Pardoned

This past Tuesday my parents took me back to Smilow for another check of my bloodwork and a breathing treatment to prevent PCP pneumonia. It was also the day that I found out the next plan of action.

All of my blood chemistries came back normal. I didn't need any transfusions or electrolyte repletions – great signs that my body is doing what it is supposed to be doing, rebuilding.

The breathing treatment was a little odd, but no big deal. I've never had to take an inhaler in my life so it was a bit strange. The respiratory therapist took me into a room and had me suck two puffs out of this big inhaler tube to take in the medicine. Then he hooked me up to a nebulizer which was basically like breathing in and out of a big peace pipe. I had to "breathe normally" (as easy as that is) while wet, medicated air flowed in and out of my lungs for about 15 minutes. I choked on it a couple times and drool dribbled down my chin, but I recovered. I'll have to repeat this treatment twice more over the next few months as a preventative measure.

Erin, Dr. Cooper's APRN, came to see me as well as my transplant coordinator, Kathryn. So, next steps? I have an appointment with my local oncologist, the esteemed Dr. Dailey to check in and get him up to speed on what took place during this whirlwind two months since I've seen him. I'll now be back under his care. Then it's back to Smilow on July 1 where I will receive another breathing treatment and lay in the tunnel once again for a PET Scan. I'll then meet with Erin to go over the scan results. The hope is that all the chemo worked and we can say officially that I am in remission and cancer-free. On my last scan after the ICE it was determined that there were no visible signs of cancer, though there was one area in my chest lighting up – it was read as non-cancerous (possibly my thymus gland being super active?). We're hoping that this is completely gone at this point. If not, then we'll have to look at some other options to rule out cancer activity with more certainty. I'm confident that my scan will be clear ... though nervous as hell.

My restrictions? Stay away from obviously sick people. Continue my antibiotic three times a day for six months. Come back for check-ups with Dr. Cooper at 3, 6, 9, and 12 months post transplant. Continue on the no sushi, no digging in dirt restrictions. No gym for at least two weeks while my platelets continue to recover (yoga class is fine so I'm back at the studio every day). Get lots of rest. Drink lots of fluids. Listen to my body. Ease back into work as I feel ready. Other than that, as directly quoted from Erin: "Eat, drink and be merry."

They de-accessed my port and sent me on my way – a whole month of freedom. My parents went to use the restroom and I went out into the meditation garden for one last time. As soon as I heard the babbling river and was surrounded by the zen stacked rocks and exotic trees I just lost it. I had worked so hard to stay strong for so long and now that I was granted release it all just came flooding out of me – everything that I had been gritting my teeth to hold back so that I could pile drive through the hurt, the pain, the frustration and the fear.

I sat on a bench and just started shoulder-shaking crying. There were other patients out there, but I didn't care. I just stared out at the view overlooking the city as tears streamed down my face. Hot tears of pure relief and release, a physical symbol that I made it through. I sat there thinking about all of the previous times I was out in that garden – always with an IV pole attached to me, always with at least a mask on, other times with gloves and a gown to protect myself. But that day I was free to breathe in the air and to touch the weathered wood of the bench with my bare hands, run my fingers over the ridges and elevations of the stones.

My parents came out and found me red-faced and teary-eyed and sat on either side of me as together we took it all in. The fight from hell was over and we all felt a whole lot lighter.

I Alone, We Together

Cancer can be an exceedingly lonely disease, but simultaneously gives the opportunity to forge a closeness with your self that you never fathomed possible. No matter how much I try to put into words, into actions, to express what is happening inside my body, my head, my heart, it does not do it justice. No one else can ever truly understand what it is like to live with a sea of aggressively mutating cells in your body that have the power to eat you alive. A truly organic process happening inside you that you did not ask for, did not deserve. Not a doctor. Not a nurse. Not your spouse or family. Not the closest friend. Not even other cancer patients because everyone's journey is so wildly different.

I can't pretend to know what it's like for a dear friend of ours currently participating in a clinical trial to treat her breast cancer while at the same time raising two very small children. I can't pretend to know what the man across from my chemo pod needs at that moment when his eyes are glazed and his head is bowed. Every single person facing this disease, or watching someone close to them face it, handles the journey differently. It's finding a deep sense of empathy for each other that holds us all together. This is what's so amazing about the human race. Even though we can't pretend to understand the intricacies of the battles that each of us are facing, we can step up and be there for one another using our own experiences with hurt, pain, fear to know what each of us needs ... more than we may know ourselves. I have been so in awe of this deep and sincere love and caring displayed toward me.

You could take two seemingly same people - both young, strong, otherwise healthy, intelligent, determined and give us the exact diagnosis, prognosis, drugs, diet, everything, and I have no doubt that our reactions and outcomes would be markedly different. Because a certain chemo drug left no side effects for one person has no bearing on what it will do to the next, for whom it may leave beaten and broken from its wrath. Because one person can't tolerate the pain of the bone marrow stimulating shots does not mean they are any weaker than the one who can. This is because no one is the same. We are all complete individuals – structurally, molecularly, emotionally.

This is where the loneliness sets in. But it's also where I've discovered my most prized possession – my self – and that helps me to realize that I am truly never alone. This is not to discount the tremendous benefit and necessity that a strong support system brings. It's that support system that keeps me standing up so that I am capable of discovering what I am capable of. Without friends, family, strangers around me helping me to see what I'm accomplishing every day and illustrating how much having me in their life means to them, it would be easy to give up. Otherwise, it's only me in my lonely cancer world. It's this support group that helps me to realize my value in the world. Without them, it would be easy to listlessly go through the motions and just wallow in misery. With them, I've got a fire to fight.

But as painful as it is for the caregivers to know, their help can only go so far. Ultimately, it is up to me to decide to go the distance and to determine the path I am going to take to get there. Ultimately, it is me that has to grit and breathe through the bone pain, the straining tissues, the mouth sores. Only I can get myself on my feet every single day – some days which seem against all odds – and fight off the urges to give up. Only I can figure out who I am, what I need, how to get it, where to be, and who I need to surround myself with at that moment to get through it. This is at once overwhelmingly scary and incredibly empowering.

It is me who has to get stuck with a needle again, and again, and again. It is me that has to lie there in complete stillness in a narrow tunnel while cameras whir around eagerly searching for signs of cancer activity while I can do nothing but wait in agony for the results. It is me who has to watch those that love me try to make sense of something that makes no sense at all; painfully watching as I know how much it hurts them to see me suffer. I wish I could make it go away for them. I tell them that I'm going to be okay, although I'm dying inside worried that in fact, I'm not. Most often that's harder than the surgeries, the nausea, the unending fatigue.

But that's when the self comes in and building that relationship is vitally important. It took me a long time to realize what people meant when they said "this is the time to be selfish" or "this is the time to ask for help". And asking for help doesn't just mean from other people but also asking myself. When I am scared as hell and when I literally don't think I can handle being tethered to one more IV pole, I can tell myself that and we can talk through it. I can allow myself to be scared and allow myself to be honest and not worry about the ramifications. What I hear back has impressed me beyond measure. Sometimes it's the mind that kicks in as the strongest. Sometimes it's the body. Sometimes it's the heart. Sometimes it's just shear will that comes from places unknown, but it's always one of these parts of me that picks up the pieces and holds the rest of us gently until we've all bounced back and I am once again whole.

The Dream World

Whether it's the drugs or my suppressed anxieties, my dreams have been more vivid - both beautiful and frightening - than ever in my life. Often, I don't like the answer when I try to analyze them, but sometimes, it's these dreams that give me hope.

