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Another theory was eyestrain or outdated eyeglass prescription, but I had a full eye exam yesterday and they found no problems.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.