Rising hemoglobin levels

Last week I had I met with my oncologist during my regularly scheduled maintenance infusion. During this appointment, my oncologist noted that my hemoglobin levels were continuing to rise. In this post, I will briefly blog about hemoglobin, what my oncologist said, and what I may have to change. 

What is hemoglobin

I have to admit that I had no idea what hemoglobin was to be precise, I just knew it had to do with blood. Over the last half-year or so, my oncologist has mentioned my hemoglobin levels. But there were always more significant issues to talk about, so I never really put much thought into what she said. She also took the time to explain why hemoglobin is so essential.

Since I can’t remember exactly how my oncologist explained hemoglobin to me, I will share this definition from MedicineNet:

Hemoglobin is the protein molecule in red blood cells that carries oxygen from the lungs to the body’s tissues and returns carbon dioxide from the tissues back to the lungs.

MedicineNet

What the oncologist said about my hemoglobin levels

First, my oncologist noted that my current hemoglobin levels are still within the acceptable range. It just that they have slowly but steadily increased. Right now, my hemoglobin levels are right at the top of the acceptable range. If things continue like they are, it is likely my hemoglobin levels will be out of range in a future appointment.

Increased hemoglobin means my body is trying to get more oxygen throughout my body. In my case, the oncologist believes two possible underlying conditions may be causing my body to need more oxygen. These conditions are sleep apnea and being a smoker.

First, I have sleep apnea and possibly am not wearing my CPAP mask as much as I should. I probably wear my CPAP mask about half the time when sleeping. It has been very hard getting used to wearing a mask at night. Of the times I do wear a mask, I am usually only keeping my mask on for part of the night. Sometime during the night, I will usually remove the mask while sleeping. 

Looking forward, I am going to try wearing the mask more consistently. I get better quality sleep when wearing the mask. It is just so annoying to try keeping it on.

The second factor noted by the doctor is the fact I am a smoker. She wants me to focus on stopping smoking now. Smoking is an issue I plan to blog about soon (by request of many fellow cancer survivors). In this post, I will say that I will be trying to quit again. But this is a very complicated issue that many cancer patients wish to avoid speaking about with others. It does, however, make sense that smoking would cause the body to want more oxygen.

What I plan going forward

Going forward, I plan to tackle both areas the oncologist pointed out to me. First, I plan to ensure that I am always going to bed with my CPAP on. Even if I travel, I will bring the machine with me and use it. Second, I once again plan to quit smoking. I know I should want to. But a big part of me does not want to stop, and I’ll wait for a future post to discuss that. Hopefully, by making these changes, or at least attempting to do better, my hemoglobin levels will stop rising.

Song of the day: Let It Bleed

Talking about blood brought this classic Rolling Stones song to mind. It’s actually a really good song for anyone going through cancer because having a good support structure is important. The opening verse explains it all:

Well, we all need someone we can lean on
And if you want it, you can lean on me
Yeah, we all need someone we can lean on
And if you want it, you can lean on me

Rolling Stones, Let It Bleed

This is a great live version of the song from 1998.

Bonus Song: Give Blood

Lyrically, Give Blood is not one of Pete Townshend’s (The Who) greatest songs. But this song features David Gilmour (Pink Floyd) on guitar and musically is one of my favorite Townshend songs. The fact it happens to be named Give Blood is enough reason for me to use it with this post.

Tired of being tired

I’ll often fall asleep while sitting around, but only for a couple of minutes at a time.

A constant theme from my cancer experience has been a lack of quality sleep. The lack of sleep has definitely impacted my personal and professional life immensely. Actually the reason I haven’t really blogged in the last few weeks is because I have felt too tired to do so (of course the other reason is I am working on creating a new podcast and a new video series). In this post I will briefly explain my current sleep habits. Later this week I will highlight how my personal and professional life has been impacted. Sharing this may help some other cancer patients in similar situations understand they are not alone.

Current sleep status (or lack of sleep status)

Currently I get only about three to four hours of sleep a night. Additionally, each week I will go one or two nights with no sleep at all. My current sleep issues seem to stem from multiple causes. First, I seem to have lost the ability to fall asleep. And secondly, I have a cough that won’t go away; which in turn wakes me up if I do happen to fall asleep.

As to not being able to fall asleep I have tried many cures. People have shared with me what works for them and I have tried almost everything that has been suggested. The only real thing that seems to work is to become so exhausted that my body has no choice other than to fall asleep. Part of me believes I also have problems going to sleep because I know I will be up shortly anyhow, so why bother trying.

