I tested positive...got hit by the symptoms...taking an investigative drug to shorten my stay with COVID-19 and keep me from getting serious symptoms. Recovering. Tired. This is about all I can write.
See you next week.
Showing posts with label Random Thoughts. Show all posts
Showing posts with label Random Thoughts. Show all posts
Sunday, March 6, 2022
Sunday, August 1, 2021
Saturday, May 4, 2019
ENCORE #108! – Neulasta – What’s It DO???? (Plus some new thoughts…)
Though I talked
very briefly some time ago about what the various chemotherapy drugs that my
wife was treated with were “for”, I never really went into any kind of detail.
Now that chemo is
“over”, I wanted to explore what some of the long-term and lasting effects of
the treatment are. Because she reached that time – what with the odd numbing of
her upper lip, the incision pains, swollen ankles and dry skin, I’d like to
know which of those things is chemo-derived and which ones are not.
So we’ll g0 here
next:
What’s “neulasta”
and what does it do?
Chemically,
“neulasta” is N-(3-hydroxypropyl)methionyl, 1-ether-alpha-methyl-omega-hydroxypoly(oxyethylene).
Complex. Lots of chemicals.
But what’s it DO?
“Neulasta”, is a
special protein that’s based on sugar (an oligo-saccharide, meaning that the
molecule has only a few small units, in this case a sugar ) that’s attached to
a protein to form a glycoprotein.
The glycoprotein
is a very important part of a cell wall – the cells that are being targeted are
white blood cells. The white blood cells are also called neutrophils,
granulocytes and stem cells and are the main part of the blood that destroys
microscopic body invaders like bacterial infections, viruses or other germs.
The glycoproteins help the white blood cells recognize the germs.
Neulasta makes the
marrow in bones produce more white blood cells to replace the ones killed by
Cytoxan, Adriamycin and Taxotere (which I talked about esrlier) while they are
busy killing cancer cells that are growing out of control.
The “colony” in
the “colony stimulating factor” is the white blood cells in the bone marrow.
So – “neulasta” is
injected just under the skin and gets into the bloodstream. It goes along until
it reaches the bone marrow where it forces (also known as “stimulating”) the
growth of new white blood cells to take the place of the older ones killed off
by the chemicals in chemotherapy.
Side-effects?
Sure. Any one of us who’s seen the Red Devil injected in his wife, mother or
girlfriend knows what I’m talkin’ about here. With stuff like THAT going into a
human body, to expect NO side-effects would be the crazy thing! There are
“minor effects” – did any of the
researchers experience any of these symptoms? If they had, would they have
called the effects “minor”? – of the injection, things like
hives; difficulty breathing; swelling (face, lips, tongue, or throat)
as well as bone pain; pain in your arms or legs; or bruising, swelling,
pain, redness, or a hard lump where the injection was given.
More serious
side-effects (though according to the test trials, these rarely happened:
sudden or severe pain in your left upper stomach spreading up to your shoulder;
severe dizziness, skin rash, or flushing; rapid breathing or
feeling short of breath; signs of infection such as fever,
chills, sore throat, flu symptoms, easy bruising or bleeding (nosebleeds,
bleeding gums), loss of appetite, nausea and vomiting, mouth sores, or unusual
weakness.
My wife didn’t
seem to experience any of the side-effects. In fact, though we expected WORSE,
the chemotherapy (while horrible in its own right) only threw us a few curves.
Because of the neulasta injections, she didn’t seem to catch any sort of germ
at all and stayed (on the chemotherapy scale of things in our “new normal”
world) pretty healthy.
------------------------------------------------------------
There are other
thoughts I’ve had about the use of neulasta (pegfilgrastim) and I might look at
those soon. As for the use of the drug in conjunction with chemotherapy, as
with all things produced by the “Big Pharma” industry, the price of an
injection of neulasta while remaining roughly the same at roughly $6000, has
stimulated (pardon the pun) some competition from a new product, Udenyca. It’s
on the market currently and costs less as long as you use a “coupon” (can you “clip
coupons” for your cancer treatment now?) reducing the cost of an injection to
$4000…from a starting point of $20,651…)
Hmmm…
For further
thought: https://www.sciencedirect.com/topics/neuroscience/pegfilgrastim
Saturday, April 4, 2015
Easter Saturday Reflections Four Years Since I Started This
From the first moment my wife discovered
she had breast cancer, there was a deafening silence from the men I know. Even
ones whose wives, mothers or girlfriends had breast cancer seemed to have
received a gag order from some Central Cancer Command and did little more than
mumble about the experience. Not one to shut up for any known reason, I started
this blog…
Two hundred and
four posts, two hundred and eight weeks.
