Thursday, March 28, 2013

Treating what Ales you

I've been off on some ranting side trips here lately,  so thought it was time for an update on the wonderful world of Oncology.  Yep,  still getting random very expensive chemicals dumped into my body on a weekly basis.  Was closing in on being done with my treatment regime,  until going off & getting the Flu this week.
Turns out that if you nuke your immune system back to the stone age with Cyto-Toxic drugs,  things like Flu Vaccines are pretty much rendered superfluous.   And as a bonus,  that flu stuff seems to REALLY kick you when your immune system is down.  Finally feeling semi-human again after 4 or so days of Sweating/Chilling haze.  Fevers are ALMOST as much fun as recreational chemicals! (Not)   And,  you get to experiment with yet more of modern pharmacology's best new attempts.  What side effects does Tamiflu have?  We'll see soon enough.

Prior to the lovely,  and out of season visit with this new virus strain,  I was doing pretty damn well,  Getting out to ride in the good weather,  and getting slowly thru my 8 rounds of Mutant Mouse Antibody treatments every week.  For those of you who have never had any exposure to the joyful world of an Oncology Chemo Treatment room,  here is a quick look into a world you really never want to see.  Given my treatable disease,  short duration and lack of side effects,  I feel like an interloper in there,  considering what so many others have to go thru in that room,  but it has been an eye opener,  to say the least.

Once a week,  you block out most of your day,  and go visit the Treatment Room,  usually after paying  your Hematology "Entry Fee".   That Blood draw and CBC the Blood Docs just can't seem to function without.

Then,  back to "The Room".  Cheery enough,  but still not anywhere you really want to hang out.

For me,  unlike a lot of the folks who get the "pleasure" of visiting regularly and have a Port,  I get a regular IV each week.

After getting the IV in and a flush of saline,  You get a few bags of "pre-meds" as almost ANY of the drugs they give for Chemo & other treatments can have infusion reactions,  so they load you up with IV antihistamines to minimize the chance of an anaphylactic reaction to any of the infused drugs along with steroids for the anti inflammatory and immunosupression effects.  For myself,  I get a cocktail of Tylenol capsules (the Rituxin can give headaches..),  IV Dexamethasone for my steroid,  and IV Zantac and Benadryl for the antihistamines.

Given the many bags of Benadryl and Zantac,  it's no surprise that many,  if not most of the "treat-ees" have those lazy-boys in full recline and are sacked out.  Nothing Like IV Benadryl to make you a bit sleepy.   After a 45 minute or so infusion time for the pre-meds,  I get a BIG bag (Like a Liter...) of Mutant Mouse Stuff.   That gets a very specific infusion schedule,  starting at 100 mL/hour,  and ramping up each hour by 100 mL/hour to a 400 mL/hour rate.   Takes 4 or so hours at best to get that big bag in.    You can get up and move around,  as long as you take your IV pole with you.    My treatment center has a nice little snack area and I LOVE taking my pole for little walks to get snacks and heat up my lunch.  Outside of that,  reading,  net surfing and napping are the real attractions for the day.  Once you have sucked up all your anointed juice for the day,  a quick flush,  IV removal,  and out you go.

I do have to give some props to two great bunches of people.  First,  the patients I have met in that room have been 100% great,  positive & fun people.  For some reason,  cancer patients have some of the best attitudes I've ever been around in a medical treatment environment.  The only people who eclipse the patients are the Chemo nurses who run the room.  Sweet,  caring,  funny,  knowledgeable,  supportive.   I have more respect for these ladies and what they do than can be put in words.  They love what they do,  and are FANTASTIC at it.  You can call them anytime,  and they have the answer for you.  Stellar people,  doing incredible things.  

The good thing for my treatment is that it has minimal side effects,  and up until the flu laid me out,  I was getting some good riding in,  get some base in place so that when I quit poisoning myself each week,  I might be able to start trying to make up for a year of broken blood and get some fitness going for MTB season.  I was able to catch some of those REALLY nice days before that last round of snow mudded all the trails up.  Even got to see some of my Wild Turkey friends.

