Infusion Schedule is all Fowled Up

Previously, chemotherapy only had anecdotally-described memory loss: “chemo brain” as proof of a missing fragment. Recently however, clinical studies have confirmed the link. Yet, I still feel as if I haven’t forgotten that I don’t recall any prior infusions occurring on the day after Thanksgiving, as my next infusion is presently scheduled. If I remember correctly, and there are occasional disputes, this would be the first Friday after a holiday when I’ve needed to be local, and infused. And yes, the Infusion Centers are open for business on the weekdays following major holidays.

Having recently had my quarterly, post-scan, face-to-face appointment with my oncologist and survived the ordeal, we moved on from discussing the scan results to being examined to scheduling future appointments – including a brain MRI and CT Scan, and of course, my next infusion. And looking at the calendar, November 24 is that next date. Generally speaking, per previous conversations with my oncologist, rescheduling my infusions by a week or two, here or there, had not been much of a problem (my oncologist is a strong proponent of quality of life), and pretty much up to me. However, as I’ve gotten older and presumably wiser – and well aware of my creatinine level/kidney issues, my current infusion schedule is what it is for a reason – protecting my kidneys. Moving the infusion up a week or back a week is not an arbitrary, Kenny-made decision any more, despite my holiday wish least. Sure enough when I asked my oncologist if he had any thoughts on my possibly rescheduling my next infusion to five weeks or seven weeks (vs. the current six weeks), he had a specific preference: five weeks. This would mean infusing the Friday before the following Thanksgiving Thursday (the effect of which would likely cause some eating challenges for yours truly – on my favorite meal of the year no less) rather than extending the infusion interval to seven weeks.

His thinking, as he explained it to us was: he didn’t want me to wait any longer for my infusion/medicine than was absolutely necessary. Not that I don’t realize how precarious my situation is but I am sort of going merrily along of late. His rebuke, so to characterize, to me about not extending my next interval to seven weeks reminded me yet again of the seriousness of my underlying diagnosis. The last thing one can do is take cancer’s inactivity for granted. Even though I’ve been stable for four years since I was last hospitalized in August of 2013, I do have an incurable disease: non-small cell lung cancer, stage IV, and I was initially characterized as “terminal,” so hardly am I “N.E.D.”, no evidence of disease.

So my next infusion date is up to me, just not as ‘up’ as I thought it was/has been. Either I can keep my original six-week interval infusion appointment as currently scheduled or I can advance one week to five weeks (my previous regular interval). Extending it to seven weeks is not recommended. According to my oncologist, this is good news. Since my creatinine level/kidney function has not appreciably improved while extending the interval from five to six weeks, shortening the interval back to five weeks is not a concern to him which means my kidneys are up to the challenge, which is very reassuring since kidney damage is permanent. And even though waiting a seventh week for my next infusion might allow my kidneys more time to filter the chemotherapy a bit longer, it might also give the cancer some time to activate – and we certainly don’t want that.

However, nothing lasts forever, and cancer cells in particular are pretty resourceful and often figure out what’s being done to them and start doing something else which leads to different treatment. At the moment, the drug I’m infusing, alimta, is working miracles. Perhaps the next drug will be as successful, perhaps not; and that of course is the problem, the unknown. What I do know is this: a definite is better than a maybe. If I infuse the previous Friday, I definitely won’t feel like eating on Thursday. If I infuse on the Friday after Thanksgiving, maybe I won’t feel like driving. So what! A bird in hand … .

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