A Near-Real Time Review of Late Compression Phase Symptomology

Cycle 12 Day 5. 02:33 in the morning. Friday, April 10th.So I’m lying here in my bed, as you listeners should be used to by now.And I had a wake-up episode where I had this bodily sensation that my symptoms, around this stage in the cycle, were starting to intensify.There is this weird shift coming on where I feel even more intensely that, subjectively, more and more of my bodily systems are in flux.And this coincides well with the peak effects of the one chemotherapy that I’m getting continuously infused.The Treatment SequenceIf we step back and take it from the beginning of each infusion of chemotherapy, what I’m first getting when starting my infusion is immunotherapy—so antibodies.They have a more latent, modulatory effect as such, so less of an acute symptom-initiating effect to talk about currently.At the moment they only take half an hour of infusion, because I just get one antibody, and then it’s about 30 minutes more of flushing with water.Then the first chemo comes on.And the first chemo is a platinum-derived substrate that, when active in living cells, has as one of its strongest mechanisms the breakdown of the cell’s ability to correctly repair damaged DNA.This molecule has quite a short half-life. I don’t remember exactly, but it might be one or two hours.I’m getting this infusion extended over a two-hour infusion window, so it takes two hours for that poison to get into my blood via the Port-a-Cath.A Port-a-Cath os a specific port that's been installed subcutaneously over my right chest muscle. It is used for inserting a special needle into my chest, pushing the poison into the port, after which it goes down into a tube that the surgeon has implanted into one of the main veins in my circulation. That internal tube has been led straight down to where the main outlet from the heart is, where all of my blood is being pumped out, so that any poison infused will directly be pushed with that outflow into my overall circulatory system.Lovely stuff.Oxaliplatin and CryotherapyAs a side note here, it’s during this two-hour infusion window for this platinum-derived substrate—which is named oxaliplatin—as well as 30 to 60 minutes before and 30 to 60 minutes after this infusion, that I’ll be using localized cryotherapy.Namely, cooling of my hands and feet using appliances that I attach to them, which use circulating cool water in order to mechanically decrease the blood circulation and therefore the exposure of the chemotherapy to my hands and feet.The reason I’m doing this is that oxaliplatin is acutely neurotoxic.One of the most widely reported adverse effects of oxaliplatin treatment is increasing severity of peripheral neuropathy, which is your body’s peripheral nerves—especially in the hands and feet, fingers and toes—being critically damaged, and in many cases not fully repaired upon termination of treatment.That can lead to a severe impact on perceived quality of life and on your ability to fully make use of your hands and feet in day-to-day life.Apart from the neurotoxic effects, which are obviously not only affecting the peripheral nervous system but any nerve cells because it’s toxic to the myelin sheaths—the protective sheaths around nerve cells and their dendritic extrusions that they use to create synapses between nerve cells—it is also clearly affecting my autonomic nervous system.Which means it becomes an amplifier of any other perceived sensations of symptoms due to the treatment, but also any other perceived symptoms throughout my life, basically.As long as this damage to the myelin sheaths is present and not fully repaired, it will cause an amplification of any disturbance in my system.The Acute Poisoning PhaseThe other main subjective component of experiencing acute symptoms from the oxaliplatin infusion, in my case, is that somewhere between the very start of the infusion and the end of it—this time it happened around the two-hour mark—I start to feel very intense poisoning symptoms.This comes on gradually, but once it reaches a certain intensity there is no way for me to hold it back anymore, and I go into a long, drawn-out puking spree.Something in my system is alerting itself at a critical point that we need to empty Victor’s bowels of whatever is in there.And since I’ve been water fasting at this point for more than two days, there’s not much in there, and definitely not much that can come out via puking.So the first thing that happens is that any water still freely moving in the gut gets thrown out via the mouth together with stomach acid. So it will be like a yellowish, relatively watery puke.After that, my body keeps signaling that I’m acutely poisoned, so it keeps telling me to puke.However, my stomach is empty.So the only new things coming into the stomach at this point are bile acids that are produced by my organs and excreted into my gut.And as soon as there is a critical small quantity of bile acids, I once again puke those out.That doesn’t come easily. It’s not just one convulsion. It’s several deep convulsions in order for each bout of bile acid to come out.So each such puking episode, when it’s effective, will occur over maybe five to ten convulsions in short succession until enough of that bile acid is coming out through my mouth and I can spit it out.Which is not a very pleasant sensation.These convulsions of bile acid produce small quantities of a much more acidic and less liquid excretion - starkly green in colour.Then my mouth is filled with harsh acid.So every now and then I will try to clear my mouth with water, just to get rid of that acid.But at this point, I cannot drink water.If I try to push any water down the system, it just comes up straight away, so there is no point in trying to drink.This intense phase, where my body is repeatedly trying to dislodge what it perceives as intoxication—which it obviously is—will go on for around twelve hours.So if, for example, this round I initiated treatment at 11 a.m., then around noon I started the oxaliplatin infusion, and then around 2 p.m., right at the end of the oxaliplatin infusion, was when the puking started, it would then continue for roughly twelve hours.It can vary