I receive a regular showing of what I've come to call the "soldier dream." I've been having these dreams long before Beyonce's Grammy performance of "If I Were A Boy" that featured a riot police-like entourage. However, the choreography in that brought my dream to life in an eerie fashion. In these dreams there are thousands of these steel, ebony armor-clad men coming at me in syncopated rhythm. Some are marching on foot and some are on their stomachs doing the Army crawl. As they head toward me they swiftly turn their heads from left to right in perfect synchronization with their movements. Left. Right. Left. Right. Stone-faced and powerful they head toward me. When they reach me, I wake up. But I'm not afraid of them. They're the good guys. They're my protectors. All of these molded muscled men are on the attack for me. We don't need to call on Freud to interpret that one.

Another frequent offender is the running dreams. Running, running, running away from I don't know what. I never see the attacker. But suddenly my legs will give out or I'll hit a dead end or something will stop me from being able to go forward. I always have a gun on me and I raise it, but I can never, ever shoot it. My gun doesn't work or I just can't get myself to pull the trigger. And then I wake up. Usually in screams and sweats.

Often I will wake up screaming, even from deep naps. Or I'll wake up groaning and trying desperately to call out. There have been times that I've been napping on the living room couch and Craig will come running in from the far other end of the house where he'd heard me screaming to find me in a pseudo-conscious state. He'll have to talk me back to reality and comfort me until I realize that it was all a dream. As mentally taxing as the dreams and the realities are for me I think it's harder for my husband. All throughout the night every time he tosses in his sleep I feel him checking my temperature with the back of his hand on my forehead and feeling my skin for the cold dampness mixed with pooled sweat that he's come to dread but is now accustomed to.

For me the paradox is that once I do ease into consciousness it's my real life that's often harder to face. Waking up and remembering all of this all over again every day - what I've been through, what's yet to come, the aches, the baldness, the scars, the unknown - is what nightmares are made of. People wake up to escape those types of things. For me, I wake up every day and have to try to make peace with what is my reality and garner the strength to get out of bed and face it. Some days are more difficult than others. Some days I just lay and stare. Sometimes I cry. But I just let whatever I'm feeling that day happen and the important part is that I do get up and no matter how difficult it is, I am always able to get back to the realization of how lucky I am to have each day to wake up to and conquer. Sometimes it just take a little longer to get to that place.

There are also the beautiful, beautiful dreams. But sometimes these worry me more, like I shouldn't "follow the light." In one I was bouncing on clouds with a huge group of friends. As I bounced on each cloud, out would burst my favorite things - unreal colors - then all my favorite things would pour down over me like rain. We ran through these clouds and laughed and danced like it was an LSD trip.

Then there are the dreams that I can't figure out. Like last night, I dreamed I was carrying a young girl, maybe two years old, my daughter. She had delicate blonde ringlets surrounding her head like an angel. I was carrying her on my hip and holding Sammy on her red leash on my other arm. Sammy was older. She wasn't pulling. We were at a fair of some sort and the little girl on my hip wanted a balloon. I told her she could have any color that she wanted and she picked pink. I went up to the booth and asked if I could just buy a ballon. We didn't want to go in to the fair. I just wanted a balloon for my daughter. They wouldn't give it to us. There was a fat, grouchy lady behind the ticket booth who said we had to get a ticket for the fair to be able to buy a balloon. I begged and begged and finally said: "Listen lady, I am dying and I have no money. I can't afford a ticket. My child just wants a balloon, please." I was bald. This is the first dream that I've ever had where I've been bald. Usually I have long, flowing hair that I'm constantly playing with.

The woman finally balked and told us to go see "Ted." Sammy, my daughter and I climbed over a huge mound of flattened corrugated cardboard boxes to find Ted. An ashen faced man sucking back a long cigarette came around the mound of cardboard.

"We're here for a pink balloon," I said, trying so hard to stay positive and excited for this wide-eyed little girl on my hip.

"We've only got orange," he grumbled and handed her the white ribbon with a gawdy, 70s-home- decor-orange balloon floating feet above her.

She was ecstatic and didn't even comment that it wasn't pink.

Then I woke up and quietly cried myself back to sleep.

ICE Round 2: Aftermath

In the past I've thought I felt like shit, but that was nothing. I liken these past couple of days since chemo to feelings of oozy, raunchy, steaming dog shit.

I am completely zapped of energy. It takes a tremendous amount of effort to get myself out of bed and onto another horizontal surface and that's pretty much all I've been doing. When I do get the strength to shuffle around in the kitchen or to walk to the mailbox I return with a pounding heart and have to immediately sit to calm my body back done again after its excursion. What I have to continually tell myself is that this is because my body and the chemo is working so hard against the cancer cells and that my body is trying to bounce back from being ravaged with three days worth of high-dose chemotherapy. But it's hard to keep that perspective when any sudden movements cause a wave of nausea and when my brain just literally can't focus on even the most mundane of tasks.

As Craig said last night, "If you didn't feel this bad, then we should be worried." This makes sense, I suppose. I feel bad because the chemo is working. It is tearing out my insides - literally. The whole first six inches of my throat feel like an auger went through it hacking away at the soft tissue so that it's hard to speak at a normal volume and uncomfortable to swallow. Despite that, I drink and drink and drink - water, Gatorade, Crystal Light, and more water. It's vitally important for me to force the fluids to flush everything out and keep my kidneys functioning well. I also shove the food down my throat no matter how nauseous I am.

Between the steroids and my body's fatigue, I certainly have a big appetite and eating usually curbs the nausea waves. I consider it fuel for the cancer bonfire that's happening inside of me and I must continue to give it the kindling it needs so that it doesn't go out. This means many frequent meals throughout the day - and it's odd things I crave. Last night I couldn't get my mind off Pad Thai so we ordered in and that did the trick. This morning it was banana and peanut butter sandwich then a healthy portion of bacon and spinach. Right now all I want is fiery chicken sausage so I'm working on Craig to light up the grill.

I am proud to say that I have not vomited and I made it past the vomit point of the first ICE chemo. I also have not had a bowel movement ... sigh. But, you take what you can get. I'm on some different nausea blockers this time around. Zofran in the morning and then I have this cannabis-based drug called Marinol. It's synthetic delta-9- tetrahydrocannabinol, the same chemical found naturally in marijuana. It's often used for cancer patients, AIDS patients, people with anorexia needing an appetite stimulant. Side effects are "elation, easy laughter, relaxed mood." Now this is a much nicer side effect list than what I'm used to reading on the printouts for each of the chemo drugs: nausea, vomiting, diarrhea, heart palpitations, rash, hair loss ... . Truth be told I've only taken the Marinol twice. I'm a big proponent of "the less drugs the better" especially with how many I have in my system without a choice. I like to use mind over matter techniques until I just can't take it anymore, then reach for the drugs. I just never want to be dependant. The Marinol does cut the nausea very well, but I wouldn't say I experienced a "high" - not that I would know what that is like - except for that one time in college ... .

Today is certainly much improved over Thursday and Friday and to make it all better it's been hovering above 70 degrees with bright sun each day. So, even though I'm not able to do much, I'm able to lay in my anti-gravity chair, complete with flip-over shade and full reclining capabilities as I just exist outside in the warmth. There are certainly some healing powers to that. Yesterday I reclined so hard in my chair that I rolled right over myself - head in the arborvitae, ass following immediately afterward. My mom and Gramma were there playing Rummy 500 while I floated in and out of sleep all afternoon. My Gramma, who's weak from getting chemo two days ago herself, is the one who rushes over to help me up while my Mom stands turned away from me, hands between her legs bent over laughing and trying not to wet herself - her usual reaction to these types of occurrences. I also almost pissed myself I was laughing so hard at the hilarity of it all as I picked pine needles out of my mouth and scraped the sap off my elbows.

"Does this count as alternating rest with light exercise periods?" I asked my mom after the summersault stunt.