Was riding enough to start to think I was almost a cyclist again.  Sadly,  it turns out that riding by yourself can lead to some "mistaken impressions"  of where your fitness might really be.  Any notion of having ANYTHING going in the riding department were quickly squelched with one group ride.  Boy,  do I have a LONG road back to reasonable,  or even functional level of fitness.  Going to be a long and suffering filled road back.   I can't wait.

Sunday, March 17, 2013

Digital EPO

It must be spring,  I swallowed my first bug of the year last week.

Got some of those great,  fake you out spring days last week,  and I was able to ride the tail end out of the nice days.  Besides gagging down your first insect,  you know spring approaches when you get that first short-sleeve ride in.  You know it's getting close when you see people cutting out of work to sit by the lakes and fish.  Ah,  spring,  springing.  Right up until it goes back to windy-ass March weather.

I seem to have succumbed to at least some of the Bike-Geek Social networking peer pressure.  I've actually found myself using and even enjoying Strava.  I know,  I,  know,  it's either the best thing that ever happened to riding,  the worst thing,  causes people to go nuts,  begets "stavassholes"  all  that.   Turns out you can use it without going off the deep end,  or really even think about it much.  Not sure I'll keep uploading to it,  but it is a reasonable,  cloud-based training log/tool.

Course,  the dark side of it is the online competition side,  the whole King Of the Mountain and Strava Segment thing.  Being for the most part basically slow and incapable of getting KOMs on Strava,  I only see that side of the app as entertaining or just plain silly.  That said,  I can boast of at least one KOM myself.  A bike path thru a neighborhood here in "not-Boulder",  one I had no idea existed.   One mid-week day,  with a raging tailwind and no one out on the path,  I snagged that coveted KOM.  Who would intentionally make a Strava Segment on a slightly downhill,  crowded neighborhood multi-use path?  There is the entertainment value for me,  or an example of what is "wrong" with Strava.

Course,  if you want to get a "Real" Strava KOM,  you either have to be fast,  put a GPS on your scooter,  or maybe just go here

Yep,  EPO invades even the fake,  virtual race world.  Digitally Juice it up.

Course,  you could always just really go out & dope,  and do an actual race.  Since USA Cycling is launching a new initiative to catch all the dopers,   maybe you could get on Oprah too.   Even BRAC seems to be throwing some money at this this year,  since It takes $6000 to get USADA out to your local races,  even under the new USAC Race Clean Local Association dope testing money matching program.

Course,  no local guys or any of the old dudes would dope.....  oh,  wait,  seems like that already happened.   Course,  no one could go out & GET EPO to use,  would they?  Gotta be pretty hard to get,  right?   Well,  go put "EPO for Sale" into the Google & see what happens.

Wow.  Wow is about all I can say.  All the Chinese EPO you can subcutaneously inject available from a slew of sites.  Would you REALLY want to inject Chinese Knock-off "Erythropoietin" into your body?  For some local bike race glory?  Well,  maybe some would.

These sites are kind of insane,  to put it mildly.  Doping for sport instructions,  Dosing,  everything you could ask for obtaining & using the stuff.

SPORT usage

A common practice that may be used by performance sportsmen (runners, cyclists, swimmers etc.) in an attempt to increase performance is Erythropoietin. This substance is produced naturally in the body by the kidneys and is used to regulate red blood cell production. Patients suffering from anemia or chronic renal failure are legally allowed to use this form medically, however some athletes have decided to take advantage of this substance as well.

Due to medical advances, we can now inject EPO rather than blood doping, which was the common method in the past. EPO works by increasing the bloods ability to carry oxygen, thus serving as an ergogenic aid. Some studies have shown that athletes have had an 9% increase in VO2 max, 7% increase in power output, and a 5% decrease in max heart rate ((Juhn, M., 2003).

While the benefits of using erythropoeitin are unquestionable, there are serious side affects that an athlete needs to consider. After injection, the blood has a higher concentration of red blood cells and a thicker viscosity. This may lead to thromboembolic events that could be fatal. I.e. if you dope more than necessary, thrombs may stop the bloodstream during the exercises and sportsmen dies. There are serious suspicios agains EPO for the deaths of some top cyclists during 80s and 90s.

