Day -6

Day -6 began even earlier than Day -7, because I had just moved into my new, real room in the transplant unit. It is the biggest private room I have ever had, and well worth the small extra wait. I was excited to decorate and set up my work space, so I got up a bit earlier than planned to do that, which meant I had to take a power nap as we waited to get my radiation treatment.

Fortunately, that nap lasted a while. You see, there is a typical bureaucratic communication snafu between the powers that be at the Radiation Oncology Center and our helpful nurses on Davis 8, so even though Rac Onc Procedures dictate that I must have a 6-hour break between radiation sessions, they insist on having the more than officious transport crew come to get me at 2:15. No matter that they know that my morning radiation session ended at 9:10 AM or so and the soonest they can begin my treatment is thus 3:10. And no matter that the trip takes 5 minutes at the very most. And no matter that my nurse tried patiently to reason with them. So I get hustled over to wait for quite a while, plenty of time to snooze strapped into my padded gurney.

The radiation treatments themselves were uneventful today, since I did not feel faint or anxious, though I seem incapable of holding still for long enough to allow the techs to be confident enough than I’m in the right position (they have to double check every time with a quick x-ray or four) until I am well and truly sandwiched from every angle. As if to underscore this tendency in a comical manner, I managed to get hiccups twice today, once just as my morning radiation treatment was ending, and once just as they were fitting me in for my afternoon session. They said it wasn’t a problem, but I think they were trying to seem understanding while shoving me about in every possible gentle way.

Anyway, we’re now halfway through the radiation, and the only ill effect I’m feeling is a bit of incipient constipation from the Zofran they give me every day before the treatments. So we’re going to up our anti-blockage game from just Colace to Senacot as well. My apologies for these gastrointestinal details, but being badly bound up on the inside is among the worst, most uncomfortable feelings I’ve had in the hospital, including my collapsed lung in May. Spoiler alert: these tummy issues will be likely to surface again, albeit in the opposite, far more volatile mode, later on, after I get the new stem cells. So in the meantime, let’s simply look forward to a more regular Day -5.

Day -7

Today began early, for me: a 6:00 AM wakeup for pre-meds to get me set for my first 7:15 radiation session. Ativan was delivered, as promised, and I even managed to gobble down some early breakfast before the transport team (I think you could call them the SWAT team and they wouldn’t be surprised or need much of a change of outfit) arrived. I am not allowed to walk any part of this brief journey across the road, for reasons that escape me but no doubt have to do with the transport company’s self-protective policies, so the transport team straps me into a gurney, raises me to a surprisingly, rajah-like height, and wheels me along briskly. I also need to wear a special gown, a hairnet, gloves, shoe-covers, and a mask; that’s for my protection now that I’m deemed to be immune-compromised, so fair enough

The radiation treatments today were time-consuming and uncomfortable, to say the least. I was wedged into a plexiglass-and-metal pole frame which (at the risk of seeming paranoid and hostile) reminded me of something that might be used to detain Hannibal Lecter during one of his less friendly moods. I had to stand as still as possible in this device for the better part of half an hour as they adjusted it, readjusted it, made sharpie marks on my chest and back, and asked me to move over an inch or so, stand straighter, or what have you, and then finally administered the dose. I appreciated the care they were taking; after an earlier simulation and fitting visit they had fashioned blocks to protect some of my vital organs from the extremely high doses of energy they were proposing to send through my body, and these blocks needed to be placed in exactly the right spots, for obvious reasons. I was like a slice of meat being grilled from both sides (morning front, afternoon back) and they wanted to make sure the right bits were being cooked.

The morning session was the worse of the two sessions today, by some distance; they did not let me know when I could relax my posture and so my legs began to feel cramped and stiff right away (and kept cramping throughout). Also, despite the Ativan, I felt light-headed and began to break out in sweat. Uh oh, I thought, here we go again… You see, I had had similar squeamish symptoms during the simulation visit, and at that time I had asked to lie down for a while before the sweat actually broke out. The little rest had done me some good, but had interrupted the process to such an extent that my helpers had wandered off for a while, confusion hadreigned, and one of the procedures they had needed to do had ended up getting skipped. Afterwards, I had wondered if I might not have done better to soldier on, so to speak.

So today, when I feared I was going to faint, I worked harder to breathe deeply (not easy when your upper chest is being pressed into place); happily, I remembered that you use your diaphragm, which is lower down, when you inhale. I could see my sweat pouring down the glass plate in front of me as I leaned my forehead against it, but I realized that I was so well and truly surrounded by restraints that the very things that were making me feel claustrophobic, or like I was about to be executed, were in fact going to prevent me from falling down. I could sag gradually onto the bicycle-style seat they had wedged just under my butt, and I would be fine. So that’s what I did. My head slowly cleared, and the sweating soon stopped. I started to object when one the tech referred to my sweating as profuse, but when I saw the extent of the smear I’d made on the glass around me, I decided not to quibble.

By the afternoon session, I had overcome whatever my morning aversion to the radiation setup was, and recited World War One poetry to myself in a silent whisper instead of having a meltdown. My legs were still cramping up from having to hold the same pose for so long, but that was manageable with subtle weight shifts and a few (now for some reason officially permitted) breaks to stretch and wiggle. Everyone says the radiation sessions will get much shorter from now on, and thus easier to get through (their medical effects won’t truly begin to be felt till they have ended, apparently), which is a good enough reason to be glad that Day -7 is more or less over, and to look forward to Day -6.

