The side effects of the Cytoxan, and at this high of a dose, have been memorable. Diahrrea. Vomiting. Simultaneously. At least four episodes in the middle of the night. My mouth started getting sore, and I’ve just felt all-around miserable!

But now a bunch of hours have passed, and so has the vomiting. Things are more bearable.

Tomorrow is “day zero”: when I get back the stem cells we collected in November. I wonder if I’ll still recognize them! The event itself won’t be fancy (or a ceremony), but it marks the end of us trying to damage my body on-purpose. And that sounds like a day worth marking.

Also, Jana brought me a stuffed robot that I love and have to share with you all. His name is “Ondansetron”…

Also, since I wasn’t in the same intense pain as last time when I started chemo, I’m not all hopped up on opiates today.

This means I’m fully awake and aware to notice the return of metal mouth. I haven’t had anything to eat yet, but my mouth already has a metallic taste.

Not to mention that my head and stomach feel hung-over. I already had a bit of that before I started sleeping for 10 hours though.

Another interesting point about today: my doctor felt that with how low my blood counts were before chemo, and with the expected drop due to the chemo, that I ought to have a round of colony stimulating factor treatments. These treatments use a genetically modified form of E-coli bacteria to deliver a message telling my bone marrow to ramp up neutrophil production.

Once a day for the next five days I’ll be filling up a syringe and injecting myself in my belly. This five days of treatment would have cost $1300 without insurance! With insurance: $34. And it’s got to stay refridgerated or it’ll go bad.

Now I will sip my coffee and hope it takes not of metal. Cheers!

The first two days were a bit of a blur; I took the prescribed Ondansetron to make sure the nausea stayed manageable and some Dilaudid for some pain. Other than that, I don’t exactly remember what happened that day. Opiates: 1, Tom’s Memory: 0.

The day after makes more sense; there wasn’t any Dilaudid involved, but I remember aches and pains. And started to notice that things tasted weird. For the next week I would have the taste of metal in my mouth almost continuously. We picked up some lemon drops on the advice of the chemotherapy nurse; lemon drops cut through the metallic taste in saliva, providing a much-needed flavor break.

I had some pretty long-lasting indigestion, too. People described the few days after chemo as the worst hangover ever; I didn’t have noticeable nausea or headaches, but my body ached and my belly hurt. “Hangover” seems an apt description.

Another significant effect that I’ve noticed: peripheral neuropathy. I’m losing sensation in the tips of my fingers, courtesy of Vincristine. Apparently there is an 80% chance that I’ll recover from it.

Burning my mouth with hot liquids is another thing that I have to give up — I had some coffee and hot tea over the weekend, and my tongue is taking much longer than usual to heal.

In all, I think that the effects of the first round of chemo were not as bad as the warnings forecasted. I bounced back well, feeling a restored appetite by the third or fourth day, I think.

Let’s hope the next round goes as smoothly.

As long as I don’t vomit on my keyboard.

After waking up I had the pleasure of finding that all attempts to get out of bed were met with intense pain. Pain that motivated me to stay in bed and not move a muscle. Except for the muscles used in taking two Percocet, and calling the oncology nurse (Sharon) that works with Dr Norman.

I described the pain (shoulder pain, likely because of spleen interacting with diaphragm) and she paged Dr Norman to ask his advice. She called us back with the request that we head to Urgent Care, where she’d ordered some pain medication and a CAT scan.

We also called our friend Lauren (an EMT) for backup.

I got into the car verrry slowly and Jana drove Lauren and I to the hospital post-haste.

We checked-in at Urgent Care and were admitted right away, skipping triage and much waiting. Vitals were recorded, a bit of blood was drawn, and then we got started on medication.

First was the awesomely-named anti-nausea drug Ondansetron, which would be a great name for a disco robot.

Then they got to the actual pain medication: Dilaudid. It’s just about as close as you can get to pure opium. I didn’t notice tremendous effect, but my dosage amount was pretty low.

Then: a surprise visit from Dr Norman! He stepped in to give us a briefing on the next steps. He didn’t have the full pathology report on the lymph node yet, but he was hearing unofficially that there appear to be colonies of more than one type of lymphoma. His suspicion is that I could have LPL that has spun off an instance of DLBCL along the way.

That’s right… I may have double cancer. Trump card for sympathy! Twice the bounty when I beat them both!

The chemotherapy would be intended to attack and destroy both cancers during the series.

We launch our attack tomorrow at 10am.

After some time to let the medication kick in, they took me downstairs for another CAT scan. We wanted to ensure that this pain wasn’t due to some sort of rupture or bleeding. Sure enough, my spleen is totally intact.

As the level of pain itself was not reduced, and judging from the serious effort it took to get out of bed this morning, the doctor in Urgent Care recommended that I stay in bed overnight in an observation room. A scant hour later we were on our way to the room.

And so here I sit, just about ready to fall asleep. Tomorrow will be a big day: the beginning of a long series of chemotherapy. I feel anxious about having my body burned from the inside, and dealing with sickness and reactions I’ve never known. But I’m ready to start removing uncertainty, to continue trusting in the support of friends, and to give these cancer cells a much-needed “etiquette lesson.”