Category Archives: Dr Jason Tache

A year ago today…

It’s now twelve months since I sat here writing about my concerns on the night before my first ever chemotherapy infusion. Purely coincidentally today I went to Dr Taché’s office for my port flushing. As usual the chemo room was busy and good-humoured. Purely coincidentally Lisa, my first oncology nurse was working today. I asked her if she remembered that this week was our first anniversary. The son of a patient asked if I had brought flowers for Lisa and I replied, “What, when she’s forgotten all about it? She doesn’t deserve them!” There was much laughter.

The past twelve months have seen things change a great deal. The chemotherapy literally brought me to my knees at times. At times it brought me even lower and I could do nothing other than crawl on my stomach like some squaddie undergoing basic training and being subjected to live-fire for the first time. These past few weeks I’ve really begun to feel my strength returning to something like normal and even my finger nails now seem to have disposed of the last remnants of the chemo and have stopped being brittle. My wife and I have even started on the Zumba classes offered as part of the Mayor of Davie’s Fitness Challenge, and, yes, I do ache slightly lol.

I’m applying for jobs on a daily basis and  am now managing to concentrate pretty well throughout the whole day. One issue which has cropped up is whether or not I should mention the cancer, the chemo and the recovery as a way of explaining what I’ve been doing for the past twelve months, as some people I have spoken with are of the opinion that this will scare away an  otherwise willing employer. If anyone has any thoughts on this I’d be interested to read them. Two days ago I had a phone call from Williams Zophin which doesn’t seem to have its own website but is on http://americanincomelife-williams-zophin.com/. Apparently my resume had been discovered on-line by one of the managers and could I go in the next day (yesterday) for an interview as Benefits Director:  the job being described to me as, “going over union members’ benefits and making sure the paperwork is correct”. As always I tried to do some background research on the web. There is very little though there is a Facebook page. The Facebook page was a little worrying. The page contained several comments from people who were clearly and unashamedly current employees who thought Williams Zophin to be the best thing since sliced bread and were making great incomes by dint of hard work. Nothing wrong with any of that is there? No, I thought not as well, but there was another post from a lady (not visible on the page as I write) who had been approached in a manner similar to myself but had been successful in researching the company and had come to the conclusion that the company was a pyramid sales company selling life insurance. Despite this comment I thought I’d go and see what Mr Yemi of Williams Zophin had to say to me. My worst fears started to be confirmed when I walked through the door into their office. Every seat was taken by someone clearly there on interview. In fact there weren’t even enough chairs for the person ahead of me, myself, or the person who followed me, to have seats while filling out our questionnaires. A series of suited managers kept walking through the door and calling out the names of the interviewees. At this point I was very tempted just to leave but, having made at least this much effort, I thought I’d see it through, as, perhaps, they were interviewing for a series of posts – yeah right! Anyway my turn came and a thoroughly pleasant Mr Yemi asked me to tell him about myself which I did. Mr Yemi then explained the three stages of the interview process designed to ensure the right fit between applicant and company, and he then went on to say, “the job is about sales and managing sales”, to which I could only reply, “that’s not what I was told over the phone and I’m not interested in selling insurance”, at which point I terminated the interview. Why do companies do this? Why do they deliberately misrepresent what they want an applicant to do? Are they so desperate for new employees that they just trawl the web for recent resumes and get people in under what I can only call false pretences, accepting that they are going to wastefully invest their time in applicants who wouldn’t have gone had they known the true nature of the employment. Just to be clear on this, I didn’t do enough research to know whether or not the lady’s claim that Williams Zophin is a pyramid seller of insurance is true or not as I didn’t let my interview get that far. Neither do I know whether or not the products which Williams Zophin sell are any good or not as I found very little about them on the web. What I do know is that they misrepresented the job to me and I am very annoyed about that as I wasted a couple of hours which could have been better used trying to find a company which wouldn’t lie to me about why it wanted to interview me.

Still on the job-search front, tomorrow I take a two to three hours skills assessment test being proctored by a local university on behalf of a company to whom I applied for a job. Now, this company’s recruitment procedures seem to be entirely the opposite of Willams Zophin. This company contacted me having discovered my resume on the web, asked me to complete an application form, subsequently gave me a 30 minute telephone interview before asking me to take an on-line IQ type test, then asking me to write a book review of my (fictitious) autobiography. How many more stages will there be to this selection process if we presume I pass this stage? I don’t know, but I have to say it is the most rigorous selection process I’ve ever been through!

