Spent a quiet day at home. My weight is slowly increasing, 163.8 pounds as of this morning (11 stone 9 pounds 13 oz, 74.5 kg. Pick your units). This is thanks to the calorie packing meals that I’m able to get at home, well cooked, and served up when I need them. Food service is one of the things that it’s hard for hospitals to get right. I wrote earlier about my dismay when I finally got an appetite in hospital and they cancelled my muffin because they were out of them. Another problem is hospital is the mere fact that food is served only three times a day. Typically breakfast would not show up until 9 am, at which time I would have been awake for two hours, craving a good cup of coffee and a pastry. If you’re in for a length of time, you can do a certain amount of food hoarding, but one can only drink so much Boost. Boiled eggs at the hospital, in particular, were diabolical — rubbery and green. A good book on nutrition for cancer patients is published by the NIH, “Eating Hints for Cancer Patients” For me, the most important thing is to eat food that I enjoy, and where possible enrich with extra calories, but don’t overdo it or else the food doesn’t taste right. It also helps if you can prepare the food yourself, because, as all cooks know, preparing food gives you an appetite. I do miss the short slurp of wine or dry sherry when I’m cooking though – no alcohol for me until this is all over.

Loosing weight has also affected my muscle tone. A few days ago my muscles were really stiff and painful. I walk around the house every now, as well as up and down the stairs, which gives some very mild but useful exercise. I have been thinking about using the treadmill in the basement, but I don’t think I’m ready for that yet. I have some 3 lb weights however that I may be able to use. Muscle tone drops of very quickly when you’re laid up. A few days ago I was weak because I was anemic, but I don’t think that’s the case anymore. Frequent light exercise seems to be the thing.

Came back home last night. I hadn’t seen Miranda for several days so it was nice to be able to snuggle down in the couch and help her with her homework. She’s had to be more self-disciplined about doing her homework over the last few weeks since Mo and I have not always been there to encourage her, and in many ways, that’s no bad thing.

I now have a home infusion service from Apria who set me up with a pole and supplies for self-administering an antibiotic, Vancomycin, by infusion. The service comes with on-site instruction and, once you get over the initial hesitancy, it’s really quite easy to self-administer IV. There would seem to be adequate safety controls in place, and I must say that the nurse, Ginny, who came out last night was really helpful. I had not realized before that such services existed – what’s next? Home blood draws and analysis?

I see that Pat Robertson is again making crass statements, this time related to Sharon’s incipient demise. Pat is the right’s equivalent of Michael Moore – amusing, perhaps, but not to be taken seriously. Unfortunately, I suspect that there is a whole host of left-behind apocalyptic drones out there who have given up any measure of critical thinking and who hang on his every word. Please, those of you who are closer to the mainstream of religion in the US, tell me it ain’t so! I see the rapture index at www.raptureready.com hasn’t been updated in a few days, but the site is now advocating military strikes against Iran. That should bump it up a few points.

Still in hospital, with a 90% chance of getting out of here today. The doctors are still debating. One of the side effects of the chemo that is somewhat annoying is what’s called peripheral neuropathy This is a side effect of the Vincristine (aka Oncovin), and what it means for me is that I have a tingling in my finger tips, and more tingling in my feet. I don’t have a lot of independent motion in my toes. Fortunately I can still walk ok, and the effects are generally reversible during the course of several months following chemo. It’s not painful so much, but a bit annoying. My feet feel permanently cold.

More on the topic of religion in schools. I did not go to school in the US, so I stand corrected by Rick’s entry yesterday, that religious studies *can* be taught in US public schools. My question then becomes, so why aren’t they? My daughter is 6^th grade and at no time has she been taught anything about religion at our local public school. What are the major religions? What are their beliefs? What are the sacred texts? Love it or hate it, one must surely allow that an understanding of religion is an important part of a balanced education.

