2011 - A Good Year?

What a year! I've spent a fair amount time reflecting upon 2011, and have concluded that it was actually a good year.

I suffered a lot of physical and emotional pain starting in early April and it continues today; I've just learned how to cope with it and get on with life as best I can. I was in and out of the hospital on a bi-weekly basis it seems (once for 25 days) from April through August. On August 1 I went under anesthesia thinking I was getting the Whipple procedure to fix my bile and pancreatic duct problem, and woke up to the news that I have stage 4 pancreatic cancer. That was a brutal day for Elaine and I. I will never forget it. Since then, I've been receiving chemotherapy and am ready to take it as long as my body can stand it.

Anyway, my point is that 2011 was a good year. Why? Because on April 7 I became severely jaundiced and the medical search for answers led the docs to the cancer eventually (slower than I would have liked, but that is the nature of pancreatic cancer...it hides). Had I not developed the bile duct strictures that caused me to turn yellow, I could still be walking around with untreated, metastasized cancer, or dead. So it was a blessing that my body sounded the alarm when it did. Yes, the whole process (surgeries, tests, hospitalization, over-medication by hospital psychiatrists) was gut-wrenching, but I learned a lot about myself, my marriage, and my family and friends along the way. I've been able to re-connect with people from my past and discovered how lucky I am to have so many great friends who care about me. I'm closer to my family than ever before, and I've discovered the importance of living in the moment and letting go...two things I have struggled with my whole life. My experience this past year has helped me finally win that struggle.

I'm looking forward to a quiet New Year's Eve at home with my baby in front of the fire, and writing another one of these on December 31, 2012...Happy New Year!

Article of interest

Just a link to an article discussing the 40 years since Pres. Nixon and Congress tacitly declared war on cancer.

Feeling good after chemo treatment 9 of 12

Yesterday I had my 9th of 12 scheduled treatments, and it went fairly smoothly, although it was an especially long day because I had an appointment with my oncologist before the treatment began. Since he was 45 minutes behind schedule, I didn't get home until 5 pm. Aside from that, I handled the treatment well, and am still handling it. My appetite was good last night, having discovered that mashed potatoes (easy on the butter) are THE magical post-chemo food elixir I've been searching for (or for which I was searching for you preposition nazis out there). I slept untile almost 4:30 this morning and am still feeling stable. I'm fatigued from the chemo, but there's no way around that. Caffeine in large quantities only brings nausea. I'm looking forward to a restful, uneventful day. When I saw my oncologis yesterday, he marked several times how good I look and how happy he is to see me gaining weight. He said an oncologist is the only doctor who will applaud weight gain. I'm 202 lbs. after a decade at 180-185. I'd ordinarily be pissed at being "overweight" but I need all the buffer I can get, and with the cold sensitivity from the oxaliplatin, the extra insulation isn't a bad thing. All of this has bolstered my optimism about beating this damn cancer. Christmas was great, and peaceful. I hope everyone who reads this (and who celebrates) did as well. I will end this with a quote I really like: "It is not length of life, but depth of life." --Ralph Waldo Emerson

Inner Strength

"The good Lord gave you a body that can stand most anything. It's your mind you have to convince." --Vince Lombardi

This is a good one for me. That's all. Hope everyone is enjoying the holiday season. I am. So far so good anyway. I'm still fatigued a bit, but my appetite and energy levels are returning to normal, just in time for Christmas. This makes me happy. Next chemo is 12/27, so I can enjoy the next week, I hope...

Peace.

Chemo today

Today was the 8th of 12 treatments, and the second of Round 2. The nurse practitioner at VCU Stony Point has found the perfect combination of anti-emetics (puke and nausea fighting meds) so that today was by far the least challenging treatment I've had so far. Of course, it's only 5:30 pm and I have slow drip of 5-FU for the next 2 days, so the treatment isn't over by a long shot. I'm going the optimistic route and thinking I will sleep tonight (as well as one can sleep with a needle in one's chest) and there will be no puking. I'm eating drop biscuits and vanilla pudding as I type and feel decent given what went into me today. It's weird, but I'm starting to get used to this chemo thing. Hopefully this time the tumors will shrink and give me some hope going forward. I'm talking with my oncologist about the cyberknife when I see him in 2 weeks, before the next treatment. It's a different type of treatment involving radiation, but it's an effective non-surgical way to zero in and attack the tumors. The question is whether I'm a candidate for that (and whether insurance will cover it). We shall see soon enough. I'm tired so that's it for this über-interesting post (rolling my eyes).