Which leads to my cough. Since being on chemo, and now Rituximab (my maintenance drug), I have a cough that won’t go away. Sometimes I can go up to an hour without coughing. Then at other times I cough at least every five minutes. Laying down seems to make the coughing worse. Due to this I now sleep on a recliner, so I can keep my head and chest higher. This doesn’t really seem to help much at all. But I continue to do so because I feel I keep my wife awake all night when I sleep in the bed. I’m probably going to give up on the recliner idea and go back to sleeping in bed however. I fear if I spend too much time away from the bedroom it will make my wife feel she is somehow to blame; which is completely the wrong signal I want to send.

Results from the pulmonary doctor

I have gone through two sleep studies. Recently I had an appointment with my pulmonary doctor about my cough and sleep study results. He noted that on average I get about 9 non-breathing events per hour going through the sleep study. However when I entered REM sleep I would get about 66 non-breathing events per hour. He noted this is very dangerous and is the reason I was prescribed a CPAP. Since staring to use the CPAP he has noted I only get a few non-breathing events per hour, that is whether or not I am in REM sleep. So the CPAP seems to be doing what it is supposed to. But at the same time it has not fixed my other sleeping issues, other than to make sure I stay in REM sleep a little longer. I will admit I do feel better rested using the CPAP, even if the overall amount of sleep I get is not much longer.

Other than the breathing while sleeping, none of the tests or scans ordered by the pulmonary doctor have yielded any results. There are some minor lung issues that have to do with being a lifelong smoker. But nothing he is seeing would explain my constant cough.

Currently I believe the cough is just a side-effect of the maintenance drug Rituximab that gets infused into my body every eight weeks. Actually for about two weeks leading up to my maintenance infusions the coughing does seem to become less. Then about five days after my infusions the cough begins to get worse. I have spoken with other cancer patients who are experiencing the same side-effect with Rituximab. Since the maintenance infusions will likely keep me in remission longer, I guess I’ll just put up with this annoying side-effect.

Up next: how lack of sleep is impacting my life

In this post I briefly shared the current status of my sleeplessness. Later this week I will share how this lack of sleep is impacting my personal and professional life. This will likely be in two posts. Hopefully sharing my experience may help other cancer patients understand they are not alone. And maybe I’ll receive a sleep tip I haven’t tried yet that might actually work. I look forward to day when I am no longer tired of of being tired.

Song of the day

Today’s song really doesn’t have much to do with the bog post. Recently Ric Ocasek, lead singer for The Cars, died and I thought I would post one of my favorite songs from them. I’ve never been a huge fan of The Cars, but they definitely had some good songs. Plus I think this is great example of an 80’s music video.

Bonus song

The bonus song also has nothing to do with today’s post, other than the fact pulmonary doctors deal with lungs. This classic/weird song from Jethro Tull is just timeless. I like this version because I shows Ian Anderson in action.

Bonus, Bonus song

Jethro Tull has another song that comes to mind when talking about lungs and breathing. Plus this is another chance to see Ian Anderson in action.

PET Scan and Sleep Study today

Today is a pretty busy day for me medically speaking. This afternoon I will have my third PET scan done. Then overnight I will be at the hospital for a sleep study. I hadn’t really wanted both items on the same day. But the sleep study was order weeks ago and the PET scan can only be done in Aberdeen on Wednesdays.

Back in November I had my second PET scan done. At that point I had completed three rounds of R-CHOP chemotherapy. It appeared at that time that the active cancer had been pushed into remission in my lymphatic system. Only my bones showed active cancer in that scan. Since that time I have completed three more rounds of chemo. The hope now is that no active cancer is present in my bones. Either way though my oncologist decided six rounds of R-CHOP chemo was sufficient. For that I am very thankful. I’m not sure how I would have been able to do the additional two rounds of chemo that was possible.

I won’t be able to see the actual PET scan until next week, when I meet with my oncologist. The notes from the scan will show up in my chart that I can view online. But that really isn’t the same as seeing the actual scan. The first time I had a PET scan done I had a lot of anxiety. This time I am calm and just looking forward to seeing if the chemo worked as expected. I know it is unlikely I will see a major firework show on this scan, so I really don’t see a reason to be nervous. I’ll just have the scan done today and wait until next week to see the actual images. At that time I am also likely to have a bone-marrow biopsy scheduled.

The second medical endeavor today will be a sleep study. This was ordered by a pulmonologist I saw a couple months ago. I have a long history of breathing and sleep issues. When meeting with the pulmonary doctor it was determined I should have a formal sleep study done. I’m not really looking forward to spending the night in the hospital with a bunch of wires hooked up to me. But if they can find something out and help me get some sleep I guess it will be worth it.

I’m not really nervous about either the PET scan or sleep study. Whatever is found (or not found) can be dealt with moving forward. I do however wish both of these didn’t end up being scheduled on the same day. But it is what it is.