November 27, 29 30  I will append this post for all 3 days.

November 30

Another quick day, not very crowded at the UofM Cancer Center. 
I asked the nurse if this treatment is considered an aggressive form of chemo. She said 'Yes!' I thought good, you either cure me or kill me, it's that simple. So far, it seems to be working. I'm a little weaker after today's treatment. Probably from getting up repeatedly last night to go to the bathroom. Chemo tends to try and clear out in 48 hours after it is administered. I guess you know what I'm doing until Monday Night!
(allot of pee'in)

We went back to the Broadway Cafe today afterwards. Irene had her soup and mine. I am definitely going to get a good recipe for Korean Chicken Soup, simple, but really good. I changed it up with sweet and sour chicken. It was more than I could eat and now have my dinner planned. Seems like everything comes with KimChi, like it or not!

November 29

Uneventful chemo session this afternoon. It went very well. I walked in and walked out of the session and it actually felt better than riding in a wheel chair, very invigorating! 
Afterwards, we went to the Broadway Cafe, Irene had chicken soup and I had the full BiBimBap dinner. Very good Korean food and yes, I had me some Kimchi! 
A primer on LEMS - http://en.wikipedia.org/wiki/Lambert%E2%80%93Eaton_myasthenic_syndrome

November 27

Chemo round 3 has started, 2 infusions today, 1 Friday and 1 Saturday.

The visit with Dr Gregory Kalemkerian and fellowship Dr Elizabeth Davis went well today. He said all numbers were in range and they seemed happy about it.  Of course, this is encouraging, but we really won't know much until the next scans, probably in January. This first scan after one round of chemo showed no cancer activity. 

I forgot to ask the Doctors about elevated heart rates after chemo. This morning it was 85, tonight 115 but has dropped to 108 - 112 after taking some Ativan. Vicodin works really well to lower it but I will wait until just before going to bed. I have sent a message to Dr Kalemkerian's office with this question.

The plan is for 5 to 6 weeks down time between the 4th chemo and the start of radiation. Some scans will be done in this down time period. 
Florida here we come, hopefully before Christmas. He kept saying that they will work the schedule out to our liking. We kept saying we will like anything they want to do and on their schedule. Our priority is to treat the cancer the most efficient way possible. He smiled about that, allot. 

The ride down to the Hospital in Ann Arbor is 111 miles from our drive to the parking ramp, 1 hour and 59 minutes. 

Afterwards, we wanted to get some BiBimBap, a Korean dish popular in Ann Arbor, but we tried to beat the rush hour traffic out of town instead. I guess 3 PM is too late a start. We got caught up in it but not to a dead stop. The traffic going into Ann Arbor was backed up from 14 along 23, then 96 all the way to Lansing. It looked really stressful.

Another argument with BCBS. They didn't want to pay for a BiPap machine. UofM Medical, UofM Sleep Disorders Lab, Sparrow Medical Supply and I against BCBS. We ended up winning after playing their silly games for 2 days. New Bipap, mask, hose, etc came home with me this afternoon. 

I am thankful to Sparrow Medical Supply and UofM Sleep Labs for doing battle with the bureaucracy known as Blue Cross Blue Shield. Thanks to them, especially Sparrow Medical, I have a new sleep apnea machine. Instead of a cpap, I now have a BiPap with settings comparable to what UofM CCU used to lower my co2 levels. The Respiratory Supervisor even hung up on them at one point during the argument.

Persistence pays off!

This is a complaint letter I wrote to Genesys Healthcare on November 2 2013 about refusing to admit me for breathing difficulties.

"I understand why there is a copay for ER visits with no admission but you nearly killed me by turning me away recently.

On Oct 10th, I visited Genesys ER with breathing problems. Someone decided not to admit me.

On Oct 11th, I was admitted to the University of Michigan Hospital with breathing problems which were quite severe. I was under respiratory failure with high co2 levels in my blood. I spent 1 1/2 days in the Critical Care Unit and 4 days overall in the hospital. Doesn’t sound like I should have been turned away now does it?

I do, however, give Genesys credit for finding small cell lung cancer in an earlier admission. Further treatment and testing at U of M has determined that the cancer is isolated and the prognosis is promising. I will have my second round of chemo the week of Nov 4, 2013 with 6 weeks of radiation to follow the chemo.

I will continue my treatments at the University Of Michigan Healthcare System and pay this copay under protest."

I just got off the phone with an complaint investigator from Genesys, seems an inquiry has erupted over this letter.

Hmmm...      ;-)

I finally got a test results letter from the UofM Sleep Disorders Lab.

They did a retitration on November 3rd. The results were inline with what my Oncologist expected. They are recommending a BiPap, humidifier, a wedge pillow and to sleep on my stomach or side. 

I currently use a cpap with a setting of 14. The bipap will be set at 25/16, big difference, but that was also the setting that they used in ER to get my co2 down. 

Tried today to track down the order and who the supplier will be. The letter also stated that I would be contacted in a few days to make arrangements for equipment delivery/pickup.

I hope I can finally get a good nights sleep with the new equipment. I've had so very few since Oct 3rd. I would imagine this is mostly anxiety and stress. I need stronger anti-anxiety/depression drugs! Xanax makes me jittery, go figure.

Note to self, don't eat too much before chemo. I was hungry and had 2 fish sandwiches on the way down to Ann Arbor. I didn't get sick, just a little queazy. I little snack is acceptable but a full stomach isn't a good idea.

Eating afterwards hasn't bothered me. A lot of this could be stress. Three days in a row the timing is off, late getting in the chair and hooked up anywhere from 45 minutes to 1.5 hours. We talked to the nurse and she said the only ones that are usually on time are the the early appointments.

I guess I have to chill out a little.

Why is it the chemo nurses are always worrying about constipation? HA! Not me, just the opposite and so far one short bout with it. Clean up aisle 7....lol

So far so good, everyone looks at me weird though, I don't use the heated blanket, it goes to Irene.

The first is carboplatin then etoposide. The second and third days just etoposide,   Anti nausea drugs 20 - 30 minutes before starting.

So far so good, I am getting stronger everyday and walking farther.
I plan on no wheel chairs at the Thanksgiving weekend chemo. Maybe the wheeled walker loaned to me by the family.

After this is over, it's radiation, 6 weeks, 5 days a week. I hope that goes as well.

It's pretty much automatic now.
God has let me know, 'We got this'!

Diabetics take note Etoposide and maybe all cancer chemo drugs screw with you sugar. When I got home at 6 PM 301, at 1 AM 134, eventually it comes back down.

Sleep study consult with Dr Swetha Voddi MD Sleep Medicine Fellow.
Explained to her what has happened so far and that Dr Kalamkarian thought it would be a good idea to change to a BiPap machine due to the co2 problems.

Appointment set up for November 3 2013 at the UofM Sleeps Disorders Lab.

November 3 2013

Slept fairly well until the Ambien wore off, then it was in and out the rest of the night. No report was given but I do have a follow up with Dr Voddi on
February 14 2013 @ 3 PM.

I could have swore that I woke up a couple of times and the machine was in BiPap, guess not.

Must not be urgent.