I had a CT scan yesterday, and saw the
nurse practitioner who works with my oncologist today. Nine weeks
after starting the latest round of chemo in March, the first CT
showed a decrease in tumor size across the board. Nine weeks later
there was no change, The latest scan nine weeks later again showed
no decrease. While the nine rounds of infusion have arrested the
growth of my tumors, they have also done something of a number on my
red blood cell (RBC) count. The count has been in steady decline
across the months. The nurse said, the decline in my hemoglobin
associated with the RBC decrease is the equivalent of loosing two
units of blood--perhaps 25-33%. No wonder I've been dragging around
and tiring easily. My fatigue was the worst from 5-9 days after my
last infusion when my RBC count was probably at its lowest. I've
learned that even with high blood oxygen readings thanks to my
supplemental oxygen, a shortage of RBCs can leave me easily fatigued.
On Saturday we went on a short hike in Guanella Pass south of
Georgetown, CO with my cousin Jodi and her husband Darrell. That
mild exertion at 8-9,000 feet and almost three weeks after the
infusion left me very short of breath even with supplemental oxygen.
It was so bad that I saw red flashes in my visual field for the first
and hopefully the last time.
Consequently, I'm taking a break to
let my RBC count get back to a reasonable level. In looking over my
infusion history since starting to receive pemetrexed in Colorado in
December 2011, I found that I have had infusions about half of the
time. I proposed (and my oncologist accepted) that we try a pattern
of nine-weeks on chemo followed by nine weeks off which will provide
chemo 50% of the time. Since I just completed 27 weeks on chemo, I
started my nine weeks off today. In five weeks I'll go in to have my
port flushed, and I'll get a CBC at the same time which will tell how
well my body is replenishing my supply of red blood cells.
Four weeks later, I'll have a CT and
meet with the doctor to see if it's time to begin chemo again. I
look forward to having more energy and getting in better physical
condition.
David
