The first week on this oral chemotherapoy went well enough; minimal nausea, no allergic reactions, slight fatigue. The only effect I was concerned about was swelling of my feet and ankles so the new and comfortable SAS shoes sent to me in the mail were too small. I'd been gleefully walking around in them for a few weeks and then BLAM! an alien replaced my already large feet with even bigger ones. A few nights of sleeping with my feet up on a chair resolved that and I can walk on my triple cushioned wonders again. Whew!

I had my Herceptin drip on Tuesday and then spoke with Dr. F. who'd been out lecturing at Tokyo University that morning. We decided that things are good so far and he gave me a two week prescription and sent me upstairs to get a baseline x-ray so we can compare in July.

Wednesday I rode out to the immigration office in Tachikawa with a friend who needed to get a re-entry permit. We met with another friend for lunch and laughs before driving home again to get ready for Wednesday evening classes.

This morning I decided to take a short nap after getting the kids off to school and the garbage out. I dozed off at about 8:30 and woke up when L came home from school after 3:00. Just a short nap...I'm not sure if it's a Xeloda side effect or if I just needed to catch up a little after those nights of half-sleep when I was keeping my feet up on the chair...I'm well rested for the upcoming sports days at each school at any rate. Now to plan all the picnic lunch boxes.


So far, so good

I made my way to the station in buckets of rain as this season's typhoon number four passed near Japan. The 6:30 train was not as crowded with commuters as usual and the trip to Shinjuku was not so packed. I took the looooooooooong escalators down from the Keio Line platforms (which are already underground) to the Oedo Line tracks near the center of the earth and was surprised to see that these trains were less crowded than usual too. I even got to sit down for most of my ride to Tsukiji. By 7:30, when I arrived at Tsukiji, the rain was not so heavy but the wind was whistling strongly through the city buildings. The number of people at the automated reception machines was less than half of the typical crowd. The TV on the lobby informed me that the morning trains for a number of train lines were running 20 to 30 minutes late because of the heavy rain and one train line had stopped completely. My morning train must have been one of the last trains before the delays began.

Dr. F called me in promptly at 8:30 and I told him that I'd decided to start with the Xeloda option. He confirmed a few things and explained again about what to expect and then gave me a prescription for a week's worth of pills to be taken after breakfast and dinner every day. He'll come up to the chemo room next Tuesday while I'm getting my Herceptin drip to give me the results of next week's blood work and ask how I'm faring on the Xeloda before prescribing another two weeks' worth. If I tolerate it well and the blood work looks good, I'll be on a three weeks on / one week off schedule of this oral chemotherapy and continue with the weekly Herceptin IVs for now.

The rain had stopped by the time I finished my IV and headed out the door around lunchtime but the trains were still running a little late. The sun was shining brightly by the time I got home.

I started on Tuesday evening and haven't noticed any trouble so far (knocking on wood).


Translation of Tuesday's Talk

Dr. F showed me my CT scan results and input a summary of our discussion onto the hospital computer file, printing out a copy of the summary for me. Here it is:

Results of the April 22 CT scan show the appearance of a new 1.8cm tumor in the lower part of the right lung. We determined that the effectiveness of Herceptin + Taxol has decreased. Recommend changing treatment to Herceptin + Navelbine or Herceptin + Capecitabine (Xeloda). The chance that either of these will be effective is about 20% and main side effects are decreased white blood cell count and inflamed veins for the former and decreased white blood cell count, diarrhea and hand-foot syndrome for the latter. After these drugs, using Lapatinib (Tykerb) which is due to be approved in Japan within the year, is in range.

As there has been a recent tendency for ejection factor to decrease, we're concerned that some heart damage is beginning to show due to the long term use of Herceptin. We'll re-check in a heart ultrasound in early June.

So, I didn't get any Taxol on Tuesday but I did get my weekly dose of Herceptin as my heart ejection fraction level from the last ultrasound, although lower than previous scans, was still within an average range. I asked for a week to think about the options as I thought I'd better read up a little more on the effectiveness and side effects of each before jumping in to anything. I'm leaning toward the twice a day oral Xeloda even if I still go every week for my Herceptin IVs. I have to make a list of pros and cons though.

