[4:09pm]
The BMT process has officially started.
Today, I received a dose of Gemcitabine and Vinorelbine (Navelbine). Unlike all the other chemotherapy drugs I will take, these two are the only ones which will be a "normal" dose... I believe Gemcitabine is used for pancreatic cancer, and I have received a comparable dose. Because of this, I expected these drugs to be without side-effects...
I was slightly wrong -- after an hour or so, I got that familiar "delicate stomach" feeling and a headache. The headache may be due to exertion, however -- I can tell that my red counts have been on a slow decline. (A few days ago, I had my counts. I was better than I was pre-transfusion, but still moderately anemic.)
It was nice that the infusions together were under an hour.
Also, I was equipped with a continuous mini-IV pump. Heperin is currently flowing into my catheter at a measly 0.5ml per hour! This is to prevent those pesky blood clots. I have it attached like a fanny pack -- the nurse mentioned holding it like a purse, but what sane male would do that? It's not as bad as I thought; it is pretty portable (only 100ml bag) and maintenance-free.
In fact, the nurse spent quite some time explaining how to control the pump in case of any trouble -- it is very intuitive. She repeated her instructions several times -- I guess some cancer patients are so zonked out that it is necessary. I guess I will be one of them soon enough.
Since today marked the first day of my BMT, many nurses expressed their certainty of a cure or an easy transplant. I found such optimism a little bit disturbing. Firstly, both assertions of certainty are not statistically accurate -- I'd say you need 98% or greater to use the terms "will be" or "certain." Otherwise, I'd recommend "believe," "feel," or "hope."
Secondly, it makes sense that the nurses have a solid grasp of cure rates and problem-free BMTs. This being true, then it seems that the nurses were willfully expressing a false belief of certainty in a positive outcome. I'm sure they believe that I will be cured or do fine, but I doubt their certainty.
So, why were they doing this? Is saying stuff like "you will be fine" the polite thing to do? Will reality be changed by denying uncertainty? OF course not. If anything, I believe that recognizing potential obstacles and challenges will help us deal with the future. I want to be told to expect a "shitty time" and to be reminded that a remission post-BMT is probable, but not certain. I don't want superstition to be a part of my treatment.
Don't get me wrong -- I'm not denying the existence of self-fulfilling prophecies. For example, I believe that going into a test with a positive attitude will yield higher scores. But a positive attitude strengthening the good cells and making the bad cells commit suicide... nah.
Perhaps my lack of faith is a character flaw... but I don't feel that way. I have thought a lot about my spirituality and beliefs through all of this; the prospect of death can do that. Oddly enough, I find my lack of spirituality/faith a source of strength. I am comforted in a grounded and absolute reality, and I find the prospect of nonexistence... peaceful. It certainly didn't bug me before I was born. :P
So, although I may not be certain of the outcome... I am absolutely certain that everything will work out fine in the end. Strange, huh? An absence of faith is a sort of faith in itself.
Anyhow, for good measure, I should probably counter all that philosophy with something superficial... hmm... Oh, I can't have beer anymore! Noooooooooooooooooooooooo... I'm gonna miss that. When I come out of this, I'll probably be a lightweight with my alcohol -- happy with just a six-pack. You betcha!~
Tuesday, October 21, 2008
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6 comments:
Austin
I think your attitude is realistic and I can see how that offers you some comfort.
That said, I hope the treatment is not as harsh as you are expecting. And that cure - well, let's just say that it is most certainly probable. = D
Take care.
Small caveat: they *have* done studies where rats were injected with cancer cells, and the more optimistic ones fared much better than the pessimists. But at any rate, I understand how you want to avoid false reassurances and I'm glad you seem to be philosophically okay with everything ...
I wonder how one would quantify optimism in a rat...
Still, I don't think of myself as being pessimistic... just realistic.
I don't think so either -- just had to make the point re optimism! I think in the experiment it had to do with persevering, so you're covered. :)
So - you want to be told that the BMT is going to be 'shitty'.....it certainly could be, but that is no certainty either. Wullie had a very rough time with it, but I know many who practically sailed through it.
Another way 'realism' works is to expect the worst and then be pleasantly surprised when the 'reality' doesn't live up to the expectations :)
Here's to an uneventful BMT - keep up and about as much as you can - walk as much as you can (EVERYONE who has come out of BMT has said that that helped) - and most importantly, if you are to experience discomfort/pain the don't wait for it to get too bad before screaming for pain meds!! No point in being a hero in this one!!
One thing is for certain - you have an army of people who love and care for you and are willing you through this BMT process.........Vx
Austin, you didn't mention it, but the Gemcitabine is actually part of a clinical study you enrolled in, for treatment of refractory and relapsed Hodgkin's Lymphoma. It isn't a routine part of the Stanford BMT for Hodgkin's.
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