Day -8

Today is Day -8, the day I was admitted to the UC Davis Medical Center to begin the transplant process. They count the days a bit differently here (maybe so that the numbers don’t seem too depressing as they mount up): Day -8 means there are eight days left till I get my new stem cells from my brother James, and tomorrow will be Day -7, and so on. Then, once the stem cells have been delivered (on Day 0) we start counting on the plus side: Day +1, Day +2, etc.

Before today could really become Day -8, though, I had to leave our house and make it into the hospital by 9:00 AM. I did depart, more or less when I was supposed to, but with very mixed feelings. On the one hand, not everyone with cancer has the privilege of getting a shot at a cure, but on the other hand, since I don’t actually feel sick and can’t locate any signs of renewed cancer growth, it feels a bit strange to be voluntarily committing myself to what promises to be an unpleasant, solitary, and unpredictable process. It was especially hard to say goodbye to the girls, though in (perhaps characteristically) different ways. 6 year-old Lucy rushed off quite early this morning for a play date with nary a backward glance, and I could barely detain her for a farewell hug and kiss, while ten year-old Nora (who had no social engagements and wanted to play a last bit of ping pong before I departed) got and gave multiple tearful hugs before I managed to leave. The nurse who showed me to my room asked if I had a cold; a natural mistake when you see someone with red eyes and the sniffles, I guess.

Actually, it’s not really my room, THE room, i.e., the one I’ll be spending the next 30-odd days in. It’s a private room, yes, with its own bathroom and everything I need, but it’s in the regular cancer ward on Davis 8 (i.e. the eighth floor of Davis Tower) not in the transplant unit proper. At first I was exceedingly demoralized to be told I’d have to wait for a room to open up in my final destination later on; in my emotional state, I desperately wanted to unpack, post some of the girls’ art and messages of love, and generally make myself somewhat at home. To make matters worse, it seemed I would not be moving into my real room for a few days, since the smaller room they proposed to put me in later today was not deemed suitable for someone who was staying for such a long time. After stewing for a while, I wished aloud to Kate that I could simply remain where I was for a few days, then move into the larger room when it opened up, thus skipping the middle stage and enabling me to settle in for the time being. Cogent and persistent advocate that she is, Kate persuaded the nurse to persuade the doctors to okay this plan.

So I unpacked and settled in after all, and Day -8 began with a small but distinct victory. Perhaps it was only a moral or psychological one, but it was a victory nonetheless. It was also a reminder that I have a lot going for me as I begin this process, including a supportive and engaged spouse. I am slated to begin my radiation treatments tomorrow morning around 7:30 AM, so I’ll be needing that support, as well as some Ativan, all over again on Day -7.

Calendars

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We have a lot of calendars around right now, even more than usual for the first few days of the year. The dry cleaner gave us one and a friend gave us one that will be the official one that hangs in the kitchen and we have a homemade one that Lucy filled in (as pictured) and Brad’s transplant nurse gave us three, all printed with the significant dates for his course of treatment. (This despite the fact that mostly we use a shared Google calendar and have for years.) All of these are tracking slightly different things, but mostly the same: significant dates for the transplant. We don’t know when Brad will come home from the hospital or when he will be better and we have no other plans for the year besides “get through the transplant,” and so our entire year is all but blank, except for this one looming things. Despite the unknown end date, the girls and I will cross off the days until Brad comes home.

Here’s what we have on the ones given by the transplant nurse—a rundown of his treatment: Today, January 2, Brad was supposed to call the oncology floor at the hospital to find out what time to go in tomorrow. He did, and he’s supposed to be there at nine. Tomorrow, he gets admitted. Monday, Tuesday, Wednesday, and Thursday: total-body radiation twice a day. (On Tuesday, also, Brad’s brother arrives here and then will start his prep.) The next two days: cytoxan (intensive chemotherapy). Next Sunday: a day of rest. Monday the 11th is what they call Day 0: the stem cells are harvested and transplanted into Brad that evening. And then we are waiting for engraftment—that is, for the stem cells to take and grow Brad a new immune system. Engraftment will likely take a couple of weeks, during which Brad will be tremendously vulnerable to infection and his white counts will be checked often until they begin to rise.

Of course, there are other things happening on our calendars. Lucy wrote on her calendar that today we were going to see Star Wars: The Force Awakens. We did, all four of us, and when the heroic music that all of us children of the 70s have heard a million times swelled, I could not help crying even though it came at a happy moment (no spoilers!). Brad pointed out that his transplant date is also the national college football championship. (I don’t think I’ll cry about that.) And the girls go back to school after winter break this Monday, and relatives and friends come to town, and late this month, oddly, marks twenty years since Brad’s and my first date.

Calendars, apparently, evolved from account books, and the word’s etymology seems to come from the root kele, “to shout”; on the first of the month, ancient bill collectors demanded that the accounts in their calendarium (account book) be settled up, and the word morphed from a descriptor of the account books to a more metaphorical meaning, an account of time. It has been odd and poignant that our calendars of Brad’s treatment are so closely aligned with the start of a new year. It serves as a reminder that we have been living on borrowed time for several weeks, and it is time to settle the account. I have been wishing I could freeze time, stop it somehow, or at least slow it, so that this doesn’t have to happen.

Another Latin-derived phrase has been ringing through my mind, these past days: Lente, lente, currite noctis equi (Run slowly, slowly, horses of the night). It’s from Ovid, but I actually know it from Marlowe’s Dr. Faustus. But the horses always go the same pace and the calendar’s new days come around again without fail. As Marlowe would have it, “The stars move still, time runs, the clock will strike.” Our borrowed time is up, and tomorrow morning in Brad goes to the hospital.