in intensity, but as for almost any and all previous treatment rounds, it was very intense for those twelve hours.After the Puking StopsWhat happens after that is that the very acute effects of oxaliplatin toxification slowly dissipate.So there remains a latent symptom of feeling acutely poisoned, but there is a turning point where I no longer feel the need to continue these intense puking sessions of bile.From that point onwards, I usually don’t puke anymore, but there is this continuous perception of nausea which carries on all the way up to refeeding, to a larger or smaller extent.But it is there.The 5-FU InfusionNow, going back to the infusion itself: after the oxaliplatin infusion, I’m not done by far.What happens next is that, whether I’ve started puking or not—usually I already have by this point—the treating nurse detaches the oxaliplatin and flushes my Port-a-Cath and tube with water.After that, the second chemotherapy is initiated.It starts with a bolus dose, so a one-shot dose manually pushed into me with a syringe. That takes around ten minutes. It is there to create an initial concentration of that second chemotherapy.After that, they attach directly to my Port-a-Cath an external hose, which goes into a small bottle-like compartment. Inside that bottle there is a balloon filled so that pressure is exerted on its membrane. Inside that balloon is the solution containing the second chemotherapy.That balloon stays with me for the coming 46 hours.It slowly releases fluid into my system via the port, down into the connected tube, which then pushes it to the outlet of my heart, where everything enters circulation.This second chemotherapy is called 5-FU, short for 5-fluorouracil.Uracil has a connection to the T that you might know from DNA. DNA has a backbone, and that backbone has base pairs attached to it. Your DNA sequence is basically a combination of C, T, G, A.This 5-FU is kind of a version of the T in the DNA sequence, but it’s a flawed version.So if it is integrated into DNA or RNA, it will result in replication error, and therefore may result in cellular death.And that is the case irrespective of what cell the molecule gets incorporated into.So, as is true for any chemotherapy, it is not specific to cancer cells. If it is having its desired effect inside a cell, it is not necessarily dependent on whether that cell is a cancer cell or not.You will get similar toxic effects in healthy cells as well as in tumor cells.The effect of the continuous infusion of 5-FU is felt over a much longer time period.And obviously the effects are compounded. There is a synergy here with the other chemotherapy.The more structural effects on a cellular level—killing cells off, damaging them enough that they themselves or the immune system identify them as damaged and clear them up—are affected both by the oxaliplatin, which causes enzymes trying to repair or replicate DNA to malfunction, and by this flawed DNA base analog, 5-fluorouracil.Why I Woke Up TonightThe reason I’m bringing all this up now is that I woke up tonight on Cycle 12 Day 5—Infusion Day 3—and it has been around 13 hours since I removed the pump that was continuously infusing me with 5-FU.So I am close to the peak window of exposure to 5-FU, and I am in the time window where the combined effects of the latent exposure to oxaliplatin in cells and the continuous exposure to 5-FU would be felt most intensely.The mechanism behind this intense feeling is, as I just said, the accumulated damage to cells, as well as the immune response triggered by this damage.Those damaged cells may belong to various tissue types throughout my body.What is also being felt is the immune response itself.One of the main components there is that, upon identifying this vast landscape of damaged cells, some of my immune cells send out inflammatory signaling molecules called cytokines.These cause rippling effects throughout my body, leading to sensations of unease, inflammation, and bodily systems being disrupted and shaken at their core.This can lead to disruptions in sleep, sensations of pulsation, throbbing, heat.And there is an amplified component here from my already stressed nervous system, which amplifies these perceived effects of the cytokine signaling and the broader immune signaling that is ongoing.What I’m perceiving now is basically the acceleration of these symptoms.These symptoms will keep intensifying over the coming hours, throughout the night, and throughout the entirety of tomorrow.The Added Layer of HBOTAnd there will be another layering effect here, because tomorrow at noon I will be jumping into an HBOT chamber to undergo hyperbaric oxygen therapy.This adds another layer of stress to my bodily system.There is a clear reason why I add this at the end of the protocol as well as at the start of the protocol.The reason I add it at the end of this compression phase is that it will be an extra intensifier to further stress the cells that have already been damaged.Hopefully, in the case of tumor cells, this means they are pushed past a trigger point where they are not just stressed but are actually so metabolically stressed that they can no longer sustain themselves.Hopefully this is less so the case for my healthy cells.Some of them will be partly damaged, but may be able to recover through this, because regenerative processes may be initiated inside them due to the HBOT, where the oxygen level is increased intracellularly through the combination of breathing 100% oxygen and being in this high-pressure atmosphere.The other effect I am expecting, and one of the reasons I’m doing it, is to trigger my immune defense to more acutely respond to and clean up the debris and damaged cells where oxygenation has caused an increased number of reactive oxygen species that some cells cannot sustain.Hopefully, to a larger extent, the tumor cells.This has been indicated in both in vitro and in vivo studies.Due to the HBOT, my perceived symptoms will become even more severe.As I alluded to during one of my first nightly reflections, this causes a very intensified sensation where so much of my bodily systems are perceived to be in flux and warped that it can feel almost psychedelic at its most intense.I