XVII: A Gasp of Air
Chemo brain has sapped me of my typical loquaciousness so I’ll keep this brief. Yesterday I completed the final dose of conditioning chemotherapy — a drug named Melphalan — which required me to keep ice in my mouth over approximately 4 hours to decrease the risk of painful mouth ulcers it’s notorious for.
The six days of chemo weren’t fun. I dealt with evening nausea and vomiting on days 3 and 4 of chemotherapy and felt pretty crummy overall during that stretch.
However, after I finished the infusion yesterday afternoon I felt a burst of the vitality I’d been lacking over chemo infusions. I walked about 2.5 miles total in the U shaped hallway of the stem cell transplant unit and had much more energy for conversation than the preceding days.
It’s hard to say how much of this rebound from crumminess is related to a systemic respite from cytotoxic therapy versus just clearing the psychological hurdle of chemo being done. Probably a bit of both.
Unfortunately things will likely once again get worse before my path is clear to recovery. I get my stem cells reinfused tomorrow. The following 7–10 days will see my blood counts plummet, likely requiring at least a few red blood cell and platelet transfusions. I will be at the highest risk for infection in this window as my circulating white blood cells diminish and the stem cells take their time to engraft into my bone marrow (basically restarting the factory).
Hopefully my ice chewing persistence spares me of mouth sores, but my gastrointestinal tract will take a beating from the chemo as well (chemo basically effects cells that turn over most frequently — which means it blasts rapidly dividing cancer cells but also hits the constantly replenishing lining of your gut hard). Or to put it in the words of Tormund Giantsbane…
All said, I’m hopefully two weeks or less from discharge assuming all goes well. The care team here at UVA has been spectacular, from the attending physicians to the nursing assistants. Most patients are lucky to have one caregiver with medical literacy and attention to detail. I have three — Brooke, my mom, and my dad.
I want to take a moment to thank everyone who has reached out over the past week whether via call, card, text, e-card, Facebook or Twitter. In the fog of chemo I haven’t been able to individually acknowledge everyone who has, but know that I am overwhelmed by the outpouring of support.
Next up: day zero.
