Dr. Oz and Apple Juice

This past week, Dr. Oz launched an "extensive national investigation" into the arsenic content in popular brands of apple juice sold in the United States. Details can be read here: Dr. Oz and Arsenic in Apple Juice.

Dr. Oz claims that some of the samples his contracted lab analyzed contained more arsenic than the FDA's allowable limit for water of 10 parts per billion. The FDA's limit for apple juice is 23 parts per billion, because the arsenic found within the juice is a mix of the harmful inorganic arsenic and less harmful organic arsenic. The samples with higher levels predominantly came from other countries, where arsenic is more prevalent and testing is less stringent.

His findings have stirred up a controversy amongst the FDA, juice drinkers, and himself. As a media figure, whose goal is to increase viewer and readership, he's found a winner with arsenic in apple juice. That said, of course I think it's important for consumers to be aware of what they're consuming, and for the FDA to adequately regulate those products.

For someone who was fed Arsenic Trioxide-- an inorganic ("harmful") version of arsenic-- 50 times this past summer, the current debate has an element of irony and amusement.

IVIG

I received the intravenous immunoglobulin this morning. When we got home, I took a two hour nap. The infusion went smoothly, though now I feel a bit like I have the flu.

Dr. Goldberg said he hasn't seen an immunoglobulin deficiency as a side effect of Arsenic Trioxide in other APL patients. So this might not be from the arsenic. Hmmm.

The extra antibodies should help me through the chemo round that starts Monday. In the beginning of October, they'll test my IgG level again. If it's still low, I'll have another infusion then. This winter we'll address what it means if my level appears to be chronically low. Not worth worrying about it now.

Blood Test Results

First and most importantly, my PCR remission test showed that I am still in remission. Fantastic!

One of the other blood tests came back showing a slight snag in my recovery. My immunoglobulin (IgG) count is low (i.e., I have an antibody defiency). This explains why my cough/cold has persisted for six weeks.

The treatment to correct the deficiency is called intravenous immunoglobulin therapy (IVIG). Over a period of six hours, I will receive an infusion of antibodies donated from between 3,000 and 10,000 healthy donors. At this time, I don't know much more than that. The registered nurse at the cancer center, who informed me of the irregular test result, said they would prefer to discuss the treatment and possible side effects with me in person.

Good-bye Arsenic, Hello Irene!

This morning I completed my 50th and final dose of Arsenic Trioxide. Just in time! If I weren't done, and Hurricane Irene stays on its current projection, it's unlikely I would be able to get to Dr. Sharma's office on Monday for another infusion.

I won't miss the arsenic, but I will miss Dr. Sharma, Lily, Shannon, and Lynette. Dr. Sharma is a brilliant and caring oncologist. I was more than a patient to her-- I was a person. Nine in the morning, on the Fourth of July, she met me at her office because she didn't want me to miss a day of treatment.

Two weeks ago, I called her office because the site of my IV infusion from that morning had begun to bruise. Bruising is one of the symptoms of leukemia, so I was worried I might have relapsed. She wasn't at her office, so Shannon took a message. Five minutes later, Dr. Sharma called me from the hospital to reassure me the bruising wasn't from leukemia. She could have addressed my concern the following morning during my appointment. But she cares, so she called.

I will also miss the other members of the Cancer Club with whom I became friends. With these friends, when you first meet each other, you skip the pleasantries. You learn about each others' diagnoses and treatment programs. It's the standard ice breaker. Then, you learn about their families. Finally, once you really know each other after multiple infusion sessions in the same room, you talk about the weather. I hope and pray each of them wins her battle.

The result of my PCR remission test hasn't come back yet. Maybe Monday. At least I will have a hurricane to distract me during the weekend wait. The storm is expected to hit here Sunday.