We laughed more - Marinol induced or not, that was funny stuff. I guess my reflexes are a bit compromised.

ICE Round 2, Day 3

Today was a tough day. I was pretty much a waste of space. It took so much motivation for me to get out of bed and do any walking or moving whatsoever. My colleague, Michaela, stopped by in the morning with her adorable baby on her way to the day care. That was so sweet and it really gave me the motivation to get moving. So I got a few laps with the IV pole in then it was back to bed and that was pretty much how the day went. I'd wake up and watch a movie or some TV, then back to sleep, then wake up to eat, then back to sleep.

All day I haven't been able to form a cohesive sentence and my mind is moving very, very slowly. I'd catch myself just staring at the wall for a good 30 minutes trying to get the energy to get up to go to the bathroom - which I do so, so often. I am so pumped with fluids it is painful. I have been hooked up to IV fluids since Monday at noon - nonstop. Plus, I'm supposed to continually be drinking and I'm getting the big bags of chemo dripped in. So, I feel like a walking swollen udder. My hands and feet feel double their size and my face especially feels so swollen. Some may mistake my stomach for a baby bump it's so swollen and hard. I feel like I've gained 85 pounds since I've been here but my mom and Craig say it's all in my head ... . Right. The steroids make me ravenous so dinner has been a big dinner and I'm sure that doesn't help with how beefy I feel.

Adding insult to injury is the dryness of the air here which causes my skin to feel so tight and the skin on my hands is just peeling away. Plus I'm struggling with being able to regulate my own temperature. All the drugs and the Lupron which has put me into temporary menopause causes lots of hot flashes and sweats - believe me, my heart goes out to middle age women going through this. The heat waves are unreal. I look forward to a shower at home and my humidifier and new tempurpedic pillow. Plus, of course, a big Sammy hug. Ahhhh.

As today is St. Patrick's Day Craig brought me over a heaping plate of corned beef, chunky garlic mashed potatoes and asparagus from Whole Foods. That certainly satisfied the palate and made me feel like I had a little bit of a St. Patty's celebration, though no Guinness this year - Carbolatnin, Iphosphomide and Etoposide instead. Not exactly an even trade off.

We didn't end up having the St. Patrick's Day parade around the floor. On one of my walks Jennifer spotted me and asked if I was ready to shake my shamrocks. I told her that there'd be no shamrock shaking tonight. Shaking might just put me over the edge. She laughed.

But my mom, Craig and I had a nice St. Patty's evening visit and my Uncle Kevin swung by for a visit as well. Earlier in the evening the vice president of the cancer program came to see me which really meant a lot. We work together in my career capacity here at the hospital and it was so sweet of her to take the time out of her crazy busy schedule to come see me and to offer lots of words of encouragement. It's wonderful to have people around with such positive energy and I am continually so thankful for the amazing care that I've gotten here.

I even landed a massage and a Reiki session back-to-back so I had some good relaxation this afternoon. The Integrative Medicine department here is so integral to the healing process. Something like that can really brighten a day for someone who just has no energy left and can just lay there and be pampered. It was perfect.

Word is that I get to be released tomorrow morning and I am very, very much looking forward to being unhooked and to getting out in the fresh air instead of looking longingly at the sunny, blue sky from my hospital bed.

But for now it's time for bed. I am so, so, so tired despite so much sleeping. I guess there's a lot of action going on in this body. I've got to give my good cells a fighting chance.

ICE Round 2, Day 2

I awoke feeling pretty groggy from a quite interrupted sleep and the effects of the chemo starting to kick in. But once I ate breakfast and got myself moving and showered things were better. Then it was a parade of visitors which was great to keep me distracted from my woozy weakness.

My sister is back from California and my brother is home on spring break so they came by to spend much of the afternoon. My boss stopped by bringing some more laughs. My Dad came along to spend time with me. Our dear friend Leah, who's always bursting with sunshine - even more so now with the glow of pregnancy - came by with a doctored up card featuring Sammy's mug and shamrock sugar cookies. Of course, my faithful husband has been here every evening after work. And, I even had a visit by a real-life clown who provided some fantastic entertainment to my brother, sister and me.

Our good friend Keith, whom Craig works with at the summer enrichment camp he teaches at and who's son I used to babysit for, finished up a gig at The Bushnell entertaining before a kid's show and decided to come over and give me a little show to cheer me up. He was dressed up in all his "Tabasco Pepper" character garb and we just had a blast.

He taught me a few magic tricks. He "tested my reflexes" and had me balancing peacock feathers on my hand and juggling kerchiefs with him. We juggled balls together. He told jokes and had my siblings and I in stitches.

I guess the adage that "laughter is the best medicine" is true. Just before Keith walked in I had called for the nurse for some anti-nausea meds as I started to feel pretty uneasy. Well the drugs never came, and I never needed them after Keith was through. I felt a million times better.

My nurse Jennifer and I talked about the fantastical idea of staging a St. Patrick's Day parade tomorrow around the floor and having all of the patients march banging bed pans and blowing on tubing and such for some entertainment. Then she drew me a very impressive clover on my white board. It's nice to have nurses with a sense of humor.

Craig and I ordered in pizza as the greasy grilled cheese that came on my dinner tray wasn't cutting it. Pizza was delicious for sure. Then a Reiki volunteer came to my room and I was treated with a nice session which got me all relaxed before bed. It was so bizarre because as soon as she saw my face she said: "Are you Karin, the Karin that writes the blog?" Turns out that her nephew dates someone that I went to middle school with who sent her my blog a while back and she was all caught up on my life. My world seems to be shrinking more and more every day when I realize all of the connections that we have to each other. It's a comforting feeling to constantly be reassured how amazing the interconnectedness of the human race is. You only have to peel back a few layers in a person to find some commonality and mutual relationships.

After the Reiki session I crashed real hard right after Craig left last night - all that stimulation got to me I guess. I fell asleep without the aid of any meds and never even took any anti-nausea meds before bed. I slept through all the med switchovers during the night and slept solid until 6am. Still woke up very lethargic, but one more day down. And that's huge. I can't wait to get out into this beautiful weather - high 60s and sunny - I'm just so glad that it's supposed to last all weekend so that I can soak a bit of it in too.

Hair Today, Gone Tomorrow

The hair that finally grew back enough to cover my head after the ABVD chemo treatments is now gone. My scalp just couldn't hold onto it. The follicles opened up and out it came, like my head was making an offering to the chemo Gods.

It happened real fast, exactly two weeks to do the day that I had my first day of ICE chemo - exactly as Dr. Dailey had predicted. It started with a familiar scalp tingling on Sunday - tremendously itchy and throbbing. Then Monday the hair cascade began. Tuesday my scalp ached with that feeling you get when you've had a ponytail in too long or when your hair's been tied up tight in a bun with jabbing bobby pins for a dance competition. It's the feeling when you let your hair unravel and then rub your scalp to let the circulation back in - it hurts to touch it and to move the hair around, but you can't stop doing it. Or at least that's me anyway.

Tuesday morning I woke up in a nest of short, dark hairs that covered my pillow. Disgusting. The shower was worse. The water added weight to my hair that my scalp just couldn't hold on and out it came in thick, black clumps. Enough hair to coat one of those creepy hairless cats. Much Drain-O needed. All day yesterday hair fell out at the slightest touch and the ache in my scalp only increased.

As soon as Craig got home he looked at the fistfuls I was pulling out and we both knew what had to be done. Out came the buzzers again. I can't just sit by and watch hair pile up around me. It was time to take matters into my own hands. So Craig took me up to his workshop and buzzed it to the shortest length - after a little fun with some mohawk sculpting. My scalp was immediately relieved and I felt freed. I really don't mind the G.I. Jane look and Craig actually prefers it (or so he says.) I didn't have time to get attached to the crazy curled, dark brown hair that had grown from November to now so it wasn't nearly traumatic as it was parting with my long, blonde locks last May. It's just strands of fibrous protein anyway.