So, back to waiting for that first chemo infusion. It occurs to me that all over the world tonight there will be people in the situation in which I found myself twelve months ago. If any one of those people is reading this I would like to say to them that they may as well know they are probably in for a rough ride, but it is one which is made more bearable by a good medical team and the love and support of family and friends. You will make many discoveries along the journey, finding support from people from whom you wouldn’t expect to receive it, but also discovering that some people you thought you could rely upon absolutely just seem to fade away. You will find people who ask inane questions and others who talk to you with empathy and knowledge. My advice would be to join the blogging community, it’s a wonderful source of support. Whether you are one of those people just starting out on the chemo-trail, or are already travelling the route I wish you well on your journey. To those whose blogs have helped to sustain me during my own journey along the chemo-trail, especially my long-suffering wife, I say a very appreciative thank you.

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Filed under Cancer, chemo, chemotherapy, Dr Jason Tache, Job Search

So I REALLY need a colonoscopy?

I saw my oncologist, Dr Taché, on Friday, it’s the first time I’ve seen him since my scan gave me the all clear. He wants me to have a colonoscopy. I’d thought that my last scan revealing no cancer in my body after six months of chemotherapy would have meant there was no need for a colonoscopy, but, no, it seems I still ought to have one: I will leave you to imagine the sense of delight I experienced on being given this information!

Dr Taché also thought he detected a “click” from my heart and so he wants me to see a cardiologist to get a specialists opinion. Now, I don’t know about you, but, until Friday I’d never heard of a “heart click”. There’s not an awful lot about it on the web but it seems that the “click” is the sound of the heart’s valves as they open and close. So, far as I know this “click” has never been detected before and so, presumably, it’s a relatively new development post-dating the chemotherapy and therefore, I presume, possibly being a response to the poisons pumped into my body during the six months of treatment. Am I concerned? No, not especially, as, from what I could discover, this is by no means an unusual thing, and, as I’ve experienced no cardio discomfort when exercising or going about my daily business, I doubt it is anything significant at the present time. To the extent that I am concerned it is that I’m now getting to an age where the body functions nowhere near so well as it used to do (if I’m honest I hit that age a while ago!), so my concern is that this “click” may be the harbinger of more medical problems. Hopefully the cardiologists advice will be to lose weight and exercise steadily.

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Filed under Cancer, cardiology, chemo, chemotherapy, colonoscopy, Dr Jason Tache, heart click

More problems than cancer?

I saw my oncologist, Dr Tache, yesterday and described my symptoms to him. He listens, and it’s obvious he does, and that’s good. When I was telling him that there had been two or three days when the roof of my mouth, much of my tongue and the top of my throat had all been numb, his ears really, really, picked up and he commented “I’d have sent you to the hospital.” It seems these symptoms might be indicative of my having had a stroke. They aren’t symptoms I’ve ever heard of in connection with a stroke and I’d just put them down to side effects of the chemo and/or the neulasta which, of course, boosts my white blood cell count but can be quite painful, this time causing pain from my pelvis to my knees for three or four days. Had I had trouble with my speech, with my vision, crushing pain in my chest or my arm or even a sudden urge to void my bowels then yes, I’d have associated all of those things with a heart attack, but not the numbness in my mouth and throat which in many ways seemed just to be an extension of the varying patterns of numbness I’ve been experiencing on my tongue ever since I started the ABVD chemo to rid my body of Hodgkin’s Lymphoma. Anyway, although we went ahead with the chemo yesterday, Dr Tache is concerned and wants me to have a variety of scans and specialist reports to make sure my heart, brain and lungs are all functioning as they should be which is all fine and dandy, just as it should be, but, of course, some of them must first be approved by my insurer, so, who knows whether or not Dr Tache will get to know what he wants to know and whether or not he will be able to make an informed opinion as to how we continue my treatment.

We all had a great time with my daughter who had an absolutely nightmare trip over here. She’d booked her flight with US Airways from Manchester in England which meant a drive of about 100 miles from her home in the West Midlands. When I went to bed the night before her flight the flight had been put back, but, when she arrived at the check in at around 8 a.m., she discovered that the flight had actually been cancelled. The best US Airways could offer was a flight on the Sunday, two days later. Not a lot of good when you fly home two days after that. Now, I know nothing about US Airways reliability but this site http://www.euclaim.co.uk/us-airways-flight-delays seems to show that the Manchester – Philadelphia flight was cancelled three times in seven days which hardly sounds good does it? Anyway thanks to the efforts of her husband and British Airways my daughter managed to book on a BA flight from Manchester to Heathrow and then on to Miami, finally arriving at her hotel some 21 hours after she left home that morning. I think her journey was worth it. Will she ever again try to fly US Airlways? I doubt it.

