And so we find ourselves at November 8, 2007.

It is cold and partly sunny today in Boston. Yesterday was cool and bright. Tomorrow will be more of the same. Life in the city has calmed down some since the World Series, and I have noticed fewer birds around. The mice in my apartment are gradually disappearing, and I covertly played the "C" card to my landlord in order to get a new stove and new tiling for our floor. Oh yeah, and yesterday was my last day of chemo.

Wait, what? That's right. Yesterday, November 7th, 2007, one day before the 11th month anniversary of my diagnosis with acute lymphocytic leukemia, I finally finished chemotherapy for this dastardly disease. Three months later than I would have liked, but it is finished. And boy, what a day was yesterday. I'll start with the good part: my hematocrit, the percentage of red blood cells in blood, was 40.5, with healthy being between 34.8 and 43.6. When I was diagnosed almost a year ago, I think it was 14 or 15. This is probably the highest that number has been in over a year and a half. So much red blood! So exciting! My white cell count was 2.1, and it should be above 3.5 to be in the normal range, but that will eventually come back. So my body is finally starting to work again.

Of course, however, there is always a bad part. Yesterday, there were a few bad parts. Part one: my left arm exploded. Kind of. Well, it blew up. By blew up, I mean it expanded. Let me explain: One of the drugs I received yesterday and have received before, methotrexate, infuses over three hours. I no longer have my catheter, so every time I need an infusion, I get to have an IV put in my arm. Now, I have bad veins in general. I have had a lot of trouble with getting IVs to work. So, I was stuck twice yesterday before my blood was flowing properly. Here's where it gets gross. At one point, about forty-five minutes to an hour into the infusion, somehow, the needle came out of my vein. It didn't come out of my arm, just found its way out of the vein. What this meant was that chemotherapy was infusing, not into my bloodstream, but directly into my arm tissue and such. Let's not ignore the fact that I decided it was necessary to take a nap, having not realized what was going on with the needle. I woke up thirty minutes later to a forearm about four times its normal size. My left hand felt like it was asleep, and I couldn't really feel my forearm. I think it is fair to say I freaked out. I mean, there was a whole lot of chemo where it shouldn't be. A nurse came, took out the needle, and gave me a hot pack to help the swelling go down. They assured me that this wasn't uncommon, and it wouldn't affect the levels or toxicity of the drug. The nurse then stuck me (again) in my right arm, and they finished the transfusion. My arm and hand are still slightly swollen, but nothing has turned a funky color yet, so I guess it will be okay. No gangrene so far. What an adventure.

That was part one. Part two was my spinal tap. It did not go so well. Last time, my spinal tap took around 15 minutes. This one took between 30 and 45. In that time, I was repeatedly numbed, stuck in the spine, and numbed and stuck again, to no avail. My spinal fluid was just not flowing. The idea is that the doctor sticks the needle between the vertebrae into your spinal fluid, and they withdraw 3 cc's of spinal fluid, which is replaced with 3 cc's of chemo. After much grimacing and joking that my spinal fluid was Gone!, the woman doing the procedure finally found a good spot, although not without hitting one of the main nerves that controls my right leg. That was a freaky feeling. It felt like a bunch of needles were poking my whole leg from the inside out. But it was over quickly. So that was the spinal tap. Good times. Good times with needles.

I am pretty sure my body was rejecting everything that the doctors and nurses were trying to put into it yesterday. It was saying to them, "Enough. I have had enough. No more." Sadly, that was not to be. But I made it! I still have to go back this evening to receive more fluids, as well as the flush for the chemo, so one more major IV poke. Hopefully this one will actually work. I am not that excited right now because I still have to be stuck tonight, and I don't feel all that great. I feel fine, actually, but next week, I will feel even better. Give me a few days for this to sink in and for my multiple holes to heal up. Then, call me, and we'll celebrate. Hokey doke, take care on this fine fall day, and enjoy the long weekend! Pax.

The "vicissitudes of fortune...