Ups and downs

Last night and this morning were awful.  I've been feeling fantastic lately, but woke up at about midnight feeling completely dreadful, and that lasted through to about 11 am.  I'm starting to feel better now, but it was a rude wake up after what seemed like weeks of smooth sailing.  I haven't been sleeping too well lately, but waking up last night at midnight was the last straw.  I finally took a nap this morning and that helped, but I am very aware that I do not get enough sleep on a regular basis.  It's starting to impair my already impaired thinking, and it makes it more difficult to deal with my anxiety issues (for which I take meds on a daily basis).

I don't know why I'm writing any of this, other than perhaps to remind myself that as I move through this battle, I'm going to have good days and bad days.  I have to be ready for both.  The bad days have been fewer lately, and I very much want that to continue.  Anyway, I guess I'm just bitching and moaning because today hasn't been all too pleasant.  It's dreary and raining buckets here as well.  That doesn't exactly enhance the ambiance around here.

Here's hoping for a better tonight and tomorrow...

The Christmas Season & Spirit

This past weekend Elaine and I decorated the house for Christmas, including trimming the ole tree. We had a terrific time. I vowed weeks ago that I would jump into the Christmas spirit and season with both feet (I have been known to be bit Grinchy in the past). So far so good, and I am enjoying it. The Christmas music is already starting to wear thin though, so I'll need to keep that on the DL as much as possible. I'm too much of a musical snob to listen to the same flipping Christmas carols over and over for a month. At least I'm self-aware. I'm also trying very hard not to act like this is my last Christmas, because it isn't. It would be easy I think for me to feel sorry for myself act that way, but I genuinely don't feel that this is my last. I think I'm going to be fighting cancer for some time to come, but I also think I'm going to win. This is uncharacteristically optimistic for me, but as the over-used cliche goes: it is what it is. In any even, our Christmas is off and running, and I'm feeling pretty good about the whole thing.

Slight blog redesign with some RSS feeds...and Christmas begins

For those who actually notice crap like this, I redesigned my blog a bit and added some news sections.  I also think it's easier to subscribe by email now than before.  I'm starting to enjoy this...

Today we begin decorating for Christmas, and I've promised myself I'm jumping  in with both feet this year (and from now on).  It should be a beautiful day in the Old Dominion.  I'm looking forward to the quality time with Elaine.  That's all for now.

Still feeling good...

After the chemo rematch began, Monday, I didn't know what to expect this week.  Well, I'm pleased to report this has been by far the fastest recovery I've experienced from the chemo.   I've already worked out twice this week and am really working on what I eat to avoid to much corticosteroid weight gain.  Dosing that down has helped too.  I'm a solid 208 lbs as of this morning.  Ordinarily that would stress me out, but I need all the buffer weight I can get, especially muscle.  Working out has helped my energy and stress levels, which shouldn't surprise anyone of even modest intelligence.  Sometimes it's tough to overcome the fatigue and actually get moving/exercising.  Once I get moving though, it's full tilt boogie (a little Janis Joplin reference for you...you're welcome).

So my spirits are good, my body feels good, and I've been renewing and solidifying a lot of current and old friendships lately.  I really feel good and am still planning on whipping this beast and going to nursing school to be a chemotherapy nurse.  Never quit.  Ever.  And now, shiny keys:

Round 1 of the Chemo Rematch - Ends today

Well, treatment #1 of my second round of the FOLFIRINOX regimen will be in the books once my 5-FU ball is detached mid-afternoon.  I am excessively pleased with the minimal side effects this time and complete lack of vomiting.  I haven't even really been that queasy.  Feeling good is good enough for me...5 more after today starting 12/13 and every other Tuesday. I will be done in early February and then it will be time for another MRI.  But that's getting ahead of myself.

I've tried to stay focused on the present as much as possible, and enjoy every moment that I can.  I've been reading a lot and learning a lot about myself since I first got sick in April.  More importantly, I've learned how many people in life genuinely care about me.  That, more than anything else, has given me strength I didn't know I had. 

Neither time nor distance has diminished any of the friendships I've forged in my life, and for that I am truly thankful.  From childhood to adulthood, you've all been there for me in one way or another.  I love my family and friends more than anything, except Elaine.  To paraphrase Barry White, she's my first, my last, my everythang....

Totally sleep deprived but otherwise feeling GREAT!!!

