Sunday, February 15, 2009

The last weekend as a free man...

...or, if you want to take a more optimistic view of things, the last weekend before I start killing my cancer.

I've eaten very well over the last couple of weeks -- Gary Danko in San Francisco, Michael Mina in San Francisco, and Joël Robuchon in Vegas, one of just a couple of three-star Michelin restaurants in the US. Now, it's crummy food and no wine for a long time. C'est la vie.

Some minor changes to the schedule. Our friend Ray picked up my car yesterday and began the arduous three day drive to Arkansas -- what a great guy, and we are of course very, very thankful.

We'll fly out on Tuesday. We have an apartment -- it's evidently not a very good one but it will do until we can improve the situation. It is in a good building, but the previous tenant is also a patient of BB's -- and he just wrote a harrowing account of a simple central line placement that nearly turned into one of Countess Bathory's rejuvenating spa treatments. Anyhow, the particular apartment we are moving into is evidently not exactly furnished very well. Hmm....did I bring my Blu Ray player for nothing?

Wednesday we'll run around shopping. Thursday I am going in for more blood work, although I have been assured that this is nothing like the 30-vial draw on my first visit. If they want to take half a dozen vials, I can live with it. My bet is they take the 12 or 14 that City of Hope used to do. Not the end of the world, but as I've written elsewhere, I picked the wrong disease for somebody that doesn't like needles.

I presume on Thursday I will also formally sign consent to sign up for Total Therapy 4, which is the study that randomizes between the standard Total Therapy 3 treatment and a "Lite" version that may have reduced toxicity. The core differences, and I apologize if I'm repeating this:

* Lite version has only one cycle of induction, versus two (same drugs though)

* Lite version uses fractionalized Melphalan for the high-dose treatment: 50mg/m2 for four days straight in conjunction with ongoing Velcade, Thalidomide and Dexamethasone, as opposed to 200mg/m2 in one fell swoop in the Standard arm.

* Lite version has only one cycle of consolidation, versus two (again, same drugs).

The lite version is about six weeks shorter than the regular version, which sounds good to me, but I also don't want to go through all this crap only to have it not work. So if I'm in the Lite version and I'm not achieving Complete Remission, I will ask to be taken off Protocol and given another induction cycle, etc. Similarly, if I'm in the Standard arm and achieve Complete Remission after one cycle of induction, I'll ask to be moved to the Transplant phase immediately.

Both Lite and Standard harvest after the first cycle of induction, interestingly enough.

On Friday, we meet with BB, and he'll go over the blood work, etc.

On Saturday, I will get a plain ol' shot in the arm containing 2mg Velcade/m2. By the way, turns out m2 measures total surface area of the body. Seems curious to me -- I would think that body mass in kg or m3 for body volume would be better measures...but this is the standard measure so that's the way we go.

On Monday, they will sedate me and install the port, while at the same time doing the first of many bone marrows. That afternoon, I'll get my first Melphalan application administered through the port (10mg/m2, which seems like a lot depending on how much body surface area I've got -- more than I did a few years ago, that's for sure! But the 200mg or 50mg doses they give during the high-dose chemo are administered over continuous 24hr drip versus this one IV push, so that won't be as daunting as it seems.

On Wednesday, another bone marrow. And then that afternoon, I get plugged into the chemo soda fountain for a few days.

Tomorrow, I'll be getting my head shorn pretty short. And I will help Parker with her school project. The school is observing Black History Month and every student in Parker's class drew a person out of a hat and is supposed to make a poster about that person's life. Parker drew George Washington Carver. I can't wait to help her.

In the meantime, all I can think of is the funniest bit Eddie Murphy ever did on Saturday Night Live, way back in 1984. I wonder if any of this will make it to the poster? :)

Hello, my name is Professor Shabazz K. Morton. In 1895, at the Tuskagee Institute in Alabama, a black man named George Washington Carver developed a new method of soil improvement through crop rotation to end the South's African cultural dependence on cotton alone. As a result, Carver came up with hundreds of industrial uses for the peanut. Sure, industrial uses.

Meanwhile, one night, he's having a few friends over to his house for dinner. And one of them leans over and says to Dr. Carver, "Excuse me, George? What's that your putting on your bread?" Carver says, "Oh, that's nothing but a butter substitute that I made from peanuts. I can't digest all that animal fat, you know."

So the other fellow tasted it, and he says, "Hmm.. this tastes pretty good, man. Mind if we take a peek at the recipe?" And Dr. Carver says, "Take a peek? Man, you can have it. Who's gonna eat butter made out of peanuts? No, I'm working on a method to compress peanuts into phonograph needles."

So, Professor Carver's two dinner guests...Edward "Skippy" Williamson and Frederick "Jif" Armstrong - two white men - stole George Washington Carver's recipe for peanut butter, copyrighted it, and reaped untold fortunes from it. While Dr. Carver died penniless and insane, still trying to play a phonograph record with a peanut.

This has been "Black History Minute". I'm Professor Shabazz K. Morton. Good night.