July 24 -- Last Friday was Chemo Cycle One, Day 8. I only got one drug, Taxol, so it was a much shorter day and we were home by noon. Having taken in all the new procedures and details last week, this week I elected to put on headphones, lie under a pile of blankets, and escape into my Pandora folk station. Remember how last week I described my response as being a little "adventurous and swaggering"? Yeah, not so much now. Over the week I developed a really visceral terror of even approaching the Infusion Center. Part of this is classical conditioning -- avoid that which make you sick -- and part is that it forces me to confront the seriousness of my illness. Many of you have commented on how "brave" and forthright I seem. The reason I can do that is that I keep my bigger fears securely stashed most of the time, where they cannot easily slip out and bother me. Not so easy to do when someone is about to pump toxic chemicals into you because that's what it takes to fight this.

So far, I've had a much better response this week than last. I've felt reasonably normal, have been eating decently well, and just feel a little achy and tired (when I'm not feeling jittery and wired from the anti-nausea meds, which work by blocking neurotransmitter receptors). The meds are doing their job. David and I are even contemplating beating the heat by going to the Harry Potter movie later today! It's possible that my body just isn't shocked this week the way it was last, but I suspect it's mostly that I didn't get Cisplatin this week. I guess I'll find out in two weeks, when it's Round Two, Day One.

The new thing this week is an injection of Neulasta, which stimulates the production of neutrophils in order to boost the immune system. I'm told I can anticipate aches in the marrow-producing regions like the hips, long bones, and sternum.

I'm developing a whole new relationship with food. At the beginning of last week, just chewing and swallowing was a challenge, and I turned to canned nutrition supplements to make sure I was getting reasonably adequate calories and nutrients. (I've lost almost 20 pounds from my pre-surgery weight; the best that can be said about this is that, based on my current BMI, I no longer contribute to the nation's obesity epidemic.) Chemo works by interrupting cell division in rapidly-dividing cells. In the body, this includes the cells lining the alimentary canal from mouth to ... the other end. One of the consequences is alterations in the sense of taste. So, even though my appetite is quite good (at this moment, anyway), eating is not the pleasure it used to be. Flavor profiles are very flat, and I can taste some things and not others. (Hummous, for example, read as "garlic" and "chickpea", with no hint of sesame or lemon and certainly not as an interesting melange -- not worth eating -- and gummi bears have no taste whatsoever.) Very assertive flavors work best, such as a tomato-based lentil soup I had recently. But to some extent, eating is now an exercise in satisfying hunger in whatever way is not actively offensive. (Note to Alex: no need to send more M&Ms, though I surely appreciated the first batch.)

The more astute among you are saying, "Wait! if chemo affects cells in the alimentary canal from end to end, aren't there effects at the other end too?" Short answer: yes.

Luckily, I'm told side effects like this will resolve once chemo is finished.

The last big thing I want to tell you about is that after something like seven months of taking round-the-clock, on-schedule pain relief meds, I am now back to occasional, as needed, use. This happened very suddenly, and the best I can figure is that I just decided to be done with the surgery and move on. I'm put in mind of a kid I taught a while ago who we affectionately called "The Puker". Every day, he'd come into science class and leave several times to visit the nurse, the bathroom, or, sometimes, the trash can. One day, as he stood retching over the trash can I said matter-of-factly, "It's time to be finished with that," meaning "for today". The kid never puked in class again. I think at some level I must have told myself the same thing. On a related note, the bit of incision that developed an interior, draining pocket, and that I've had to pack with gauze twice daily for the last six weeks, has finally closed. So I really do feel done with that.