[I asked Google’s Gemini AI to create a color cross-hatch drawing from a selfie taken yesterday at the beginning of my chemo session. ChatGPT did not produce a successful result given the same instructions.]

I intend to update this post throughout Saturday, my first day follwing Friday’s chemo treatment.

The most recent update will appear at the top. Read down to toward the bottom to get the whole story, if you’re interested.

Saturday, July 25, 3-8 a.m.

I awoke a few minutes before 3 a.m. with what felt like the creeping start of a dehydration headache. So I sat up, waited, then got to my feet and came out to the kitchen for a glass of Gatorade.

I opened my laptop as I sipped my way through the Gatorade. The cloying flavor of artificial flavoring makes imbibing a chore. But not unpleasant enough to forgo altogher. An hour later, I had done the first pass through email, deleting the 90% that required no more than a glance at the title/sender to know it wasn’t something I needed to see. Started on a post for the day, including coaxing Google’s Gemini to create the drawing featured in this post. Then I turned off the lights and went back to bed. It was just a few minutes after 4.

And I slept soundly until about 5:45, when I had to get up in order to take out any trash to guarantee I wouldn’t miss an early city pickup, which might come anytime between 6 a.m. and 4 p.m.

I did learn something. I have come to associate what I’ve referred to as the 15% fuzzy brain feeling with the accompanying feeling of being somewhat lightheaded or dizzy. But today my brain felt clear, the 15% of cobwebs swept out. But the background dizziness remained, signaling a need to be slow and careful while moving around.

I had been treating them as two parts of the same side effect. Now I know they are distinct and can vary independently, even if they usually travel together.

In any case, I went through the refrigerator, and almost all leftovers went into my trash bag. Then any discarded mail left on the counter. Yesterday’s coffee grounds. A large bag of deposits scraped from the two cat litter boxes on the bedroom side of the house. It ended up as a half-full bag, but heavy. I walked it out to the trash bin, then rolled the heavy plastic bin out to the street.

Saturday moring selfie

Returned to the kitchen to find I had left an item on the kitchen counter, so I made the walk out the street again in order to deposit the addition into the bin. You can see the bin in position by the street in this morning selfie.

Back inside. Fed the cats after cleaning four cat dishes. Morning feeding is dry food only. Made a fresh pot of coffee. Drank another glass of water while continuing this post. That’s enough for the early morning.

It’s now 8 a.m.. Enough of the chores for now. I’ll update again later in the morning.

Infusion Day, Friday, July 24, after arriving home at a few minutes before 3 p.m.

Similar to my return after my initial chemo/immunotherapy infusion, I felt only minimal effects the rest of the day. I little more lightheadedness, requiring extra care to maintain balance while walking around the house, but not enough to feel a danger to myself.

I shared part of a sandwich with Meda and drank a glass of water. Fluids are the priority for the next few days. And sipping is easier for me to tolerate rather than trying to drink each 10 oz glass in one or two big swigs.

Then it was off for an hour nap.

At 5 p.m., Meda and I sat out on the back deck. We both had drinks, but mine was water! I had a couple of slices of seed bread for the small group of birds waiting for our arrival. By six or so, I was in the kitchen making a quick clam sauce—canned clams with plenty of garlic, butter, olive oil, lemon juice, and rosemary—to serve over whatever pasta we had on hand.

Yes, I had several servings. And some fresh sliced tomato.

After eating, we watched a bit of television.

I didn’t get to bed until nearly 9:30, an hour after my usual target time. That required energy, so I must have been feeling okay.

Infusion Day, Friday, July 24, First Week of Round Two
8:30 a.m. to 2:30 p.m.

My infusion session lasted a full six hours yesterday, comfortably seated in Chair 6 of the Queen’s Cancer Clinic on the 4th floor of the Kuakini Medical Plaza. Once again, I was in the top notch care of Nurse Pattie, who does everything she can to make my stay as pleasant as possible.

Being the first week of a three-week cycle, I received all three drugs used in this regimen.

Gemcitabine. Cisplatin. Durvalumab. Below are brief descriptions via Google, along with details on who manufactures each—a detail my reporter’s mindset couldn’t help digging into.

Gemcitabine (Gemzar) is a potent but generally well-tolerated chemotherapy. As an antimetabolite, it kills cancer cells by disrupting DNA replication. It is a cornerstone treatment for pancreatic, lung, breast, and ovarian cancers, and is frequently combined with other agents like nab-paclitaxel or cisplatin.

Gemcitabine for intravenous (IV) delivery is produced by several pharmaceutical companies, prominently including Sun Pharma (which manufactures the ready-to-administer IV formulation Infugem), Eli Lilly and Company (original developer of brand-name Gemzar), and Meitheal Pharmaceuticals.

• • •
Cisplatin is a platinum-based chemotherapy drug used to treat various solid tumors, most notably testicular, ovarian, and bladder cancers. It works by binding to cellular DNA to create cross-links that halt DNA replication, triggering cell death in rapidly dividing cancer cells

Cisplatin for intravenous (IV) chemotherapy delivery is manufactured by several pharmaceutical companies, including Accord Healthcare, Fresenius Kabi, and Teva Pharmaceuticals.

• • •
Durvalumab (sold as Imfinzi) is an immunotherapy drug and monoclonal antibody used to treat various cancers like lung, bladder, and liver cancer. It blocks the PD-L1 protein on cancer cells, helping your immune system find and destroy those cells. It is given only in the first week of my three-week cycle.

It appears to be the only one of the three drugs in my treatment still protected by patent and regulatory exclusivities, and the primary commercial rights and underlying patent estate are held by AstraZeneca (developed originally through its subsidiary MedImmune).

When the session was completed and the IV tubes removed from my chest port, I packed up my stuff and was able to walk out, wait for the elevator, and wait for a friend who was on the way to pick me up. Yes, I felt lightheaded, a common feeling these days. Otherwise, I felt okay and safe on my feet.