May 31: The bump seems smaller, but more tender. I'm thinking it was just an acne bump that got big and swollen to the point where it felt like part of the bone. I reported it at triage, regardless. The call took 1.5 hours to get through, but I did it. The pain is more on-and-off now, but it seems to happen when I chance position. Standing after sitting or laying down, laying down after standing, shit like that. Going to guess it's the change in blood pressure, mine's always been normal to low. The nodes in my neck are very small now, though. Just the devil's node remains any sort of notable size. My leg is still kinda stiff and weak at times so I may have to work it more with some kicks or something.
June 1: I fucking hate the cancer place. The smell, the feel, most of the people. I'm glad I have to wear a mask, it blocks the stink of the place. Seems my increasingly-reinforced impression that medical professionals are only useful for second opinions when it comes to topics you already know is being proven correct yet again. Least my head bump is going away. Nodes still twinging, seem even smaller today. Lots of neck bullshit during my stretches, along with some pretty strong nerve tingles on the bottom of my right foot.
As expected, the physiotherapist knew jack all. They make you fill out these little forms before you see anyone, listing symptoms and what you're after. For Short Term Goals, I wrote "get a second opinion", and for Long Term I wrote "walk like I used to or die". It seems she didn't read it at all, nor the profile she guarded zealously. I was curious to see what was in there and if onc-kun listed me as non-compliant, and managed to read the first page of my profile before she kind of cut me off from it. I went over my symptoms and concerns about my leg/neck, and she was no help at all. I have NO IDEA how someone can work specifically as a cancer patient physiotherapist, all day every day, and not know the names of any of the drugs with even passing familiarity. Knowing what regimen someone is on should help immensely, and it was all right there in my file. I'd give it a pass, but she didn't even know what a cycle is, the most basic part of chemotherapy and most general term used.
Physio chick asked what I think caused it, I said most of it was likely due to the tumors, the medication and the high dosing, which she asked about. She had immense trouble understanding how big my DEX dosing was, so after 2 failures I spoke very clearly and used small words and it seemed to sorta click. I said twice I had brought up concerns about the dosing before treatment, that it was only AFTER it became a problem that anyone took me seriously, and that the onc decided to reduce my dose. All for context and to answer her questions about dosing. Twice.
She kept repeating that she's not a pharmacist and doesn't know drug names/dosing (why'd you even ask about my DEX dose) and that she can't fix my problem. Despite me saying (and writing) that all I wanted was a second opinion, another pair of eyes to see things that I can't. She does this for a living, she must know SOMEthing. She confirmed that I have weakness in my left leg, that my neck seems to be having problems. So basically shit I outright told her. She said the cracking can be any number of things, which I know, I just said that it started with this whole cancer stuff and I was concerned something was knocked out of alignment. She didn't even check my knee, but she did double-check my shoulders, back, and hips and said they seemed symmetrical. It's the most I could hope for from her.
She said walking would help and she could show me some leg exercises if I wanted, but I'm very familiar with the standard physio exercises and I know for a fact that my own regimen is a lot more intense. It's how I got from falling down the stairs to just walking with a slight limp. She took to blaming it all on the medication, that she couldn't fix what was wrong, and kept repeating that (again) she is not a pharmacist and that only the doctor can change my dosing. I had to repeat myself AGAIN that I knew that, that the onc and I had already dealt with that, that it wasn't why I was here, and that I was JUST HERE for a second opinion. All while being talked to like I was a toddler. Holy SHIT. Anyway, I ended up asking if I could see my profile since it's my info. She let me see the first page, but seemed really hesitant and kept angling to take it away again and questioning what I was looking for.
