September 9, 2011

Each day I learn a bit more.  Apparently what awaits me during chemo depends upon me being heart healthy. Thus, today was ECG day. The ECG tech was positive: a little normal leakage around the three major valves he looked at. He said he had to look pretty hard to discover it in each case. This probably means that chemo will proceed with R-CHOP and Velcade (more below). I thank my numerous friends who wanted to play handball, tennis, cross-country ski and hike and my wife who is provoking me to walk every morning.

As I was leaving Cardiology and heading back through Imaging to my car I came across JMcR, one of my jam group buddies. Ah, small town living. Nothing is secret. He was gowned and being wheeled for tests. Not good to see. McR is a former Boston policeman with many miles on his legs. He has rediscovered his childhood love for playing the clarinet and for singing. He has a marvelous tenor voice--almost sweet. He presented with pneumonia (informed the jam group via email) but in looking for causes today he mentioned hepatitis. We were in an area in which construction was occurring so it was hard for us to communicate, but I was struck by the fact that he was muddled and couldn't find the words for what was wrong with him. Perhaps he was confused because we were outside all of our normal contexts. We have seen some of this during our jams, but the wine flows and it is easy to toss this off since we are all of an age in this group. I really hope he comes out of this well. He seems to have had continuing problems this past year and I worry about him. 

Last night was pretty successful. As is usually the case we all work out what little things we are missing in the show as we go along, so that the band sounded good. Conductor mistakes were limited as were cast errors. (The prior evening one singer--forgetting the late insertion of a repeat--came into her song 8 bars too early!) And the band finally is appropriately mixed and fed back to. We can actually hear our colleagues who are way across the stage from us. The sheer length of the show (90 minutes) restricts the amount of dance music we have to do. So I managed to get through it all even getting off a couple rides, one on Corner Pocket and the other on Tuxedo Junction. Fun time. But the exertion is such that I am light-headed when I get home from the adrenalin. Cooling it out today to get through tonight.


Okay time for nuts and bolts:
1. R-CHOP or CHOP-R is a common chemotherapy for B-cell lymphomas. It consists of:
R = Rituximab = an antibody against a specific protein found on the surface of B cells. It destroys both normal and malignant B cells; C = Cyclophosamide = a DNA altering agent; H = Hydroxydaunorubicin = also a DNA alterer; O = Oncovin which prevents cells from duplicating; P = Prednisone = a pretty commonly used steroid.
2. Velcade = Bortezomib = a proteasome inhibitor (?)


I am to get this stuff on a 21-day cycle called CHOP-21:
Day 1 = R-CHOP + Velcade
Day 4 = Velcade
Day 21 = get ready to do it again tomorrow


There are to be 6 cycles of this 21-day regimen, which, if it all starts at the beginning of October, means involvement until mid-January 2012. There goes my neighborhood! I read that usually another CAT scan is run after 3 cycles to determine progress. Immediately I want to know if AbJ does this, and if there are no further clinical signs the remainder of the treatment is aborted. Wouldn't that be nice? I won't count on it. However this is likely to screw up the future in the following ways: Will I be able to make all the Jazz Kicks rehearsals in the fall plus the Dec concert? Will I be able to help my wife and daughter as the latter gets surgery in late Nov? And will we be able to get out of Dodge to Phoenix for some weeks in the winter? I guess it will be per usual: one day at a time.