The tumors that we were zapping away at with the Taxol have virtually disappeared, so I'm glad that it did work so well while it worked. The new tumor appeared after my January scans though, while I was still on Taxol, so I guess it's farewell Taxol, hello feeling in my fingers and toes (already returning after the three week break I had). The CT scan did confirm that there are no metastases to other organs or bones too. Costs will remain 44,000 yen a month max. after refunds so I won't have to worry about cost limiting my decision anyway.


Velcro Wall Jump

The kids and I (except M who had previously arranged plans) went to the annual Family Fun Festival otherwise known as Oyako Matsuri near the station. The kids were encouraged to make the usual fabric craft flowers to celebrate Mothers' Day and play various games with volunteers. This year the local youth center organization had a stamp rally where kids could get cards stamped for measuring their grip, flexibility and vertical jumping prowess at their booth. Completed cards could then be shown to receive a small prize like a pencil or a figurine or a ticket to try the Velcro wall jump http://www.metroinflatables.com/showgame.html?id=36 which was set up in the large room on the 12th floor where I emceed the kindergarten graduation party a few years ago.

Naturally, the kids wanted to try the ultimate stage of this physical fitness test so we went to get them some stamp cards to record their performance and were told that the parents should also participate. "Fine by me." I thought, and had fun gripping, stretching and jumping up with a string attached to a belt around my waist and a measuring device. Results: I have a much stronger grip than the kids do and I'm more limber than the kids are in spite of my stomach getting in the way but they can all jump about 10 inches high than I can.

Off we head to the elevator for the final stage. N and L were already in Velcro jump suits with Velcro mittens and feet by the time J and I arrived. The wall and a ten yard long "runway" were basically fancy variations of the age old inflated moonwalk with a similar inflated target shaped trampoline between them. This set filled the entire room.

L had trouble picking up any sort of speed on the huge air filled tubes and didn't bounce very high. N's performance was not any more inspiring. J and I were called over to get our Velcro suits. I had to wait until J finished her jump as they only had one large sized suit and the medium large one was just to small for big old me to squeeze into. I watched her struggle down the runway and throw herself at the wall to be peeled off by two volunteers and hoped that the suit would be too small so I could bow out of the potentially embarrassing situation. I couldn't decide which would more embarrassing, being too fat for the suit or to clumsy to even make it to the trampoline, and decided that injuring myself on a huge cushion of air was probably more inconvenient for all involved.

No such luck; the suit fit fine so I bravely made my way to the starting point. I managed to run in slow motion down the runway, jump (more like fall...) on to the trampoline and reach for the wall as I ascended only to find that I'd stuck to the wall before my feet ever left the trampoline. I guess it's made for shorter people. At least I didn't twist or break anything. I did wonder though, on the way out the door, where all the other moms were at this stage. They were probably downstairs getting pencils or cheesy figurines.


Good Pickin's

The ladies of our local chapter of foreign wives of Japanese men held a baby shower for a friend today. It was a potluck lunch and from the lovely assortment of dishes, it was easy to deduce that most of us were ready for a break from Japanese cuisine. We had spinach quiche, a Mexican salad with layers of lettuce, onions, avocado, salsa, olives, sour cream and cheese to be spooned over tortilla chips, cheese and crackers, tomato stewed chicken, a black bean dip with pita bread, a summery pasta salad, a healthy green salad, chocolate chip muffins, a chilled blender borscht with sour cream (yes, I finally found canned beets near Tsukiji!), a friendship cake (the starter was smuggled into Japan in a suitcase), chocolate mousse, a yellow cake topped with chocolate, strawberries and grapes - nothing Japanese on the table at all. We did have a little iced green tea on the drink table, with hazelnut coffee, raspberry leaf iced tea...I was nervous about offering my pitcher of violently purple soup but it sold well, not as well as the chocolate mousse, but that can't be helped. The kids had sushi with S as the lunch was a ladies only event.