Customer service has programmed me to give some sort of feedback when a stranger I'm interacting with is watching me read, so I was saying "right" and "correct" to myself. "I don't think you'll find anything INcorrect in there," was her response. I had to explain that it wasn't what I was looking for, so she directed me to a desk where I could get a copy of my own to take home. She questioned how I could know what a correct dosing is. A fair question, though it was put to me like I was a child who didn't know what was good for them. I said I know my body very well and that I study A LOT of shit. "Do you think that the doctos don't study? Because it takes a LOT--" oh my god woman, no one said oncs don't study shut up oh my god shut the fuck up
After about 40 minutes of dealing with this kindergarten teacher masquerading as a physio expert, listening to her explain obvious things that didn't need explaining and were not relevant to why I was there, all because she kept making mistaken assumptions that I had to REPEATEDLY explain away... I got tired of dealing with her and packed up and went. Didn't want to hear her say YET AGAIN that she can't heal me, and having to respond YET AGAIN that I know that, that I didn't expect her to, and I was just there for a second opinion. Yes, it really was this repetitive and idiotic. Looking at the people she has in there, I'm guessing most of them are extreme normalfags or old folk who need really simple language and a lot of repetition. They can have her and she can stick with them. I'll avoid going anywhere near her place again if I can avoid it, though some small part of me can't help but wonder if I got saddled with her specifically on purpose since the onc didn't seem to want to help me in that department at all multiple times.
I chilled for a while by the entrance, then decided to check out the info desk she'd mentioned. What she DIDN'T mention was that there was a $25 fee to see my own damn medical information, so I guess that's why she was so hesitant to just let me read the damn thing. Thankfully the woman behind the desk was a fucking human being that was willing to talk with me like an equal, and she even waived the fees to boot. I learned some things from the paper stack, and I'll put them here if you're curious, along with what we already know. I'll use less technical talk since I doubt you guys care much about the lingo:
- My heart displayed normal left ventrical wall motion during my MUGA test. LVEF is 64%
- My biggest tumor was my chest one; anterior mediastinal mass was 7.1 x 4.6cm on the right. This was the one hurting my sternum and chest. There was a second "active focus" closer to my left side. I saw that one on my CT results; it was a surprise but it made sense.
- There was a 1.3cm one in my retropectoral (kinda shoulder/chest area, hence the "pec" part) and some minor activity on the other side where this whole journey started, but the onc said he wasn't worried about that one.
- The cervical tumor (above my collarbone) was up to 3cm long and was really active. This was the one pushing on my neck tendons and making laying down more of a chore than it needed to be. The ones above it also got an honorable mention but no sizes listed. I can say that they were about 1-2cm just feeling around, but the feel-size likely had been added to by the layers of skin and shit over them. My neck node definitely felt bigger than 3cm, for example.
- Nothing cancerous below the diaphragm and no B symptoms (fevers, sweats, &c.) so I was classified Stage IIA, "unfavorable" simply because of the size of the one in my chest (bulky mass). I can say it's gone down considerably.
- Something I did learn was that there was some uptake around the shoulder and neck parts of my skeleton, "likely representing marrow expansion" and they put "consideration should be given to marrow biopsy". The onc didn't mention this, so either he forgot or he wasn't worried. Naturally I had to learn this on a day I went in to have my head-neck joint asked about, but it wouldn't make much sense for it to show up in this specific spot unless it was just inflammation. Pretty sure it's just more joint bullshit, especially since uptake in early stages' CT scans just kind of "happen" a lot and no one know why.
- Some physiologic uptake in neck and thorax, as well as abdomen and pelvis area. Anyone who knows anything about FDG PET/CT scans knows that just seeing some uptake in unrelated areas isn't worth more than a mention due to bodies being weird. The specific areas they mentioned in the breakdown are known for benign uptake, it just needs to be on the report. Also my spleen is free.
- "CONCLUSION: Marked increased metabolic activity within lymphadenopathy above the diaphragm as described. No evidence of splenic involvement. Generalized uptake within marrow may be due to marrow expansion. Marrow infiltration by Hodgkin's disease is not excluded and bone marrow biopsy recommended."
Beyond that, the reports were fairly professional with decent detailing, so I respect him for that at least. I capped the day off with picking up the Akynzeo at the pharmacy and stocking up on supplies I've eaten through; the steroids gave me a small paunch around the mid-section remember, contrary to the expectation of losing weight, so I'll have to be smart about balancing caloric intake with nutrient profiles. It's gone down noticeably with my lifting and latest fast. One of the cashiers there remembered me but couldn't help me find anything with Sandalore in it. She was super interested in the receptor binding info though, since apparently she had been dealing with her own hair loss and had some bad unwanted hair growth from using Rogaine. Minoxidil will do that. I said if I find anything from my experiments and survive this ordeal, I'd share shit with her. So far I have no idea if the current approach is helping or not, but my eyebrow shedding has all but stopped, right in time for another dose of toxic garbage. Cleaned some stuff, showered, went to bed.
tl;dr: I got a more detailed report on my disease status, and if you need physiotherapy look me up instead of going to the ones on-site. I'll get you fucking moving better than they will, and I'll know what the fuck you're on and what it does to you as a bonus.