...and other disappointments connected with worldly circumstances...are principally the effect either of gross imprudence, of ill-regulated desires, or of bad or imperfect social institutions" (John Stuart Mill Utilitarianism, 106). I interpret this sentence to mean that change in fortune, specifically regarding ill fortune, is dependent on human action. I could certainly be wrong here, but it seems Mill is saying that we control our own fortunes. He notes a few lines earlier that "even that most intractable of enemies, disease, may be indefinitely reduced in dimensions by good physical and moral education and proper control of noxious influences, while the progress of science holds out a promise for the future of still more direct conquests over this detestable foe."

Mill's phrase the "vicissitudes of fortune" has been nagging me all day. I wish I could believe if society pulled together and started actually caring about change, most, if not all, ill fortune and "other disappointments" would disappear. I know, however, that it won't. We can treat cancer; we can't cure it. I believe that no matter how pleasant we can make our circumstances and surroundings, there will always be an unspoken and indescribable unhappy feeling creeping around. There is something inherent in us that allows for us to not be happy all the time. But this something is not under our control, and social change, however good, will not take it away.

I have been struggling to push this darkness to the back of my mind. The honeymoon is over, and I have been reminded just how hard it is to be a college student, what with the late nights, studying, incomprehensible philosophers, or just trying to keep days straight. I have always had to work to keep my life organized, and now I have a whole new dimension to consider: chemo, my white blood cell counts, whether or not my temperature is rising. I am mostly successful in keeping cancer in the background. There are some days, however, when I just want to not think about anything. Yesterday, for example, I had work at the gym. I love working there in the mornings during the week, but the weekend is a different story. I worked from 8-2 yesterday, and by the end, I was exhausted. There had been too many people, too many children running around, too many customers projecting their angriness and unhappiness towards me. It was too much for me, when I have been going almost nonstop for over a month now. I broke down when I left the gym; I started crying so hard I couldn't breathe. And then I got on the train and came back to my apartment. I baked some cookies and got caught up on my Grey's Anatomy. And then I went to Barnes and Noble and bought a few new, beautiful books, and I felt better. I feel better.

Everything is different for me now. I can't handle the same type of stress or activity that I could a year ago. My tolerance has been adapted for hospitals and needles and pills. I am very slowly relearning how to be busy me. I am going through some tough times, but they are moderated by the good things that do keep happening and the good people I have around me. Today was better than yesterday. Tomorrow may or may not go well. I just have to wait and see what Fortune drops on my lap. Hopefully good things. Good luck to everyone else struggling this week. Life will necessarily get better. Peace.

I guess there was some sort of major sports-related debacle in Boston recently?

Yes, the Boston Red Sox won, swept rather, this year's World Series. Yes, I go to school in Boston. I go to school directly across the street from Fenway Park. This does not, however, necessarily mean that I am a Red Sox fan or even that I participated in the extensive celebrations. I am fairly certain that I slept through the ALCS win, although I did have to photograph the goings-on at Fenway the next day. I was almost asleep two nights ago until someone nearby started pounding on a cowbell, and the mayhem began. These, however, are instances for which I will pull my "C card." I would love to have photographed the reaction to the ALCS win and the World Series win. Seriously, how many times will I be in Boston when the Red Sox win the World Series? Probably not too many. But I could not afford to stay up until 2 in the morning in the cold with hordes of riotous people, especially when I am more susceptible to sickness. My cold has come back either way, but it never really leaves. So I suppose this was one of those times when cancer interfered with being a normal student. I regret not photographing everything, but I know I made the right decision. There's always the Patriots?

In other news, today I was interviewed/spoke in front of the first-year Boston University medical students. I was nervous; I was hungry; I had no idea what to expect. The discussion went Awesomely. I didn't stutter too much, and I only lisped once. Seriously though, I am so happy with how receptive the students were. Apparently I was very "eloquent" and provided a necessary contrasting perspective for these students, usually so intent on the science of medicine. The focus of the conversation was my experience with doctors and my opinions on how to find a balance between treating illnesses with medicine and treating the patient as a Person. My view is that a doctor needs to be able to empathize with his or her patients. It is not fair to any person to be treated as an object of Science, when they really just want someone to treat them as equals. I have found this especially hard for medical students and interns to understand because they are trying so hard to maintain doctor/patient boundaries, in addition to the fact that they don't have much experience with patients. My case is special also because I was by no means a passive patient. I wanted to know what was going on with me, whether I understood it or not. It is insulting to me if you don't recognize my intelligence or the fact that I need to be active. The hospital was the worst place for me, which I think my doctors eventually understood, even though it took some time to get used to my nature.

