have been greatly exaggerated, dear reader, I assure you. Let me begin by apologizing for my long absence over the past week. Have you ever had one of those days wherein you had a list of things to accomplish, and yet somehow the business – or, perhaps, busyness – of living just seemed to keep getting in the way? I think I have had about seven of those in a row. So I beg your indulgence as I now pour forth a week’s worth of news for your education and entertainment.

Let me begin with the basics. I have reached the midway point of radiation therapy, and – assuming that all goes well and nothing changes – I have completed about two-thirds of my chemotherapy. The good news is that there is light at the end of the tunnel. The less-than-good news is that my current state of side-effects induced hell makes that light seem to be the headlamp of the oncoming locomotive. I suppose that I shouldn’t complain too much about side effects; I should take them as a sign that my treatments are working, or at least that they are having an effect. But there are just so many of them. . .

Shall we examine the side effects of radiation and chemotherapy? The most apparent to me is the ever increasing pain level – most of my pain is concentrated from my hips down, expressing itself as a vibrant and pulsing ache in my joints (especially my knees). Also, for the first time in weeks, the scar that runs up my left thigh aches as well; the pain there is more dull and timid, but definitely present. Because of this particular combination, standing and walking have become a good deal more taxing over the past seventy-two hours or so. Last week, my radiation oncologist added a new weapon to my arsenal of pain medication (Fentanyl, an opiate, in a patch that dispenses 25 mcg/hour); this was to augment the Lortab 7.5 elixir that has been my primary pain management tool for the past couple of months. Surprisingly, I have noticed very little difference with the patch. Perhaps it has taken the edge off the pain in my joints (damn, would it be even worse if I weren’t wearing the thing?), but I haven’t seen any vast improvement. As for the Lortab, it continues to be effective (basically), though I’m growing increasingly concerned about the amount of acetaminophen that I’m ingesting. It comes out to be about 1000mg every four hours. Couple that with the chemotherapy-induced insomnia and I’m sure to get five doses a day. Something tells me that 5000mg of acetaminophen a day is a sure recipe for liver failure. Suffice it to say I’ll be bringing the medication situation to my physician’s attention again soon.

Did you like that off-hand comment about insomnia? Yes, it is an absolutely fantastic side effect with which to wrestle. Also, I’m fairly certain that it’s Adrianne’s favorite of them all. She’s always worried that somehow she is keeping me from getting a good night’s sleep. I’ve assured her that this is not the case, but when she finds me staring at the ceiling – or my iPod – or the wall – or her – in the middle of the night, she remains mysteriously unconvinced. It seems that, at this point, about four hours of sleep per night will do just fine. In the meantime, I have tried to be productive, to utilize my waking hours in the single-digit ante meridian darkness as some kind of creative outlet. It worked for the first couple of days. Riding on the edge of REM sleep, I tapped into some serious creative energy and began to generate some thought-provoking (to me, anyway) story ideas; the next morning, I was sure to put as much down on paper as I could before leaving for the office. Unfortunately, by the third day of this pattern, the lack of sleep began to generate an oddly hallucinogenic melange of images and emotions. While the results were intriguing, I’m fairly certain they would be so only to me; and honestly, in most cases, they degenerated rapidly to those almost-nightmares that tickle one’s brain at the liminal threshold of consciousness. Panic attacks at three a.m. bode less that favorably for the day ahead.

In addition to a lack of sleep, I’m also beginning to suffer from a profound lack of facial hair. Actually, I’m rather past the beginning part. Four or five days ago I noticed that bits of my beard would fall out almost every time I touched it. So I tried to behave myself and not touch it. Of course, that didn’t go so well. After all, what’s the point of wearing a beard if one denies oneself the opportunity to stroke it in an aloof and knowing manner? Long story short, I am once again clean shaven. It’s boring, I know, but at least I know the radiation therapy is doing something constructive.

Of course, the sore throat probably should have been sufficient evidence of that fact. Mondays, it seems, aren’t too bad; Tuesdays are only mildly annoying. Since I’m about four weeks into radiation treatment, I’m seeing that the weekends provide a bit of relief from the barrage of whichever subatomic particle is making life unbearable for whatever microscopic minions of death remain. Since both therapy clinics were closed last Friday in observation of Independence Day, I had three days to relax and recover. That was quite nice, but now the irritation caused by radiation has returned with a vengence this week. In the morning when I undergo the treatment, everything is (basically) fine; in fact, I’ve become so accustomed to the procedure that it’s almost a twenty minute nap once I’m bolted to the table. However, by late morning, I begin to notice some minor swelling and discomfort at the back of my throat. By late afternoon, I can feel how swollen my new tongue has become, and my throat is scratchy and screaming with indignation every time I swallow. And it’s only Tuesday; and I don’t get another day off until Saturday. I’m imagining that this will only get worse. It was mentioned that the sore throat does occasionally necessitate a brief hiatus from the treatment schedule; however, I have no intention of acknowledging that level of discomfort. I’d much rather just push through this and finish the treatment schedule. As with all things medical, however, the decision may not be entirely and unequivocally mine; so we shall see.

The late entry into the side effects competition (and the definite winner of the “most random” award) is that my cuticles are all becoming very dry and overly tender. Actually, typing hurts. This is a first. I was warned that my fingernails may become brittle (which hasn’t happened yet) or that my fingertips may become numb or begin to tingle (also not happening); but I’m imagining that this may be a somehow-related effect. My fingertips have become rather sensitive to pressure at this point, so I have started typing in bursts; I work out a few hundred characters in my head and then try to speed through them as accurately as possible. I’ve tried various moisturizers (and even gloves at night) to try to repair the damage, but so far nothing is working. This, too, I shall assume, will pass.

And that, dear reader, covers all the new side effects since our last conversation. I am definitely open to suggestions on how to remedy any or all of these, so if you have any ideas, please feel free to share in the comments section. I promise that tomorrow’s entry (yes, I am going to post something on two consecutive days) will be less medical and more interesting. I have much to discuss – past, present, and future – so I do hope you’ll join me.

Until then, take care of each other.

Long is the way. And hard, that out of hell leads up to light.
- Paradise Lost, II.432