FL Treatment and Aftermath

 

The Quiet Storm: My First Round with B&R

When you read about chemotherapy, especially the B&R regimen for follicular lymphoma, you prepare for immediate battle. Other patients' accounts speak of swift and decisive symptoms—nausea within hours, fatigue that drops like a curtain. What I discovered was something altogether different: a slow tide that crept in over days, subtle at first, then increasingly insistent.

The False Dawn (Tuesday - Wednesday)

The morning after my first infusion, I woke at 3 AM feeling completely normal. 180.4 pounds—I'd start tracking this daily, a concrete marker in what would become an increasingly abstract experience. That Tuesday morning, I did what I always do: drank water, walked four miles in the pre-dawn darkness, then spent an hour on the Peloton. A 610-gram salad with sardines followed. Everything was routine, including the short infusion that afternoon.

I remember sitting in the hot tub that evening with a glass of wine, having just made Israeli chili in the Instant Pot, thinking perhaps I'd be one of the lucky ones. Perhaps my body would shrug off these chemicals like a minor inconvenience.

Wednesday morning continued the illusion. Another five miles walked, another hour on the bike. Leftover paella for lunch. It wasn't until noon that the first whisper arrived—a queasy uncertainty centered in my digestive system. Was I hungry? Was it the treatment? The rice didn't help clarify matters. Looking back now, I realize this was the poison's polite knock at the door.

A note on expectations: The delay surprised me. Every account I'd read suggested symptoms would announce themselves boldly and immediately. Instead, my body gave me nearly 48 hours of normalcy—a gift, perhaps, or a cruel tease before the real work began.

The Descent (Thursday - Friday)

Thursday (181.1 lbs)

The queasiness had taken residence, no longer a visitor but a tenant. Still, I maintained my routines—three miles walked, an hour on the Peloton. But something had shifted. The sensation wasn't quite pain, more like my gut threatening mutiny at any moment, ready to reject anything I'd eaten or might consider eating. Food still had taste, but taste had lost its meaning. I ate turkey nachos for dinner not from desire but from duty, knowing nutrients mattered even as my body expressed its indifference.

That evening, sitting and talking began to feel like watching myself from a distance. The hot tub provided an hour's refuge before I retreated to bed, grateful for the escape sleep offered.

Friday, November 21 (177.8 lbs—first significant drop)

This was the day the treatment truly made itself known. No acute pain, but something worse: a complete evacuation of motivation. A low, dull ache permeated my entire midsection, not sharp enough to complain about but persistent enough to color everything gray. I attempted to watch TV but found it impossible to engage. My body was physically capable of anything, yet I desired nothing.

"Physically capable of anything but no desire to"—this paradox defined the experience. It wasn't weakness exactly, but a profound disconnection between ability and will.

Kim made hamburger noodles. I managed a few spoonfuls, eating as an act of faith rather than hunger. Then came an unexpected craving—ice cream. Perhaps my body sought simple calories it could process without effort. I ate an entire pint of Häagen-Dazs, the cold sweetness one of the few sensations that penetrated the fog.

The Nadir (Saturday)

Saturday (175 lbs—down over 5 pounds from Tuesday)

Saturday brought a curious morning phenomenon—a brief window upon waking where motivation flickered, only to extinguish within the hour. Still, I pushed through a four-mile walk when Kim left for work. Halfway through, reality took on a surreal quality, though my balance and gait remained steady. It was as if I was walking through a dream of walking.

The day's activities—eating leftover nachos, sitting with water and the TV, a trip to Walmart for ice cream and produce, an hour on the Peloton—all felt like enormous efforts. The simple task of washing and dicing vegetables for a salad seemed Herculean. I did it anyway, then ate my salad with sardines, had more ice cream, and was in bed by 9 PM.

The strangest aspect: Complete inability to engage with anything digital. The computer and internet, usually sources of endless fascination, might as well have been artifacts from an alien civilization. My brain simply refused to process or care about virtual information.

The Turn (Sunday)

Sunday (175.2 lbs—stabilizing)

Sunday morning brought a qualitative shift. The abdominal ache remained but had transformed into something like a faint memory of itself. Engagement seemed possible again—not easy, but possible. I drove to Costco for shopping and gas, a task that would have been unthinkable 24 hours earlier.

Back home, I ate cottage cheese while actually engaging with the internet—the first time in days that digital information registered as meaningful. A 3.3-mile walk followed, and though weariness crept in toward the end, it was normal fatigue rather than the existential exhaustion of previous days.

By afternoon, I found myself making lists of tasks, planning ahead. The dull ache persisted, perhaps slightly worse than the morning but nowhere near Saturday's depths. The storm was passing.

Lessons from Round One

This first round taught me that chemotherapy doesn't always announce itself with drama. Sometimes it arrives like fog, gradually obscuring the landscape until you realize you can barely see. The B&R regimen, at least in my body, worked on a delayed fuse—two days of false normalcy, then three days in the depths, followed by the beginning of ascent.

What sustained me through the worst of it wasn't heroic determination but simple routine—maintaining some movement each day, forcing down nutrition even when food held no appeal, accepting that this was temporary even when it felt eternal. The weight loss—over 5 pounds in less than a week—told its own story of a body under siege.

Most surprisingly, the primary battleground wasn't my immune system or my energy levels, but my capacity for engagement with the world. The treatment didn't make me sick in the traditional sense; it made me profoundly indifferent. Perhaps that's its own kind of healing—forcing a retreat from the world while the chemicals do their work.

As I write this, preparing for round two, I'm grateful for the knowledge that the pattern has shape and boundaries. The storm may return, but I now know it will also pass. And in between, there will be hot tubs and ice cream, small walks and smaller victories, the quiet determination to maintain what routines I can while my body wages its necessary war.

Next round begins in two weeks. I'll be ready with my scale, my walking shoes, and a well-stocked freezer of Häagen-Dazs.

Important Note: This post was heavily edited by Claude AI from extensive notes taken over time. It describes one individual's personal experience and should not be considered medical advice. Anyone facing a cancer diagnosis should work closely with their oncology team to develop an appropriate treatment plan.