Yesterday, I resumed the chemo therapy (Votrient) after a three-day interruption.  I have to admit I loved the break, and both the psychological and physiological effects seemed important, though sorting out the two isn't easy.  All three of the primary adverse reactions (at least the ones that most affect me) were mititgated: my appetite was better (though no meal tasted as good as that first steak once I had stopped); I still crashed, but the naps didn't seem as frequent or profound; and the diarrhea abated.  I felt almost like my old self.  Votrient also raises the blood pressure, so once on it, I had begun taking three anti-hypertenison meds; I continued with those, since I didn't monitor my blood pressure over the three days.  We go to the KU Cancer Center on Tuesday, and one of the oncologist's thoughts is that we might lower the dosage (from 600 mg. to 400, with 800 mg. being the standard starting dosage, one that drove my blood pressure up to intolerable levels so that I was on for only a month or so).  If we continue with the 600 mg. dosage, I need to know how often (if at all) I can take a hiatus.

The Internet is a mixed blessing.  One of my friends who was diagnosed with breast cancer said that her doctor at Johns Hopkins told her to stay off the Net: there was too much misinformation, and even the accurate information was only generalization.  But I think for most of us the doctor's advice is impossible to follow, and I went back a couple of times over the last few days to read about Votrient, the first time I'd done so in several months.  The GlaxoSmithKline site was the most complete, though between the medical terminology and the many abbreviations, much of it was impenetrable to a layperson (or at least to me).  The side effects it has with me are exactly the most common ones observed in the clinical trial, though luckily I've been spared nausea.  The median length of treatment was 7.4 months (I'm in month ten); the longest was just over two years, certainly an encouraging figure.  Interruptions or cessation of treatment was necessary in 42% of the subjects.  Many of the subjects required an immediate reduction of the dosage, which was normally from 800 mg. to 400 mg., so, given the overall statistics, if the oncologist decides to reduce my dosage from 600 mg. to 400, that wouldn't seem to be disheartening.  Now if I can just remember these statistics till next Tuesday, perhaps I'll be able to ask more intelligent questions.

There were links on all the sites to others on kidney cancer.  I ventured a few samples, but just as had happened a year ago, they were too discouraging to pursue very far. 

Language matters.  A lot of us academic types, I've noticed, have favorite words.  My friend Carol is bravely involved in an unpleasant, but necessary task, which she described yesterday as "fraught and imbricated."  I love the word "fraught"--what a solid, rich, one-syllable word.  I think that it almost disappeared from usage for a while, but now I hear it often.  I'm embarrassed (well, at least in front of Carol) to admit that it takes me a few minutes to drag 'imbricated' from my old critical vocabulary and remember what it means; I'm pretty sure I've never used it and can manage without it.  When I was writing books with Virginia, she had the uncanny and very useful knack of remembering, when on page 18 I used the verb 'suggests' ("This interpretation suggests..."), that I had used it on page two and thus we needed to find a synonym.  Sometimes I'd get lazy and say to myself, "Oh well, Virginia will fix this."  Virginia's favorite word was 'adumbrate'; there were rarely ten pages when one thing didn't adumbrate another.  And my own favorite jargon word was/is 'perspicuous.' ("Meaning is never perspicuous" was a sentence I wrote more often than I--or anyone--needs to.)

One of my current pet peeves is all the war reporters who think 'cache' is pronounced like 'cachet.'  During the first Gulf War, Connie Chung talked about the 'Calvary' so many times that the crawl at the bottom of the screen actually replaced 'cavalry' with 'calvary.'  I've also liked to think that my immediate and indignant e-mail helped get her fired as military commentator.  I also embarrass my friends in restaurants by (helpfully, in my opinion) telling servers that the final 's' in 'vichyssoise' is pronounced and that 'bruschetta' has a /k/ sound, not a 'sh.'  I don't like 'anyway' as a marker of a change of topic, but 'anyways' makes me cringe.

Chemo and lingo--today's subjects, one probably more important than the other.