I ain't nothin' but a houn' dawg...

... sheddin' all th' time.

Today there was some serious molting, and the bare patches spread like a glacier in a new Ice Age. Also, the mouth sores, though not as bad as chemo week 1, are back in a fairly major way. I am not as unwilling to have them, though, as they are alerting me to the state of my immune system.

I've been able to work both days this week, and expect to put in about 19 hours. This will keep me in yarn quite nicely!

Hare today, goon tomorrow.

Yes, that's the punchline from the famous "Little Rabbit Foo-Foo" joke, boldly appropriated by me. Currently:

• Most of the hair is gone, though there's enough left to make the truly bare patches look ...disturbing.
• I have a new appreciation as to why men with short / no hair wear hats. I am wearing one well-nigh constantly.
• On the other hand, when I need some radiational cooling, it's available at the drop of a hat!
• There may not be a whole lot in my head, but there's certainly enough space for whatever's there -- in fact, if I didn't have a pronounced double chin, I'd look quite top-heavy.
• Our smaller kitty has decided that the top of my head is very nice to lean against.

Today was a quiet day, though I did manage to cook a real dinner (sauted chicken breasts in a shallot pan sauce with baked potatoes and broccoli.) And tomorrow, I'm going to try and do some work.

And the hair is leaving, right on schedule!

The little bristles of my whiffle-cut are falling all over the place. It started this afternoon, and just yesterday -- nay, this morning -- they were as secure as if they'd be there forever.

This is just what the medical oncologist predicted. "Let's see," she said, "Your first treatment is September 12? You will lose your hair September 30." Amazing thing, modern science. So glad I had my head shaved; it would be very difficult to stay calm about this while pulling big clumps out of my head.

I have towels on all the furniture I normally use, and we're not changing the sheets until the moulting has abated. Then, like a bird, I will await my new feathers.

The third day seems to be the iffy one.

I was full of steriod-fueled energy yesterday and this morning, but faded in the afternoon and actually had a bout of nausea (though no sickness) this evening. No mouthsores as yet, though I can feel them in the offing. I am trying a new mouthwash.

I did get a lot done today, though; many bills paid, some writing done, even a bit of my own work, plus picking up for the cleaners. And yard work! I have a whole strainer of green tomatoes, and Grandpa's tomato pickle recipe somewhere on my computer...

Not such a smooth groove, this time.

We got to the D-F rather early for our 11:15 appointment, and were very pleased to be taken immediately by the lab nurse. The IV line was placed in my hand, as it was last time, but it wasn't quite as comfortable (more on that later). Blood was drawn, and as we were wafted to the 9th floor by the elevator, we were thinking, "And maybe the doc will take us early, too." I had had a bit of pre-chemo anticipatory nausea, and so was riding in on an Ativan, which may have aided this delusion.

No such luck. "Just so you know, the doctor is running about an hour and a half behind schedule."

When I was called for the taking of the vitals, I mentioned that I would be amenable to seeing the nurse practitioner. "She has a patient scheduled too," I was told, "but we'll see what can be done."

The urgency is that I have to have the Neulasta shot (I had nearly written "foolish Neulasta," but since my red and white counts are both fantastic, I will refrain from bad-mouthing the Wonder Drug) 24 hours after the chemo treatment starts, and so, since chemo was scheduled for 1 pm, I had scheduled the shot for 3 pm.

At 1:30, I saw the NP. Looks like I may not see the actual surgical oncologist ever again, based on the schedule for the rest of my treatments. We talked about this and that, and I learned a thing, namely that withdrawal from steroids can cause shakes and heart flutters. So, instead of using less decadron, I will use more, tapering off instead of stopping with an abrupt bump.

Then there was a half-hour wait in the infusion waiting room, while the infusion gnomes hand-mixed my particular kill-to-cure brew. We are now pushing 2:15, and I am starting to stress, because re-scheduling the shot will not be fun.

Finally, we were brought into a slightly less pleasing infusion cubicle than the last one, and that's where the fun started. See, the first chemo, the one they "push" is a  vesicant, so it's really important that it not leave the vein into which it is getting pumped. (I will ask how it doesn't damage the vein next time -- I do know that this one can damage your heart.) And as the infusion nurse began to administer the drug, my hand began to hurt. Not burn or sting, but really hurt, both downstream from the insertion point and around it.

• Analysis: The IV line is poorly placed -- probably nudging the wall of the vein. Best to replace it.
• Further Analysis: If you are having infusions at Dana-Farber, ask if Anne Lundquist can be your infusion nurse. The woman knows venous anatomy, people. She went for the large vein that curves around the outside of the forearm like it was a well-known street a few blocks from home.

And all went smoothly after that. Also, I learned another thing! (Two in one day!) It seems that:

• Some mouth sores can be quelled by chewing ice while the chemo is being administered -- but alas, not for this type of chemo.
• The mouth sores generally are worst when one's immune system has crashed. Therefore, they are a fairly reliable indicator of when one ought to be staying away from folk.

This fascinated me, and made me feel rather differently about the durn things.

I do feel both peculiar and queasy, but I was able to eat chicken-and-rice soup with a zucchini cut up in it. (I am not telling anyone how long it took me to type this entry.) And now, bed.

(Oh, do not be scared by the pictures in the Wikipedia entry. This is much more mild.)

Hairlessness is strange

Today I had the nice lady who cuts my hair shave it all off.

While it would be nice to believe that I wasn't going to lose my hair at all (and it certainly looked all strong and springy), certain signs from regions other than my head are warning me that the lossage has begun. So, she gave me a wiffle, which feels really strange. Girls almost never have cuts like this, and I had no idea that hair was so firmly directional in its growth. And family legend is correct -- I do have two birthmarks above and behind my right ear. I can't see them, but confirmed that they were their. The lady with the clippers referred to them as "raspberries," so they are not large.

I don't look as bad as I thought I was going to, which is a relief. The eyes looking at me in the mirror are still mine, and with a headscarf on I look like something out of Bruegel. Or a Pirate Queen. Or both!

Since we had a warm and humid day, the cooling and evaporative functions of hair were immediately apparent by their absence. But, I will adjust. I think I will be more comfortable, though, when the hair finally does fall out and I don't have to deal with all these prickles.

I wish phrenology were still a science. Then I could Bare All for Science by simply removing my hat.

Honestly, I was a little distressed thinking that I might become distressed. And it is a bit distressing. A very ashes-to-ashes moment, seeing all one's hair on the floor like that.

"Behold your servant, Lord, a sheep of your own sheering."

A few homely truths

So, a few things I haven't read in the chemotherapy literature, but which seem to be true based on experience.

Chemotherapy makes one's urine smell like the distilled effluvia of a dozen swamp monsters. Not that I've spent a lot of time distilling swamp monster effluvia, but you get the picture.

Mouth sores happen mostly at the hinges of the jaw. This can make eating difficult even if you've rinsed with baking-soda so that your food doesn't make things worse. They also seem to occur at the edges of teeth. I've fallen asleep and awakened with a nice fresh crop, right along the line of my upper teeth. Therefore, one bites and chews with great care. If I needed lessons in attentive eating, this would be it.

Baking soda rinses make orange juice taste very odd indeed.

The weary, weak feeling caused by chemo is more like mono than it is like the weariness after surgery, or childbirth. One feels as though one could zip through a series of errands, only to accomplish one or two and have to return home for several hours of rest. (I would not have expected the literature to tell me this, because how could the writer know the reader's experience of health or illness?) I expect that my experience with all three sorts of exhaustion is helping me to bear this -- it must be pure hell for some of the more vigorous, athletic types to be so reduced.