Chronicles of a
Cancer Patient

Chemo Rookie

Hi friends,

A few of you wanted me to let you know how things went today, on my first day of chemo. I appreciate your support more than I can explain. I thought I’d let you know how things are going.

It was long. 6 hours. But most of that was just sitting and waiting. There are a lot of paperwork and procedures on the first day, and it certainly wasn’t the hospitals fault. I expected it to be long, and I brought some entertainment. And anyway, it’s certainly not like I had anything better to do.

The Cancer Center at Sherman Hospital was really great. Because it was my first time, they put me in a private room with one of those snazzy hospital beds and spent a lot of time explaining things to me. I received 9 kinds of drugs today, and the oncology nurse sat with me and my parents for the whole process, which I felt was really extraordinary, even if it might be standard.

The only thing I had trouble with was the one drug that was probably the least of my worries. They gave me some regular ol’ Benedryl to compensate for any allergic reactions I might have had to the chemo and the stuff couldn’t have been more annoying. Maybe it was an extra high dose or the fact that it was an IV drip. My head couldn’t stay awake, but my legs couldn’t stop moving. Picture Sleeping Beauty as a sprinter, or a cross between the Tryptophan-like tactics of poor John Kerry’s speech writers and the body of a dancing Napoleon Dynamite.

I came home drowsy and slept it off. A friend brought us a fantastic dinner, and since then I’ve felt – to my sincere surprise – really well. The nurse said that this would happen, that the steroids would make me feel spunky for awhile, but that I would drop after a day or two (so I figure I better get this e-mail out while I still got some spunk! Note: for evidence of “spunk,” see John Kerry joke, paragraph 4, line 4.).

The best news of the day is that the bone marrow test came back today and it showed that my bone marrow is completely clear of cancer. Had the cancer spread to my bone marrow, my chances of survival would have considerably dropped, so I can’t tell you what a relief it is to know that these bones of mine are clean.

To be honest, I was really anxious about today. There’s a lot of discordant information about chemo therapy – how it’s terrible, or how it’s not-so-bad, etc., etc. – and especially about the first day. I believe this dissonance is due to the fact that chemo therapy is a distinctly individual experience, and that each person is effected mentally and physically in decidedly different ways, even by the same drugs. As it turns out, today was a relieving, giant step toward getting rid of this dumb thing.

That being said, I understand the more difficult parts of chemo therapy are still to come, so I’m not counting my chickens quite yet. Nevertheless, I’m indescribably consoled by having experienced the chemo process firsthand and to have seen the immediate reaction my body takes to the drugs. I also feel very confident that I’m in good hands at the Cancer Center at Sherman, and that comfort, you can imagine, feels priceless.

Thank you again to all of you for helping me through this. Being the social person that I am, I’ve found that it has been the concern, affection and humor of my friends and family that has given me the most strength during the past weeks.

Future Cancer Survivor,
Dave Hahn

I will be going to chemo every two weeks for six months.

The particular kind of chemotherapy I am given is called ABVD.

There will be a passing exam at the end of this blog. Study hard.

Before all this I didn’t really know what the difference between chemo and radiation was, it all just seemed like some nondescript, horrible stuff that I hoped I never had to go through.

But the world keeps spinning, and it turns out chemo and radiation are two different things. I’m still not entirely clear on what radiation is, and I’m not sure I’ll even have to go through it, so I’m happy to just discuss chemo.

Chemotherapy is a treatment for cancer that involves an IV, a lazy boy recliner, and chocolate chip cookies. The lazy boys at the place I go are all green and covered in fake leather. They are lined up against a wall with dividers between them, giving the same sort of fragile privacy that similar dividers provide in men’s bathrooms.

Each lazy boy has a phone next to it. This is in case you are super busy and need to make important phone calls whilst they are pumping you full of the drugs that will damn-near kill you. I don’t know anyone this busy.

Each chair is also equipped with it’s own television that gets poor reception of local stations. This is convenient if you are really nuts about daytime television and you wouldn’t miss your soaps for anything.

The cookies are in the waiting room. I don’t know where they get them, but they are awesome. Clearly the bakery keeps the best cookies for us cancer patients. They probably use a pound of butter in each cookie, but I mean, what do we care, right? What, is it going to give us cancer? Gimme one of those damn cookies, and put more butter in it next time.