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Filed under Cancer, chemo, chemotherapy, Dr Jason Tache, Neulasta, Stroke, US Airways, White blood cells

Three more months

I seem to have been living in some kind of a daze these past few weeks. I guess the chemo is starting to take a bigger toll on my energies – it’s certainly starting to take a toll on my waistline, though that’s probably not a bad thing in the long run!

It’s now just over a week since I got the good newws from my oncologist, Dr Tache, that my CAT scan results were “good”. I had to ask what “good” meant! It turns out that, as far as they can tell from the scan my Hodgkin’s Lymphoma is gone, but, as “we don’t have a Star Trek scanner” we need to continue the chemo for another three cycles. It is good news. I know it’s good news and yet, the continuing of the chemo feels like a continuation of the gaol sentence as, from the outset I was told I would be cured. When I knew the chemo was working on the cancer itself there was a fair trade off between the fatigue, the queasiness, the need to not mix with people, the limitations on where I could go, the lack of employment and cash on the one hand and the expectation of good health and a long life on the other, but, if the lymphoma is gone then there is now really nothing for me to set those things off against and in a way that is an unexpected blow to my morale. When I knew the chemo was attacking the cancer as well as my body then I understood why I walked along the street like some kind of nonogenarian penguin who, having, spent their entire life at sea has landed in port, got totally rat-arsed and lost their walking frame to boot, but now when I walk that way I don’t really understand why. I know, intellectually, that it is to make sure the whole cancer is totally eradicated from my body, that there’s nothing lurking somewhere awaiting an opportunity to leap out and scream “I’m back and this time I’m not going away!!!”, but that’s not the same thing as an emotional understanding is it? Don’t get me wrong, I’m not full of self-pity over my plight – I’ve read enough blogs over which I’ve shed many tears to know how very fortunate I am – but I’m ready for moving on and I think that, emotionally, I need something which shows that I am doing.

When I started to lose weight I thought to myself, “This is ok, I could do with shedding a pound or twenty” and I had this image in my own mind that the physical me of, say, ten years might start to emerge, but, as I look in the mirror, the me I see starting to emerge is the me of fifteen to twenty years in the future and that’s a scary thought – actually it’s also a scary image but we won’t go there! I think, though, that this image of the future is something to which I am able to attach a resolution which is to improve my physical condition, to work my body while I still can, to restore muscle tone and shape rather than looking like the proverbial bag of spuds, but, again, it’s something which I want to start doing now and yet I know I don’t have the wherewithal to do it yet, or rather I know that if I do try then there will be a loss of energy for the next few days. As I only feel to have energy for three or four days out of the fourteen day half-cycle that’s not really a good swap is it?

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Filed under Cancer, chemo, chemotherapy, Dr Jason Tache, fatigue, Hodgkins Lymphoma

“I don’t think it’s the cancer I’m feeling.”

Those were the words of my oncologist Dr Taché yesterday before the start of my third cycle of chemotherapy. The suggestion is that, perhaps, what Dr Taché was able to feel, is the healing of the incision from my biopsy. It’s difficult not to get excited about the possibility that maybe, just maybe, the Hodgkin’s Lymphoma has been killed but the reality is we don’t know, and as Dr Taché was quick to point out we need scans to know what is going on. I suppose the lymphoma could have shrunk and be hiding beneath, or perhaps even within the biopsy healing, so at the moment I’m working hard at containing my excitement as I would prefer continuing darkness to a false dawn at this stage.

In the run up to yesterday’s appointment I’d been experiencing both daytime cold sweats and night sweats for the previous four or five nights, both of which I associate with the onset of the cancer and its development from Stage 2 to Stage 2B. In addition I’ve had sore throats and tightness in my chest, coughing when breathing deeply or encountering cooler/moist air. I’ve also been feeling shaky several times a day, and from time I’ve been getting hand tremors: it’s this last which I’ve had most difficulty in accepting with any degree of calmness. So to find that maybe, just maybe, the lymphoma has gone may be a great relief, but only if it actually has. Anyway Dr Taché’s office is now involved in the usual discussions with our health insurance provider to get approval for the scans, and so there’s the tension of will they approve them or won’t they? Clearly time is of the essence as I need to have these scans done and the results evaluated and back with Dr Tache within a fortnight and I know that the last time we went through this it was touch and go. Of the scans the most important is probably the one which will reveal any damage to my lungs from the bleomycin as there is the possibility that the cough etc are the result of damage from that drug. If there is excessive damage then the bleomycin will be dropped from any future treatment – hence the need to get the results before the next infusion. It won’t be replaced by any other drug. The protocol says to just carry on with whatever other drugs are being used so that will be AVD instead of ABVD.