Up since about midnight, but woke up hungry and energetic.  Very happy there was no vomiting involved; I didn't even come close!  This is 1st.  It's a rainy day in Goochland, so a perfect day for me to catch up on some sleep and recover.  I want to be working out again by Thursday.  I feel more determined than ever to win this fight.  It helps to have such a large cheering section. 

I'm still upbeat and looking forward to Christmas, and decorating for Christmas.  I'm jumping in Griswold style this year...sans saucer sled. ;-) 

Thanks again to all my family and friends who have continued to prop me up time and time again.  I can never thank any of you enough.

Peace to all.

Mike

Chemotherapy - Round 2 - And some photos

Ding, ding.  Round 2 of chemo starts this morning at 8:30 am.  6 treatments total, ending in February.   I'm still on the same regiment (FOLFIRINOX) but at the original dosage I began with Round 1 in August.  (My oncologist upped my dosage at treatment 4 during Round 1, and that was completely horrible, so we're not doing that again, thankfully.)

I'm nervous, but mostly because the side effects are so terrible.  At least I've been able to pack on the pounds and work out in the interval since my last treatment.  I'm almost at 200 lbs., which is about 12 lbs. heavier than when I started Round 1 in August.  So I've got some wiggle room to lose weight.  This is a good thing.  Like Dr. John says, I'm trying to accentuate the pos-i-tive.  It isn't always easy to be upbeat, but I'm doing my best.

Here's a photo of me and my pooh bear, Tina.  It makes me smile. 

And here's me and my mom on Thanksgiving Day at my in-law's house:

And here's Elaine and her PIC, Tina:

I have a lot to be thankful for...

Even though it may seem like I've got a pretty bad deal here, I'm extraordinarily thankful for the life lessons I have learned since getting sick in April.  I'm even more thankful for the people in my life who supported me throughout, and helped me see the lessons through all the fog.  It's not about how much money you have, how big your house is, how prestigious your job may be, where you went to school, what political party or religion you follow, your family name, the car you drive, or the clothes you wear.  Life is all about the human connections we make and what we do with them and our brief time on earth.  If you're not living in the present, you're not living.  That's what I think anyway.  Since it's my blog, I can say whatever the %$#@ I want about it. 

To be continued...

Insomnia and fighting off the dark thoughts

I've been having trouble sleeping through the night since learning my MRI results, and it's getting frustrating.  I am looking forward to Thanksgiving this week, and seeing friends and family, but at the same time it's next to impossible to forget that 6 more chemo treatments loom starting the Monday after Thanksgiving.  It's very difficult to "stay in the present" and not worry about what lies ahead.  I'm doing the best that I can.

I have a lot to be thankful for this week.  Maybe I should start a running list...first I think I'll try to get back to sleep.

This sucks.

MRI Results and More Chemo

Well, this past Monday I had my abdominal MRI to determine the effectiveness of my first round of chemotherapy.  My oncologist called Wednesday to tell me that although there has been no growth in any of the cancerous masses (pancreas and outer lining of my stomach), there has been no shrinkage either.  So after 6 weeks I am right back where I started, but no worse off (at least physically...mentally is a different story). 

Starting Monday, 11/28 (right after Thanksgiving) I return to chemotherapy for another 6 treatments over 3 months.  Same regimen, albeit dialed back to the original dosage so I can better tolerate the side effects.  The increased dosage was too  powerful and I'd never make it through 6 treatments at that level. 

To say I'm disappointed in the lack of progress is an understatement, but at the same time I am at least pleased that the cancer hasn't grown.  I am going to enjoy the week ahead, including Thanksgiving, and eat and workout as much as I can.  I want to get as much strength and muscle mass back as I can in a short period of time.  I've got to win this fight. 

Many thanks to all of my friends an family for the love and support.  I wouldn't have made it this far without it.  You all know who you are and  I love you.

Treatment #6 of 6 is almost history

Today at 12:40 pm I get my flourouracil ball detached and this will officially end this round of chemotherapy.  Hopefully it was my last treatment. 

I get a complete abdominal MRI on Monday afternoon 11/14, and see my oncologist on 11/22 to find out what comes next: more chemo or surgery.  As I've written repeatedly, surgery is my goal.  The waiting for the MRI results will be excruciating, but not nearly as bad as recovering from chemo.  This last round gave me a rough night Tuesday, and the first half of yesterday was absolutely dreadful.  By last night, however, I had a hearty appetite and slept through the night without incident.  I feel pretty good today, although extreme fatigue will be with me for days to come.