This morning I woke up to a pillow with a case of five-o-clock shadow. The stark white of the pillow case was contrasted by a healthy amount of little black stubble. It won't be long until I move from G.I. Jane to Mr. Clean.

Chemo goes after all fast growing cells, hair cells being some of the fastest, so it only means that the chemo is on the attack. I can only imagine that the cancer cells are leaving my body just as quickly as the hair is leaving my head.

Hot Stuff

Well my bad day on Wednesday spiraled even further down. I guess my tears weren't for nought. I really was feeling awful evidenced by the 100.6 temp that registered on my thermometer late that afternoon. I took my temp at 2pm and it was 100 then every half hour after that it kept increasing until I hit the "scary" point of 100.5. When I surpassed that I knew I had to call the Cancer Center, though I dreaded it knowing what they would tell me. As I suspected they told me to immediately head to the Emergency Room. Do not pass GO. Do not collect $200.

I stayed calm and packed a bag of random clothes and random books, magazines and gadgets to keep me busy as I had no idea if I would be admitted and if so, how long I might be kept there. Craig packed me a snack bag and we were on our way, dodging through traffic down 91 at the peak of rush hour.

The on-call oncologist had called ahead to the ER for me so when I arrived it was from triage right to a room - one of only two private rooms in the ER. Being neutropenic was good for something I guess. I was a paranoid wreck knowing how many strange germs are floating around in an ER, nevermind the busiest one in New England. I wouldn't touch anything and was constantly Purelling myself. I was given a mask for anytime I had to leave the room and once they finally put up the neutropenic precautions signs outside my door, nurses began wearing masks before entering my room.

Plain and simple, being in any ER is not a pleasant experience. The "bed" that was put in the room for me was a black mattressed stretcher that felt like a body board. The thin sheet that covered it wasn't long enough and kept sliding down so that my head would touch the exposed plastic. Craig was stuck on the equivalent of a folding chair. All of this would be fine if we were there for just a couple hours, which you would hope would be a normal ER stay. But 6, 8, .... 12 hours. Not so much. The one solace was the flat screen TV on the wall. A gift donated for each of the ER rooms at Hartford Hospital from a man who spent some time there as well. I can't even explain what a difference having that piece of comfort and I am forever grateful for his generosity.

I was seen very quickly by a resident who checked me over with lots of stethoscope listening, symptom questioning and physical examination. As I already knew, besides being feveral, I didn't have any other symptoms. I was only there because I had no immune system and running a temp meant that I was likely on the brink of some kind of infection. I was sent for a chest x-ray then had to pee in a cup - all normal results. Bloodwork was next.

The nurse wanted to stick me in the arm to draw my blood and run an IV so that they could start antibiotics if necessary, but I was persistent that they use my port. I have a port in my chest for a reason. I explained that my veins are full of scar tissue and recounted how many times I had to get stuck last time I had surgery before they could find a viable vein. Well, she didn't know how to access a port and said how long it usually takes to find someone who can. I did not care and told her that she needed to find someone who knew how to do it. Especially if I was going to be admitted, I did not want to have to sleep with a needle in my arm and I didn't want to have to get stuck again when someone could access my port. My relationship with the nurse from that point on was rigid at best. It didn't get any better when she sprayed saline all over me trying to set up the IV fluid pump. She must have been having a bad night.

So we waited. Not too long after, another nurse came in who was an expert in port access and - what are the chances - graduated high school with Craig. They remembered each other immediately. She was one of those girls who was an EMT since forever ago and Craig said that he certainly wasn't surprised to see here working in the ER. That made me feel comfortable and she accessed my port with ease ... though more tape than I've ever seen used. My skin is still red and irritated from it days later. Ah, well. You take what you can get.

At the same time this was happening, another woman came to draw my blood. They both came at me at once as one of the cultures can't be pulled from my port. This means I had to get stuck twice anyway. As I laid there I had this one lab technician on my left pulling tubes full of blood from a needle she stuck in my arm while the other nurse stood over me on my right side and pulled a turkey baster-sized tube of blood from my port. For some reason she held this turkey baster clearly in my line of vision. No matter which way I looked blood was coming out of me and my left arm ached and pulsed from how tightly wound the lab tech had tied the turnicat.

"Oh, my back," the tech groaned as she reached for her chair to hold up her huge, bulging body pulling my blood-filled tubing taunt.

"Ohhhh, my back is killing, phew" she moaned again. I was so disgusted with her lack of tact that if my arms weren't occupied I may have punched her in the face.

Craig noted my anxiety and deep, loud breaths and stood at my feet and squeezed them. These are the situations where inner strength kicks in. And these are the situations that I think back on later and realize if I got through that I can get through anything. I don't know how I didn't pass out. Finally, the vampires left with their viles.

More hours passed. Another doctor came in and told me that he spoke to the oncologist on-call and that the plan was to hold off on the IV antibiotics until it was decided whether I will be admitted. This would be decided by the results of my lab work. They would look at my granulocytes, a type of white blood cell. Because my overall WBC count was so low, the phlebologists would have to do a manual smear, meaning they would have to count the cells by eye as no machine would be able to detect them. If my count was more than 500 I could go home and follow up with Dr. Dailey in the morning. If they were under, I would be admitted.

So, we waited some more ... got to watch The Office baby episode and roll right into late-night TV. Somehow Craig was able to fall asleep in his rigid chair with his head sharing half the pillow from under my head. It was close to midnight when they came back with the verdict: a count of 143 granulocytes - not even close. Damn it. Knowing that he wouldn't have to take me home Craig left so at least one of us could get a good night's sleep.

So it was me alone in my little ER room until my new nurse, Jim, came in and things were a million times better. He was so nice, so attentive and so friendly. I immediately lit up and knew that the rest of the night would be so much improved. He hooked me up with the super strong IV antibiotics that would flow through my port throughout the night. He brought me three styrofoam cups of water and finally the Tylenol that I had been aching for for my pounding headache. We talked about his daughter, West Hartford, snowboarding and he kept checking in on me throughout the night, yes, the night. It wasn't until 6:30 a.m. that a bed opened up on the oncology unit and Jim himself brought me up there. I think he was just as excited for me as I was to be out of there and away from the germs and noise.

Trying to sleep in the ER was an impossible feat as every few minutes you hear calls over the loud speaker like "active trauma five minutes out", "environmental needed in red pod for mop up," "active stroke rolling in," "EKG needed stat" ... etc. People are at the brink of death and the ER staff is frantically busy saving their lives. It's not a place for a cancer patient with a high fever. I can't imagine how those doctors and nurses do what they do. I found out later that the ER was so packed that night that there were 47 people on stretchers waiting for beds - every inch of the place was taken up. It's no wonder with so many people using the ER as their place of primary care, especially in a city as poor as Hartford. And they say we don't need health care reform? I digress ... .

The welcoming wagon was there when I was brought up to the fifth floor. The nurses and PCAs recognized me right away and many said they weren't surprised to see me back there knowing what high doses of chemo I received. I was put in the same room I was in during my stay the week before and there was a lot of comfort in that. I asked for a breakfast tray which came right away and after they took my vitals I reclined my bed flat and fell right asleep.

Dr. Dailey came by to check on me and he decided it best to keep me one more night to receive some more strong antibiotics to kick whatever might be brewing. So my mom came to spend some time, we played Scrabble Slam then I slept through most of her visit (at her insistence). A co-worker came with a smile and some great magazines. Craig came that evening and we hung out, took some masked walks around the floor, Skyped with my brother and sister-in-law, and he stayed until I fell asleep for the night (at my insistence). Though much deeper than in the ER, a full sleep is still hard to come by in a hospital. I had to be woken every few hours for a vitals check and because my blood pressure was very low they kept increasing my fluid drip meaning nature calls were another cause of frequent wake ups.