Chemo Ahead

The other day, I noticed a man wearing a fundraiser T-shirt with an imprint of a traffic warning sign that read "Cure Ahead" instead of "Curve Ahead." Very clever. As I'm finishing my tenth and final week of Arsenic Trioxide, I've been thinking about what lies ahead on my path to complete remission. My curve this fall is the chemo that will lead me to being cured.

My schedule:

(True) True Grit

"True Grit" became a buzz phrase this spring when the Coen Brothers' remake of the 1968 film adapted from the Charles Portis novel was nominated for ten Academy Awards. Since Sunday, when I spent the day with my younger brother, Matt, the expression has been buzzing in my head. In the story, U.S. Deputy Marshall Rooster Cogburn is described as having "true grit." But his fortitude is fiction. Matt has reminded me that there is such a thing as (true) true grit.

Last week, Matt was promoted from his role at Nougatine to Garde Manger at an affiliated restaurant, Jean Georges-- the premiere restaurant in the famous chef's portfolio and one of only nine restaurants in the United States to have earned three Michelin Stars in 2011. For any aspiring chef, Jean Georges represents the pinnacle of employers. Understandably, Matt's very excited, which made his accident Saturday even harder to bear.

A Poison Mystery (Part 2)

After a harrowing investigation, I've come to the conclusion that the poison in the huckleberry pie at the Shelbourne Restaurant & Bakery is the same compound being administered to me intravenously on a daily basis.

According to a white paper I found on arsenic trioxide, the compound has been used for therapeutic purposes for 2,400 years. In the fifteenth century, William Withering made the following argument supporting arsenic-based therapies: "Poisons in small doses are the best medicines; and the best medicines in too large doses are poisonous."

A Poison Mystery (Part 1)

On July 31, 1922, 17-year old Lillian Goetz ate lunch at the Shelbourne Restaurant and Bakery on the corner of Broadway and 25th Street in New York City. Deborah Blum writes in The Poisoner's Handbook, "According to police reports...Lillian ordered a tongue sandwich, coffee, and a slice of huckleberry pie. It was the pie that killed her."

That hot summer day, almost exactly 89 years ago, 60 people became sick and six died, including Lillian, who worked as a stenographer for a dress goods firm located near the Shelbourne. Investigators determined that arsenic had been added to the dough bowl. They suspected the dastardly deed had been done by the  baker or his assistant, but it was never proven. Instead, lunch customers at other restaurants that summer began refusing to order huckleberry and blackberry pie for dessert.

Before my first five week round of the arsenic treatment, my Uncle Bobby told me about the book, "The Poisoner's Handbook: Murder and the Birth of Forensic Medicine in Jazz Age New York." He informed me it contained a chapter dedicated to arsenic. My response: "You are crazy. Do NOT give me that book." I had zero interest in learning the details of the gruesome history of an element I was about to have injected into my body 50 times.

Apparently, Uncle Bobby is crazy. Either that, or he really cares about me (he has been very supportive throughout this ordeal). During my visit back home two weeks ago, he gave me two new books, one of which looks to be a fast-paced thriller. The other, not surprisingly, was The Poisoner's Handbook. I debated whether or not I should read the chapter on arsenic. After much deliberation, I concluded that a willingness to become knowledgeable about the chemical element would be proof to myself that I am mentally tough. Besides, Dr. Goldberg had said my drug is "different" than the arsenic used to poison...

Back to the Grind

Vacation is over. I am writing this with an IV needle in my left hand. Today starts five more weeks of Arsenic Trioxide five days a week.

It's hard to go back to this routine. I know all the right thoughts to make this day easier, and I am thinking them. By tomorrow I will have regained my positive mindset.

I Need a Vacation

I need a vacation, but I don't mean that in the traditional sense. I'm looking forward to going to work Monday morning. I miss being in the office and around my colleagues. The vacation I need is from my second job - beating cancer.