On Monday I had to start taking a pancreatic enzyme supplement because I wasn't digesting my food properly and therefore was not getting proper nutrition.  The supplement had an instant impact however, and everything seems a-ok at the moment.  Weird tidbit: the supplement is made from pig pancreas.  I hope I don't develop the urge to dig for truffles with my snout, or turn into "Pigman" (Seinfeld reference).  Anyway, I'm feeling good and looking forward to a visit from my mom, brother, and one of my nieces this weekend.

My best friend from high school, Terry O'Connor, came to visit this past weekend, and we had a blast.  I treasure his friendship, and that of his entire family.  Here's a photo from the weekend:

Long overdue post

I can't believe the last time I posted was October 5!  This month has flown by.  The day after my last post, on Oct. 6, I had to have an emergency ERCP to replace the stents in my common bile duct.  I woke up that morning with a series of symptoms that made clear to me that the duct was blocked.  I emailed my gastroenterologist, Dr. Sandhu at 6 a.m. explaining my circumstances, and he replied within 30 minutes.  I was in and out of VCU Medical Center that same day with a brand new, covered metal stent that should last from 6 months to 2 years.  I was home that evening by 5 p.m. and felt light years better.  The improvement in my appetite and energy level was immediate and stark.  Of course, the party lasted only a few days because the following Tuesday, Oct. 11, I had chemotherapy after an office visit with my oncologist.

On the 11th my oncologist, Dr. Shaw, told me that I was doing really well with the chemotherapy (and most people can't handle the regimen I'm on) and was going to "reward" by increasing the strength of my chemo drugs by 5% across the board that very day.  So my already harsh chemotherapy was about get more challenging.  I have to confess my instant reaction was "great, I'm doing really well."  Once the drugs started to drip though it was obvious to me that I was in for one hell of a ride.  The neuropathy in my fingers and toes was almost instantly worse within minutes of the first drug (oxypalatin) going in.  I couldn't even touch room temperature objects without sharp pain in my fingers.  Then the next drug (irinotecan), the one with the worst side effects, started and within minutes I felt nausea like never before.  By the time that bag finished dripping I was barfing like a champ.  They gave me lots of anti-nausea drugs by IV and that helped me recover and eat when I got home that evening.  The truly amazing thing was that I rebounded very quickly--more quickly than with any previous chemo treatment.  By Wednesday afternoon, the next day, I was up and about and eating semi-normally.  Elaine is convinced the stent replacement was crucial to my quick recovery.  By Saturday, two days after my 46-hour chemo ball of the last drug was detached, I drove the pick-up truck, with Elaine, to and from a furniture store and was moving furniture to and from my buddy's house up the road.

Over the next week and a half I managed to gain weight (I was up to 188 lbs. at chemo on 10/25) and exercise as much as my fatigued body would allow.  When I arrived at chemo Tuesday, the nurses remarked at how great I look.  That's always a nice feeling.  I didn't barf at chemo this time, although I came about as close to doing so as one can.  This time it hit me at 2 a.m. on Wednesday and it was awful.  I slept very little that night and despite Herculean efforts, could not sleep during the day yesterday.  Last night, however, I slept like it was my job and feel good this morning.  (I'm back on caffeine again by the way, but only one cup of coffee or tea in the morning).  I get my chemo ball detached today at about 1 p.m. and then I am less than  two weeks away from my (hopefully) final chemo treatment on Nov. 8.  The following Monday, Nov. 14, is a big day.  I am having a full abdominal MRI to see what progress, if any, we've made in killing off the bastard cancer cells, and whether I am a candidate for surgery (the Whipple procedure) that will eliminate the need for bile duct stents for the rest of my life.  The surgery is my goal, which is strange in a way because it could kill me and will take up to 2 months to recover.  However, it could also extend my life significantly beyond the 11 months this chemotherapy is supposed to buy me.  The result of the MRI could also be that I need more and/or different chemo. We shall see but I'm hoping for a truly Happy Thanksgiving.

I want everyone to know that I genuinely appreciate every word of support that all of my friends have provided.  I can never thank my wife enough.  She is an amazingly strong woman, and a phenomenal caregiver.  I love you, Elaine, and always will.

This is more like it

Despite a splitting headache (I quit caffeine for good yesterday) I feel great today, and am full of energy.  This is the polar opposite of how I felt yesterday.  I was up early and walked the dog despite the cold (the sensitivity lessens each day removed from chemo) and feel terrific (again, headache notwithstanding).  Staying away from caffeine has absolutely helped with the nausea, as has the change to Zofran.  Elaine was so happy to have my help this morning, and to see me feeling like my "old self" even if only for one day.

