New normal

• Hemoglobin 12.3 (normal 14.0-17.3)
• Absolute neutrophil count 3.1 (normal 1.4-7.5) — NORMAL
  
• White blood cell count 4.1 (normal 4-10) — NORMAL
• Platelet count 255 (normal 150-450) — NORMAL

New blood work, first in a month (see updated charts). Progress is happening — only hemoglobin remains subnormal.

I should be happy, but I'm not. Chronic optimism works against me here. I hoped for, expected, then simply assumed faster change; I thought all the levels would be well inside the normal range by now. Instead, hemoglobin rose only 1.3 points — less in the last 4 weeks than in the 2 weeks before that. Still a long way to go to hit 14. Now I'm extending the horizon, thinking in terms of the 120 days it takes your bone marrow to replace your entire blood supply. That'll be around the middle of March.

In one way, though, it's reassuring. I'm still plagued by intense daily headaches. I'm a basket case by mid-afternoon most days. The low hemoglobin might contribute to this. Nobody seems to have much of a better idea.

My doctor hypothesized they might be rebound headaches from the ibuprofen I was taking, a lot of it, for various reasons: hip muscle spasm, headaches, dental inflammation, more headaches. I'd heard about Excedrin rebound headaches, but I always thought they came from withdrawal from the caffeine in Excedrin. Turns out you can get rebound headaches from almost any analgesic — ibuprofen, aspirin, Vicodin, even acetaminophen — if you take it for more than a week or 10 days. My doctor told me about this on Tuesday and I stopped the ibuprofen completely the following day, noting that it can take 4-7 days for rebound headaches to subside. Well, today is day 7 since I took any painkillers. The headaches did diminish at first, but in the last couple of days they've come back, just as strong as before.

Another theory was eyestrain or outdated eyeglass prescription, but I had a full eye exam yesterday and they found no problems. They're raising my reading glasses strength to +1.75 from +1.5, but the doctor said that minor change shouldn't be causing massive headaches.

Chemo is a massive bodily insult, and it just may be that the headaches will go on for a while no matter what I do.

Meanwhile I’ve also learned some jaw stretches and massage trigger points for my nighttime teeth clenching. They do seem to be helping, and my teeth are finally getting less sensitive. For a couple of weeks there I could hardly eat, since everything – cold, hot, sweet, crunchy, spicy — hurt my teeth. I'm also trying self-hypnosis and binaural beats, both very relaxing but not an instant solution.

One piece of really really really good news: the MRI results showed no evidence of avascular necrosis in my hip joints. (They thought they'd seen this on my CT scan just before chemo.) I was looking at major surgery if that had turned out to be true. Hard to understand how they could see something on the CT scan that doesn’t show up at all on the MRI, but according to Nurse M the MRI just makes a much better picture.

I'm working more, survived 2.5 hours of meetings on Friday, but I'm really only up to about 60 percent. In the gym I’m working out at full steam, can drive my heart rate to 175 in sprint workouts with no problems. Not bad for a 50-year-old guy whose maximum heart rate is supposed to be 170. So I do feel better physically, even if my head pounds all afternoon most days and I can't work as much as I want to.

My therapist at the cancer center talks about finding a “new normal” in life after cancer. Much as I want to jump back into my old life, forget this ever happened, it ain’t gonna be like that. I have to go slower, take more time to re-enter, readjust expectations and commitments.

I hate that. I once told somebody that my philosophy of life was to run, flat out, until I had to stop. "Slow" isn't really in my vocabulary. At least until now.

Inverted

My next blood test won't be until Jan. 28, so no new numbers today. Feeling better and stronger every day in most ways. Still having colossal headaches from nightime teeth clenching, but I bought some self-hypnosis CDs that help calm the jaw muscles down at night. So do yoga inversions: the inversion sling, headstands, shoulder stands. I never realized you could stretch the sides of your face in a shoulder stand. Plus, it reboots your brain.

Think about it: gravity does a lot of damage. Skin, breasts, testicles, muscles, ears — everything eventually sags under its force. That's happening to your internal organs as well. Spending a few minutes upside down every day reverses the direction.

A lot of people think of yoga as some kind of fringe thing, but to me it's essential. It does more to rejuvenate, strengthen, and calm me than anything else. There's ancient, real knowledge here, about how body and mind connect. And unlike a lot of exercise modes, you can do it all your life. BKS Iyengar is 89 years old and still practices 4 hours a day. Extreme, OK — but I wouldn't mind being able to do what he does when I'm 89.

Monday I had an MRI for possible avascular necrosis in my right hip joint. Amazingly fast — I was in and out in 50 minutes. Man is that MRI machine ever loud. They gave me earplugs but my ears still rang all day afterward. Forgot to take off my two silver rings, so the magnet made my ring fingers quiver, like scared little minnows attached to my hands.

No results yet, and I don't really want them, either. Now that I know the problem is there, I can feel something that might be related — pain at the adductor muscle attachments — but only in extreme hip positions such as certain yoga poses. I'm taking it easy on those, having no problems at all walking, riding a bike, etc. I'll wait for the doctors to evaluate this.

Meanwhile I came across another great HCL resource: Rob's User Friendly HCL Site and Chat Room. Lots of current and former HCL patients, very welcoming, some good information here.

Only numbers

At my last post, on New Year's Eve, I'd just received upbeat blood test results. There's been more good news this week, especially being able to work out again. Still going at a reduced intensity, but I'm doing full-length workouts now — weights, cycling, swimming — and it feels like only a matter of time until I recover all my strength.

Unfortunately, that wasn't the whole story. Bad insomnia plagued me all week, waking me up for good at 3 or 4 in the morning. Thursday I managed a full work day, about nine hours more or less straight through on a grant proposal I'm writing with half a dozen colleagues. Friday morning, another four hours on that proposal. It was intense work: a lot of concentration, rapid thinking, staring at a computer screen, pressure to meet our deadline.

It felt great to work again, but by Friday afternoon my head was pounding like a taiko drum. Now it's Monday, and the headache's still hanging around, even after going back to bed for a while this morning. My teeth hurt again from nighttime teeth grinding. My bite splint helps a bit but doesn't solve the problem. Did some reading about bruxism and discovered that bite splints probably can't fix this, but nobody really has a better idea, even though about 20 percent of the population suffers from this.

Insomnia + teeth grinding = headache, maybe, but I still don't understand why it's so much more intense than it's ever been before. (These aren't new problems for me.) I ruled out various possible causes — supplements, caffeine, squinting — by cutting them out completely for three days, with no effect. I'm praying it's not a cracked or infected tooth.

So I'm seeing this headache as part of the recovery from chemo. However tempting, it's unrealistic to expect to jump back into my normal work life overnight.

Last week's test results are only numbers. They're good indicators of important variables, but they don't tell the whole story about what a week of intravenous poison did to my body, or how much recovery time it still needs. I have to keep taking it a little easier for while, rest more, not expect too much too soon.