Good Friday was
last night.
Why do they call
it good? Strangely enough, the best explanation I have ever heard or seen
popped up on Friday on my niece’s Face Book post in the form of a comic strip
drawn by legendary artist, Johnny Hart, creator of the strip “B.C.” and
co-creator of the strip, “The Wizard of Id”:
This is the only
reason such a day, such a celebration could be called “good”.
Four years ago,
my daughter and I were talking about Good Friday on the way to the service and
back. She observed that this the only specifically Christian Holy Day that the
secular world has been unable to coopt. We decided that there’s no way that
such an event could be made cute or represented by cuddly animals, people in
costumes or from which candy companies might not spin adorable commercials or
bunnies laying chocolate eggs. Any attempt to “cute-i-fy” Good Friday is doomed
to failure by the nature of the day.
It’s grim.
Gruesome. Dark. It’s all about torture and execution.
Outsiders –
those who don’t know of, believe or otherwise acknowledge Christianity – find
it offensive and inexplicable; perhaps even insane. “Why would you possible
want to remember the horrific execution of your rabbi and teacher?”
Last night I was
reminded again that the events leading up to the execution of the Christ are
NOT about the failure of God to accomplish His mission on Earth. The
crucifixion was NOT a backup plan and a bad one at that.
The events prior
to Good Friday were an exhibit of
everything that is rotten in Humanity and a display of ample proportions of
exactly why it needed forgiveness and saving.
The infant Jesus
was born a slave to an empire both global and cruel. His birth sparked the
slaughter of hundreds of other innocent newborns by decree. His life exposed
the tedious, unremarkableness of thirty years of growing old in an ancient
world and the loss of his father during adolescence; his three years of
ministry exposed him to corrupt government, avarice and greed, ridicule by the
intelligentsia, betrayal and abandonment by friends, public adulation turned
mockery, lies, a corrupted justice system that did not represent slaves,
gambling and drug abuse.
What does this
have to do with my wife’s breast cancer? Last night, I was shamed by His
suffering because I have for some time now begged and challenged Him to
explain, “Why have you made me suffer so?”
He hadn’t
answered my plea until that night four years ago when He said, “I can’t explain
that, Guy. But I can say that I have been with you in that suffering because I
understand suffering. I understand despair. I get you. That’s why I haven’t
cast a lightning bolt in your direction for your impertinence. I understand, as
few others can, your suffering, and I’ll stand by you and answer what questions
I can. Look at your blog – lots of answers there. Not ‘the answer’, that won’t
come until we can talk face-to-face; but you got a lot of them. See you later,
bud.”
I know this
isn’t about breast cancer exactly; I suppose I pulled a Johnny Hart on you all.
Be that as it may, my prayer is that you might find some answers to your
suffering. If you can’t find answers, then I’d be happy to talk with you. Just
leave me a comment and I’ll reply…
Saturday, March 1, 2014
Round Six: Random Thoughts On Breast Cancer, Reconstructive Surgery, Lymphedema, Pain, Work, Suffering, and Joy
From the first moment my wife discovered
she had breast cancer, there was a deafening silence from the men I know. Even
ones whose wives, mothers or girlfriends had breast cancer seemed to have
received a gag order from some Central Cancer Command and did little more than
mumble about the experience. Not one to shut up for any known reason, I started
this blog…
My wife got sick
this week.
REALLY sick! I
won’t go into the nasty details, but I will note a comment she made: “I haven’t
been this sick since before chemo started!”
That got me to
thinking. I know I’ve commented on this before here: http://breastcancerreaper.blogspot.com/2012/12/chemo-killed-coldsand-other-weird.html
That was a year
and a half ago, so I decided to see if anything has changed in the intervening
months.
It turns out
that chemo itself may boost the immune system: “…new research published online
on April 4 in the Cell Press journal Immunity shows that effective
chemotherapies actually work by mobilizing the body's own immune cells to fight
cancer.”
When the chemo –
targeted for particular kinds of cancer cells – smashes the cancer, the destroyed
cells break up and the bits and pieces of a protein called ATP (adenosine
tri-phosphate) start to float through the bloodstream. When the body’s cells
pick it up, they mobilize and start to create anti-bodies against that
particular kind of ATP. That kind of ATP is only found in the cancer cells, so
the body itself begins to fight back!
Neulasta, which
stimulates the growth of white blood cells in bone marrow, “super-charges” the
body and pretty soon, you have a mobile force attacking the cancer cells.