All-in-all I felt much better on Saturday morning and I was so, so eager to be released home, but I knew that it was all conditional on my white blood cell levels. I showered wearing my socks because I forgot flip-flops - hell no was a stepping in the communal shower barefooted - I know a thin layer of cotton probably didn't offer any protection, but it was a mental thing. I wolfed down my breakfast - quite delicious cinnamon French toast, and kept my ear to the nursing station for Dr. Dailey's arrival. Finally it came and he asked:

"So, are you excited to go home?"

"Yes ..... ," I replied with a goofy smile.

"Well, you can. Your counts are up to 7.5," he said. This is normal range meaning no more neutropenia, no more masks. My heart lifted.

Since my release it's been sunny and nearly 50 degrees every day and I've been relishing every minute of it - seeing friends, hiking, working out outside, running, reading on my lounge chair in the sun. Fantastic.

I really feel great. Such a huge turnaround from last Wednesday it's unbelievable to me. Besides the rash of red raised dots I've developed all over my hands, arms, and legs as a reaction either to one of the drugs or to my WBCs increasing so quickly, and the bloody tissue I keep blowing out, you might actually mistake me for a healthy person. And I'll continue to relish these feelings until I go back in for Round 2 next Monday. I have one week to get myself psyched up for it and that is my sole life mission at the moment.

Coming Out of the Dark

The clouds have begun to part. Literally. Monday the sun peeked through for the first time in nearly a week and with that sun peeked through my strength and even some clarity of mind. After Saturday night's horrific experience things began to look up. I suppose it's all relative, right?

Sunday I was strong enough to get out of the house and instead spend the afternoon on my parent's living room recliner watching Dante's Peak and USA vs. Canada. I got to see my little bro, which is nice and he even accompanied me on my short walk around the neighborhood. I still felt nauseous and weak but nothing compared to the days prior.

Monday, I drove myself to the Hartford Cancer Center for an appointment. It was a balmy 45 degrees and I had the car sunroof open blaring a Judy Garland Broadway compilation CD a friend had dropped off for me. I felt great in big part due to the fact that I had a good, solid bowel movement. I thought that the moment was deserving of trumpets and fireworks. Though they didn't come, they did play in my head. I felt a million times better. And after the puke, when I suddenly came out of that nausea cloud, it felt as if I'd found my legs again after months at sea. For four days straight it felt as if I had just stepped off the ride at the amusement park that spins so fast it makes you stick to the wall and the floor drops out from underneath you. I always hated that ride. It felt like my stomach was not in my abdomen, but instead in my throat, and that what was in my abdomen was churning through my intestines in a radioactive manner. No. Sudden. Movements.

I even wore jeans and a cute top to Monday's appointment. I showered and put on mascara. These were big steps. I certainly wasn't feeling 100%, but I'd say 65%. Today, we're up another 10 or so percentage points. I joked and laughed with the ladies in the lab. We talked about Justin Timberlake and his Soupville SNL skit. Denise, my favorite, was there to take my blood and she was so concerned about what I was going through. She gets all teary-eyed and always tells me that she loves me. I found out that she's no longer out at the Avon Cancer Center where I'll now be having most of my appointments since it's much closer for me. This was sad news, but I know we'll pass each other.

I met with Dr. Dailey and told him about my weekend escapades with the constipation, the nausea, the vomiting. He was sympathetic and we talked about some new options that we can try for ICE round 2 that might help things, including more steroid and a medical marijuana-like nausea blocker (oooooooh) that he says works well with a lot of young people. Despite my weekend symptoms, he thought that I was doing very well with everything, considering. This was encouraging. My blood levels were still holding okay. I'm a bit anemic but he wasn't too concerned. He wants to continue to check my blood every other day. He expects the big drop to happen this weekend and for my white blood cells to stay low (nearly non-existent) for at least a week when the marrow stimulating effects of the Neulasta shot wear off and the chemo effects really kick in. From this weekend forward I'll have to really confine myself to home and controlled environments. No movies. No restaurants. No big crowds. Definitely no contact with anyone who is remotely sick. If I catch a bug of any sort not only could it delay my treatment schedule but my body might not be able to fight it off. I am not going to let that happen so I plan on heeding his warnings to the extreme.

Then it was time for the Lupron shot. This shot will serve to shut down my ovarian functions in hopes to protect them during the high-dose chemotherapy and to eliminate monthly bleeding as my platelets will be low and there is a risk of hemorrhaging. I'm told that it will also give me menopausal symptoms like crazy mood swings and hot flashes. Depending on how my body reacts I might go on a low-dose estrogen to counteract things. Basically, I'm just a human beaker bottle. A little of this potion. A little of that toxin. Let's get me to gurgle just enough, but not bubble over ... . And let's see what different colors I can turn while we're at it.

My oncology nurse whom I had all during the ABVD, Diane, opened the door with a box in her hand. She had a look on her face like she was a little kid who just spilt a whole gallon of milk on the floor.

"I have a really big shot for you," she said, scrunching up her nose and lips. "I'm sorry."

Oh, dear.

"That's okay," I said back. "I just won't look at it."

"Oh! You're so good! Can I just take you home with me?" she exclaimed and came over and gave me a big hug. "You're just so good. I don't know how you guys do it," she said.

I realized that she felt so awful thinking that the shot she had to give me would add to the pain I was already going through, but to me, it was just part of the process. If it was going to protect me or make me better, just stab me with it. I can take it. It also made me realize that other patients might not react that way. I wonder if others would fight back at her begging her not to come at them with the needle, refusing their treatment. I'm sure it happens. This is why oncology nurses should be considered on par with angels.

I didn't look at the needle, but I believed her that it was big when it seemed like it took forever for the drug to go in. I had to pull out a cheek and she shot me in the upper behind. It really wasn't a big deal at all. Diane is very, very good at giving shots. It just went deep and there is still a dull ache in the injection area today. I zipped back up and was on my way with a slew of follow-up appointments over the next few weeks until my next ICE infusion - March 15.

Until then I'll continue my walking. I have not missed a day yet no matter how shitty I've felt. Sometimes the walks are longer than others. Sometimes they're slower than others. But it's important to me to move every day. I also get outside every day which is getting easier now that it's finally not precipitating. Fresh air does wonders. I have so much paperwork to focus on and administrative work to be done that I am not working, I still get a sense of accomplishment completing all of those tasks. I'm eating pretty well. I can keep most everything down now and my appetite is strong. I'm instructed to be on a "high-calorie, high-protein" diet. This is much different than my usual low-fat, lean-protein regimine. Basically right now I am just eating as much as I can when I am feeling up to it as I know how much my body needs the fuel for this fire inside me. I'm still focused on raw, non-processed foods, though I make the exception for peanut m & m's.

I hope that these improvements continue and that I'm out of the dark when it comes to the nausea. The achiness and weakness that is expected to set in in next week is something that I can deal with - napping is easy. Trying not to vomit is not.

ICE Round 1, Day 3, 4 & Aftermath

Obviously I have slacked on the daily updates. Getting the strength to write was near impossible. In short, I've been feeling awful. After day one, there was no more dancing with the IV pole. After the second day of meds things certainly got to be woozy, cloudy and anxiety provoking. By Friday after Dr. Dailey stopped by to tell me I could be discharged I was showered, packed up, shoes on and unhooked from the port waiting eagerly in a hospital chair when my mom and sister arrived to take me home. Since I've been home, I've been spending most of my time trying not to vomit or mustering the strength to get off the couch.

