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Saturday, November 30, 2024
An Idea
Medical update
As they say at the start of each episode of the TV mystery series I am addicted too, "Previously..."
Originally, the rituximad infusion was in a "% solution" that required a large jar dispencing 900 ml. Initially, 12 years ago it took 2 days to administer. As they recognozed that I was tolerating it well, they increased the rate and soon I was spending only one day in the clinic.
This time around it was planned that I would again spend 2 days for the complete 900ml infusion. They started at 50ml per hour "to be cautious." I was convinced taht I could tolerate a faster rate and with my oncologist's blessing the rate would be increased according to how well I was reacting to it. Every half-hour the attendant would check in with me and I insisted they amp it up. By 3pm the last drop made its way down the tube and into my arm. I headed home having spent less than 6 hours I drove home. Thatwas October 2. October 30 I got hooked up for my second dose. I insisted they start at 100ml and they complied. It took 4 nhours after several increases. 26 November was dose number 3 and got a lovely surprise. As the attendant was attaching a small bladder to the "tree" and was about to hook me up, I said with mild alarm "I don't think that is my infusion." Two other attendants conferenced and decided it was, indeed, mine. Bless their hearts, they decided to alter the solution from that huge jar into this little clear pouch. The same amount of the drug was theie but in considerably less solution. I was overjoyed! I asked how long the this infusion would take. "We should be finished in about 90 minutes," Happy happy, joy joy... [Ren & Stimpy]... I was on the road by noon.
Indulgences
Day 3 was all eating, drinking and pampering. I got a haircut and the best pedicure I have ever had. We also visited Colectika Gallery which has become a pilgrimage on every trip. It's a well-curated gallery of indigenous art and we never get out of there without buying something. We also visited their second store in the ZR which was much smaller but equally well put together.
On our walk we passed a "shots bar" where one could walk up to a tiny bar on the sidewalk have a shot of your favorite spirits and be on your way. It was no bigger than your average walk-in closet.
Thursday, October 31, 2024
Two weeks later
Infusion number 2 went swimmingly! I was out of there before 2pm, a record. My white blood cells are back up to normal after a 6-month gradual decline. This indicates that the chemo is working. I am back on the Revlimid so coughing is back as well as some fatigue. Blood work on 20 November and infusion number 3 on 27 November.
Back to my vacation...15 October was a great activity day. We started with breakfast at Mi Cafe [Caroline's favorite]. We then went shopping and I purchased an old Huichol mask at the Olinala Gallery.
This is a little gem of a place offering older pieces of indigenous art artifacts. Wandering about we sampled beer & cocktails at Los Muertos Brewing Co. and Yambak. Yambak is a three story bar-cafe offering 20 artisanal beers and excellent pizza. The décor is graffiti inspired, playful and captivating. The other great feature is the men's room with a row of urinals fashioned out of repurposed beer kegs.
We walked to the Zona Romantica and dined on world famous tacos at Sonorita Ollas Altas. They also serve an excellent rum-laced horchata.
Back in "My Happy Place"
On the 14th I headed south to Puerto Vallarta. In my second week of chemo I was pretty aware of some side effects. Back in 2012, I had no side side effects... at all! This time with the addition of the Revlimid I knew right away there would be some. The most prominent side effect was coughing and it was chronic. The second was was my equilibrium but that was minor. It was most manifest upon standing but occasionally it hit unexpectedly. I also found that I was more fatigued after walks.
The afternoon we arrived we taxied to the condo [400 pesos] and got settled in. by the late afternoon we decided to walk to town for an early dinner and a stroll. We ate at Pipi's which is on the way to the Malecon. We polished off a couple of huge lime daiquiris, each. Dinner was delicious and I remembered how well we ate in Puerto Vallarta for about 25% what the same meal would be in the Burg. Believe me when I say that the food is top notch. The influx of aspiring cooks and established chefs creates a culinary atmosphere that borders on haute cuisine.
After dinner we walked to the Malecon which was bustling and lit up like The Strip in Vegas. sat for a few minutes to watch the Papantla Bird-Men [Voladores de Papantla]. They climb to the top of a flag pole, tie their waist to a tether, start the platform spinning and fly down to the beach spiraling arounds the pole.
It wasn't long before I realized I was intoxicated. Two Old-Fashions on the plane followed by two Daiquiris which were about 20 ounces each had me weaving and talking loudly. We cabbed home and put our feet up. About 9pm we were greeted by the familiar fireworks which go off every night from the "pirate" ship that cruises the Bay. I slept like a baby.
#lymphoma, #puertovallarta, #pipi's
Thursday, October 3, 2024
The Beach Chalet
The Beach Chalet is one of my favorite restaurants in SF particularly because they do good fish & chips. It is also a lovely historic building facing the ocean with nice views of the Ocean Beach and Golden gate Park and the Great Highway.
https://en.wikipedia.org/wiki/Beach_Chalet
Hooked up
After driving for 2.5 hours through horrible rush hour traffic, I arrived at The SFVA at 8:30. I'd p[lanned to have breakfast but now I didn't have time. They had me checked in and seated in the Infusion Clinic by 9AM. I did not have to see my oncologist which was odd. They ordered the Rituxan and it arrived 20 minutes later and I was hooked up.
There were no other drugs this time. They did give me Tylenol and a couple of Benadryl orally. The infusion started at 50ml per hour; after about an hour they raised it to 100. There was no adverse reaction so they upped it to 200 within the next hour. I had visit from my Oncologist so I asked if he thought I could go for the full 900ml in the one sitting. and he gave the nurses the go-ahead. I was up to 200 by lunch-time. Unfortunately, there was no lunch. I should have packed a sandwich. Note to myself for next time. I did have a bag of gummy bears so that sufficed. I was out of there by 3:30 so I headed for The Beach Chalet for fish & chips! That did the trick and I was on my way home. About 8PM I was completely spent and headed to bed. I was awake about every 2 hours still quite exhausted. I guess that was a result of taking the full infusion in one sitting. I started on the Revlimib pills when I got home; they were delivered that morning. Revlimid is the brand name for Lenalidomide which "exerts immunomodulating effects by altering cytokine production, regulating T cell co-stimulation, and enhancing the NK cell-mediated cytotoxicity." Basically it stops cancer cells developing, stops blood vessels growing in the cancer and stimulates part of the immune system to attack the cancer cells. The side effects are myriad, but considering how I react to drugs I am confident that I will not encounter any.