June 2: Chemo day. Neck twinge before I got out of bed when I was laying in a weird position, but nothing when I went from laying/sitting to standing like I usually do. Guess it's getting better. I really didn't want to go, but everything seems dull and I can't muster the reaction for it at all. Probably in a schizoid Close and got turned into a blank. cluster A has its upsides. I am genuinely curious how the fasting nausea-control will fare with just the Akynzeo backing it up, however. [Dose: x1 Akynzeo, x2 Dexamethasone, nothing else.] No Ondensetron. I have the metachlopromide and a fuckton of Gravol if shit goes south, but not eating anything for 2-3 days doesn't give your body much to throw up or feel nauseous over. Your digestive tract basically goes into a mini-hibernation. Rubbed some more crap on my scalp. Did a cardio workout beforehand since it's supposed to help, neck behaved unlike usual. Grabbed my H2 water, Naproxen, and gtfo. Meds made my mouth really dry.
Every time you go in for an appointment, you go to the front desk after COVID screening and you get a sheet with the time, date, and area printed off on it. It said 1st Floor, Systemic. I was on the main floor, and I'd gone up in the elevator with a staff member last time so that's where I went. There's a floor map on the wall by the washrooms, but someone was using it as a loitering spot, so didn't bother to double-check. Turns out the facility has an "up elevator". Let me explain: You press 1 for Floor 1. The elevator goes up to Floor 3, then Floor 2, then Floor 1 but doesn't open the doors, It does this two more times then rockets up to Floor 5 and starts the process over, before finally opening the door at the floor you wanted. I had two people get on/off the elevator and they all chucked knowingly and said, "You got on the Up elevator, huh?" and similar. Floor 1 brought me back to the main floor. Turns out Main is Floor 1. Aight.
The now-unoccupied map showed it was just around the corner and at the end of the hall, basic L maneuver. I followed the very large ceiling signs around the corner and a staff member randomly confirmed it was the right direction, though I wasn't looking for help. Another too"false"-cheery Karen nurse cut in and said she could just take me there, even though it was a straight shot down a hallway with no obstacles, but cool. She attempts to make small talk, and it's always the same bullshit. I hated it at work and I definitely hate it now, but the good thing is that I don't have to sugarcoat it with an employee's veneer now. People like this never seem to know what to do with me when I don't go through the motions, so the small amount of humor I get from watching them scramble to deal with someone who isn't indulging in the traditional pleasantries makes the interactions marginally more bearable. Even if it's with someone who sounds like she's either going to complain about the state of her casserole or ask for my manager.
"How are you?"
"I have cancer."
[momentary short circuit in the normalfag brain]
"W-well I mean besides that."
*shrug* "Well as can be expected."
"Even if you have cancer you can have some okay days, right?"
"Must be nice."
She got the hint and stopped trying to get me going after that. She's probably nice, but I also know the vibe pretty well and there would have been zero meaningful discussion and would be more tedious than helpful. I just walked toward the sign as was my original plan, and found the room. This one was shaped like a long 0 ring with the desks in the middle, and a bunch of equipment at the top of the loop. All of the chairs were fairly close together, there were some beds, and the chairs had no curtains. Great. I asked about it and the nurses were cool with shifting me over to a place with more privacy. People stress me the fuck out on the best of days, and I'd rather not traumatize some poor old lady with my potential horrible reactions to the Dacarbazine. One of the nurses was motorcycle nurse from my first go, she said she recognized my "grump" and we talked a bit about some stuff involving her bike before she had to go off and do Designated Cleanerfag duties.
My nurse for the day seems familiar but I know I hadn't had her before. She'd been trained at another cancer place, one that she often hyped and brought up some interesting info I hadn't known. I will say this about the nurses at this place; the oncs may have terrible communication, the physiotherapists may know nothing about cancer, and the telephone tag is a pain, but the nurses are amazing. Easily 8/10 on average and you fuckers know how hard it is to get a 10 out of me. They're all in this because they actually give a damn, and many of them have been in hospitals or centres just like this for their own disease treatments, including cancer. My nurse was no exception. She knew what it was like since she's been there and avoided plying me with all the stupid empty platitudes you normally hear, but she did say that she'd be praying for me and sending me good thoughts and some other stuff. She came across as slightly new wave spiritual as she repeated a few times that she believes in the power of words/vibes.