Seizures and hypertension are also demonstrated in those athletes who are blood doping. Most athletic federations have banned this practice and a haemoglobin limit of 18.5 g/dL has been implemented.

The injection of EPO in the body is a practice that would be very beneficial to any athletes involved in endurance activities. It would allow them to carry more oxygen per unit of blood than before thus improving their performance. This is not a sound technique however as there are strict regulations around it and there are many adverse health consequences that have been reported.

Dosage and Administration
Cancer Patients

Subcutaneous 3 times/wk dosing: 150 units/kg 3 times/wk. Reduce the dose by 25% when Hgb reaches a level needed to avoid transfusion or increases more than 1 g/dL in any 2-wk period. Withhold the dose when Hgb exceeds a level needed to avoid transfusion and restart at 25% below the previous dose when the Hgb approaches a level where transfusions may be required. Increase the dosage to 300 units/kg 3 times/wk if the response is not satisfactory after 4 wk to achieve and maintain the lowest Hgb levels sufficient to avoid the need for RBC transfusion and not to exceed the upper safety limit of 12 g/dL. Discontinue if after 8 wk there is no response as measured by Hgb levels or if transfusions are still required. Weekly dosing: 40,000 units/wk. Reduce the dose by 25% when the Hgb reaches a level needed to avoid transfusion or increases more than 1 g/dL in any 2-wk period. Withhold the dose if the Hgb exceeds a level needed to avoid transfusion and restart at 25% below the previous dose when the Hgb approaches a level where transfusion may be required. Increase the dosage to 60,000 units/wk if the response is not satisfactory (no increase in Hgb by at least 1 g/dL after 4 wk of therapy, in the absence of an RBC transfusion) to achieve and maintain the lowest Hgb levels sufficient to avoid the need for RBC transfusion and not to exceed the upper safety limit of 12 g/dL. Discontinue if after 8 wk there is no response as measured by Hgb levels or if transfusions are still required.

They even let you know all about those pesky "laws" and "rules" about ordering prescription drugs online with no prescription.  Course you would go check with the relevant "authorities" in your area before ordering your drugs.

Is it legal to purchase these products?

Since laws differ from country to country, we recommend you to contact your local FDA or customs office regarding the regulations and restrictions of your country. Are you a legitimate company? We are a professional mail order service licensed to sell and distribute pharmaceutical products. We have been established for over 4 years, supplying original, high-quality anabolic steroids and bodybuilding related products, prescription-free over the Internet.

Do I need a prescription to order?

A prescription is NOT required to order our products.

Oh,  and that pesky "customs" and Shipping issues?  All taken care of.  Here are your customs intercept rates,  by country,  and most are happy to let you know that if YOUR shipment gets intercepted,  they will happily send another.

How are products shipped?

We ensure that all packages are shipped with maximum discretion. Since prescription is submitted, products are removed from their original boxes and repacked with extreme care and precaution, specifically to minimize shipment volume. Our organization name is not indicated on any package and shipments are made from various shipping points in the world established in different countries to ensure maximum discretion and highest probability of successful delivery. With custom we have 99% success to USA and Canada, 100% success to any country of EU and 90% success to Australia. Problems with custom are only in New Zeland.

How do you ship?

We ship our products world wide and all packages are shipped very discreet.
- Our organization name or anything else that would imply pharmaceutical contents of the package is never used in our shipments.
- The size of our packages are never larger than what would cause unnecessary suspicion. If the order is too large to fit one of these packages, the order will automatically be divided into two or more packages (always included in the S&H-charges).
- Shipments are made from various shipping points in different countries.
7.Is there any Customs problems.Normaly there is no customs problems,if refused by customs ,we will resend, you will receive all of your products.

SO there you go.  Everything you need to know to inject random Chinese liquids under your skin.  What could POSSIBLY go wrong.   Have at it,  and look out for the dope cops at the local races.  Let me know how it goes.  Me?  I think I'll just keep getting rejected by my Oncoloigist when I ask for EPO come cross season.   Again,  Wow,  just Wow.

Sunday, March 3, 2013

OH, goodie!

