My Personal Best (or Worst?)

In thinking about the Winter Olympics next month, where athletes not only hope to win but also to set their "Personal Best" records, my latest little joke is that I've been continuing to set my Personal Best in the chemo competition. That is actually one of the games you don't want to win. It is a select group, however - it's not as if just anyone can get chemo. You have to qualify with a scan or a blood test, and you could say it involves a lot of training and a support team (doctors, nurses, friends - as opposed to coaches, massage therapists, and teammates).
Since I was diagnosed in April 2009, this is my longest run of chemo without a break. With this chronic disease, what you're working toward is periods with "no evidence of disease" (NED, pronounced like the man's name). Women with this cancer look forward to "dancing with NED."
For example, I had a few months of treatment, then was NED for 6 months, restarted chemo and had, say, 4 months of NED. ...
My current record starts in mid-Oct of  2012 and is still on. There are 2 tiny tumors remaining in my abdomen, and I'm not done until they disappear from the scan.
I get my treatment - a traditional chemo drug plus a newer targeted agent - every 4 weeks. (Before switching to that combo of drugs in mid-August, the schedule I'd always had was weekly chemo 3 weeks out of every 4. The schedule varies depending on the chemo drug and other factors.)

Yesterday was my treatment day, which typically involves 3 stops at the cancer clinic:
1. Lab to draw blood to make sure my system is strong enough to benefit from the chemo. For example, some chemo drugs are known to be hard on your red blood cells, so they want to check that the level is high enough; if it gets too low over time and continued chemo, getting a blood transfusion will fix it.

2. A nurse does the initial intake to check my vitals, medications, and latest side effects, then Dr K shambles in. His presence is so modest - he wears a tweedy blazer, not a lab coat. You wouldn't know what a great doctor he is, or how accomplished he is in other ways: researcher, photographer, climber. Or that he is a family man, who the chemo nurses have described doting on his granddaughter. When chemo nurses get cancer, they go to him. He treats everyone from VIPs to charity cases.
Typically I don't have many issues I need to discuss with him, and we'll just chat or joke about politics, because otherwise we would cry about them. He told me clearly when I first saw him that an office visit lasted as long as a patient needs. For some reason - it wasn't on my conscious agenda - at that first appointment I asked about end of life issues, and he said we could always talk about it, and that we could also schedule an appointment at the very end of the day so there would be no pressure to end it at a particular time! Who is this man?

It's very cheerful there, throughout the clinic - from the receptionists to the nurses to the security guards. As a regular, they all know me by name; we're like friends. There is so much laughter. Who are these people?

3. If I pass the blood test, he sends me down to the chemo floor, where I get hooked up to the IV machine and start getting infused with "pre-meds," which help prevent reactions, then one chemo drip over a period of hours, followed by the other chemo drug over a few more hours. Lastly there are a few "flushes" with saline and Heparin to clean out my port, a device that was years ago was surgically implanted near my collarbone that makes my blood system easy to access. As someone with bad veins, I particularly appreciate the port, but even patients with good veins like their port from everything I've heard. If you're anticipating ongoing treatment, ports are so very nice to have. The total visit time varies, as you might expect given all the variables above, but usually runs 6-7 hours.

So, yesterday was my chemo day, but surprisingly I did not get chemo. When Dr K saw what the chemo drug had done to my skin, he said there was no way I was getting treatment, but instead was to take a break for at least 2 weeks to recover. I'm to check in with him early next week if I think I could benefit from seeing a dermatologist.
In early February Dr K and I will meet just for an office visit to discuss which of the drugs on the menu I should try next. I already know the main possibilities, and we've discussed their pro's and con's at previous junctures; in fact, Dr G (the great 2nd-opinion specialist I somehow managed to see twice) gave me an ordered list with additional reasons, so I already have a pretty good idea where I'm headed....

... which is to Vancouver next weekend to the Western Canada Dharma Celebration, with Gen-la Dekyong granting Amitayus Empowerment. Blessings of long life, good fortune and wisdom. Just what I need - what we all need. Thank you Buddha.
I even hope to attend her Modern Buddhism public talk on Thursday evening.

Hope you can make it.