I am watching the events in Palestine and Israel with great interest. If Sharon is out of the picture who will pick up the olive branch? Surely not Netanyahu? Back in the early seventies I spent three months working on Kibbutz Erez, near the Gaza border. When I was there it was a relatively peaceful time. One day a friend and I went to Gaza, and I remember seeing the bullet holes in the buildings and being very aware of the Israeli patrols on the street. However, as I said, it was a relatively peaceful time, and I found the Palestinians very hospitable; they lost no opportunity to bemoan their occupation by Israel. This is something that we take for granted in the west — the right to self-determination. Now, I also think that the Palestinians have been idiots in the way that they have resisted the occupation, but an occupation it is, and I do not believe that anything can get settled until the Israeli withdrawal from the West Bank is complete. I’m not a big fan of Sharon, but I do applaud the withdrawal from Gaza and I hope that Palestine can reciprocate and demonstrate to Israel that it can be trusted.

WBC (White Blood Cell) is 10.41 – slightly above the normal range. Platelets are 216 (normal range 150 – 450). I continue to feel good. The latest news about by blood infection is that the bacteria are kind of wimpy, and the likelihood of needing to remove my port-a-cath is low. The next round of chemo, CODOX-M, the less brutal of the two regimens is due to begin on Monday as outpatient. On day 1, this regimen consists of the following:

• Rituximab. 375 mg per square meter. This is the expensive stuff that is grown from mouse cells. The measure 375 mg per square meter is how the dosage is calculated; from my skin area, or Body Surface Area (BSA). My skin area is calculated in turn using a formula that considers my weight and height. The following website has a calculator for BSA: http://www.halls.md/body-surface-area/bsa.htm So, using the default formula (Mosteller) and plugging in my weight (72.5 kg) and height (5’ 11”) I get a BSA of 1.91 sq m. This yields a dosage of 716.25 mg by my calculations. (Of course, I’m not a doctor. I don’t even play one on TV.)
• Cyclophosphamide. 800 mg/sq m.
• Vincristine. 1.4 mg/sq m.
• Doxorubicin. 50 mg/sq m.
• IT Cytarabine. 50 mg. The IT means that it is injected into the spinal cord. (IT = intrathecal)
• IT Methotrexate. 12 mg.

That’s it for day 1. I have a 3-ring binder that tells me what each of these things does, what the short term side effects are, and what the long-term side effects are. Having already gone through one round of CODOX-M and not having suffered any major side effects gives me more confidence that I can do round two, but I still need to remain vigilant.

There was a possibility that I could have been discharged today, but my intern stopped by just after noon to let me know that they were still awaiting results of the blood cultures. As I understand it, however, I will be discharged tomorrow, and the only question is whether I get discharged needing an infusion service for the antibiotics, or without needing antibiotics.

[morning]

WBC (White Blood Cell) is 9.58 – back in the normal range, but will, of course, overshoot tomorrow. Platelets are 81 (normal range 150 – 450). I feel good and took a few spins around the ward this morning after breakfast. As I noted yesterday, my blood has tested positive for a bacterial infection. They have not positively identified what bacteria it is, but the antibiotics that I’m taking should keep it at bay. There is a good possibility that they will have to remove the port-a-cath – I’m hoping not since it is such a convenience and lets me avoid getting stuck so much.

The weather in Stow is pretty bad, so Mo will not be visiting today. On the positive side, Miranda gets a snow-day. She went to see the “Chronicles of Narnia” yesterday with her friend Hadley and really enjoyed the movie. It’s on my must see list when I get out of here. I remember enjoying the books tremendously as a child. If there were any obvious Christian overtones to the stories, I don’t think I noticed them. When all is said and done, the symbolism of self-sacrifice and rebirth is actually not uniquely Christian anyway. I am sure that C.S. Lewis was writing from the heart, and if that happened to be a Christian heart, then so be it.

This touches on an area that I would dearly love to see changed in US.

Education

I would dearly love to see public schools permitted to teach religious studies as a legitimate subject. It’s clearly important in understanding society, and faith is part of people’s make-up. Outlawing faith from public education is self-defeating. What has happened by banning it from public education is that religion in schools has become a rallying point for the religious right, much like the well-intentioned but ill-executed Roe v. Wade decision. The left asks too much sometimes – would it not have been better, for example, if Ralph Nader had not run in 2000. I wonder what a Gore presidency would have been like. We have nothing to fear from the teaching of religion in schools, so long as it is taught in the spirit of true inquiry. As I have written earlier, it is only when religion becomes a wall and stifles dialog that anyone has to worry; and when I say anyone, I include members of other faiths, as well as atheists.