While the Center
for Disease Control in Atlanta strongly urges post-cancer folks to get the
vaccine against seasonal influenza because of weakened immune systems, they don’t
really give any hints at the subject of my curiosity…
So – the question
remains: does the LOSS of chemotherapy expose a patient to infection by more “usual”
illnesses? I still can’t find any research to support my thoughts, and while it
seems logical that this would be true, it remains to become the research topic
of some clinic somewhere. I’ll keep you all posted.
Resource:
http://www.sciencedaily.com/releases/2013/04/130404122048.htm,
http://www.cell.com/immunity/retrieve/pii/S1074761313001386
Image: http://i1.ytimg.com/vi/rAxNwvR-1f4/hqdefault.jpg
Saturday, January 18, 2014
Round Five: Random Thoughts On Breast Cancer, Reconstructive Surgery, Lymphedema, Pain, Work, Suffering, and Joy
From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…
As strange as it may seem, this blog entry is about me.
Me and skin cancer.
As of two hours ago, me and skin cancer suddenly have become intimate partners. At least skin cancer and my forehead, eyebrow, and cheek.
Yep: I have skin cancer.
Nope, I don’t have to have anything but a few layers of skin removed in three places. I sent FaceBook message to my family today that read:
“So then – I'll be going in for the removal of 3 squamous cell carcinomas on my face. Dr. said we caught them early, they'll do the Mohs Micrographic Surgery (http://www.skincancer.org/skin-cancer-information/squamous-cell-carcinoma/scc-treatment-options). Truth to tell, I'm not overly worried. Dr. doesn't seem worried. The treatment doesn't have to be done fast, so I can make an appointment this summer and get it done at my leisure...Just thought I'd let you all know! Tell anyone else who needs to know -- no secret, no hassle. Simple surgery. The site below explains it to those who DON'T know about this kind of thing!”
The truth here is that I CANNOT be worried. I don’t have to have both of my breasts removed.
I don’t have to go through 16 weeks of chemotherapy.
I will not be losing my hair.
I will not have a port put in.
The doctor’s going to cut teeny, tiny chunks out of my face with the instrument above called a curette. It looks horrible, but it’s TINY (actual size relative to Human hand: http://www.adeptmedical.co.nz/images/products/NZ3431%20in%20hand.jpg). They’ll look at the chunks under the microscope until they aren’t cutting out any more cancer cells, then put on some bacitracin and let the hole heal up; then that’s it.
Nowhere in the description of the treatment is there a warning about taking something to prevent vomiting my guts out.
If I sound disparaging, please realize that I KNOW skin cancer can be serious. Googling skin melanoma images shows an uncountable number of awful pictures that clearly illustrate the seriousness of the disease.
However, in the scheme of things:
“About 39,620 women in the U.S. were expected to die in 2013 from breast cancer…(“In 2013, there were more than 2.8 million women with a history of breast cancer in the U.S. This includes women currently being treated and women who have finished treatment.”)” (http://www.breastcancer.org/symptoms/understand_bc/statistics)
“…out...of…317,500…squamous cell carcinoma patients – some 6500 people (or 2%) – died from the disease in the US in 2012.” (http://www.skincancer.org/skin-cancer-information/skin-cancer-facts)
This cancer is treatable. Using the Mohs procedure, the treatment success rate is 94-99% for what is on my face. I will not only survive, in a short period of time, the cancer scars will disappear and in a few years, I probably won’t even think about it.
That will not be the case with my wife and any number of other women (and a few men) who suffer the ravages of breast cancer. They will always remember. We will always remember them.
I will always stand by my wife.
We will always stand by those who suffer from breast cancer.
Image: http://skincancer909.com/wp-content/gallery/gallery-1/surgical-instruments-small.jpg
Saturday, December 21, 2013
Round Four: Random Thoughts On Breast Cancer, Reconstructive Surgery, Lymphedema, Pain, Work, Suffering, and Joy
Random, huh?
Whew! Talk about
random! Why would thoughts of death intrude on this holy time of year when we
celebrate Santa Claus, children, “Ho, ho, ho!”, RUDOLPH THE RED-NOSED REINDEER…
Oh, and the
Birth of the Christ Child.
I think about
how Target and Walmart and Kay Jewelers and Marshall’s have coopted the season.
And Christians fight back with pictures of Santa kneeling at the Manger.
