Last night I started my seventh round of chemo. I'm doing twelve rounds in this phase of treatment, so when I've done my fifth dose on Sunday, I'll be just over halfway through this phase of chemo. I think I've said that since the first couple of rounds, I've been rebounding more quickly from the five days of chemo -- my appetite comes back more quickly, and my energy for walking longer distances rebounds around the same time, which is about five days later. However, I'm also noticing something that seems like a cumulative effect of the chemo: most days I feel as though I'm swimming through molasses. I feel sluggish, lethargic, and mentally foggy. It could be worse! Last night I tried taking the chemo without the Ondansetron anti-nausea medication (which causes constipation) and woke up in the middle of the night feeling nauseated. Constipation it is, then. Or rather, it's the drugs I take to counteract the constipation.
A couple of weeks ago I had my annual "wellness check-up" with my personal doctor. Actually I switched to a new doctor, mostly because I wanted to go to a clinic that was closer to my house than the old one, but partly because my old doctor pissed me off by not ordering an MRI after the first seizure and especially by getting defensive when I went back to him after the tumor was found to try to get him to rethink his earlier decision. I had three nagging problems I wanted to deal with on top of the "wellness" stuff that the insurance company insists be checked on every year. One was the nagging pain in my left shoulder, which has felt a lot like the pain from rotator cuff tendinits in my right shoulder a couple of years ago. Another was a patch of persistently dry, chapped skin under my left big toe. Then there was my plugged right ear, which I couldn't seem to clear with my wax removal kit. The second two problems were relatively easy to deal with.
She assigned physical therapy for the shoulder problem. The physical therapist diagnosed the problem as bursitis, not tendinitis, on my first visit, but in his written notes he seems to be calling it everything: bursistis causing impingement that then causes tendinitis. I'm doing PT twice a week and home exercises every day, and it seems to be getting a little better already. He said it would take four to six weeks, which is a lot less than what it took for the tendinitis. I asked him if tai chi would help prevent these problems in the future (once I'm done with chemo), but he said basically I need to get back to the upper body strength exercises I was doing before I started treatment for the cancer.
Yesterday, after a PT session, I got an MRI and visited my oncology nurse practitioner. She was over an hour late for our appointment, during which time I had to argue myself out of believing that the delay was because the MRI had revealed a new tumor and she was preparing herself to deliver grim news. No such thing. The MRI showed no sign of a tumor. She showed me the last four, which capture the wound from the tumor removal collapsing and healing. Fascinating to see in a long range time lapse view.
However, she also told me that my oncologist, Dr. Mrugala, has taken what is essentially a promotion at the Mayo Clinic in Phoenix, effective in January. She has also decided to move on with her career, meaning I will be shifted over to a new oncology team midway through my treatment. Another nurse I worked with, Natalie, is already gone, which is why I've been hearing back from other nurses when I leave messages at her number. This causes me some anxiety, but I was placated by the fact that my old radiation oncologist, Dr Halasz, will be able to step in to provide some continuity. I actually didn't know how to feel when Carrie gave me the news, and I was a little surprised by how bereft I felt as it sank in. I've hardly ever seen Dr. Mrugala, who strikes me as more of a research scientist than a physician, and Carrie has been great, but I've never felt as much kinship with or sympathy from her as I did with Dr Halasz and her nurse, Gaia. But in my foggy mental and emotional state, any change is hard to process. It probably didn't help that Carrie was signaling some distress or uncertainty on her own part, or that I thought I caught a whiff of alcohol when she first entered the room. (That latter bit is completely scurrilous and probably just a product of my anger at how long I had to wait. I was seriously getting ready to walk out, I was so pissed.) I appreciated my Mom's suggestion that I may end up liking my new treatment team even better than the old one.