoey again, flew to Manitoba to visit our great family-like friends in Steinbach. This was a much needed clean eating (mostly), and restful vacation. We napped. We strolled. We ate from organic gardens. We watched Zoey get spoiled :). We also got eaten by mosquitoes... But I can overlook that ;). Much love and gratitude to CT and her family for taking such good care of us! 

Back at home, with no trips planned after chemo #5, we had to deal with the effects of yet another "nearby" forest fire. Due to the raging fires in NW USA, our southern Alberta skies were engulfed in dense smoke. Our air quality rivaled that of Beijing! Just stepping out for a few minutes affected my breathing and irritated my throat. Everyone, regardless of health, was advised to stay indoors. This lasted about a week. I had to stay indoors during that time except for appointments and such, which was fine since I was still quite tired after chemo. After the smoke cleared, we have been doing our best to savour what is left of summer!  And, take it from me, summer is much more enjoyable with clear skies, fresh air and normal hemoglobin levels :).