I intend to suck the marrow out of today and then watch Roy Oswalt send us to the NLCS for the fourth year in a row.  Go Phils!!!!!!

PS - I'm down another pound to 179, but it could be because I've been exercising more.  Gotta watch the calorie count more closely.

Bad Day

I'm having a rough time today, and it's mostly frustration with the ever-present queasiness from chemo.  It never quite seems to go away, and the slightest misstep -- the wrong food, the wrong beverage, too much of one or the other -- and it immediately returns as full-blown nausea.  I'm over it.  Today I am going back on Zofran (a previously prescribed anti-nausea med) and stopping with the Phenergan, which lately has not been all that effective.  The Zofran seems to be helping a bit this morning, but I still have this undercurrent of queasiness and fatigue which I can't seem to shake.  I'm working hard to keep my frustration from boiling over into anger, because that upsets my stomach all the more, but it consumes all of my focus and energy (of which I have little at the present moment).  I've lost 5 pounds since last Tuesday (down to 180) despite eating all I can.  This is discouraging in the extreme.

I know that we all have good days and bad days, but lately I feel like I've been getting a glut of bad ones.  One or two days of "feeling good" out of each two-week chemo cycle isn't cutting it.  I will address this with my oncologist on Tuesday when I am scheduled to see him next.  I wish I could know for certain that all of this is worth it and that the cancer cells are dying in droves, but I don't.  All I know is how I feel and most of the time it isn't good.  The thought of two more months of this overwhelms me at times, like now.  There are others far worse off than me, but this knowledge doesn't seem to help me.  I just want to feel better and more energetic, but nothing I try seems to work. 

I guess there's always tomorrow...right now I just have to deal with it as best I can. I'm trying.

What a difference a day makes...Chemo Treatment #3

Chemo treatment #3 was Tuesday 9/27, and I go back today to get the "ball" taken out.  Tuesday night was positively dreadful, with lots of vomiting and sleeplessness, not to mention a bastard of a headache.  That was by far the worst experience so far.  Perhaps it was enhanced by the flu shot they gave me. Whatever the reason, it was awful and made for a long day yesterday for Elaine (again).  Thankfully I slept well last night with no issues (other than the general discomfort of sleeping with a ball of chemo attached with a needle to my porto-cath).  I woke up this morning feeling fairly decent, had some tea and ate some breakfast before 8 am.  I feel like a completely different person so far this morning, in a good way.

The nerve damage/cold sensitivity gets a little worse each treatment.  Metal doorknobs, ceramic cups, glasses, etc. at room temperature (air conditioned) cause pins and needles instantly in my finger tips.  Tile and wood floors do the same to my feet.  This is still only an inconvenience though; it could be much, much worse.  I still have my hair and haven't developed any mouth sores yet, so in that regard I am lucky.

Had a great visit from my mom last week/weekend.  We didn't do all that much but it was wonderful just to spend time together.  The extra hands for Elaine didn't hurt either.  I'm looking forward to a repeat visit asap, as well as a visit from my big brother in the not too distant future. 

And now, for a little humor:

These photos were taken at the beginning of chemo on Tuesday.  The shirt and button cracked up the nursing staff.  They paraded other patients into my room to ogle my twisted sense of humor (Elaine designed the shirt and button, and the whole concept was thought up by my best bud Derek). 

More weight gain!

I was very happy to weigh myself yesterday and discover that I now weigh 186!!!  This means I've GAINED approximately 8 lbs. since starting chemo last month.  My appetite is good and I work out whenever my body will let me. 

I'm really happy to have my mom here for the weekend.  We've been watching movies and playing Scrabble and generally having a great time despite the nasty, rainy whether. 

This coming Tuesday is chemo treatment #3, which means next week will be awful (nausea, etc.).  I'm already beginning to dread it.  I actually dread the side effects more than the treatment itself. 

Feeling better...random tidbits

Today has been fantastic.  I feel good and I don't go back to chemo until Tuesday.  So hopefully I will have a whole week to eat, exercise, and recharge for the next round.  Optimism is starting to build, and this can only help. 

I can't wait to see my Mom tomorrow through the weekend.  We'll play a ton of Scrabble, watch movies, and work in the yard together (weather permitting). 

I've held steady at 182 lbs. since last Wednesday, despite not having much appetite.  My appetite is back so hopefully I can tack on a few before next Tuesday (chemo round 3).  Speaking of which, it's dinner time here.  Sicilian pizza here I come.

