Bloat
Cancer class was good. Pretty sure I passed. I've got a fairly straightforward treatment plan: pre-medication with lupron (for fertility preservation) and steroids (to help tolerate the infusion), blood work and height/weight checks to make sure I'm physically fit before each appointment, three hours in the chair for the CT regimen itself (plus pre-cooling for 45 minutes and post-cooling for 1.5 hours for hair preservation), then five days of post-infusion injections to help rebuild the immune system and anti-nausea meds as needed, every three weeks for four sessions total. My most likely side effects are inflammation and joint pain, plus the typical digestive upsets and weakened immune system, and of course hair loss.
The nurse had a lot to say about potential effects of chemotherapy on the gut, particularly how seriously to take any amount of irregularity.
"If you get constipated, your bowels could get obstructed and then rupture and you could die." This followed by a long, severe stare around the room.
We are supposed to make extremely liberal use of the emergency department. If you get a fever of more than 100.4 degrees for an hour? Go to the ER. If you don't poop for three days? Go to the ER. If you have shortness of breath or stub your toe* or think you might have pinkeye**, ER, ER, ER. They apparently don't have a proper urgent care system so they just give cancer patients a free ticket to emergency services for whatever concern.
One of the most interesting things I learned in cancer class: chemotherapy makes you toxic. To other people. You have to detox for ~72 hours before you, ahem, share bodily fluids. For some patients who get a pump installed, there's a whole protocol for managing your sweat and urine and so forth -- in my case, there's not too much to think about, but it's certainly interesting to feel sudden sympathies with poison dart frogs. Just say no to cannibalism during chemo; no one wins in that scenario.
I have a gap week between IVF and starting infusions, so I'll be taking the time to get a COVID booster and stocking up on various over-the-counters, prunes, ginger ale and crackers. And doing arm exercises to try to encourage my veins to pop out more, hello pushups my old friend.
The cold cap fitting appointment provided a chance to meet all the nurses and get a tour of the infusion center, which has very nice feng shui and is well decorated with things like strings of origami cranes. Everyone was very friendly and welcoming and we talked about microbiomes for a bit.
In other news:
Hallelujah, egg harvesting is almost complete. Today was the 29th and final shot of the series, and the surgery is tomorrow morning at 8am. I am so very glad to be done with self-administered injections for the moment. There is something about the inevitability of having a nurse sticking needles in you that makes it easier to tolerate -- you don't really get much say in the matter, you're just taking their instructions and relying on their expertise, which is an exercise mainly in stoicism. Whereas self-administered pokes, even if you're a coward who has to have your husband do the actual injection, are anxiety-inducing because ultimately you're the one (ahem) "calling the shots." Luke has got fine needle skills by this point -- it's not his performance I'm bothered by -- it's just the whole thing is very unpleasant.
I did develop some coping strategies, particularly for the more painful shots, mainly involving singing myself a distraction song. Unfortunately I can't usually actually remember any songs in the moment, so Luke has been treated to such spontaneous compositions as:
Song, song, I'm singing a song / sing sing song song / is it over yet / o thank god
and
I'm a lumberjack / bananas, coconuts and grapes / fuck fuck fuck / aaaah
...
I am particularly bloated at the moment, which is not surprising when you do the math from yesterday's ultrasound results. The IVF "trigger" condition is to have the largest follicles measure at least 18mm. I have several in the 18-21mm range on each side, plus a bunch more in the 12-17mm range -- the doc didn't do an exact count, but he told me I have something like 15 to 20 harvestable follicles on each side. So basically my ovaries are like goose eggs right now. Riding a bike over some bumps to get to my last blood draw appointment this morning... well, I spend a lot of the ride standing up. I have to pee about every half hour because there just isn't the usual amount of room in there. I will be glad when they suction it all out tomorrow, though I guess it'll take another week to subside. And I'm still at risk of ovarian hyperstimulation syndrom for the following week, for which my doctor has prescribed lots of fluid with electrolytes, and 60g of extra protein every day.
If you're not familiar with normal protein intake, that's basically three extra protein shakes on top of regular meals. I would not normally go for the supps but I'm not sure how else to do it. So yeah, bloated.
*and develop spontaneous bruising or bleeding that doesn't stop in 10 minutes -- you may be short on platelets
**or any signs of infection, look, this letter isn't intended for actual medical information, I reserve the right to sprinkle the text with a light seasoning of satire for my own entertainment