The End of Chemo! Or is it?; Omicron and Chemo

It’s December 23, 161 days ATN and THE END OF CHEMO!

I know – it’s been a month since I’ve posted things. But it’s been a busy time. HOA budgets and end-of-year disclosures. Asphalt projects. Christmas shopping and doing the annual M&M’s Collection (42 flavors this year. The elves are locked down this year so some of the packages will be going out a bit late). An IT nightmare at Koherence Labs (I Will Not Upgrade Servers Under Chemo. I Will Not Upgrade Servers Under Chemo. I Will Not Upgrade Servers Under Chemo…)

And to top it all off the chemo-induced fatigue has become more pronounced with these later cycles, so I’ve been spending much more time napping.

But – we’re done with chemo! It’s the best Christmas present my oncologist could’ve given me!

This post is dedicated to the memory of my Uncle Herbert Chun, who I had the pleasure of hosting when he had LVAD surgery at Stanford Hospital. And despite the circumstances it was a true pleasure to have him, my Auntie Gail and cousin Scott stay with me for those few months. The side-effects and hassles of cancer treatment seem small in comparison to what he endured. He went on to live a fulfilling five years with the VAD, and his passion for life is an inspiration to all of us he touched.

The End of Chemo! Or is it?

When the journey began I was told at the infusion teaching session that I’d undergo eight chemo cycles spanning sixteen weeks. Then a few cycles in my oncologist started mentioning nine cycles. She double-checked and apparently the infusion teaching nurse had botched the number and nine was indeed the number based on the clinical trial.

I was thrilled when I reached cycle nine. Some of the cumulative side-effects – namely fatigue, neuropathy, and nausea – were starting to become pronounced. But it was the last cycle!

Then on the morning of day 3 – the day the infusion would be complete – I received a call from PAMF to schedule a pre-infusion checkup for cycle 10. Cycle 10!? What cycle 10? I told the caller that I was on a nine cycle regimen and there should be no cycle 10. She asked if we could schedule the visit anyway and she’d get back to the nurses to follow up. Let’s just say I wasn’t at all thrilled. I’d already mentioned to JT that if anyone sprung a cycle 10 on me I’d use my chemo-induced electrical super powers to have every device in PAMF spontaneously combust. (For those of you who missed out, I seem to have an ability to cause kitchen appliances – even industrial ones found in restaurants and delis – to combust. I’m still trying to control this new-found ability though and may have accidentally taken out the electrical grid in the neighborhood just prior to cycle nine. Oops.)

A couple hours later I got a call from my oncologist’s nurse. She said that I was indeed on a nine chemo regimen. But the FOLFOX order was placed for 12 cycles, which is why there was some confusion. They’ll keep the extras on hold “just in case”.

So Christmas was saved (as was the radiation oncology lab, which is kind of necessary for my next stage of treatment).

Omicron and Chemo

I’m sure everyone has heard of the omicron COVID variant by now. It’s incredibly transmissive and can evade the existing vaccines, but the early data suggests it tends to result in milder symptoms. It’s highly likely that we’ll all be exposed to omicron in the very near future. I’ve followed the progress of COVID over the past year and a half mostly via Dr. John Campbell’s channel on YouTube. I highly recommend it – he does daily updates from an international perspective (he’s in the UK).

When booster doses became available I discussed with my medical oncologist if and when I should get one. This was around cycle 6. My oncologist said that I could get a booster then, but any benefit would be more psychological – because of the chemo I was on I wouldn’t mount a decent immune response. Since I only had six weeks left in chemo we decided I’d wait until early January to get a booster since then my immune system would’ve recovered sufficiently to mount a response (and wouldn’t yet be whacked by whatever it is chemo-radiation will do).

This was of course before omicron made its debut.

In the cycle 9 pre-infusion appointment I mentioned to my oncologist that I planned to make a two day trip to Las Vegas over Christmas since my brother and sister in law would be there. Her first reaction was that she’d rather I go to Hawaii since Hawaii has COVID under control rather well, while Las Vegas has too many unvaccinated individuals (not to mention all the tourists of unknown status!). But she cleared me to go as long as I took precautions – namely avoiding crowds, masking, and washing hands a lot. As she put it, “You deserve it!”

She also ordered Neupogen, which is a white blood cell booster, which would be administered at the infusion clinic when I returned the chemo pump on day 3.

So on day 3 I arrived, VERY happy to be returning the pump for the last time, and was told that Anthem hadn’t approved the Neupogen. (This strikes me as rather short-sighted on Anthem’s part since if I do contract COVID they could be in for quite a bill.) I considered paying out of pocket, which would have been somewhere between $1k and $2k. But after some discussion with the infusion nurse and what she had been told by my oncologist – namely that I was still cleared to go to Las Vegas as long as I took extra precautions – and since no one seemed too concerned, I opted to forgo the Neupogen.

So what precautions am I taking? Well first of all I’m avoiding the airport and driving. That’s one of the advantages of living on the mainland – you can drive anywhere. I’m still waiting for the bridge to Hawaii to be built. Second I’m staying in a (junior) suite in MGM Towers. It’s not too much more expensive than staying in regular hotel rooms, but the Towers are more like apartments and don’t have casino entrances, so its easier to avoid crowds. I’m also upgrading from fabric masks to KN95 masks and may double-mask (interestingly the KN95 masks are easier to breathe through than the fabric masks…). And I’ve got a small bottle of hand sanitizer to carry around.

Aside from one or two restaurant outings – and an obligatory visit to M&M’s World – I’m not really planning on going out much, so hopefully this will be enough to keep me COVID-free.

(One of the odd things about Omicron is that according to the UK Symptom Tracker the most prevalent symptoms of Omicron COVID are 1) headache, 2) runny nose, 3) fatigue, 4) muscle aches, 5) sore throat. These interestingly are the same symptoms of FOLFOX chemo. So do I have COVID or am I just chemo’d?)