This isn't going to be easy

It seems that it's taking me longer to recover from chemo round 2.  The fatigue is finally starting to wane today, but the nausea is always lurking beneath the surface and I have to force myself to eat at times (like this morning's breakfast).  My weight is back down to 182 but I'm hoping to add to that this week as I get closer to round 3 next Tuesday.  I fear that it will get progressively more difficult to bounce back after each treatment.

Mentally I feel fairly strong but at times I am overcome with overwhelming sadness over the whole situation.  Thankfully Elaine helps me talk it out when these feelings come over me.  This makes it far easier to cope. 

This weekend I did manage to help Elaine go to the dump and flip our memory foam mattress (FYI a king size memory foam mattress is a heavy, bulky bastard with no handles).  I did some modest household chores too, so I guess I wasn't completely useless.  I feel that way sometimes--useless.  Again Elaine is always there to pick me up when I'm feeling down.

Cold weather this morning

It was 45 degrees this morning here in the woods when I walked Clyde.  This is noteworthy for several reasons.  First, it means we're getting closer to Fall, my favorite season.  Second, it means one of the side effects of my chemo is brought into full bloom.  One of the drugs in my regimen is called oxypalatin.  One of its most bizarre side effects is extreme sensitivity to cold.  I have to drink room temperature or hot liquids.  I can't go in the fridge or freezer, etc.  This lasts about four days.  What happens is a sharp tingling sensation like pins and needles throughout your fingers and, as was the case outdoors this morning, my feet.  It's more an annoyance than anything else at the moment.  Thankfully it didn't affect my nose, mouth or ears.

Right now my biggest issue is fatigue.  I simply have no energy whatsoever in the first few days after chemo (which itself lasts 3 days because I get the slow-dripping 46-hour ball of flourouricil (5FU) after the other drugs).  I should start to get more energy as the weekend progresses, and hopefully will be feeling good again next week when my mom comes to visit.

Right now all that I can do is focus on sleep, fluids, and nutrition.  I'm hoping I will have the energy this afternoon to do some housework and take a little off Elaine's shoulders.

I realize that a lot of my posts are not particularly interesting but it's good for me to keep a running diary of this kind of stuff. 

Chemo Round 2 - Post script

As my last post said, I had chemo on Tuesday.  Today I get the ball full of the last drug in my cocktail (5FU) detached from my port.  I'm looking forward to getting the needle out of my chest (again), although this time around the needle/port didn't cause me any discomfort.  I think it bothered me more during and after Round 1 because the port was less than a week removed from being surgically implanted in my chest (near my left collar bone).

Yesterday morning was dreadful.  I woke up at 3 am vomiting and with a splitting headache.  After some meds and Elaine's calming influence I was able to get back to sleep but I felt completely awful until close to noon yesterday.  Since then, however, I've been on an upswing and woke up this morning feeling much, much better. 

I find that the deeper I get into the chemotherapy the better my attitude has become.  I guess this comes from the feeling that something is being done to kill all the damn cancer cells in my pancreas and scattered about my peritoneum (lining of the abdomen).  My oncologist has already helped someone my wife knows kick pancreatic cancer (albeit not metastatic like mine) and this was a real boost to my confidence.

So the bottom line is that I think I'm coping fairly well.  I'm looking forward to seeing my mom next week.  I also hope to have my brother visit sometime this fall to work on some home projects together and have some quality time. 

Treatment No. 2 Tomorrow

Tomorrow I go back for my second chemo treatment, and I'm beginning to feel anxious about it.  I've heard the side effects get worse as you progress; I'm hoping that won't happen with me.  I'm also nervous about the blood test and my "counts" that dictate whether they can treat me at all tomorrow.  I desperately want to avoid missing a single treatment, but that may be a pipe dream.  Only time will tell.  I've been loading up on nutritional foods and supplements with an eye toward keeping those little platelets and other cells in abundance (except the cancer cells).

It was a nice weekend and I was able to do some yardwork on Saturday.  I did the trimming while Elaine rode the mower.  It was quality time.  Today I feel good but am very aware that that will change tomorrow and in the few days that follow.

BEEFCAKE!!!!!!!!!!!!!!!!!!!

I was absolutely thrilled to hop on the scale this morning and discover that I have gained another 3 lbs.  That's 4 this week and has put me back over 180 for the first time in months.  The more I gain, the more I can afford to lose when the chemo won't let me eat, not to mention the nutrition factor.  I'm feeling upbeat and ready for a beautiful Saturday of yard work and PSU vs. Alabama @3:30, then Cliff Lee takes the mound tonight for the Phils.  I have a feeling this is going to be a great day.