We had a few chats about shit while they rigged up my right arm this time, mostly how I managed to clear up nearly all of my visible acne (apple cider vinegar baths + Neutrogena cleanser + some oils) so she can pass the knowledge on to others. The best vein was the one I pointed out on top of my arm rather than the underside. It wasn't near a nerve this time, thank fuck, but there WAS a valve and we had to be careful. Got more compliments on my veins. I got pumped full of Liquid Loathing, and Liquid Loathing: Not Red Edition. Excreted orange-pink in the bathroom, came back, had a small neck problem just sitting there but still no position change bullshit. Then the Dacarbazine drip started and it's always the one that's immediately the worst. It also takes like an hour because they can't just push it. The same cycle of arm pain, then joint paint, then chest pain happened again, only on the right side and less intensely this time around. The tumors are a hell of a lot smaller for one, and I'm not dealing with shitty nerve pain for another. Pain above my heart, guessing all of that even before this was that pec area activity mentioned in the report. My ankles and calves kept feeling weird and crampy so I took to moving around more. Three more bathroom trips, all of them very clear. Lots of heart flutters and some extra leg weakness.
I can always tell when I'm near the end of the Dacarbazine drip because I always become extremely tired. It's like you haven't slept for days and your limbs all feel weak. Kept saying "it's all good" instead of the usual variety of responses I give when everything's cool. Think the dex is already making my face swell, I look like shit. Kept my fingertips frozen throughout the entire thing, here's hoping it mitigates some of the damage in my fingertip nerves. Tried an ice pack on my head under my hat, but even at its coldest it didn't feel that way and was awkward to keep in place, gave up before the drip. Paced a lot and kept my legs moving even if it was just marching in place by the bed behind my curtain. IV arm hurt like a bitch upon needle removal but quieted down after that. Didn't even need the little space heater I'd brought along for pressure-free warming.
Went home, drained some bone broth, started a batch of vegetable broth for easing off fasting. Drained myself again, too. I'll try to move some more if I don't pass out to help flush the last of it out of me. Pretty sure the calf fuckery is from the DEX kicking in. It also prevents you from actually falling asleep, like some kind of fucked up divine punishment. You're so damn tired and are on the edge of falling asleep, but when you close your eyes it never comes and you're just stuck like that. Sat gently running my fingers through my hair until I could do so on both sides 5 times without any loose hair coming away. It took an hour, lost about 40 hairs, possibly more. Water has that unpalatable sweet taste to it again, just not as strong.
DEX wore off around the time I expected it to and I accidentally passed out on the couch for an hour and couldn't move for a while when I awoke. That on-off nerve pain in my abdomen I've had since I recovered from the constipation came back pretty strong, so I had to move slowly getting up, but no neck bullshit. Drained the veggie broth, saved the vegetables to make some stuff with, INTENDED to go to bed but found I was more awake now. Left leg is back to being a stiff bastard but not painful. Less noticeable if I walk on the balls of my feet, so I just have to watch my knee if I do that. My eyebrow shed is back, and I lost a few eyelashes, too. They itch when they're loose so it's easy to tell. Water, teeth/face grooming, hair oil, bed.
June 3: Woke with some noticeable weakness in my shoulders and upper body, eventually faded a bit to general fatigue in those areas. The DEX swell is there, just not strong, but seems to be affecting me all the way up to my fingers this time. Moving them around seems to have helped. Some minor bloat from the DEX. Neck has some mild stiffness and a whisper of pain when I mimic some of the moves that were more likely to set it off, and it cracks, but seems the neck issue is on the exit. Most noticeable discomfort is on the right side tendons. Not sure if purely normal progression or affected by the chemo, so it makes me wonder what the nature of it was. I'd had similar pains in the past when I was sleeping on the floor and I DID have a couple naps there on a blanket in the week leading up to the problem appearing. The lump is pretty much non-existent and I'm fairly sure it was an acne bump that got carried away with itself since I have a few of those hidden on my scalp. Tachycardia still present but not as bad, more pronounced when laying on my front.