My wife and
daughter and I watched one of our season’s favorites the other night, Joyeux Noël (a 2005 French film about
the World War I Christmas truce of December 1914, depicted through the eyes of
French, Scottish and German soldiers…written and directed by Christian Carion…screened
out of competition at the 2005 Cannes Film Festival…nominated for Best Foreign
Language Film at the 78th Academy Awards. The film was one of Ian Richardson's
last appearances before his death on 9 February 2007.)
The one
Christian Holy Day Wall Street has never been able to coopt is Easter, because
Easter is secularly speaking, about a gruesome, governmental execution. For
Christians it’s about sacrifice and Resurrection – much like the film, Joyeux Noël.
Much like life
in the shadow of death that breast cancer brings everyone who experiences it,
loves someone who experiences it, works with those who experience it.
This holiday
season is somewhat sober for me for many reasons. Yet somehow that has created
in me a deeper appreciation for the joy of this same season – a profound
thankfulness for many, many things. This thankfulness isn’t like the Christmas
play in MERRY CHRISTMAS, CHARLIE BROWN! Rather it’s like the thankfulness of
Linus’ recitation of Luke 2: 1-14 – calm, peaceful, fully aware of what he is
saying.
May your Holy
Day Season be the same.
Monday, November 18, 2013
Round Three: Random Thoughts On Breast Cancer, Reconstructive Surgery, Lymphedema, Pain, Work, Suffering, and Joy
Of course,
cancer itself if never far away. The child of a colleague of mine was recently diagnosed
with leukemia…and now from afar, I can see the horror and terror of the impending
campaign against cancer all over again.
Yet, I have
found progress and some amount of joy recently. Talking to an old friend of
mine, we were catching up on the recent experiences of our wives, both of whom
were diagnosed with breast cancer – my wife’s journey I’ve written about here. He is a more private man and aside
from telling his group of online friends about the diagnosis and some of the
steps of the treatment, he really didn’t say much.
Until my wife
was diagnosed as well. That commonality of dismay drew us together after years
and while I don’t often see him, I feel a deep and abiding connection with him
and know that our lives intertwined in a startling and unexpected way.
So I discovered
that other things can now distract me. I’ve grown roots that I’d never needed
before, and discovered a new strength I never knew I had. That I never knew was
possible – it was a forged kind of strength. You know the kind if you’ve seen
the LORD OF THE RINGS movies. It was the kind of strength that came from the
reforging of something that was broken – Narsil – and then remade into a
stronger, sleeker, more powerful weapon, the new sword, Andúril.
It accomplished
great things once, that is, it stopped the dark lord, Sauron and nearly
destroyed him. It was remade to accomplish greater things still and when Sauron
once again attempted to take over Middle Earth, Andúril not only assured his
defeat, it ushered in a New Age.
It appears to me
that the New Age has not arrived. The health of my parents is deteriorating and
my son left for 5 years of service in the Army.
It appears that
while I may have been reforged in the fires of my wife’s struggle through
breast cancer, I will be tempered by new fires – and perhaps pass through to be
part of greater things.
Just in case you
were wondering – this is called ramblings for a reason…
Saturday, September 28, 2013
Round Two: Random Thoughts On Breast Cancer, Reconstructive Surgery, Lymphedema, Pain, Work, Suffering, and Joy
Daughter noticed
first and commented that my wife’s chest looked…wrong somehow. This was after
my wife had called to make an appointment for another fill even though the
lymphedema around the left boob was still there. Not as bad as at first, but
not completely under control. This time around also included FB exchange with
my sister – who works at a clinic where lymphedema is CURED.
Apparently there’s
no such thing up here in the city we live in. Lymphedema is just something you “live
with”. So why can they cure it in a city that is world-renowned for its medical
establishment but not here, the home of a premier research university? Is it
sheer hubris of the doctors here that they can’t cure it and tell their
patients they have to suffer? Is it mindless greed, an attempt by the medical
establishment to milk a cash cow until it’s dry (a particularly apropos image
in this case)? What? My wife has discussed moving her clinic to that city some
150 miles away if that’s what it takes to get treatment!