P.S. - The beefcake reference is from South Park, so if you don't get it don't ask :-)

Weight Gain! A Short Post

Good news! I actually have managed to gain a pound in the past week!  My appetite and ability to cope with the side effects is very encouraging.  I still get nausea and all-over body pain, and tire very easily, but my meds help (except for the fatigue).  I'm trying hard to be optimistic, while giving myself the space to be blue when the mood hits.  Overall I'd say I'm handling this fairly well, and am trying very hard to complain as little as possible.  Speaking of complaining, one thing: I hate that I can't drive while I'm on my meds.  I'm basically legally under the influence in terms of sleepiness, etc. which seems to be a side effect of everything I take.  On the plus side, our gasoline budget has been cut in half, as well as the wear and tear on the vehicles.

Anyway, I think I'm doing very well as I near the end of the first two week cycle.  Chemo this coming Tuesday...maybe it'll be harder this time, but then again, maybe it won't!

Hanging in there

I was so happy to get the chemo ball and catheter out yesterday so I could get some sleep, and sleep I did.  I took a two-hour nap from 5 - 7 then slept from 9 -7.  I'm still fatigued as hell but that's 12 hours of much needed sleep.  I am eating, which is a good thing.

One thing I really didn't like was a side effect I experienced yesterday when I got home from the VCU.  All of a sudden every single muscle and bone in my body began to ache like I'd just been in a train wreck.  I couldn't get comfortable and frankly would've gone insane (seriously, it hurt that bad) if it wasn't for the pain meds.  Dilaudid is a wonderful substance.  Once that kicked in I was out cold for two hours, then went to bed.  Thankfully that aching hasn't returned today (yet) but I'm ready for it now. 

I got a little exercise this morning but am now completely spent.  I'm hoping that will improve gradually each day I am farther removed from the chemo so I don't lose my Adonis-like physique (HA) and whither away to looking like Mr. Burns in The Simpson's.

Okay, I'm going to get my game face on for the PSU opener today at noon (Indiana State...snore).  I hope everyone has a safe, and fun Labor Day weekend.

The opposite of yesterday

I woke up this morning at 3:15 with nausea like I've never experienced.  I took my meds and passed out in the living room recliner where I continue to sit.  I feel extreme fatigue.  Even my individual toes are exhausted.  Oh well.

I go back to VCU to get my 5FU (shorthand for the drug that's in it) ball removed, so I won't be tethered to that for a couple of weeks.  Did I mention how difficult it is to sleep with a needle in your chest/collarbone area? If not, my bad...it's very difficult.  When this sucker comes out at 1 today, I'm going straight home to sleep.

Hopefully I will feel better gradually as the first round of drugs wears off.  Word is it gets worse each round, but I'm hoping (me, hoping?) to be the exception to the rule. This is a very new regimen for pancreatic cancer, and seems clear that everyone reacts differently.

Short post today.  Heat, serve, and enjoy.

The Day After Chemo Day 1

The past couple of days have been quite challenging.  As many of you know from Facebook and previous posts, I was supposed to start on Tuesday.  Well that didn't happen.  After making me wait 2+ hours and telling me my treatment was about to start, they told me they made an administrative error and told me they couldn't treat me that day.  Try to imagine the emotional kick in the gut that was for me.  So they rescheduled me for yesterday (8/31).

The chemo session yesterday went from 9:00 until about 3:30, but mostly was hassle-free.  Better yet, it was completely barf-free.  I had enough nausea for about 20 people, but no cookies were tossed.  Last night I was able to eat saltines and plain, dry whole wheat Eggo waffles with relative ease.  Then I slept for about 9 hours.

Imagine my surprise when I woke up this morning feeling better than I have in more than a week.  Go figure.  Now, there's still time for the many potential side effects to rear their hydra-like selves, but I am optimistic for some reason that it won't get much worse.  Now get this: my optimism worries me.  What can I say?  I'm psychotic.

I have a slow dripping ball of chemo attached to my porto-cath that I have to wear until tomorrow at 1.  Then I go back for round 2 on Tuesday, 9/13, and then every other Tuesday thereafter for 3 months.  I think I can handle it.  If you are interested, here's a summary from the New England Journal of Medicine that discusses my chemo treatment, known as Folfirinox: NEJM - FOLFIRINOX

The nurses at the VCU Massey Cancer Center-Stony Point are about the nicest people I've ever met, and they do their jobs spectacularly.  I am thankful for their outstanding care.

