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Bicycle or Unicycle ???

Posted by Frederick Wasti
Apr 05 2014

Today's entry is about cycles - unicycles and bicycles, two words that nearly everyone should be familiar with.

The bicycle (or "bike") is probably the more familiar of the two vehicles for most people, since most of us have ridden one as a child (often first with, and then hopefully without "training wheels") and/or as an adult (most certainly without "training wheels", right?). On the other hand, the unicycle is something that most of us have (wisely) never even tried to ride, since it requires considerably greater balancing skills to do so.

The terms "unicycle" and "bicycle" are actually fairly modern words, both being used for the first time in the 19th Century (the bicycle was invented in the early 1800's and the unicycle in the later 1800's). However, the stem word that both terms share, "cycle", is much older -- it was derived from the Late Latin "cyclus", which in turn was derived from the Ancient Greek "kuklos", both meaning "wheel". The two prefixes "uni-" and "bi-" are from Latin, and, of course, indicate the number of wheels (or "cycles") on the vehicle, either one or two, respectively. [And, of course, there are also "tricycles", which have "tri-" (for "three" in Latin) "cycles" instead.]

The earliest bicycles that were in common use had two wheels of considerable difference in size (and they were probably not all that much easier to ride than unicycles):

Bicycles have evolved over time, of course, and some modern lightweight bikes have been optimized for great speed, either for individual racing,...

..., or for team racing,...

Another very different modern design is that of a "recumbent bike",...

..., which is supposedly easier on the hips, back, shoulders, and arms than a traditional bike. However, most bike riders settle for something a bit more mundane. A popular current design is what is known as a "hybrid bike", having tires a little "fatter" than the "skinny" tires of racing bikes, and usually also having "regular" handlebars (as opposed to the "drop handlebars" common on racing bikes). This hybrid bike,...

..., is quite similar to my own personal bike. Such hybrid bicycles are good for all-around biking, especially on pavement, but, of course, they represent compromises in design. For example, while the hybrid's tires are "fatter" than on a racing bike, giving better traction, greater stability, and a slightly more comfortable ride, with only a modest loss of speed, a hybrid's tires are not "fat" enough to be suitable on sand, such as is this "classic" bicycle,...

..., much like the one that I recently rode on to and from the beach in Florida. And, of course, there are "off-road" bikes, such as this one,...

..., that have extra-sturdy frames and wide "knobby" tires for traction and stability on very rough terrain.

As for unicycles, most of us are at least superficially familiar with basic unicycles (such as used by circus clowns, perhaps, or as seen on TV),...

..., but unicycles have also evolved in different ways, too. For example, here is a racing unicycle (not for the faint of heart),...

..., and here is a motorized unicycle, for the ultimate in maneuvering in heavy urban traffic,...

..., such as getting-to-Dana-Farber-on-a-Monday-morning rush-hour traffic. (Wear a safety helmet, though.)

Now, you might be wondering just why I am discussing bicycles and unicycles here. Well, please let me try to explain:

First, here is a quote from my clinical trial protocol: "Part C is a maximum of 26 cycles of 28 days. Ofatumumab will be given intravenously every other cycle. Alemtuzumab will be given as a subcutaneous injection every 14 days."

So, during Part C of the trial, each cycle is 28 days long, and there are two treatment days during each cycle, 14 days apart. Alemtuzumab (Campath) is given (by injection) on every treatment day. However, since Ofatumumab (Arzerra) is "given intravenously every other cycle", the 28-day cycles alternate between cycles where Ofatumumab is given and cycles where it is not.

Every treatment day starts (after some "waiting room time") with a blood draw, and certain blood test results have to be received back from the lab before any treatment for that day can be prescribed, which does involve about an hour or so of "waiting time". Currently, on every other treatment day (after some more "waiting room time"), I also have to see my nurse practitioner or my doctor for a brief check-up, which also involves some extra time as well. (For much of the trial, I had to meet with one of them on every treatment day, but the good news is that this requirement was eased a few months ago to just every other treatment day, since I seemed to be doing OK.) The Alemtuzumab injection itself takes very little time, but there is some "waiting room time" involved before I actually get into the infusion area for the injection. Nonetheless, on treatment days that do not involve an Ofatumumab infusion (which, in Part C, are three-fourths of the days), I tend to think of such days as "short days" (since they usually involve just a few hours of time).

Any treatment day that also involves Ofatumumab takes considerably more time than a "short day", since the drop-by-drop intravenous infusion of Ofa takes about four hours, and one of the pre-meds that have to be given before the infusion (Methylprednisolone) involves a drop-by-drop infusion itself, even before the Ofa can be infused. The good news with Ofa treatment days, which I think of as "long days", is that they make up only one-fourth of the treatment days, only once every other 28-day cycle.

So, following the description given in the clinical trial protocol, there are 26 cycles (taking 28 days, or almost one month, for each) in Part C. However, since only every other cycle involves a "long day", I've come to think of each cycle in Part C as having a length of 56 days (almost two months long), involving one "long day" followed by three "short days". So, when I see my doctor and he says something such as "Well, we're up to Cycle 16, and [...]", it tends to surprise me, since I have come to think of Part C as having only 13 cycles (because there are only 13 "long days"), and, in my mind, we'd only be "up to Cycle 8" on that day.

As a result, a person reading the clinical trial protocol literally might refer to a 56-day period of time in Part C as a "bicycle" (because it would be two cycles long), but I tend to think of such a 56-day period as making up only a single "unicycle". However, regardless of whether Part C is really comprised of 26 cycles of 28 days each, or can be thought of as 13 cycles of 56 days each, the ~really~ good news is that Part C should end for me in ~November~, when I will be graduated from this life-saving clinical trial into another (hopefully ~very~ long) W&W ("watch and wait") period...

Meanwhile, I'll be pedaling my "unicycle" just as fast as I can - <grin>.

In the meantime, my blood counts continue to be "pleasantly boring":

So, it does seem at least that I'm pedaling in the right direction...

:-)

Categories: General, Leukemia