While in the hospital, I read a post on a leukemia discussion board that resonated with me. At the time, the patient was partway through his ten weeks of the daily Arsenic Trioxide drip. He wrote that instead of viewing the daily regimen as a nuisance, he was treating it like a job. His job was to get better. Each day, he would show up on time to the appointment, keep a positive attitude, and take responsibility for his health.

Over the past five weeks, I have mirrored his approach.

A Day at the Beach (without the beach)

 

After tomorrow, I will have completed three of the ten weeks of the Arsenic Trioxide (not including the two week break in the middle). I've been asked how the daily IV infusion makes me feel, and I've finally found the right metaphor to describe it:

When I leave the oncologist's office each afternoon, I feel like I've spent the day at the beach. It's that sunburned, dehydrated, woozy, exhausted feeling that's normally cured with a pina colada and a lounge chair positioned to face the sunset. Except I don't actually have the sunburn, and I didn't actually play in the surf and sand.

I haven't tried the pina colada and lounge chair remedy yet. Maybe I should, though I am not complaining about this day-at-the-beach side effect. It is nothing compared to what chemo can do. I'm making the most of my Summer at the Beach (without the beach) before the season ends and I begin two more rounds of stronger chemo (Daunarubicin).

In my first post, I'd hoped to be walking on a white sandy beach by August. That won't be happening. But it will eventually, and I'll relish that exhausted feeling at the end of the day.

Giggle It, Just a Little Bit

This morning I forwarded Ryan an email from What to Expect, which is a website filled with useful tips for parenting during a child's first years. Any time the daily email's topic is relevant, I forward. Today, when I saw the subject line, I laughed, and forwarded. My objective in sending this particular email had nothing to do with improving our parenting skills. 

I hoped a colleague of Ryan's, preferably his boss, would be hovering over Ryan's desk when the email's embarrassing subject line appeared in his Outlook Inbox. Yes, I admit, I was looking for a laugh at my husband's expense. These days, I look for any opportunity to laugh. 

Unfortunately, the prank backfired on me.

Miss Scarlet, in the Drawing Room, with the Arsenic...

Arsenic is a classic murder weapon. The height of its popularity occurred in the Middle Ages and Renaissance. Today, it mainly lives on in murder-mystery novels and the game of Clue.

Later today, arsenic will also be flowing through my veins. Although receiving 50 doses of what has traditionally been considered a poison is a little disconcerting, it is better than having Prof. Plum or Col. Mustard wack me 50 times with the lead pipe or the candlestick to knock out my disease. I continue to be amazed by the medical advances that have been made for a condition that only strikes 800 people in the U.S. each year.

Cancer from Cell Phones? -Added to my Worry List

The World Health Organization has announced that cell phone use can increase possible cancer risk. I received this news alert on my iPad right after I returned home from a last-minute appointment with the oncologist. I reacted like any newbie paranoid cancer patient would: I ate a bowl of mac and cheese and three chicken nuggets and took a trip to Amazon.com. I ordered headests for each of our cell phones.

I certainly don't want a brain tumor on top of leukemia. The article also mentioned product advisories that state you shouldn't be in direct contact with the device when it's transmitting data. So does that mean I should put on gloves before hitting send on an email on my Blackberry or using my iPad? Can you get tumors in your hands? I need to do more research.

Cell phones are just one more item on my new worry list. I am now concerned about artificial sweeteners, the radon level in my basement (despite Ryan's insistence that ours is at an acceptable level), contamination of our drinking water, organic vs. non-organic fruits and veggies, and Katelyn falling off the bed. Her favorite book right now is Eight Little Monkeys. She imitates the doctor by wagging her finger and says a slurred version of "No more monkeys jumping on the bed." I'm afraid next she'll imitate the monkeys falling off the bed. Now that I'm thinking about it, I should have gotten her a helmet on Amazon while I was ordering the headsets. I might just do that when I finish writing this.

Before my diagnosis, I was moderately paranoid, but not like this. "Cancer" is scary, and it's even scarier when it's your family's reality instead of an abstract possibility.