At any rate, our
discovery of the whole process of the placing and filling the expanders has
been piecemeal at best, so I thought I’d present what we NOW know, several
months later…
The expanders
are tough plastic devices – I can’t say “bags” any more – because they are
nowhere NEAR that simple! Checking around, I wasn’t able to find any
cross-sections showing HOW the thing is built, but I did find this description
on the GOOGLE patent page:
Self-sealing tissue expander and method/US 5066303 A/Abstract
“The
self-sealing tissue expander includes inner and outer layers of relatively
nonflowable material and a median layer of flowable material, The median layer
of flowable material which can include one or more sublayers of flowable
material is under a predetermined compression imposed by the inner and outer
layers due to a prestressing of the tissue expander shell during formation of
the tissue expander. The self-sealing shell seals an opening in the shell wall
following removal of an infusion needle. In all embodiments of the invention a
needle stop member is provided to prevent the needle that accesses the fluid
chamber from passing outwardly of the tissue expander. The need for a septum, a
fluid conduit or a special fluid entry opening in the tissue expander shell is
thus optional. The shell can also be made relatively more stretchable in some
areas than in other areas.”
It was accompanied by this diagram:
This made a bit
more sense – if you count the dashed lines as layer of the expander. It would
also explain how the doctor said she would just fill another chamber of the
expander.
At any rate,
that’s what we learned today. Hope it’s helpful!
Saturday, August 24, 2013
Random Thoughts On Breast Cancer, Reconstructive Surgery, Lymphedema, Pain, Work, Suffering, and Joy
So today I’m
headed for the Great Minnesota Get Together! While I have not attended the
State Fair for seventy-five years (http://www.startribune.com/lifestyle/220067891.html),
I’ve gone to the Fair since I was about 13 and only missed a few in there
because I was out of the country. My family makes SURE I get there at least
once – no matter how tight the budget.
I also turned to
this Bible verse recently (yes, I am a religious person, Christian by choice, and
have been all through this breast cancer change in life):
“I will extol
You, O Lord, for You have lifted me up,
And have not let my enemies rejoice over me.
2 O Lord my God,
I cried to You for help, and You healed me.
3 O Lord, You have brought up my soul from Sheol;
You have kept me alive, that I would not go down to the pit.
4 Sing praise to the Lord, you His godly ones,
And give thanks to His holy name.
5 For His anger is but for a moment,
His favor is for a lifetime;
Weeping may last for the night,
But a shout of joy comes in the morning.
And have not let my enemies rejoice over me.
2 O Lord my God,
I cried to You for help, and You healed me.
3 O Lord, You have brought up my soul from Sheol;
You have kept me alive, that I would not go down to the pit.
4 Sing praise to the Lord, you His godly ones,
And give thanks to His holy name.
5 For His anger is but for a moment,
His favor is for a lifetime;
Weeping may last for the night,
But a shout of joy comes in the morning.
6 Now as for me, I said in my prosperity,
“I will never be moved.”
7 O Lord, by Your favor You have made my mountain to stand strong;
You hid Your face, I was dismayed.
8 To You, O Lord, I called,
And to the Lord I made supplication:
9 “What profit is there in my blood, if I go down to the pit?
Will the dust praise You? Will it declare Your faithfulness?
“I will never be moved.”
7 O Lord, by Your favor You have made my mountain to stand strong;
You hid Your face, I was dismayed.
8 To You, O Lord, I called,
And to the Lord I made supplication:
9 “What profit is there in my blood, if I go down to the pit?
Will the dust praise You? Will it declare Your faithfulness?
10 “Hear, O Lord, and be gracious to me;
O Lord, be my helper.”
11 You have turned for me my mourning into dancing;
You have loosed my sackcloth and girded me with gladness,
12 That my soul may sing praise to You and not be silent.
O Lord my God, I will give thanks to You forever.”
O Lord, be my helper.”
11 You have turned for me my mourning into dancing;
You have loosed my sackcloth and girded me with gladness,
12 That my soul may sing praise to You and not be silent.
O Lord my God, I will give thanks to You forever.”
Psalm 30
The relationship
I’ve have with God these past two-plus years has been up and down. Not from God’s
side -- God’s been there the entire time. From my side, I’ve been an
on-again-off-again follower. Anger has been an issue, but fortunately, God is
the God of the UNIVERSE and has taken my anger, absorbed it and then given back
solidity.
Not so much me.
While I have YET
to do any dancing about breast cancer, the mourning is pretty much past and the
sackcloth has definitely been replaced by...well, not gladness, but
THANKFULNESS.
My wife has been
getting expander fills in the months since they were placed and in both looks
and feeling, she is rounding out beautifully! So while my soul may not be
singing God’s praises, I’ve been humming them more often lately. My heart may
not be healed yet, but I don’t feel as if I’m bleeding any more.
And I’m finally
working on forgiving God for including breast cancer in my wife’s life
experience. I continually tell myself that as God of the Universe, God knows a
lot more than me and knows a lot more about the future.
Right now, I’m
learning to be at peace with that.
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