I handled the Carboplatin okay when it was added on the third day bringing the total hours of receiving drugs to five. However, each night when the meds finished dripping, I got very nauseous despite all the nausea blockers I would take hours before. Luckily, the "as needed" anti-nausea meds seemed to cut it, though on the last night I woke up needing it twice. I wasn't feeling hot at all Friday morning, but I wanted to go home so, so badly that I sucked it up as hard as I could. Dr. Dailey came by and I told him that I was doing okay and that I was definitely ready to go home. He agreed and provided me with some at-home scripts for nausea blockers and Atavan. I felt as if my head was disconnected and that my eyes and appendages were buldging from all the fluid I'd been in-taking and all the hot, stale air. I hung my head out my mom's car's passenger window like a dog on the way home and she even opened the sunroof for me though it was snowing right into the car.

But it wasn't all bad. I just feel so badly right now that it's hard to remember anything else, but I'm trying to focus on the positive as unfortunately I've got to do it all again ... twice. I had great surprises from some more visitors. Nicole came by to have lunch with me. Melissa, Leah and Kyle came Thursday evening, while my chemo was dripping, with treats and smoothies, then my brother-in-law, Eric, showed up to add to the laughs and Craig stayed until I was ready for sleep. We got quite rowdy as they played props with the ridiculously small TV monitor on an arm that served as the entertainment in my room. More co-workers stopped by with gorgeous flowers, sweet notes, and my fav Starbucks treat.

All the nurses were truly, truly amazing. I had great care the whole way through and never felt alone or neglected. They even rolled around with a "high tea" cart on Thursday while Craig and I were relaxing. A nurse in a crazy purple and red hat came in with a vast array of fresh pastries and donuts, coffee and tea to choose from. Fantastic! I enjoyed a 45-minute massage which felt fantastic on my achey legs especially, and even received a Reiki session the morning of my discharge. I was so taken away to a peaceful place that I didn't even hear my boss come into the room with a latte for me - very stealth. I also took a wellness workout class with two other cancer patients - one just 18 years old who had been in the hospital for a month, and a 60ish year old woman who was neutropenic and had to wear a mask to protect herself. I, on the other hand, managed to snap the exercise band they provided us while doing a set of tricep curls. It was humbling and made me realize how good I still have it, and how I do not want to lose my strength and how hard I'll have to work to keep it.

Now I am home and as I said, my time has literally been spent trying not to vomit. Friday I felt real woozy, but my symptoms were controllable for most of the day. My mom and sister cleaned my whole house while I slept and watched bad TV. Then Craig got home and my Dad arrived and we all just relaxed and watched the Olympics and I watched them play Wii Fit trying to do their own ski jump and slalom races, Craig bouncing up and down on the Wii board dodging wrecking balls in the obstacle course. I kept asking them to do funny things to keep my mind off the pain. Those included my mom doing mock Olympic sports around the house with a "Fuck Cancer" beanie on her head. This was funny. I'd call out "speed skating," "short program," "skeleton," or "bobsled" and she'd pantomime. Oddly, they all looked alike. It was hilarious.

But then suddenly the laughing turned into awful, awful stomach pains and I got very serious and snippy. I hadn't had a bowel movement since I was admitted to the hospital and the nausea blockers tend to block the action down there too. So, it was debilitating s-pains to the point where I was asking someone, anyone, to just stab me in the stomach to alleviate the pain. I sipped on hot chamomile tea, did the exercises that my mom said she would do with her c-section patients that were clogged up, but nothing (still) has seemed to work. With awful pains and vomit hovering right at my throat sphincter I was able to get up to bed, take an Atavan and fall asleep.

Yesterday I woke up with less stomach pain though the nausea was still there. Craig had to drive me back to Hartford Hospital to get a Neulasta shot at 7 a.m. This is the equivalent to 10 of the Neupogen shots that I used to get during the ABVD. It will serve to stimulate my bone marrow and get my counts back to reasonable levels. The nurse practitioner explained that I'll have a lot of bone pain in my hips, shoulders, chest, and gave my a prescription for vicodin. I'm starting to feel it this morning and may in fact go get that script filled. The rest of the day yesterday I was uneasy but stable. I got enough strength to take a walk with Sam and Craig down at the park, which was hard, but felt great. Dr. Dailey told me to alternate rest periods with activity periods so I'm doing my best, even if it's just a few minutes on the treadmill. Much of the day was spent cuddling with Sammy and watching trashy tv like "16 and Pregnant," "America's Next Top Model" and "Real World DC." I ached to be able to sleep, but the stimulating effects of the steroids matched with the uncomfortable stomach feelings prevented that so I watched "Billy Elliot," started a puzzle and picked at whatever food I could take - forcing down nutrients.

Then nighttime came and it was almost time to be able to take an Atavan which helps with nausea and anxiety. I got up off the couch to let Sammy out while Craig slept a few cushions over. I shut the front door, turned back around, burped, and that was the end. There was no stopping it. I woke Craig up to wrenching vomiting. I made it to our nice, wood-woven garbage basket in the living room - not ideal - but better than the floor, I suppose. Craig ran to get a replacement and I shifted my barf aim into a cardboard box as he hovered over me. It kept coming and it sounded and smelt inhuman as I wretched animal-like. I despise, despise, despise throwing up and can't remember the last time I did it. Tears streamed down my face and I was sweaty and achey in my already raw intestines. I had been so proud that I never threw up from the ABVD. I guess high-dose chemotherapy is no joke. Once I brushed my teeth and showered I admit that I did feel better. For the first time in four days I wasn't nauseous, but I worry that this will continue, and I know how important it is to keep nutrients down.

This morning? So far so good. More achey and weak than nauseous so hopefully that's a good sign. My little brother made the trip from Roger Williams so I am looking forward to seeing him today and hope to again be able to make it out of the house for some fresh air and a walk. Other than than, just taking things literally hour by hour.

ICE Round 1, Day 1

So I survived the first day of the ICE chemo regimen. We "checked in" to the HH Spa in the fifth floor of the Bliss Wing (appropriate) around 8:30 a.m. yesterday. Nearly 24 hours later, I've had two sacks of chemo drugs, a constant drip of fluid at the rate of half-a-cup every half hour from 11 a.m. yesterday on, three small sacks of another drug to protect my bladder against the chemo effect, lots of snacks that I brought and (gasp) two pretty decent hospital meals.

My room is large and private. I have my own small (very small) TV that gets lots of channels and my own bathroom and sink. However, no shower. This I have to share communally with the rest of the floor. I've asked my mom to bring back flip flops for me as this reminds me of college days and I'm a little skeeved about going in there barefoot.

I have a huge window that runs the length of the far wall through which I was able to watch the chunky snow flakes mixed with soothing rain throughout the day. Signs of healing. It seems there will be mixed winter weather outside the window for my entire stay here, but I actually think that's more tolerable than bright sun would be as in this type of weather I feel like you're supposed to be cooped up and cozy. The sun would only make me ache to be outside soaking it in.

The care has been nothing short of extraordinary. And I'm not just saying that because I work in the marketing department, really. I've been truly impressed by the resources, the attentive care, all the offerings. We've been flooded with helpful pamphlets and printouts with details on each of my drugs. We had a visit from a social worker to talk about finances. A nutritionist is scheduled to stop by at some point. Craig was given a rickety but mildly comfortable cot to stay the night in. There are no limitations on accepting visitors or having sleepovers. I'm signed up

for a "wellness fitness class" Thursday morning with the other patients on the floor. Volunteers will be coming by to give me a therapeutic Reiki session each day, and I was even given a gift certificate for a massage scheduled for 11 a.m. Thursday right here in my room, paid for by a generous grant from an organization called Angie's Spa that has partnered with the Gray Cancer Center. All of these pieces certainly balance out the bad. It's *almost* like our Sandals honeymoon. I can get plastic canisters of oj and cranberry juice or mini cans of gingerale whenever I want it and Hood ice cream cups are available on demand! My bed moves up and down and I can adjust my foot and back positioning with ease.

