Saturday, March 20, 2010

FOLFOX Round 3: We Are Experiencing Technical Problems

I have to undergo 12 rounds of FOLFOX in all.  If you're thinking "Hey, that sounds like a boxing match," you're right.  Boxing, for those most of you under 30, is how trained professionals beat each other senseless before there was mixed martial arts.  Unlike MMA, a boxing match does not happen in a cage.  I suspect MMA uses cages because all the fighters look like criminals.  Have you seen these guys?  A bunch of tattooed skinheads beating each other up. Sounds like English soccer fans.  Umm.... where was I?

Oh yeah, the hyper-extended boxing analogy.  In the first few rounds of this bout, you take a few punches, but it's not that bad and you recover quickly between rounds.  It's the stage where you're feeling out your opponent.  In the later rounds, your opponent learns your weaknesses and gets more aggressive.  You take more blows and take longer to recover.  In the final rounds, your opponent is going for the knockout.  You get knocked down each round and need a standing eight count.  In the end, you've endured 12 rounds against a tough opponent, you've taken all of his punches, but delivered none of your own.  You got knocked down but you get up again.  Somehow, beyond all reason, the judges declare you the winner on points.  See, like boxing, the match is fixed.

So the round started the usual way, three hours in the infusion room.  No problems with the port this time, the blood return was pretty good.  My blood cell counts were on the low end of normal last week.  This week they're beginning to drop out of the normal range.  So my oncologist wants to keep an eye on them, to see whether I need corrective action.  That means shots of Neupogen or Neulasta (G-CSF or pegylated G-CSF respectively).  Maybe, if my red cell counts drop too, I'll get erythropoietin (Epo) and compete in the Tour de France this summer.

Tingly fingers started pretty quickly and even a cold-ish room is enough to precipitate this side effect.  Although the weather warmed up, the ground is still cold and so are the water pipes.  So I need to remember to let the tap run for a while on warm before touching the water.  Or, I could stop washing my hands and showering.

This round came with technical problems.  The 5-FU continuous infusion pump is supposed to run about 48 hours.  So, when I left the doctor's office on Tuesday afternoon, I expected to return on Thursday afternoon for the pump to be disconnected.  Well, Wednesday night, at 11:30, the pump alarm signaled that the reservoir was empty.  So, I got up and took the batteries out of the pump (the nurses lock out the controls) to silence the thing.  I went to the office on Thursday morning to figure out whether (1) I didn't get enough volume to begin with or (2) the flow rate was faster than usual.  Either would account for the early empty signal.  Turns out that the reason was (3) a buggy pump.  The reservoir was not empty, but the silicon brain thought it was - it must be running Windows XP. So the nurse reset the pump to deliver the rest of the dose and I returned at 5 PM, when the reservoir was really empty, to have it disconnected. I suspect that the real reason for all of this is that the nurses wanted to see me twice in one day.


  1. Hey, I'm 21, and I know boxing! Enough to know besides Paqciou and Mayweather are the only ones worth watching.

    Oddly enough though, not enough to know how to spell "Pacqiou"

  2. OK, I qualified the age cut-off. Isn't it ironic that, to spell "Pacqiou," you have to Google "Mayweather?"

  3. That would be Pacquiao. LOL on the Windows XP comment and the buggy pump. Hang in there. I'm praying for you.

  4. So you took the battreies out of the pump at 11:30 pm. I do the same for smoke detectors. Try fetching a ladder from the garage at night. Only, due to small spaces, I walk the ladder to the front door. Luckily no cops drive by during this time.