Shifting gears: I can definitely tell that those G-CSF injections after my last chemotherapy helped me bounce back better. This time: no injections. This time: I’m feeling weaker than one row on a calendar.

See? Even my bad jokes have low blood counts!

Current side effects on tap include getting all bloaty from just about anything I eat, and a noticeable increase in the loss of sensation in my fingertips. The former is annoying, the latter is worrying. Here’s hoping the numbness is reversable!

And my heart has again started faster than normal while at rest. Since I’ve already run into this on a previous cycle I’ll be able to keep more calm this time. CALM!!!

All of this has happened before, and all of this will (likely) happen again. Three more times.

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.

When we got to the desk the friendly staff announced “you must be Tom Music!” My reputation (and my appointment) preceeded me.

They took me to my room, showed us where to find the snacks and then an oncology nurse came in and gave me a “chemo teach” — a summary of all of the drugs I was going to receive, and the possible side effects.

In the meantime Nurse Ruth Ann was plugging into my chest port, preparing all of the equipment needed to start my magical journey.

The waypoints for the day were Adriamycin, Cytoxan, Vincristine, then Rituxin. The Adriamycin came in three large red syringe canisters — like some sort of massive poison Jell-O shooters.

Before we began, I got more information on the UW’s analysis of my lymph node biopsy. A few things stood out in the report:

• There were two separate colonies of cancer cells
• It could be that one was a slow-moving, and spun off a more aggressive type
• It could be that both are just different forms of a more aggressive type

Even though we didn’t have a definitive result yet, the likely presence of an aggressive cancer meant that R-CHOP was the way to go.

One more cc of Dilaudid helped to get me more comfortable, and then it was time to get started. In went the Adriamycin. She did that one by hand, since they need to be able to stop instantly if anything looks like it might be leaking. That stuff can burn!

Next the Cytoxan. Then lunch arrives! A tasty sandwich for me and my suite-mates. Grog all around!

The Vincristine starts up and goes without a hitch. Next up is the Rituxin. This is one that can cause allergic reactions, so they start really slow and crank up the pace every half hour.

We start at 50cc/hr. Little to no trouble. Bump it to 100cc/hr; starting to get a bit of a rash. Breath feels “heavier.”

My dad flew into town from a business trip so he could be around for support; he and my mom arrived just when the Rituximab was starting to get to me. Poor kids, they missed the easy part!

They crank the drip to 150cc/hr, and the rash gets a bit stronger. My head is itching. My stomach starts to feel bad. We go to 200cc/hr and there was pain in my belly and up my torso inside. Made use of a blue bag. It was time to stop cranking up the pace: we’d found my maximum.

It sounds like the pain I was experiencing could be some immediate tumor cell death. My spleen was a major cancer hog, and I had a ton of lymph nodes up and down my abdomen that were enlarged. That is indeed where most of the fighting would take place.

I’ve developed a fever during the Rituxin, so they Tylenol me up. As folks help swivel me off the bed into a wheelchair, I notice that flexing my abs doesn’t hurt my shoulder anymore. Hooray for progress!

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