My nurse, Susan, was with me all day yesterday and she was so thorough and thoughtful. The first step was to access my port yesterday morning. It's all done under a lot more anti-infection protocol here as an inpatient. She wore a mask, gloves, a gown, and I had to turn my head during the insertion. The needle went in beautifully and now it's all covered and taped and nothing that I have to worry about for the rest of the stay. I can even shower with it accessed after they cover it with cling wrap.

The day progressed with a whole lot of waiting, but Craig was with me all day, and we kept busy taking walks around the oncology/palliative care unit (with my IV pole in tow since we are now attached), reading, napping, playing games, etc.

Late morning I took a drug by mouth, Allopurinol, that will lower the amount of uric acid in my blood and protect my kidneys, which can be damaged by one of the chemo drugs. Then at about 5pm came the nausea blockers, also by mouth: Zofran, Emend, and Decadron. It wasn't until 6:30pm that I started the chemo drugs. I'm told this is because the pharmacy mixes all of the outpatient chemo first since the cancer center closes at 5pm then they tackle it for us inpatients. After they mix it the drug bags go through four different check points to verify accuracy, so it's understandable that it took a long time.

Susan was detailed in explaining what the effects of each of the drugs would be. She went over everything about the amounts I was being given, how long each would take, matched it up to my ID number and told me that I should feel no differently than I did before she started dripping them in - and if I did, to let her know right away.

The first was the Etoposide (E). It dripped into my port for one hour. Then came the Ifosfamide (I), which dripped for three hours. With such a late-day start, this meant that I received chemo until after 10:30pm last night. The Ifosfamide is the one that is nearly double the dose a normal adult would receive as part of the pediatric protocol I am under. The Carboplatin (C) won't come into play until Thursday when I will receive all three ICE drugs. All the while that these are dripping, I receive IV fluids as well. It's extremely important that I drink a lot even on top of that to flush out the residual tumor particles that the drugs are smashing through. I get to pee in what's called a hat in the toilet so they can monitor my urine output. They're watching all of my bodily functions very closely.

All yesterday I felt great. My parents arrived to visit for the evening just as the chemo was getting started. They joined Craig and I as we watched Jeopardy, chatted and laughed and ordered in a couple of pizzas from J Restaurant/Bar just across the street - they deliver right to the floor! I was so hungry from the anti-nausea drugs and steroids. I powered my whole penne pasta florentine with chicken hospital meal then 4 pieces of pizza. I guess my appetite isn't affected. However, Dr. Dailey warned me this morning that I might want to tone that down as the stomach upset may still be on the horizon. I did some laps around the unit with my parents and showed them the lounge area where there's a big fish tank, comfy couches, and a pantry with food and drink up for grabs. I'm grateful that I'm able to walk around and eat whatever I want. I really have no restrictions.

It wasn't until about 11 a.m. last night when I started feeling crappy. I all of the sudden had a huge wave of nausea, complete with that hot, scary feeling. Way worse than I ever got with the ABVD chemo. Sweaty all over and head spins and that awful awareness of my throat sphincter. I thought for sure I was going to vomit. I called for the nurse and she was able to administer another anti-nausea drug which Dr. Dailey had ordered in anticipation of this reaction (God bless him) to be given on demand. It worked well and had the dual effect of knocking me out to sleep which helped everything. The night nurse said she tried to wake me up and I wasn't budging, even with a shove, so I guess I slept deeply, at least for a few hours. But then I was woken every three hours to receive Mesna, a drug that also drips into my port for 15 minutes and will protect my bladder from damage that can be caused by the chemo drugs. I got the last one at 6 a.m. and have been up ever since.

Today, same routine. My sister flew in from Cali late, late last night, delayed by the snow, and her and my parents are currently sleeping at my house and taking care of Sammy. I can't wait for them to arrive later this morning. It'll be great to see her! Craig is also taking a half-day of work and will be back to be with me later this afternoon. Even if we're not talking or all doing our own thing it is great to have others around me, so that I don't feel alone, especially when my IV tether puts things out of reach. Even though I can unplug it from the wall, it's not exactly dainty and the spider-like wheels don't make it into tight spaces to reaching things can be difficult. It'll be a good feeling to be detached on Friday. But until then I know that it's feeding me life-saving meds so I'll deal with it.

Another video produced by my talented husband. We found some creative ways to pass the time. I wonder what we'll be doing on day 4, eek:

The Time Has Come

Tomorrow starts my first round of pediatric high-dose ICE chemotherapy. It'll require 3 nights and four days in the hospital, but Dr. Dailey tells me that it should be "uneventful" and that I'll do well with it. Being in the hospital will allow me to receive the fluids that I'll need and the pre- and post-chemo meds plus super anti-nausea blockers. It's important that I'm monitored for side effects. I'm told that I'll be able to unhook from my port for periods of time so that I can walk around (plus apparently the steroids will make me very restless). I'll have my own room and Dr. Dailey has already told the nurses that I'm coming, that I'm "really nice" and that I work there at Hartford Hospital, so that's a plus! I'm just trying to think of it as a little spa retreat for a few days - on demand cocktails and all.

These past two weeks have been full of preparation. First and foremost was the embryo preservation and the final count is 3 healthy, growing embryos that are now being cryopreserved on a shelf in a secret location until we are ready to use them. We are thrilled at the outcome and so happy that we went through the process. It makes our future even brighter.

I've been walking every single day. Luckily it's been beautiful out so I've been able to get fresh air. On the days when I don't get out before nightfall, I now have a fabulous treadmill on loan from a very generous friend! I've been upping my calorie intake trying to put on some pre-chemo pounds and eating lots and lots of fruits and veggies and au natural foods. I've been reading up on stem cell transplants, watching video blogs and reading about other's experiences, researching my chemo regimen, visualizations, and coping mechanisms. I digested another Dr. Bernie Siegel book and am just about done with Lance Armstrong's "It's Not About the Bike" - very, very inspiring and the book I've most been able to identify with. We share a very similar coping style and mentality and hearing his struggles and triumphs really affirms my beliefs as to the best way to take cancer head on.

Craig and I took a road trip over the four days that we had post-IVF procedure and pre-start of chemo. We went to Philly, a city to which I've never been, and I got to run the actual steps that one of my idols, Stallone, climbed as Rocky, we ate cheesesteaks and explored the Franklin Institute. Then it was on to Virginia/DC to visit my college roomie and her fiancee - two of my favorite people in the whole world. We had a fabulous time just hanging together eating good food, playing Wii, exploring Georgetown, watching the Olympics and marveling at all the spandex over a few beers. They're the kind of friends that you just automatically fall back in sync and comfort with as soon as you see them no matter how long it's been. That was exactly what both Craig and I needed. Plus, I got to fulfill some Matron of Honor duties and help pick out wedding invitations and weigh in on tux choices for their wedding in May, which makes me so happy. We came back recharged and sore from all the belly laughs.

I feel ready for this - as ready as I can be, I suppose. I've packed a bag of comfy clothes and another bag of healthy snacks to counteract the hospital food. I'll be arriving with a little mini cooler and another backpack full of books, magazines, card games, laptop, iPod, crosswords, word searches and various other distraction paraphernalia. I think I'm covered.

Now it's time for what is hopefully a good night's sleep then check-in under "Diamond" at 8 a.m. Maybe there'll be a towel sculpted into the shape of a swan waiting on the hospital bed to greet me.

Dream Fulfilled for a Borderline-Obsessed Rocky Fan

Cancer, you don't have a fighting chance. "Eye of the Tiger" is putting it mildly. I've eaten lighting and crapped thunder before, and I will do it again with gusto. Whatever it takes, I'm ready for the fight.