The rest of the cancer center is pretty sterile looking. The walls are painted with the soothing, tan color that they always use on those HGTV shows. Hanging in the corner is an embroidered acronym that cleverly uses the individual letters of CHEMOTHERAPY in a sad prayer. There are also small dolls dressed as nurses. This corner freaks me out.

The real nurses sit at a big desk and talk on the phone to doctors. Behind them is a big ice and water machine. The water and ice machine is the biggest piece of equipment in the whole place.

When you come for your chemotherapy session, they first take your blood and send it off to “the lab,” which must be a place very, very far away, judging on the amount of time it takes for things to go and come back from it. You then have to wait a few hours for the far-away people at “the lab” to test your blood.

An order is then sent to “the pharmacy,” another place in a far-off land, where they measure out and mix the drugs that they will be giving you. The drugs have to be measured exactly, based on your height and weight that day.

Meanwhile, you are still sitting in the lazy boy, watching your soaps and eating your butter cookies. The nurses hook up an IV to the port that was surgically implanted in your chest and give you huge amounts of “saline.” “Saline” is something that looks like water that is apparently not water that makes you have to go to the bathroom a lot.

Before the drugs come, the nurse, who in my case, is sort of cute, puts several drugs through your IV. First, she puts in a steroid called Decadron. This is to bolster your system before the other drugs destroy your system. Having Decodron is a lot like having a direct IV drip of pure, liquid caffeine.

Then the nurse puts Benedryl through the IV, which makes you extraordinarily tired. You might fall asleep at this point, but as you are unable to stop moving from the Decadron, sleep is not really an option.

Then the chemo drugs come. Their are four different drugs that need to go into you before you can leave. The first one is colored like red Kool-Aid. It’s a little frightening to see the red liquid floating down the IV tube towards your body. You think, “OH GOD, here it comes!” And the nurse is looking at you, and you are looking at the nurse, and suddenly it seems like all the other patients are looking at you, and you are looking at them, and the red stuff is coming down the pipe, and the nurse is looking at you, and you can’t stop fidgeting, and the room is getting smaller, and it’s coming and it’s coming and it’s coming!!!!

But then it’s not so bad. It doesn’t feel like anything. One by one they put all the drugs into you and it doesn’t feel like anything. You might as well just watch your soap operas, because it’s not exciting. I bring my laptop or my iPod and watch movies and listen to music.

Then they give you a few shots that will, again, help fix the system that the drugs just screwed up. By this point you are pretty sick of being stuck with needles and you have had your fill of butter cookies. They take out the IV and they tell you to go home, that’s it.

Dr. Crazy Finds Cure For Cancer

Mustard Gas was first used by the Germans in World War I to gas French soldiers. The gas only killed 1% of the soldiers exposed to it, but the side effects of the chemical were enough to significantly slow whole advancing armies and to contaminate large areas of land that could have been used in strategic positioning.

Mustard gas is a chemical weapon that is dispersed in aerosol form. There is little, if any, immediate effect, but 4-24 hours afterward, those exposed to the chemical experience severe blistering of the skin and lungs. Exposure to more than 50% of the body is usually fatal.

Between the 1940’s and the 1980’s, mustard gas (in liquid form) was one of the key ingredients in chemotherapy for Hodgkins Lymphoma. During World War I doctors found that exposure to mustard gas slowed cell division in those exposed to it, which is the main objective of most cancer treatments.

That’s right, mustard gas is used to cure cancer. Even today it is still used in some places, it is the first drug in the MOPP chemotherapy cocktail.

I, however, am treated with a newer kind of chemotherapy cocktail, ABVD, and nobody’s giving me mustard gas. It’s no wonder, though, that chemotherapy has gotten such an intimidating reputation over the years.

My chemo nurse said something last time about how great it was that I had such a supportive family during all this. That is definitely true, and I understand what she means. But I couldn’t help but think, are there families out there that are not supportive? Are there families out there that say, “Now honey, you know I love you, but I just don’t support your decision to have cancer.”

