Monday, August 20, 2012

Planes, veins, and automobiles

Had more than a little excitement last week, especially on Wednesday and Thursday.

Wednesday began with a float plane ride from Sechelt to downtown Vancouver (Coal Harbour). Phil gave me a couple of tickets before he left, and this was my first chance to use one. Picked a beautiful day for my first ever float plane experience. Only thing that would have made it better would have been the chance to sit up front in the co-pilot's seat, but a rather burly businessman beat me to it. At least I had the back seat to myself so could enjoy the view out of windows on both sides.
Float plane dock at Porpoise Bay just prior to take off.

Sechelt from the air. My house is hiding somewhere just beyond that long string of houses in the background.

Coming in over Stanley Park.

Vancouver seconds before we touched down.


Enjoyed the flight enough to do it again sometime. The flight was very smooth - only turbulence was felt when passing over the bit of water between Keats Island and Bowen Island. Travel time was 1/2 that of the ferry, and I arrived considerably closer to my destination. Also appreciated the fact that a free shuttle bus was standing by on the Vancouver side waiting to whisk me to the Skytrain station so that I could quickly and easily make my way to the Cancer Agency. A float plane ride: one more thing off my bucket list!

Little did I know that more excitement was to come once I got to the Cancer Agency lab. Had to give yet another vial or two of blood so the study group could record the various levels just prior to my receiving the chemo drug.

Things were progressing normally enough until the lab tech called my name. That's when the man sitting next to me (he had been there for about 10 mins) touched my arm. It was Jim Toy, principal of False Creek Design Group and former president of the Interior Designers Institute of BC, and someone who I knew quite well in my former life as a architecture/design writer. Jim has had his own cancer battle, and now his mom is also going through it - she was the reason they were at the Cancer Agency. Jim and I spoke briefly before I went in to have my blood drawn. I sat a bit longer in the chair than most following the procedure as I have to press on the puncture site for a while due to slow clotting time (thanks, Dalteparin). When I was finished, I stepped back into the waiting room to talk to Jim and his mom a bit before they, too, met with the morning's vampires. The conversation was cut short, however, when Jim suddenly noticed that the right sleeve of my white linen blouse was rapidly becoming more wet red than dry white. Back in to see the lab tech for a quick clean-up and clean dressing. Made sure things clotted better the second time as I kept pressing the puncture site the whole time Jim and I talked (about another 10 min). In the meantime, his mother opted to go to the treatment room by herself so Jim and I could continue our conversation. When she re-joined us, she insisted on holding her puncture site for at least 10 more minutes. "I don't want to look like her," she told Jim in Chinese! I replied that she need not worry as she already had on a red t-shirt. We all laughed at that. Left the building together as I made my way to the Fairmont Building to see my oncologist at the day clinic.

My oncologist was off on a much-deserved holiday so I had a locum, a woman I had met at least once before. She spoke very fast and I had a bit of trouble following some of what she said. But she wore beautiful blue shoes, so I forgave her. In addition to confirming that I would be getting the study drug, the locum also went over the results of last week's pre-chemo/baseline tests. Seems my back/hip issues are caused by an abnormality in the sacrum (large, triangular bone at the base of the spine and at the upper and back part of the pelvic cavity, where it is inserted like a wedge between the two hip bones). The abnormality showed up on the bone scan, but only a biopsy will confirm whether it is arthritis, osteoporosis, or metastatic cancer. The locum suggested (as did my oncologist) that there might be some benefit from a course of radiation at the site in question as well as the area of my shoulder/neck that is also proving problematic. If that course of treatment was given, there would be a delay in the start of my participation in the drug study. Soooo, I suggested we go ahead with the drug study and, if the back/hip and/or shoulder/neck pain gets worse apply the radiation treatment then. The locum agreed that was the best course of action. So that's what we're doing.

Other than the sacrum issue, not much else was new re the bone scan. The CT scan should some progression of the disease in some areas, but stability or regression in others. On balance, however, everything shows some spread so back on treatment I am.

After the locum (and that day's student - there's a different one every visit) finished poking and prodding and going over the various test results and letting me know how the study would go, I met with the study nurse who went over the study protocol and procedures one more time for good measure. The study nurse reminded me that I could obtain copies of any of my oncology reports or tests results by asking at the release of information office at the cancer agency. I'll do that tomorrow. I'll also drop off the prescription I was given for Imodium at the agency's in-house pharmacy en route to treatment tomorrow (yes, I know Imodium is an over-the-counter medication, but the 'script enables me to have it for free and also enables the study team to count the number of doses I took should I have messed up my record-keeping in some way). I was then released for the day.

Had a very nice dinner with Donna and our friends Karen and Fang (pronounced Fong - she happens to be a microbiologist at the cancer research centre).