can just lie down in bed and withstand the beating of all of these disruptions, and just have to accept the frailty of my bodily mechanisms at that point.The whole point is that this added stress from the HBOT should hopefully only be subjectively felt, but not necessarily be connected to any additional deleterious damage to healthy cells in my body.And I should come out of that, in due time, more balanced because of a more effective cleanup of damaged cells.I can clearly remember and perceive, and I am convinced, that this has led to a slower recovery for me during these last two treatments, because these were the only prior cycles where I added this modality of HBOT prior to infusion and post-infusion.So the aberrations in my system will be felt for a few extra days, but they will dissipate over time.And hopefully this will give an additional edge in terms of tumor kill-off and restoration of my healthy systems going into the recovery phase of each treatment round.The reason I have added this modality is to intensify the pressure on tumor cells so that I can hopefully get an even more efficient result in decimating them with each iterative round of systemic therapy.The reason I want to do that, of course, is that my latest PET-CT scan looked much worse than expected.Much worse than they have ever looked.So we shall have our first more concrete feedback on how well this strategy has fared somewhere within three weeks from now, as we will have the first PET-CT follow-up scan since restarting treatment, once my system has stabilized metabolically from this third cycle—or twelfth cycle total.What I’m Feeling Right NowSo there you have a rundown of what’s happening in my body right now from a more scientific point of view.What I’m currently feeling subjectively is this ongoing disease—or rather unease—in my stomach.The stomach lining is just like a very sensitive membrane that keeps being very sensitive throughout the day and throughout the night.But since yesterday, I’ve been able to start drinking water again, so I try to do that more regularly, to get down water and rehydrate myself from the first 24 hours where I was becoming more and more completely dehydrated.Life force is slowly coming back to me.But there is this continuous feeling of nausea and very low energy that hinders me from doing much at all.Still, since two days back, I’ve taken one short walk each day.Yesterday’s was a bit longer than the previous one.I even stayed around for a while in the art studio where I’ve been helping out a bit with creating the templates for the mouldings of facade decorations—before heading back home to rest.And tomorrow I will have an even longer excursion, as I need to head to the HBOT facility in Bromma, Stockholm.That’s about a 45-minute commute at this tempo with my current health, including about 15 minutes of walking, one way.So that will be quite an excursion compared to the activity my body has seen in the last few days.And while lying in bed, I’m also trying to stay a bit physically mobile, just to keep my circulation going so that my body can better clean itself of toxins, damaged tissue, and inflammatory chemicals that it is generating due to the toxins.The Blood IncidentI think that rant is enough for now.I need to try to get back to sleep.A big milestone was passed yesterday when the 5-FU pump was removed, but it did coincide with an accident caused by the nurse who came to my home to remove it.What they do is first remove the pump itself, but there is still a small hose externally attached to the Port-a-Cath.Then they flush it with saline water. Either they have a bag of saline or a number of syringes with saline that they push into this hose.After that, they should close the back valve so that there is no pressure coming out of the Port-a-Cath.But this nurse must have forgotten to close that back valve.Then he removed the hose and the syringe, and was putting a plaster over my Port-a-Cath area.When I looked up, I saw drops of blood on the cover he had used to put all his gear on.And I asked him why there was blood, because I usually don’t see blood when they remove that special syringe. It’s like a small plastic syringe that goes in.He said, yes, that can happen.But then he looked down at my torso and saw that it was covered with a pool of blood.What had happened was that when he removed the needle, he had forgotten to turn off the back valve.So when he removed the needle, blood was just spurting out of the opening where my Port-a-Cath was, and he didn’t notice.So it was a good thing that I noticed, as otherwise there would have been blood left in my tissue around the port and the port itself would have been somewhat affected. So we had to perform a second flushing of the port. I had to clean up the blood.It was all over my wool tank top and over my jeans.And that was that.It was the first time that happened.But there are always new things happening.You have to be on your toes in this game.It’s not like any other game.Most games are quite regular. After playing a few rounds of them, you kind of know the rules, and things only change on the margins.Whereas here, anything can basically change in an instant.So with every cycle, there has always been something new.This was one of those things in this cycle.And there will probably still be more things coming.A Poem from the First NightSo now I’ll go back to energy-saving mode.And I’ll leave you with this.Or first I’ll also quickly read the poem that I composed during the first night of the most intense poisoning, right after my continuous puking had dissipated, when I was lying in bed for hours and hours and hours during the day and during the night. I was pulled to write this upon waking and hearing the birds chanting outside.As Night Turns to DayAs night turns to day, Outside my window,Nature shakes off its drowsy veil.Songbirds incantate the dawn’s first ray,Filled with vigor, billowing in play.Inside my window,I lay here - stale, lifeless, and pale.Battles raging deep inside, with no respite,I lay still, in mighty plight,As day turns to night.Namaste, fam.Be mindful of your life force. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit victorsalander.substack.com