The previous Friday was a Portuguese holiday. I went to get blood drawn, and my place in Cascais was closed. They were probably open Saturday morning. I forgot. On Monday morning, I had the blood draw done after dropping Soren off at school, and, as expected, I was told the results wouldn't be back until the next day. I drove to Champalimaud, told my oncologist I didn't have my bloodwork, and asked if that would prevent treatment number 8.
"You're probably fine, but I won't treat you without knowing how your body is doing."
My bad.
Two days later — here we are. This is number 8.
As planned, we're doing imaging next week to see how things are progressing. Then she said something I didn't expect. She's scheduling treatment number 9, even though we may not need it after seeing the scans. I'd assumed she'd want to push through all 12 regardless. Another reminder that you can plan very little when you're fighting cancer.
You might be wondering why I dress up for chemo — always in a button-down shirt instead of the shorts, t-shirt, barefoot Craig you all know. Easy access. A button-down lets them get to my port without having to remove a shirt. And you've got to complete the package with decent pants. Those come off the second I'm home. I hate shoes.
Surgery
If the imaging looks the way I hope it does, surgery could be sooner than we thought. There's still an eight-week gap required between my last chemo treatment and surgery — irinotecan needs time to clear from my system. That window also gives my body a chance to recover and rebuild some muscle.On the surgery front: I have a consultation with the Champalimaud surgeon on May 19th. I'm interviewing them. I hope they pass. I've done the research on reputable CRS+HIPEC centers in the US and mapped out how to use ACA insurance to pay for it — and yes, I romanticized the idea of living in New York or DC for a few months. New city, new adventure. Honestly, it would be a pain in the ass and lonely. Soren's in school here. Tina stays with him. And the ACA angle — I enjoy finding a good loophole, but that's also a headache. Getting this done at Champalimaud in Lisbon is the right call. My insurance is already in place; it'll cost a fraction of what it would stateside, and I'll recover at home. Our landlord just approved us for another year starting in August, so that worry is off the table too.
The Dexamethasone Revelation
I'm expecting to feel better through treatment 8 because of something I finally figured out.Toward the end of my first chemo run — FOLFOX — I was getting brutal hiccups while home during the two-day pump. The chemo nurses give me pills to take on days 1 and 2 of each cycle. I didn't know what they were for, but my oncologist eventually told me that excess corticosteroids were causing the hiccups and prescribed something to counter them. I took those pills - the hiccups stopped, but I didn't like stacking drugs. I stopped taking both pills - no hiccups. When FOLFIRI started, I made the same choice and didn't bother telling my oncologist. Hard-headed, I know.
Then, during a conversation about my sternoclavicular pain, she mentioned something about not overdoing corticosteroids — including the pills I'd been skipping.
After treatment 6 — the one right before the Iowa trip — I finally took them as prescribed. Went on a long walk with Henning on day 1 without feeling exhausted. I felt great. After treatment 7, Kaiser was here, and I took them again. Felt great again. Sure, you push harder when a friend of 35 years shows up, but the pills were working. So tomorrow and Friday, I take the pills.
The drug is dexamethasone, a synthetic corticosteroid. My oncologist prescribed it as part of the standard FOLFIRI pre-medication protocol to reduce inflammation and control side effects. It's the same reason it made me feel so much better when I finally stopped being stubborn about it.