On Thursday I reported to the Cancer Agency at 10:30am for my first dose of NKTR-102. Unfortunately, the pharmacy only didn't see the note that indicated my latex allergy until after the drug was prepped for the IV. Turns out the plug in the IV bag was made of latex and there was concern that it might contaminate the drug and, thereby, affect me. So I spent the better part of two hours doing crossword puzzles, reading, and listening to my iPod while the pharmacists scrambled to get the thing sorted out. When it arrived, it was in a brown plastic bag - turns out the drug is somewhat light sensitive. The plastic bag acted as a shroud that hung over the IV bag while the drug was being administered.

The nurse at the chemo day unit told me to let her know if I experienced any of the following while receiving the drug: sweating, watery eyes, runny nose, excess saliva in the mouth. I had none of that, but I did have a headache. Was told that wasn't a noted side effect, but she marked it down just the same. The next 90 minutes passed without incident as the NKTR-102 dripped into my veins.

After saying toodly-doo to the chemo day unit, I rode to Granville Island via taxi. Didn't want to take public transit and/or walk in case there was a sudden side effect onset. Spent time at the studio with Roz, Penny and Barbara before Barbara left for the day and Penny rushed off to an evening event. Roz and I hung out, slurped gelato at the back of the market while watching the boats float by in rhythm to a busker strumming a Spanish guitar. We then dropped by Chapters so Roz could buy a book for Jon's birthday present.

When I first arrived at the studio, Roz noted that I looked a tad "spacey". Nothing specific, but just kinda out of it. I admitted to feeling a bit off, but couldn't say what didn't feel quite right. However, when I started looking at the books on the shelves at Chapters, my vision became noticeably blurred. In fact, it felt like my left eye was moving back and forth very quickly while my right eye was going up and down at a similar speed. Had Roz check my eyes. She detected no movement and reported that the pupils weren't dilated or anything. All appeared normal to her (she's an RN, so a good one to consult re such matters). She concluded that it was something operating at the nerve level. Since I was still able to manoeuvre normally and felt no pain or discomfort other than the blurred vision - which I knew to be a potential side effect of the chemo - I thought it best to see if matters got any worse before seeking emergency assistance. In fact, the sensation gradually lessened as the evening wore on.

Off for home then. Roz was driving Penny's car, which is a wee Suzuki and much smaller than her usual ride which is a Lexus SUV. Leg room was at a premium. Not only because I was sitting in the seat behind her, but because a bamboo ladder was hovering over the emergency break and stick shift at about elbow height. It was impossible to move the ladder to a more convenient spot because the entire  - and I do mean entire - car aside from where we were sitting was stuffed to the gunnels with all things fibre as Roz and Penny were transporting their wares to the Sunshine Coast where they would be offered up at the annual Hackett Park Craft Show/Sale. I could barely see out the front window from my vantage point, but somehow managed to direct Roz from Broadway and Granville to Burrard and Davie where we were to rendezvous with Penny. Of course, B&D just happened to be the busiest intersection in the entire Lower Mainland at the time of day, and it took five light changes before we could make the turn off Burrard onto Davie. The delay at the intersection cut deeply into our narrow time allotment, so the drive to the ferry was something akin to a qualifying heat for a NASCAR race.

We arrived at the ferry terminal with plenty of time to spare. Good thing as there was some sort of delay at all of the ticket booths. After waiting at least 5-10 minutes, we managed to buy a ticket for the next sailing and still had time to drop by the Good Karma Kitchen for a pre-boarding snack.

A word of caution: If you should ever find yourself in need of a wee something whilst waiting for the ferry at Horseshoe Bay and you are not able to make the hike into the village for refreshment, do approach the Good Karma Kitchen with a healthy degree of caution. Note to self: DO NOT ORDER THE VEGGIE DOG!!! This warning comes too late for Penny, alas, and she was presented with a white hot dog bun that felt warm but looked suspiciously unheated. Further, the "dog" was the customary length but eight-sided as if it had just been extracted from a tight-fitting package. It, too, did not appear to be heated in any way. The colour was a most unappetizing puce. The only condiments on offer were a somewhat crusty French's mustard, green onions, and ketchup. I opted for the cinnamon bun, but since I later read the list of ingredients NOT in said confection (boxes of the cinnamon buns were stacked next to the order window) "cinnamon" might well have been the only thing I actually consumed. There was, apparently, no dairy, no eggs, no sugar, no wheat, no nuts, no raisins. At least it filled the void somewhat more agreeably than a puce veggie dog with crusty French's mustard might.

Hit the sheets within 15 minutes of arriving home.

Slept most of Friday and until very late Saturday morning. Also slept in on Sunday. Started feeling like "myself" on Monday afternoon.

Can't wait for the diarrhea to set in!!! Oh, wait. Yes I can!!

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