I hope the medical students understand that the best thing they can do is treat someone with respect and some degree of empathy. Hopefully my sitting in front of them increases their understanding that while I am still a patient, and I need to be treated for my disease, I am also one of their peers and should be treated as such. They actually gave me a standing ovation at the end, which, while embarrassing for me, makes me hope that maybe some of what I said sank in. Maybe my experiences can be positively translated to help others. That's what I hope, anyway.

I have a midterm tomorrow that I am really not prepared for, but I think it will turn out okay. After that, I will be sleeping and sleeping some more. Happy Tuesday, sad toad. Things are looking up. Peace.

Gawsh, what a week.

I am pretty sure that I have spent much of the past week studying. I had a midterm last Thursday, which I think went fairly well. Yesterday, I finally took my Human Infectious Diseases final exam. This was one of my classes from fall '06 in which I received an incomplete. Now it is completed, and only have one more incomplete to take care of. Whew. Sunday night, crazy girl that I am, I played flag football. I also decided it would be fine to cover the one girl who was actually good. She was running all over the place, and I got to tail her. I think I did a decent job, although I was exhausted by the end of the game. But I was running! And I didn't pass out! I am so happy that my body is finally coming back to life.

Speaking of my body pooping out on me, it has been two weeks since I last received chemo. Following protocol, today should have been my next - and last - encounter with the wicked drugs. But of course, it would be too easy for everything to go according to a set plan. I did not receive any chemo today. Once again, my white blood cell count was much too low to proceed. My neutrophil count (they are the first responders to infection) has actually plummeted from .97 to .18, and they need to be above 1.0 to continue. So next Wednesday I will go in for labs, but we aren't expecting my counts to be high enough until at least two weeks from today, if not longer. Of course I am disappointed, especially as this now means that I am neutropenic again. My immune system won't be able to combat any nasty little bacteria that decide to invade my system. Due to the nature of city-living, unfortunately, bacteria are nearly impossible to avoid. The trains and buses are crawling with germies, as are just about all public places. So while I am not going to restrict myself to my room for the next two weeks, I do need to be overly careful of crowds and such. Do not, however, believe that this will hinder me in any way from trying to find various Halloween parties this weekend; it will not. Regardless of my susceptibility to everything, the show must go on.

Today was good for one thing though: I met with a nutritionist at Dana-Farber, and I now know what I should be eating. She told me that cancer patients' protein needs increase, which I did not know, and she gave me an extensive list and explanation of foods high in protein. She also gave me a sheet that listed "Phytonutrient rich foods." I have since learned that phytonutrients essentially make up most plants' immune systems. The immune systems of plants have beneficial properties for humans as well, so I will be eating more of my leafy greens, red peppers, squash, apples, blueberries, apricots, papaya... The list goes on. I am definitely excited to go shopping now. Go Guava!

Generally, I am exhausted. It is not bad, because it means I am busy and getting things done, but I am still exhausted. I can not believe that November is in one week; this year is going by so quickly. Well, this school year. The rest of the year rather dragged. The important thing is that I am in a good place right now, even though I still have chemo looming, somewhere in the near or distant future. So even though I am super tired, this is the type of tired that can be solved by sleeping in one day, as opposed to the other type of tired that can only be solved by the transfusion of blood products. Life is definitely getting back to normal, whatever normal is anymore. Alright, enjoy the end of the week. Peace.

I was shot in the arm today.