I've also been getting supportive e-mails and FB messages from friends, and from former colleagues through Linked In.  It's easy to forget how many friends you make during your life; I have been reminded and am, again, thankful.

Okay, that's enough mush.  I feel good for now and that's really all I can ask for.  As Janis sang so soulfully: "Feeling good was good enough for me, mm mmm, good enough for me and my chemotherapy" -- or something like that ;-)  Kris Kristoferson wrote that song by the way, if you didn't know that.

Babbling now...until next time.  Comment away.

Chemotherapy and Attitude

Tomorrow I begin my chemotherapy.  Since it's my first day, it will be my longest; it could take 7 or more hours.  "Normal" days may be closer to 5 hours.  I will go every other week for the next 3 months.  My attitude is this: I'm scared and dread the potential side effects.

One thing everyone, including people with and without experience with cancer/chemo, says is "think positive,"attitude is everything," and "you can will yourself to be well."  I have no quarrel with these statements/sentiments.  They very well may be accurate.  I don't know.  No one really knows.  Individual experiences (success stories) do not justify generalizations or absolute truths.  I should probably mention here that I keep my religious views to myself, so I'm not going there.

Here's my problem: I'm am pessimistic about this whole cancer thing that I'm going through.  Each step of the process -- since April -- has been a colossal failure, medically-speaking.  I have no reason to believe I will magically begin to improve.  It could happen; experience doesn't predict the future. I personally wouldn't bet on it though.

This is when folks say, "think positive," etc.  Great.  I appreciate the support.  But here's the thing: I can't turn off my pessimism like a light switch.  I feel what I feel and am not able to will myself to be optimistic about my chances of "success."  I wish I could flip that switch.  Maybe it will happen on its own, but it's beyond my control.  It would be nice if it would happen before chemo starts tomorrow.

These are just my random thoughts and feelings.  If I've offended anyone, I am sorry.  This blog is about me, however, so if you don't like what I say, feel free to go away.

When call screening bites you in the butt...

My cell phone rang last night around 6 pm with a number and area code I didn't recognize.  As is my usual practice, I let voicemail handle it.  Well, I listened to the message and it was JOE WALSH.  The Joe Walsh.  Yeah.  He called to say "hi" and make me feel better.  My mom knows him and told him about my situation, so he offered to call me to talk.  He also said in his message that he'd call me later this weekend so we get to talk in person, and that he was going to be sending me "some stuff" to make me feel better.

I have to give a big shout out to my mom for contacting Joe, but the rest of it was his idea.  I think that shows what kind of guy he is.  Now if I can just get him to come to Goochland to teach me how to play the solo from Rocky Mountain Way...

Link to American Cancer Society Pancreatic Cancer Overview

http://www.cancer.org/Cancer/PancreaticCancer/OverviewGuide/index

So here's the story...

This all started on April 7 when I became severely jaundiced.  I had a blockage of my common bile duct with sludgy stuff from my gall bladder.  I had an ERCP to clear the blockage and my doctor placed a stent to clear the stricture/blockage.  My body didn't like that and rejected the stent.  So the doc put in another one.  That lasted even less time.  

Then my gall bladder came out, and fresh stents were put in the bile duct.  Two days after coming home from that, I was vomiting and sick as a dog (despite taking Zofran for nausea).  So my surgeon ordered another CT Scan (I've had 3, not to mention an MRCP and EUS) and discovered that my pancreatic duct was dilated (this is bad).  So they readmitted me to the hospital.  By now it was the end of May and they'd ruled out cancer and primary sclerosing cholangitis (a deadly disease of the biliary system) through testing.  The treatment for me was prednisone (this is the standard treatment apparently) but my body did not respond to it.  After checking my pancreas carefully for cancer (MRCP and biopsy), I was scheduled to have a Whipple procedure, a complex surgery to re-route the digestive tract, and remove a large piece of the pancreas and the ducts.  This took place on Monday August 1st.  As soon as the surgeon got me open, however, he saw that my abdominal cavity was full of "nodules" (his term) which he immediately tested.  They immediately came back as malignant and he stopped the Whipple procedure.  

Now I've mostly recovered from the abortive Whipple and am getting ready to start chemotherapy.  On Wed. 8/24 I had a catheter surgically implanted in my shoulder/neck area, and on 8/30 I get my first dose of chemo.  My cancer is inoperable. 

It has been a wild 4 months, and I've been extremely lucky to have the support of my wife, Elaine, and my family and friends. I'd be lying if I said the chemo didn't scare the hell out of me.