Sunday, January 3, 2010


4..3..2..1.. I can finally see the light at the end of the chemo tunnel, and I'm hoping that these last four rounds will disappear without much trouble. Over the past two days, number four came and passed, so I'm left looking at three remaining rounds of chemo on this torturous schedule.

Over the next few days, I'll be expected to take four times as many Neupogen shots in order to spike my white blood cell count far beyond the threshold of adequate recovery. The doctors are intent upon harvesting my stem cells, freezing them and keeping them available on the off chance that my body forgets once again how to make new, healthy bone marrow. At this point, such a development seems unlikely, and the vaccinations I intend to receive at NCI will cover the purposed accomplishments of a stem cell transplant, anyway, but I suppose I'd rather be safe than sorry.

Harvesting my cells will entail connecting two IV lines, one from each of my arms, to a machine constructed for the very purpose of collecting blood content. For me, it's a "been-there, done-that" kind of experience, though I hope that this time it doesn't quite last seven hours and I can manage to walk away from it without any ruptured veins. When I went through a similar procedure during my first stint at NCI, I had a tumor fever, the actual procedure took three hours longer than anticipated, and one of my veins popped like bubble wrap and bled profusely. I'd like to believe that I've already seen the worst that can happen, and while I hope it goes more smoothly this week, at least I know I'm prepared for anything.

Either a stem cell transplant or the administration of these vaccinations down at NCI in Bethesda, at least one or the other, will inevitably come to pass. The intention of such procedures is obviously to keep me healthy for as long as possible, and realistically to save my life. Unfortunately, they each require that my immune system be beaten and battered, broken down to a level of complete vulnerability, which can conceivably be dangerous, and will most definitely be uncomfortable for me, to say the least. My guess is it will be just like the beginning of chemo all over again, when I routinely yearned for death and an end to what seemed like never-ending, inexplicable misery. I'm hoping that this time I'll be better prepared for it, though I really don't think it's something for which I can realistically prepare myself.

Preparation can really only take us so far, and pain will feel like pain regardless of how ready you are to be overcome by it. Being prepared is far from being able to protect oneself, which is damn near impossible as far as I'm concerned.

When my grandpa had a stroke, I knew his time was limited, but I couldn't prepare myself for or protect myself from the pain of losing him. When my girlfriend first spoke of leaving New York for a job and a life in Boston, I was made aware that our time together might have begun to dwindle, and despite my denial, I don't know what I could have done to protect myself from that impending pain. And now, having met someone who has lifted me from the depths of sorrow and taught me to believe in this life again, I'm constantly reminded that despite my deepest wishes, I can do nothing to protect her from her own cancer. For me, I can remind myself what it was like to have my body broken down to nothing, the way it will be again, but I know there's no feeling like the real thing, no camouflage behind which I can hide, and nothing I can say to myself that will fully prepare me for it.

It is, nevertheless, a part of the process, and I'll gladly take my beatings if it means surviving this thing. I still have three rounds of chemo before I undergo more scans to determine the length and intensity of the proposed radiation I'll receive prior to the vaccinations or even the notion of a stem cell transplant, so I'll continue to proceed one day at a time. (I've learned that this is the best, or really the only approach, since my requests and attempts at falling asleep for days or weeks at a time have gone for naught. Honestly, at this point, I'd gladly settle for sleeping through an entire night.)

There's a lot we can never be prepared for, but I'm going to do my best to run through these final three cycles like a bull. Chemo is one obstacle for which I feel as prepared as I'm ever going to be. And I'll keep treading towards that light at the end of the tunnel, because with each passing day, it can't come anywhere but closer.