The Game Plan

Here's a breakdown of my current understanding of where this crazy road will take me over the next few months. There's lots that will be happening in between these milestones, but these are the highlights. I by no means have it all figured out yet and there are lots of variables on the timing of things, but after a meeting with my new cancer-kicking team at Yale, lots of online research and scans through my spiral-bound "Yale Cancer Center Autologous Stem Cell Transplant Program Patient and Family Resource Guide," this is how things are shaping up in my head:

-Now: More hormone injections, ultrasounds and blood work

-Wednesday, Feb 17: Egg retrieval surgery, ICSI happens, and we'll know if the eggs fertilize by the next day - they'll incubate those that do fertilize and freeze the ones that grow to 8 cells becoming embryos.

-Thursday, Feb 18-Sunday, Feb 21: The last hoorah - recovering from surgery and trip to Philly to run up the Rocky stairs and eat a cheesesteak then down to Virginia to spend some down time with my college roomie and her fiancee.

-Tuesday, Feb 23-Thursday, Feb 25: Pediatric ICE high-dose chemotherapy begins as an inpatient at Hartford Hospital. It consists of Ifosfamide, Carboplatin, and Etoposide and is often used against recurring lymphomas and those preparing for a stem cell transplant. Because I am "young and strong" they are given me the higher dose high-dose chemo given to children because they can more easily bounce back from it. The chemo infusion will last over three days and I'll be in the hospital for all of it so that I can be monitored for my symptoms, given the correct amount of fluids, etc.

-Back home to recover for approximately two weeks: I'll be receiving shots of Neulasta during the off-time – same premise as the Neup shots I'm used to from the first go-around, but more hard-core.

-Once my blood counts recover I'll go back for a second and likely a third 3-day in-patient ICE infusion with two weeks recovery between each

-Down to Yale for a PET-CT Scan: The goal is that the ICE will have put me into complete remission (no signs of cancer). From here on out, I'll be under the care of Dr. Cooper and his stem cell transplant team at Smilow Cancer Center at Yale.

-One week's worth of Neupogen shots twice a day to skyrocket my blood cell count and force me to create millions of stem cells, the creators of all other cells. Normally there is only 1 stem cell per unit found in our blood as most live in the bone marrow. They are going to pump me up so hard with the Neupogen that the stem cells will be forced to push out into my blood and the goal is to get 5,000,000 per unit. And I thought I had bone pain during ABVD while my marrow was working hard. The nurse told me plainly that I may feel like I'm having a heart attack because the bone pain, especially in my sternum, will be so bad.

-Pending a high enough count, it's time for stem cell collection: I'll be hooked up to an apheresis machine for 2 two 3 hours at a time for 1 to 5 days depending on how quickly my body produces the stem cells. I'll have an IV pulling blood out of one arm; the blood will travel through the apheresis machine which will scan for stem cells and trap them inside of it; then my filtered blood will go back into my body via an IV in my other arm. This is all an outpatient procedure. What they collect will be bagged and frozen in storage.

-One to one-and-a-half weeks to recover.

-High-dose chemo part II: I'll go through six days of another high-dose chemo regimen called BEAM (Carmustine (BICNU), Etoposide, Cytarabine (Arabinoside), and Melphalan). This regimen is so toxic that the stem cell transplant is required as a recovery method from it. A normal body would not be able to rebound from it which is why a new infusion of blood cells is required for survival/cure. I'll go down to Yale to receive BEAM chemo every morning for three hours then come back home and a nurse will come to our house and administer it every evening for another three hours. I'm told that I will have a lot of diarrhea. In the words of my new oncology nurse at Yale, Erin, "I will think that I am going to pass gas, but it is not going to be gas ... ." I like her candid nature already.

-On day 7 of that week, my frozen stem cells will be re-infused into my now blood cancer-free body: Leading up to this we'll be counting up to it as in "Day -6," "Day -5" as I go through the BEAM. It all leads up to the day of the re-infusion: "Day 0," meaning that my body is starting from scratch and as I move forward it is Day +1, Day +2, etc. It's a rebirth in a way. I'll be starting from scratch with no abnormal, mutated cancer cells.

-Two-week hospital/hotel stay: After my stem cells are re-infused will be the most delicate and dangerous time. The effects of the BEAM will kick in and my white blood cell count will literally be down to zero. Added bonus, I'm told that my entire body will smell like a combination of "garlic and creamed corn" as a result of the preservatives frozen with my blood. It will take the stem cells some time to create the red and white blood cells and platelets that my body needs. Stem cells are the "mother cells" which in a way, "give birth," to all of the cells in our body. Half of patients that go through this spike a fever afterward and I will need to be checked every day and receive multiple blood transfusions. Plus, my immune defenses will be nonexistent. Because of this, I will be put up at a hotel that is five minutes from Yale so that I can easily get back and forth. I won't be allowed to be left alone and I won't be allowed to go to restaurants or any public places, just the hospital and the hotel for 12-14 days.

-Lots of antibiotics and scans for a long, long time

Overall, the ICE will be about two months and the stem cell transplantation process takes about 3 months so it's looking like June will be when I begin to get my life back again - new blood cells and all. I'm very ready to get started. I feel like I have a good understanding, at least enough to know the many questions that I still have, and I'm so very grateful that this opportunity for a second chance at beating this cancer exists. There is a 30-50% cure rate after high-dose chemo and stem cell transplantation and after Dr. Cooper met me and assessed my specific situation, he said I have a 65% chance at success for a forever cure. This is the same chance Lance Armstrong was given at the onset of his treatment and look what he's done since. I don't doubt for a second that I'll make it through this and come out stronger and more full of life than I've ever, ever been. It's just going to be one hell of a few months.

The Little Follicles That Could

Something is brewing. Despite all odds, my little follicles have made a remarkable growth spurt over the past two days. We had another ultrasound appointment this morning and low and behold the few follicles that were just emerging during the last disappointing ultrasound have now sprouted and pushed their way toward maturity (with the help of these past two days of hormones, and I like to think all the walking and visualizations I've been doing and all the grapefruits I've been eating).

Craig and I were completely taken aback when the doctor went over the numbers with us and said how much more promising things looked and how pleased he was. We went in there ready to pull the plug on this ordeal knowing that we gave it our best shot. But this time the bright, white room felt illuminated and refreshing. This experience has been nothing less than a roller coaster ride - the kind where your feet dangle unprotected below you.

We now have four mature follicles to work with, each of which could possibly contain an egg. This is nowhere near the dismal news we received on Wednesday that just one was mature with three showing potential. These little guys have pushed right past the 10mm marker necessary. I knew all the swelling and bloating I was feeling had to be a good sign. My ovaries were just a little slow - they're allowed to get chemo brain, too.

This is still of course nowhere near the 10 follicles that they like to see when doing a retrieval, but clinically, the doctor recommends that we move forward and that our chances of getting 1 or 2 embryos to freeze are good. Is the situation ideal, no? But for the hand we've been dealt, we're very happy.

We decided that the fact that these follicles are fighting so hard to grow means that we can't give up right now. Someone (baby Frosty, perhaps?) is trying to tell us something. So we're going ahead with the retrieval - fully knowing that the chance (though smaller) still exists that we'll end up with no eggs or with eggs that don't fertilize through ICSI. But if we don't try then we'll never know, and the last thing we want to do is look back on this chance with regret in the future.

We're prepared for it not to work out and will be completely fine with that. We know that having a biological child is not the only way to be a parent and look forward to the chance to create a family no matter what the "means" of making that family is. Like "Brangelina," we'll have our own United Nations of love under our roof. But maybe, just maybe, there'll be some mini Craig-and-Karins in the mix.