And by shot, I mean I was given a shot. Specifically, I was given a virus. Even more specifically, I was shot with the flu virus. Fortunately for me, the virus had been killed. As the flu season looms ominously in the distance, it recently occurred to me that perhaps this year I should get a flu shot. I asked my doctor who resoundingly said, "Yes. Get the shot." I suppose it makes sense: I have few white blood cells to combat any sort of viral infection that may decide to find its way into me. Since there is no prescription available to battle viruses, my best option was to receive the immunization. Now that the virus has been injected into my system, I will be able to create antibodies for it. That way, if I do happen to catch the actual flu virus, I will already have built up a resistance. So awesome. Best case scenario, I just don't catch the virus.

Today was sort of ridiculous, in the way that my days tend to be. I suppose I should preface this by explaining what is currently going on in my life. I noted a few posts ago that I was asked to be interviewed in front of the first-year medical students regarding my perspective on terminal illnesses and such. Okay, exciting, I can do that. But the plot thickens. This story was pitched to The Boston Globe, the main newspaper here in Boston. The story was picked up by the "Higher Education" department, and they decided to expand it beyond my talking to the med students. Basically, there will soon be an in-depth profile of me in The Globe involving interviews, photos, possibly multi-media, and excerpts from my blog. The reporter who is writing the story is going to be shadowing me a bit over the next week-ish to try and get a better sense of who I am and why I am who I am. It is pretty intense, and I wish her luck. The really ironic thing is that while she is profiling me and the photographer is taking pictures of me doing my thang, I am supposed to be coming up with an idea for a photo essay for my photojournalism class. And I have no clue what to do. I kind of want to do my photo essay on the photographer doing a photo essay about me, but I'm not sure if that would work so well.

Anyway. So today, I get to my Hinduism class, and my professor starts by saying, "Before we begin, Caroline, would you like to explain to everyone about the people from The Boston Globe who will be joining us in class next week?" Now, I knew that the reporter was planning on coming to a class at some point, but I hadn't expected her to have worked so fast in getting permission. (Perhaps that is why I wouldn't be a very good journalist...) So, I sort of muttered something about, "I am currently receiving chemo, and I'm talking to the med students in two weeks, and the Globe has decided to profile me, which involves their coming to my classes. So, um, dress nicely on Monday...?" I sounded like an idiot. My professor then said, "And you're writing a blog, as well? Why don't you give us the link." So, okay, I did. Wrote it on the board and everything. (Hello to anyone from class, if you actually copied the link and are visiting my b-log). I sort of doubt they will, just because I know how college students are, and I know that they don't tend to care tremendously about what their peers do in their free time. Regardless. My teacher's announcement was unexpected, and I was quite taken aback. The point is that a reporter and photographer will be joining me in class on Monday. We'll see how it goes.

Although the subject of much of the profile, I have essentially stopped worrying or thinking about how I have changed and how it is affecting my daily life. I don't really see the point anymore. I am who I am, regardless of disease or drugs, and that's cool with me. Finally, briefly: my blood counts have fallen since last week, which was to be expected. Hopefully they will come up again for next Wednesday when I am scheduled for my FINAL chemo treatment. Happy white blood cell thoughts, that is all I ask. Alright, thanks for sticking with me. More updates as life happens, which it inevitably will. Happy Hump Day. Pax.

Let us now all exhale a collective sigh of relief that another post has been written.

I would say that I am not sure why I don't update more frequently, but this week I know exactly why. This week I received my second-to-last chemo treatment. No, it was not my last one, but we are almost there. After nearly eight weeks, my blood cells had finally regrown enough for me to be able to kill them all again. It's rather contradictory: just when I am finally starting to feel healthy and full of blood, I get to go and have lethal drugs injected into my system. I say lethal because they kill cells. I am pretty sure the drugs will not actually kill me. There are, however, no guarantees of this.

