Monday's chemo infusion appointment was fairly uneventful. Similar to my experience with Round 1, the infusion of oxaliplatin and connection to the 48-hour pump of 5FU didn't create any immediate side effects. I was able to eat a normal lunch and dinner on Monday, and Tuesday morning, I was able to go in to campus and teach my classes, but went home to rest immediately after finishing my second class at 12:20pm.

Tuesday afternoon and evening between the hours of 2pm and 10pm may have been the worst 8 hours of my life. Between the waves of nausea, overwhelming fatigue, and stabbing abdominal pain, relief was rare and temporary. None of the palliative medications, including my narcotic painkillers, provided any relief. For some of this time, I literally sat in by bed, rocking back and forth and weeping because the sensory overload was just too much to handle. As the evening turned to night and then morning, the pain lessened somewhat, and hours-long stretches of sleep provided some relief.

Wednesday, I stayed in bed and slept as much as possible until my appointment for an infusion of IV fluids and more anti-nausea medication. Thankfully, the fluids and nausea meds worked, and the nausea mostly subsided by early afternoon, so I was able to go in to campus for some end-of-semester student presentations. By Thursday morning, I was feeling nearly normal except for the fatigue, so I was able to again teach my classes, and then return to campus in the late afternoon for more presentations. Throughout this time (Tuesday-Thursday), I wasn't able to eat much beyond grapes and watermelon, and even that was in fairly small quantities. Thursday night was perhaps my best night of sleep in the past three months, with 8+ hours of uninterrupted slumber.

Friday morning, I had the CT angiogram to examine the blood flow to the tumor in my sinus cavity. I'll meet with the ENT specialist on Monday to discuss the results and find out if the tumor can be biopsied. After the appointment, Melissa and I went out for lunch, and I had my first real meal since Monday (a delicious cheeseburger with fries from Taco Diner). 

Today, I've been eating more normally, and aside from lingering fatigue, feel nearly normal again. My local oncologist is still confused about why I've experienced such severe side effects to this chemo regimen, so he ordered some additional blood tests to check for enzyme levels and chemo toxicity that might explain this pattern.

Story time with daddy

My favorite part of the week was sitting on the floor tonight, reading dinosaur books with Raegann and Matthew. I haven't had the energy for most of the week to spend any significant amount of time with either of them, so it was encouraging just to be able to hold them in my arms and have a shared experience. Each moment like this becomes so precious when the circumstances of your life make its transience so salient.

I don't know how old I was when I first understood the concept of death, but I can't remember a time when I didn't cognitively understand that life was a finite thing with a beginning and an end. It's pretty easy to give mental assent to the idea that we will all die; in my experience it's been another thing entirely to experience that mortality in the form of a Kaplan-Meier curve. It is, all at once, enshackling and emancipating. On one hand, the clock is ticking down, and on the other, every second is a gift. In this liminal space between life and death supplied by a Stage IV cancer diagnosis, I've found myself shifting between these perspectives, sometimes mutliple times within the same moment. In trying to find myself in the perspective of emancipation more regularly, this week I have been reflecting on Psalm 90:12: "So teach us to number our days, that we may apply our hearts unto wisdom." As I've considered my own life and the concept of numbering my days, I think the Psalmist is recognizing that a healthy perspective on our personal mortality results in fewer wasted moments. As we recognize, rightly, that every second is a gift, we find ourselves wasting fewer moments, and using our time more wisely.

Melissa and I continue to be grateful for all of the support that we have received from family, friends, neighbors, and those in the community. For those of you who are praying for us, here are the specific things you can remember this week:

• That we would "number our days" and make wise use of the time that we have.
• For continued progress toward diagnosing and developing a treatment plan for my sinus cavity tumor.
• For unusual efficacy of this chemo regimen against my specific cancer.

Thank you for caring for us in so many ways, tangible and intangible. We are so thankful.