Forgive me, readers, for I have chemo’d; it’s been 3 weeks since my last confess—update.
When we last updated, we’d just dealt with the abscess, and I was feeling better. It was truly wonderful to feel my body improve. My energy improved, my mood improved, I was being productive again.
Chemo Cycle #4 started May 26^th. Remember, even-numbers cycles/treatments are 5-day in-patient adventures. And, after finding myself hospitalized after each of the previous two cycles, the doctor has lightened up the dosage.  I felt good going in, but there’s still anxiety. Would the new, lower dosage the doctor was preparing mean that I’d have a better recovery between treatments? We were tired of surprise stays at the hospital. Would the still-healing abscess be okay? We liked the new no-pain version of it. Would I get the good room for my 5 days in the hospital? Because, important things, right?
Treatment went well. I got the good room. My love and appreciate for the staff of 4 South grows with each visit. This was my fourth stay on 4 South in a two-month span, so we get to know staff and tricks for nice stays. I know now:

• I can bring my own pillow to sleep on,
• I can bring food (there’s a dorm-sized fridge in the rooms) so I had fresh fruit and my iced tea always available to me,
• Others can bring food in, so Kathy sometimes brought lunch from outside or dinner allowing me to avoid the hospital food.
• The hospital food isn’t horrible, but it wears thin. They do have an awesome chef’s salad.
• The WiFi is incredible, so I was able to get a lot of work things done.

 The cycle isn’t over when they take down the last infusion bag. The real stuff happens afterward. I am happy to report no nausea and no loss of appetite with Cycle #4. Yay!! In my mind, based on the good experiences, it should go like this:

Step 1 – 5 days of treatment
Step 1 – 2-ish days of crash
Step 3 – 2-3 ish days of fatigue
Step 4 – Gradually improving to days with less fatigue and more normal
Step 5 – Gradually improving to normal days until the next treatment.
Crash days are like being a pile of jello. You can think, but focus is fleeting because you are tired – actual tired. Moving is possible, but just too much work. If you have had a great workout where afterward, you’re thinking, ‘gee, I wonder if I have enough energy to steer the car?’ That’s a crash day. This time I knew it would happen, so it wasn’t horrifying. It just happens.
Fatigue is different. It’s part of crash days, but it has its own role after the “tired” has improved. Fatigue is NOT like being tired. A nap won’t fix it. It’s like being….done. When you’re resting, you feel okay, but you just don’t feel like moving. You know moving is good for you, but you don’t feel like it. So when you do move, it’s best to remember to go half-pace of your normal. When you exceed your fatigued-body’s preferences, it goes like this:

I’m sitting and feeling normal and decide to change the laundry loads. I walk the 20 feet to the dryer, open it, and bend down to pull out linens into a basket. I then lift the basket to the folding counter. I’m now standing and folding towels. One towel. Two towels. Dang, my arms are weak…weird. Three towels… Am I panting? This is not a treadmill, this is standing still. Four towels.. *sigh* Lean on counter. Folding towels sucks, why has no one automated this? *deep breath* Why do my shoulders hurt? Five towels. Why does it feel like I’m in quick sand? Did the air turn to mud? Six towels. I feel funky….

This is when you sit. Immediately. There are tricks:

• Bending over and reaching things from above amplify fatigue; it’s best to limit these things during fatigue days,
• Realizing you are panting or feeling like you’re on a treadmill when you’re doing a casual function is a sign to take more breaks and slow the pace from whatever horribly slow pace you know you are already going.
• Know where the chairs are (or the furniture sections in stores)

For Cycle 4, I thought I was on track, but fell apart during Step 4. I had a normal-ish day with fatigue moments. Good sign. I even went to a house concert at my neighbor’s house. About two hours of talking with real people and listening to great music. I was exhausted after, but thought it was a sign of progress. The next day I was feeling poorly. Not just fatigued, but tired. I started getting very cold and very tired. So much so, that I sent myself to bed in the afternoon. A fever developed late in the evening, but I was convinced it was just a passing thing. Tylenol helped it go away, and it didn’t return. The next morning I had pain in the location of the draining abscess we had been dealing with earlier. Enough pain that I went to the doctor, who was kind enough to squeeze me in that morning. The abscess thing has turned into something else that you don’t want to know about because it is truly TMI. It shall, henceforth, be referred to as The Thing. The Thing will be fixed June 19^th with just a quickie little out-patient visit. This information, unfortunately, causes the meltdown of all meltdowns.
[Insert a few hours of crying, complaining, and bitching about how I am so utterly sick of all of this. Assume all aspects of cancer, chemo, fatigue, digestive issues, inability to travel, inability to make and keep plans, and everything wrong with the world including poverty, hunger, and war are all covered.]
Post-meltdown, I’m treated to lunch at home along with the gift of others planting beautiful flowers in the pots on my patio. I’m okay sitting still, but I deteriorate as the day continues. Put myself to bed with a thermometer. The rule is, if your temp reaches 100.5, you must call the cancer clinic. I called them at 4:30pm on a Friday with exactly 100.5 fever. It was 101 by 5pm. The Thing mentioned above hurt, and I had a fever. I know they are related, but I’m sent to the ER. Unfortunately, we learn I am neutropenic–this is the state when your white blood cells are too low and you are susceptible to everything. Germs are the enemy. Neutropenic + a fever of over 100.5 = overnight stay at the hospital. I stayed two nights. Aside from the pain from The Thing, I felt fine. Still, that’s the rules, and we honor the conservative rules because they keep us alive and healthy. I had no more fevers after Friday night. I had 48 hours of antibiotics, good pain meds, a lovely time catching up with my nurse friends, and left the hospital Sunday mid-day feeling pretty good. Hours later, Kathy and I enjoyed a fun night of dinner & cards with family as if the prior two days hadn’t happened.
It’s Monday now, and I feel good. The Thing doesn’t hurt as much; it’s just annoying. I’m back to feeling positive about the rest of this cycle. My theory is that if it weren’t for The Thing, we would have avoided the fever and the unexpected hospital stay. This actually bodes well for future treatments. Why? Because The Thing is going to be dealt with in a couple weeks, and I have high hopes for future treatment cycles once it is history.
Plan as it stands now? Cycle #5 is being delayed at my request. I want to attend the American Library Association Conference in San Francisco at the end of the month. Starting the next cycle on time would make it impossible. If we are going to treat the whole person, my spirit and morale must be a part of the treatment plan. That means going to ALA unless something happens that will create a negative impact on my physical health and healing. We’ve been able to make plans that reduce exposure to unnecessary germs. We will drive instead of flying, focus only on my highest priority meetings, carry a hearty supply of hand sanitizer, use the Clorox wipes I carry with me all the time anyway, and abide by permission (self permission) to do *only* what I can do while maintaining *good* energy. Also, I refuse to enter the Exhibits. Sorry, vendors, all that hand shaking? No way. It’s a conference petri dish in there!