Wednesday morning I hopped on a bus, and twenty minutes later, I found myself at Dana-Farber Cancer Institute with a lump of dread weighing in my stomach. I was quickly admitted and given a chair. I was then moved to a bed because I needed to have a spinal tap later on in the day. Not only was this my first time getting chemo by myself, now I was in a solitary room. Oh well; it's better than the alternative. After that, my nurse poked a needle into my right arm vein. Unfortunately, this needle wasn't returning any blood, so we had to find another vein. Luckily, I had been saving up my good veins, and there was one on my other arm. Blood was drawn, hydration was given, and then the chemo began. It began with an injection into the IV, which was short and sweet. I was then hooked up to my bag of methotrexate, which was neither short nor sweet. In fact, it went in over three hours, and it was bright yellow. Time dripped away, and I finally found myself with nothing hooked up to me. Then it was the spinal tap's turn. This was to be my seventh spinal tap, a fact I am not necessarily proud of, but it's kind of hardcore. Anyway, so this spinal tap wasn't that bad, hardly any pain. The doctor (nurse? I'm not sure) went right in, drew the fluid, and replaced it with chemo straight away. She was quite speedy. I had to lie flat on my back for thirty minutes, and then I was free to go. So I went.

I went back to my apartment. I took a cab; I had gotten cab vouchers at Dana-Farber. I got back to my apartment, and within fifteen minutes, I was throwing up. I felt kind of bad for my roommate, but not really because I'm not sure he noticed. For about forty-five minutes I tried to vomit out my stomach. And then I ate some chips and slept for an hour. And then I slept twelve more.

That was Wednesday. Today is Sunday. In the meantime, I have been battling a cold, trying to study, and running around probably a bit too much. I feel fine, aside from this beastly cold. My energy isn't quite where it was, but it is pretty darn close. I am fairly sure that this is the best I have handled any chemo since I started. I actually played flag football today. We won. I scored a touchdown. It was awesome. So this is life now, I suppose. Get my drugs, and move on. I don't have time to mope around the apartment feeling ill. I have to get back to business and soon. I am excited for this week; it should be a good week. I hope everyone else has a good week as well. Good luck with life! Oh Also: Shout out to Amy who ran the Chicago Marathon a week ago. She finished, which is more than a lot of people could say last Sunday. She ran with Team in Training, who raise funds for the Leukemia and Lymphoma Society, and I guess they raised a Ton of money. Thank you Amy!!! Good luck with your recovery. Anyway, that's all. Peace.

Dear blog,

This weekend was a lot of fun. I went to my friend's house, and we watched a movie. The movie was really weird, but it was an old movie. The really cute boy in my class waved at me on Friday. I'm going to ask my friend to ask his friend if he has a girlfriend. Well, maybe. I stayed up past my bedtime on Sunday night to watch the Bears football game, and they won! It was super awesome. And we didn't have school today! The only bad thing is I got sick again. All my friends are sick. I guess they got me sick too.

Okay, enough of that. This weekend was probably my best one since I've been back, despite having re-caught my cold. I don't think I ever really got over the last one, and I'm still immuno-compromised, so it makes sense that it came back. I just realized, however, that I can't remember the details of my weekend, which is becoming more than a little disconcerting. Yesterday and today I mostly just relaxed, this I know. I so badly needed to just sit around and not think about anything. This past week has been so overwhelming. I can't believe it has only been one week since my birthday. It seems so long ago. I suppose part of the reason I can't remember what I did specifically on any one day is that I did so much and talked to so many new people this past week. I am starting to freak out a little bit though because of my newfound inability to remember recent events. We'll see what happens with it, especially after I get chemo this week.

An interesting tidbit I do remember, though, happened when I was working at the gym on Saturday. One of the regular dance teachers came in to get the keys to the studio, and she said to me, "Wow, your hair is really growing!" I laughed because it is hard for me to tell if it's getting any longer but she said something like she measures her progress every week by the length of my hair. It made more sense than that, but it was quite funny and very nice of her to say. So I guess my hair is getting closer to a decent length, although it's still one of the shortest female cuts on campus. I like it. Anyway, tomorrow's a long day, and Wednesday is chemo. We'll see what happens. I am rested and ready to go, but I still hope everything goes well. I need this to end, now. Alright, enjoy Tuesday and whatnot. Peace.