Or maybe it’s worse, maybe there’s a whole group of Tumor Rights activists out there that have bumper stickers and t-shirts that say things like “Metastasis Is a Right,” or “Tumors Have Feelings Too,” “Chemotherapy is Murder,” etc.

Perhaps when I go in to the Cancer Clinic tomorrow for chemotherapy there will be a big crowd of Pro-Tumor protesters with signs and megaphones, chanting and throwing paint on me.

Revenge of the Vinblastin

Today was the second chemotherapy treatment. Peanut butter cookies today. I wasn’t as excited about that. Anyway, I’ve put on 9 lbs. in two weeks, so maybe that’s ok.

The cookie selection was really the most interesting part of the whole session. There wasn’t much to it. They took the blood tests, I saw the doc, they pumped in the drugs and there were no problems. I watched a movie and listened to music.

And I’m glad I’ve got my headphones (thanks Cindy) with me, because I kind of wanted to tune out the Room. Say what you will, but the community atmosphere of the Chemo Room isn’t really my thing. Picture it, the poor guy next to you is having trouble as the chemo burns away his veins, everybody in the chairs – especially the older ones – are pretty hard up and not in the talking mood, the nurses are going on and on about hemoglobin and saline drips, and somebody down the way is trying to drown their troubles in Oprah. I’m not saying that I really have a problem with being there, I guess I mean that I don’t want to be there anymore than anybody else would want to be there. My parents sat by me the whole time reading the paper, and I assume, listening to the cancer chatter of the Chemo Room. My poor parents, I don’t think I could read the “feel-good” Chicago Tribune and soak in the vibe of the Room’s suffering all at once. I was happy to escape.

The doctor was quick today. There is a Chemo Room in his office that is way worse, I think, than the place I go. He mentioned in passing today that I should maybe think about switching Chemo Rooms to come to his. A little marketing on the doctor’s part – very clever, pal. In his Chemo Room, all the recliners are facing each other, there’s no dividers, there’s one TV in the corner blaring daytime TV for the blue-haired, early-bird-special kind of clientele. There, I picture myself in forced conversations about youth and future plans, and possibly being awkwardly introduced to grand daughter’s when they come to pick up Grandma. Don’t get me wrong, I’m a social guy, and I’m usually golden with the blue-hair club, but when I’m at chemo, I just want to blend into the fake leather and watch my sappy movie.

I also heard from doc today that it’ll be more like 6 months of chemo instead of 4. Bring it on, doc.

The results from my heart scan are back. I have a mild enlargement of the heart (the left side for those of you studying for the test). This is called Left Ventricular Hypertrophy. The nurse says that it’s likely from both being anemic and the tumor being wedged up against the heart for so long. I don’t know much about it, but it’s mild, and it doesn’t sound like that much of a problem.

Mom and Dad took me home and I climbed up into my hammock between the trees (thanks Rick) for the rest of the afternoon.

And I went to work tonight and played piano. There was really no reason not to, and I like my job – playing piano and surrounded by people. I do find that my fingers are not as coordinated as before chemo, but it’s a very minute amount (that might be more related to a lack of practicing lately and perhaps not the chemo), and its probably imperceptible to people listening. Or maybe it’s not and people are being kind. Either way, it’s not a problem yet, but I have heard of this kind of thing happening later in treatment. No worries, future bosses, it goes away.

Dave 3, Cancer 0

See, what cancer doesn’t understand is that I’m the home team, and I’m undefeated. Furthermore, I’ve got the best oncologist in town pitching, and the best chemo nurse anywhere who’s catching. My brother is at first, my other brother at third, my parents are sharing shortstop and second, and the WHOLE rest of the family is covering the outfield like a volleyball team. I’ve got friends in the stands, friends in the dugout, friends on the street, friends on the rooftops. I’m kicking the crap out of this cancer. It doesn’t even have a chance.

Tito has got to be so sorry he climbed in me. He’s getting one express ticket to Tumor Heaven. The loser better enjoy the ride, too, because the ticket set me back more than he’s worth.

It just goes to show, you can’t be friends with a tumor. You invite him over to dinner and before you know it – the guy’s living with you, eating your food and using your hemoglobin without asking. Sooner or later you’re paying some professional to evict this pathetic excuse for an organism. And it’s sad, ’cause the guy can’t even live on his own, he’s just totally dependent on other people. But you can’t blame yourself, you can’t take responsibility for his inadequacies. You just gotta let him go. I mean, what a loser, right?