Lounged and sipped water for a while before getting up to brush my teeth, result in the bowl was very nice and clear. Only lost 9 hairs collectively in the bathroom and overnight in bed. Downed some water with salt and baking soda in it so I can take the last DEX of the cycle. I can't feel any of my upper neck nodes save one, which seems to have gotten more plump as it swells for drainage. Devil's node is still technically "visible", but it's harder to find by touch. Ankle pain and shifting cracks are noticeable on both sides, right calf is doing the swell-cramp mambo more than the left this time, but the left looks bigger. My sock elastics are a hell of a lot tighter on that side for some reason, so I'll loosen it and see if it goes down. If not, I'll have to report it in case of a clot. Both shoulders cracking a lot, but no major pain to speak of yet.
Had a small issue trying to remember the word "tourniquet" for a minute, but I'm slow to boot up background processes upon waking. Had the same issue trying to remember "troponin" (the protein they do blood tests for regarding potential heart muscle damage) during my drip as well and could only remember part of the middle of it, but so did the nurse when I asked about the word. I ended up getting a bunch of related-topic word association from my brain instead, all to do with memory crap, like it was making fun of me. Lethologica, Wernicke-Korsakoff, Zeigarnik Effect, shit like that. None of it was helpful in the moment beyond the humor.
Did stretches, lots more shoulder cracking, neck stiff on upper right and lower left (where the tumors are), and the pressure IS still there, but only really noticeable if I go into plough stretch. Lost 4 more hairs. Chugging H2 water. Hamstrings VERY tight, had to work to get my head onto my knee this time. Took DEX, and with that I'm officially done being administered my first (delayed) cycle. Lost 15 more hairs; I'll add that lately it hasn't just been baby hairs, but also very thick ones. I wanted to take a macro shot of the roots so you can see the effect the chemo has on the hair shaft. It adds a taper to the root end, like the normal end of the hair, only more noticeable and acute. I can see my scalp in my hair part between the shafts no matter what angle I look at it from, something that was never possible before all this.
Hour after taking the DEX and I've only noticed some minor tachycardia and leg heaviness, unlike the Unusable Limb Effect last time. Adjusting the concentration seems to have helped immensely, along with the lack of any major Ondensetron bullshit since I dropped it entirely. I've had 0 nausea, by the way, but water is still a bit sweet. We'll find out if all this holds tomorrow when I break my fast. Hope so, the little steroid paunch I got from the first run is pretty much gone and I don't want it back. You gotta see your abs, man.
Calf is still swollen, so I reported it. Doc and triage want me to go to emerg, which I expected. They just do a scan and if it's a clot then give you some blood thinners to break it up. I'll be going to a place that ISN'T the hospital I went to last time. It was a good choice overall. I was there about 6 hours and, like usual, most of that is spent waiting, but the actual wait to get in was a fraction of the time in other places; online it said the wait time was 2-2.5hrs but I waited maybe 20 minutes. Then again, I'm going through chemo and have a vein issue, so I probably got bumped up. The place was fucking freezing for some reason, and no one knew why when I asked. It took a bit to figure out just what the fuck they had going on with the gowns, but I got it eventually.
They took my blood pressure several times over the course of the visit, and it seems any time an IV is involved my blood pressure spikes 10-20 points. I can't stand them at all now and my stress absolutely skyrockets. It starts with interaction with the staff and it only gets worse if an IV is involved. My fight or flight triggers in a major way; I can't "defend" myself without the obvious problems, and I can't run away as far as I can, so my stress levels go through the roof. It doesn't help that I've never had blood drawn the day after a chemo treatment either. The veins wouldn't show, and it hurt tremendously. I'd warned the nurse that the veins on my right arm were not good for this sort of thing visibility-wise and to use the left, but she tried anyway and ended up digging around a nerve for a while until she finally got the hint and stopped. She did it on the left and was not very gentle about it here either, and left a line in which REALLY fucked me up and was extremely uncomfortable in genral. She said I could bend my arm all I wanted since it was flexible, but any time I tried the discomfort would get worse and start to hurt, so I couldn't bend my left arm at all or risk more fuckery.