How do I feel about all this? On one level I’m trying very hard not to feel anything in case it turns out that although the lymphoma has shrunk it is still there in hiding, or that the sweats indicate that it has metastasized and we should be looking somewhere else, in which case the treatment may not be working and we might have to change treatment which I think would be a huge blow to my moral. On another level I am desperate for good news. I know that the infusion before this one has caused me to react more strongly than any of the previous ones and I therefore want to believe that it is kicking the lymphoma as hard as it possibly can, but, another part of me thinks that maybe, just maybe, the lymphoma is fighting back and causing the effects rather than them being side-effects of the chemo. I don’t know what to think really. Maybe I’m like a young child on Christmas Eve, knowing I’ve been good all year and hoping that I’ll get that brand new shiny bike from Father Christmas but aware that it costs a lot of money and that not all little boys can get everything they really, really, really want just because it is Christmas.

Fingers crossed!

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Filed under ABVD, Cancer, cancer staging, chemo, chemotherapy, Dr Jason Tache, Health Insurance, Hodgkins Lymphoma

Why I don’t have enough white blood cells

I knew that chemotherapy was a destructive process, but, until I started getting really low scores on tests for my white blood cells, perhaps I hadn’t realised just how destructive.

White blood cells are a significant part of the body’s immune defences. In effect white blood cells are the security forces of the body: when they pick up on an intruder of some sort, whether a germ of some kind or a bacteria, then the white blood cells spring into action either secreting antibodies or surrounding and devouring the bacteria. White blood cells have a short life typically existing for a period from a few days to a few weeks. If the body is on the alert because of an infection then there will be more white blood cells produced in order to deal with the intruder. Conversely, when the body is not under attack then there will be less of these cells. Chemotherapy kills white blood cells.

A low-level of neutrophils means that your body is less able to fight infection and so what would ordinarily be only a minor infection has the potential to have a disproportionately large impact with the possibility of disrupting chemotherapy treatment. In order to avoid this possibility my oncologist, Dr Tache, has recommended that I have a second course of Neulasta, and, once again, everyone has told me that it could be painful. They were right! I had some pain last time but it was handled easily with Tylenol and I thought the same thing was happening this time too, but, last night, the pain ramped up another level so that the small of my back feels as though bone is grating on bone. The Tylenol brings the level of pain down for a an hour so but then it starts to climb again. Sitting is painful. Standing is painful. Lying down is painful. I feel as though I would like to try levitation so that nothing is pressing on anything else. Anyone know of a magician willing to try this for me?

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Filed under Cancer, chemo, chemotherapy, Dr Jason Tache, Hodgkins Lymphoma, Neulasta, Neutropenia, White blood cells

One lump or two vicar? Part Deux

So, here we are on the first day after the first infusion of my second cycle of chemotherapy intended to rid my body of Hodgkin’s Lymphoma which everybody agrees is “the one to have, if you are to have one at all!”

When I saw the oncologist, Dr. Tache, yesterday, I went through the symptoms I’d been having over the past week or so. Night sweats, cold sweats during the day, body temperatures ranging from  97.8F through to 100.4F but changing rapidly within a couple of minutes. I also mentioned that I’d had some pain in my neck above the lymphoma and that there had, to my mind, been a sizeable swelling which now seemed to be shrinking. This led to a prod and poke examination of the usual points and to Dr Tache saying he could feel the node: it didn’t lead to any conclusion as to what it is. There are a range of possibilities from an infection which will respond to antibiotics which I am now taking, a viral infection which obviously won’t respond to antibiotics, or an indication that the chemo is not working in which case we may be looking at bringing in doctors from the university. Naturally my wife is frantic that this will cause further delay and the delay will prove fatal, and, naturally, I’m trying to remain fairly sanguine about it and only check the new lump for size every 15 minutes instead of every 10 !

On a brighter note I came across this article on the possibility of using nano technology as a means of delivering drugs direct to the point of need rather than the whole body. http://somethingaboutscience.wordpress.com/2012/03/05/nanorobot-to-cure-cancer-the-art-of-dna-origami/

 

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Filed under Cancer, chemo, chemotherapy, Dr Jason Tache, Hodgkins Lymphoma