Treatment #3 was good. They even gave me my own private room – how sweet is that? Like I was Liza Manelli looking for the VIP seating or something. The nurse is still cute, and again, I had no complications. They took my blood, and then I even went out for lunch while they did the labs.

The results of my blood test are miraculous. I have better results on my blood test now, after 4 weeks of chemo, than I did before I started. I’m happy to announce that I am no longer anemic. Before chemo, I had enough platelets for two people, but no longer. My white and red blood cells are right where they are supposed to be. Plus, I’ve gained 14 pounds since the beginning of treatment.

I guess its starting to be clear how sick I was. Man.

The nurse sort of squints and pauses for a minute…looks at me again…smiles, “You know, I’m sort of surprised you’re doing so well, too.”

I’m the HOME TEAM, baby! Bring it on!

I’ve found out something about myself during all this – well, I’ve found out many things, but this in particular: I am awesome in adversity, it’s monotony that kills me. Strap me up to the chemo IV, I’ll take the pain and the fatigue and I’ll keep smiling, but put me in a cubicle with a pile of paperwork and I’ll never live.

I slept through the Benedryl this time, and surfed through my classical music when I awoke. My parents came and read the news. News about people on the Gulf Coast that are so much worse off than me.

I was out of the Center by 4 and off to play piano by 5. Now, in all honesty, while I may be feeling particularly cocky tonight, I am not feeling particularly good. Chemotherapy is exhausting, and as I’ve said before, I feel like a truck ran over my soul. But I went to two rehearsals tonight anyway. And it’s probably because of the steroids, but my mind is blaring out of my mouth at Michael Schumaker speeds. I’m like a revved up little boy before bedtime. I don’t want to go to bed! Just ten more minutes!

I had a fantastic talk with a fellow member of the Cancer Club tonight, someone who is clearly a kindred spirit – someone who is totally on the same page as me. It was energizing to talk with her. She had an rare form of cancer, and the docs gave her 8 months to live. A year ago. This woman has some fire in her, and she blazed down her treatments. She says the chemo tore her apart, and she adds, quietly – so that, I imagine, other people won’t think she’s a nut – that cancer might be the best thing that ever happened to her. (Might be.) Amen. The air smells sweeter, the the sun shines brighter, etc., etc. I’m so glad to be alive.

So, I don’t expect to be feeling well on Thursday, Friday or Saturday. And part of me hopes that I lose my hair this time so I can just get it over with. I expect bone pain by Monday, and my immune system should fall by next Saturday. I’m ready to tank if that’s what happens. My head’s in the right place.

Someone else’s first day of chemo:
The Enemy Within

That is how much my first chemo session cost, according to the bill I found in the mailbox today. [edit: i later found out that this bill was for 2 sessions of chemotherapy, which is one month. - djh]

(I should quickly add that this bill was submitted to my insurance company, and they should, KNOCK ON WOOD, take care of most of it.)

My first reaction was laughter (“Surely you jest!”), my second reaction was to blame for the now-empty beer bottle I have here next to the computer.

I could have bought a cadillac. Or another college education. Or 24 new keyboards. Or 96,552 bags of chips from the ECC vending machines.

I don’t get it. You cut me up, you stick a tube in me, you fill me with crap that’ll make my hair fall out, my stomach upset, my face puffy, my bones hurt, and my face break out. You make it so I can’t sleep for days and days, and you tell me this stuff might give me cancer. Then you charge me $48,276.30 and tell me to come back 11 more times?

Somebody wake me up. I fell down the rabbit hole, and now there are ladies dressed in white trying to stab me with little plastic tubes and doctors pulling out my bones.

Maybe they messed up. Maybe they meant to send this to the other Dave Hahn with cancer. Who’s also a patient at their hospital. And who also had chemo that day. In that chair. With that nurse. And that blood type. And that basic appearance.

I’m sorry guys, I really wanted to stick around, see ya’ll get married and meet your children and such, but I’m afraid “living” just wasn’t in the budget this year. We’ll try again next time.