I sat there freezing for a while (the blanket didn't help much), and after a sizeable wait I was finally carted off to have an ultrasound done on my leg. I was interested if I was allowed to see the screen since some places guard them from you, and I'd never seen my leg that way before, just my neck and chest. The nurse was a jocular Russian who actually talked to me like a person instead of a patient, which was a big help, and stocked me up with a bunch of warm blankets so I wasn't an ice block anymore. Blood clots above the knee are the most serious, so that's where they check and generally don't do the lower part.
We shot the shit a bit and she expressed a certain delight that I knew what she was talking about and kept taking a little longer so we could have more discussion. I didn't mind at all. According to her, the folk she normally gets are checked-out or on that level that makes you doubt humanity's future (my words, not hers) and it was nice to just have a proper conversation for once. Turns out she was a massive weeaboo and she actually did a quick scan of my lower leg, both for curiosity's sake and because we were partway through talking about her old Chobits collection.
I didn't see anything on the screen that was overly concerning, and she indirectly said my blood flow seemed good. I got wheeled back and waited another hour and a half. A new doc came by as I was dozing under the blankets and said that it seemed okay for now and to keep an eye on it, and gave me a requisition form for any imaging lab for another ultrasound, and recommended going in a week just to double-check. I begged the guy to take out the line, and a nurse came by and removed the horrible things so I could finally bend my arm again. I slowly got dressed and managed to make it out of the hospital with a very pronounced limp; all that laying in the stretcher was bad for it, I normally move a lot more. I was going to walk around when I got home, but all I did was hit my bed and try to lower my hospital-stress, ended up passing the fuck out.
June 4: Woke up way too early, ankles feel like shit. Got up, brushed teeth, washed face, back to bed and sleept. Woke not long later, drank some water and dozed. Couldn't get properly back to sleep the second time because my heart started beating hard, but the sleep I did get must have been decent quality. I laid and rested, half-dozing in bed until around 9am and examined my legs. The swelling wasn't as pronounced as yesterday, things like that always seem to get worse when my stress goes up. Decided to pop a low-dose aspirin and see if it helps at all. Educated what part of the household was awake on blood clots and different risk factors for them and various cancer types. Desk mouse was out for a while before I had to go to the hospital yesterday, and I was going to let her come out when I got back but that obviously didn't happen. She has been apologized to and will spend most of the day out of her cage today.
Breaking my fast around noon with broth. Shit always seems to hit the fan when I start eating again, so hopefully it won't be an issue. Early afternoon I'll consider a Naproxen to control any possibility of that loop happening again, since the aspirin will be mostly out of my system by then (NSAIDs can interact with lots of shit). I'm hesitant since it may increase my clot hazard, and I think this one may have occurred BECAUSE of my Naproxen use, during treatment and just before. Broth was good, adding some tofu for a bit of protein before I segue into meats and stuff. Clinic called saying I have a pathology appointment on the 17th at the hospital I hate for some reason. They had no idea why and there wasn't any info attached to it, as usual with that hospital, so they looked into it and apparently it was some ancient thing I'm not supposed to worry about, I guess. A+
First signs of post-fast digestive life are a lot sooner and more gentle than when on the Ondensetron, at least so far. Had some sardines, seaweed and a banana, also a slice of cheese at the request of something in me, though I probably shouldn't have. Chugged coconut water. Bottoms of my feet feel a bit swollen. Had a nap at my desk. Some of your hair roots do indeed hurt before the hair falls out. It feels like something is too stiff sticking out of your skin, like you have a little porcupine quill the width of a hair growing out of your scalp that's twisting/pressing into your skin when you push them the wrong direction. Light scalp massage with the pads of your fingers eases them up, though naturally a few get knocked loose. Not as much as you'd expect, but some. Mostly it's the endless itching, which I have a low tolerance for to start with. The arm where they jammed the unnecessary line hurts.
June 5: Set up that week-later appointment for another ultrasound to check on my leg. Very tired. Had more coconut water and food. Did stretches, had a shower. The heat made the leg worse and my foot definitely swelled more. Went down later, but ankle remains stiff and swollen. Will have to keep an eye on it.
Computer fucked up twice. Google's being a bitch and rendered a file useless. The other one isn't because it's not being rendered at all, but I have 4 movies that link so far at least. If I'm not around at the usual time, just press play because I'm going to sleep for a while. If you don't see me, either I'm still sleeping, the computer died, or a clot broke off and killed me in my sleep. (UPDATE: Was woken up just long enough to press play and pass out again.)
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