A bonus round of doctor visits seem to be in the works.  While I have been doing just fine on my latest treatment of Mutated Mouse Antibodies,  there DID seem to be a bit of a "side Effect" creep up on me. Mostly,  the drug is as advertised,  very low in side effects.  A bit tired for a couple of days,  and a strange effect of filling up my throat with goo like I have a low grade head cold.  That was about the only obvious effects I had seen,  until a few strange "heart rate" events appeared during several rides.

I was Just Riding Along,  nice conversational pace,  when several times I had a sudden strange feeling, almost light-headed.  Very brief,  but then noticed some rather "unusual" numbers on my heart rate monitor.  I have not seen Heart Rates over about 170 as a max in a LOT of years,  but was suddenly seeing 190+ values in these brief moments.  Yikes.

Ended up seeing several of these over a few rides.  Kinda unnerving,  and APPEARS to have started just after starting the Rituxin infusions.  Not every ride,  and never off the bike.   Hmmm.

Mentioning such "events" to a Doctor triggers exactly the kind of reaction you may expect.  Immediate forwarding of your broken hide to another specialist.  Next week I'll get to spend most of my Thursday getting Mouse Juice as usual,  THEN get to go talk to a Cardiologist later that day.  Yee Haw.   These little episodes were pretty strange,  and seems reasonable to check things out,  as I have never had such "events" in the past.  I predict a stress EKG and getting to carry one of their little monitors around for a few days in my near future.  Will be really cool if it turns out it is just a version of the 1% of reported reactions to Rituxin that involve Tachycardia.      

The other side of the "Cancer Sucks" equation that does not get the story told as it should,  is what happens not to the Cancer Victim,  but those who care for them.  This disease hurts a lot more than just the victim.   I was forwarded the story below from just such caretaker.  I think that the stories from the loved ones are just as important,  and so I am happy to help vent for them.  Thanks for sharing,  Cameron,  and I am so happy your story has a good ending.

Learning to Care: Lessons You Don't Expect from Cancer
I really felt that my life was perfect in the fall of 2005. My wife Heather and I had just celebrated the birth of our daughter Lily. She was our first and only child, and we couldn’t have been more excited to be new parents. However, that all changed on November 21st, 2005. On this day, I went to the doctor with my wife. Sitting in the doctor's office, we learned that Heather had malignant  pleural mesothelioma. It was a very rare and extremely deadly form of cancer.  We were shocked and terrified, and neither of us knew what to do in that moment.

I started my life as a caregiver for someone with cancer that day. It was a hard journey and something that took a lot of patience and work. You have to learn so many things. The first of which is how to make tough decisions, not just with taking care of someone while sick in bed, but someone who really needed you to be there as they went through cancer treatment. I remember being in that doctor's office and knowing that our lives were changing. We had to make a choice about where to go for treatment. There were a few hospitals nearby that didn't have the right program. That was the first choice that I had to make as a caregiver. My wife was going to get the best treatment. The doctor suggested we see a specialist. His name was Dr. David Sugarbaker from Boston. I knew that if Heather had any chance at all of beating this terrible disease, she would need the best care available.  I turned to the doctor and told him, “Get us to Boston!”

For months after, I felt my emotions rising and falling on a daily basis. On the days when I had to work, I felt conflicted, staring at the clock wishing that I was at home with my wife and baby. There were so many things to do, and I had to be the one to do them all, or so I thought. It wasn't until much later that I realized I was taking on too much.  Our community of loving friends and family were eager to help, and I needed to learn the strength to accept this help.  Perhaps one of the biggest lessons I learned throughout this experience was that in a battle with cancer, there is simply no room for pride.  Other’s will be there.  Don’t be afraid to ask them for help.

As a caregiver, you will have bad days.  This is inevitable and even necessary at times.  The important thing is to never give up hope, and always keep fighting for a better tomorrow. 

Over the following months, Heather underwent extensive mesothelioma treatment in the attempt to beat this terrible cancer.  Against all odds, she was able to accomplish the near-impossible, and beat mesothelioma.  Today, over seven years since her diagnosis, she is cancer-free, happy and healthy.  We hope that by sharing our story of success against this ugly cancer, we can help others currently battling today.  Always hold on to hope, and never stop fighting for the ones you love.