Are they NUTS? My father has said in that past that he believes that there are comedians in the back room that make up the prices for these things.

“First chemo? Ooh! Tell him $50 grand. No – how about just under? Yeah, like, $48-something. Yeah, that’ll be great! Oh, I wish I could see his face when he gets the bill! Man, is he going to need a drink. Tell me what he says, ok?”

The Sunflower Fields

“…anticipatory nausea anticipatory nausea anticipatory nausea anticipatory nausea anticipatory nausea anticipatory nausea anticipatory nausea…” over and over in my head this morning without stop. I didn’t, though. Making a mess would have just complicated things.

The Cancer Center was busy today, everybody is dying to get in here. The nurses seemed curt with each other, but they’ve got a tough job, I think they are allowed to be that way with each other now and then. When the nurse came to take my blood, she smiled and asked me how I was. She’s good at her job.

Everybody else in the Cancer Center was already hooked up by the time I got back there. They walked around with IVs and tubes disappearing under their shirts. It’s weird to see people walking around with bored looks on their faces as poison is being pumped into their hearts. It seems like they should have a more dramatic look on their faces; one like they had just been stabbed during a swordfight, etc.

My nurse tells me that my difficulty concentrating lately is due to the drugs. Something “they” call “Chemo Brain.” I’m forgetting names now. Names I’ve known for years and years. Its like parts of my brain aren’t connected anymore. I hope I don’t lose my memories.

They hooked me up to the IV and started dripping the Benedryl. I started to get nervous about the drugs coming on, and I started to feel funny. I thought about my hair falling out, and forgetting friends names, and my skin drying out, and anticipatory nausea anticipatory nausea anticipatory nausea anticipatory nausea… Then I was like, “—- this, I’m going home.”

I jump on a plane bound for Dee-troit, to hang out with Berry Gordy. Coltrane is there too, but you know how that guy is. Everywhere we go he’s taking these HUGE steps. So we get out our old, white, thunderbird convertible and motor around the city.

We stop at the Grand Canyon and get out our hang gliders to get across the gap. But Coltrane had been fooling with his hang glider the whole way there, modifying it and decorating it, so by the time we got there, it was way too heavy. It doesn’t have any practical use. So we drop him in this little town called Winslow and pick up Elton John, because that guy’s a more practical thinker. Coltrane takes off with a chick in this crazy-looking flatbed.

So there we are, me, Berry Gordy, and Elton John, in the middle of the desert, trying to think of which way to go. I tell them I want to go to the beach, and since I’m the one with the successful music career, and since they are just happy to be hanging out with a guy like me, they are cool with the idea. We motor to Malibu and buy a place right on the beach.

After awhile Surfer Magazine starts sending out photographers to check out my crazy moves, but I get bored with it. I want to take off to the mountains for awhile, so I drop the guys and take the ‘bird up to Montana for the weekend.

The people there are wild, and they act like they’ve never seen an outsider.

“What do you do for a living?” They ask.

“I’m a cancer patient.” I say.

“Do you like it?”

“Well,” I admit, “I’m still in training right now, but between you and me, I don’t think it’s for me. It’s steady, though, and they can’t fire me, so I guess it’s ok for right now.”

They’ve never heard of cancer or chemotherapy or anything like that, and it seems rude to talk about such things at the dinner table, so I pull up and forget about it. They serve gyros, and daiquiris; mint chocolate chip gelato imported from Venice, and mussels from this no-name French cafe on the Atlantic coast that makes the best kind. Out back, Sinatra is grilling a pig and mixing poi, which I think it’s pretty ambitious, given his condition.

Out of no where this big group of Tunisian taxi cab drivers runs in and wants to take all of us to their cousin’s place to buy some rugs, but I’m not into it. I thank everybody for the hospitality, and I point the car toward the Dakotas. I want to drive through the sunflower fields before I wake up.

I end up on the beach again, I think it’s the Bahamas, but I don’t know. I miss all my friends, and I want to go home, or get them down there with me. They are probably busy though, so I start driving home. I take the back roads, though, I don’t want to get home too fast.

…

I woke up and took off my headphones. The nurse was pushing buttons, trying to kill the beeping on my IV pump. They told me I should get some sleep.