Tuesday, December 7, 2010

Full Remission

No hiding the ball on this one.  The post title sums up the post contents.  We met with the oncologist today who said "best possible result."  The Scott and C household is cancer free.  Instead of writing a lengthy blog post on what this means, describing the burden that has been lifted, we went for a ski.  I'll follow up in the coming days.  Maybe tomorrow?  Go forth and sleep easy.  

Monday, November 29, 2010

The blogger's sacred oath

The last couple of posts have been kind of skimpy when it comes to photos, which means I have been failing to uphold the blogger's sacred oath to burden the world's bandwidth to the maximum of my ability.  So this is just a quick follow-up to upload a few pictures.  These were all taken on C's phone, so feel free to blame the hardware if the exposure is off.

We'll start with a picture from my last day at chemo.  To celebrate, I decided to brighten the room by pulling out the one Hawaiian shirt I own.  I actually got the shirt from my uncle after he passed away as a result of lung cancer.  This was the first time I have worn it.  Typically, Hawaiian shirts should be reserved for tropical themed parties in the middle of the winter.  And maybe, just maybe, they can also be worn while in Hawaii.  But I think chemotherapy gives you license to occasionally act outside the bounds of otherwise normal civilized behavior.

Goofy half-smile and crazy-eyes are almost certainly the result of the massive doses of Benadryl that accompanied each infusion.

The rest of the pictures are from the ski C and I went on last Friday, discussed in the prior post.

C was all smiles, glad to be skiing on a gorgeous snowy day, energy building in her legs waiting to be unleashed at the first sign of an incline.

I, on the other hand, spent my time desperately trying to fill my lungs with precious, precious oxygen.  This particular picture was taken at the top of short, but steep, climb.  I labored into position at the crest.  C was waiting, wearing the same smile pictured above, camera-phone at the ready, trying to get me to move into a better spot so she could snap a picture with the sun and mountains visible in the background.  I think I stared at her with an expression much like that she ultimately caught here.  "I can hardly hear you speak through the heaving of my chest.  There will be no more moving today!" I declared.  But, eventually I regained my breath and my perspective, and C got her way and coached out a smile:

All in all, a fine day to be on the trail in the low angled sun of an Alaska winter.

Sunday, November 28, 2010

Rapid heart beat.

I suppose I've had a post-treatment aversion to updating the blog.  Perhaps aversion is the wrong word.  Its really more of an out of sight, out of mind phenomenon.  Hey, treatment is over!  Nothing to see here, people.  Just keep moving.

I also feel like I'm holding a basket of eggs and wondering how many chickens I've got.  In prior posts, I've commented on the fact that tumors previously obvious to the touch have long since disappeared, and that the doctor overseeing this whole health fiasco has every confidence that the R-CHOP regiment behaved predictably and did its job in an honorable and workman like manner.  Nevertheless, as also previously noted, I have a PET scan scheduled in about five days.  That will give us the internal picture and really be the driver to declaring a full-, partial-, or non-remission.  After meeting with the doctor on the 7th, we'll all know a bit more.

In the meantime, I am now officially in the longest chemo-free stretch of days that my body has enjoyed since July.  In general, I feel good, but I have a lot of strength and aerobic capacity to rebuild.  I really have no idea how long that might take.  I've been diligently going to the chemo-rehab classes... and pushing past the prescribed heart rate zone.  The nurses crease their brows, toss me questions about how I feel and how I've been responding to the exercise, and then give me a pass so long as I don't get hit with sudden fatigue or find myself catching colds (both signs that I've pushed my body too hard and it has given up the ghost).  Even so, I find myself on the tread mill shuffling along at 13+ minute/miles.  [If I stayed in the prescribed heart-rate zone, I'd be going at a fast walk instead of a slow run.]  Outside of the gym, I tend to run at between an 11 and 12 minute/mile pace.  My goal for last summer was to run a fast (for me) half-marathon, something in the 7 to 7.5 minute/mile range.  Clearly, that goal has been pushed back until next summer or later.  I'll just have to see how the winter goes and how my body responds.

To anyone curious about the Anchorage weather, you will be glad to know that Thanksgiving brought fresh snow, badly needed following a week of warmer weather and freezing rain.  The ski trails are skiable once again.  I went out on Friday, and again today.  If you have never had the pleasure of skate-skiing, it is a ton of fun and a ton of pain.  It is an activity that takes both technique and fitness, the more of both the better.  My technique is only passable and, as I have already complained about for a full paragraph, my fitness is not what it used to be.  That makes for some short skis, replete with frequent stops, my body hunched over poles for support and chest heaving (heart rate be damned!).  But both days brought low-angled sun, trees draped with snow, and good conditions.  It is beautiful to be out, and given the choice between the chemo-chair and an out-of-shape ski, I will take the later.

As an update to my international call of arms, I am disappointed to report that it now appears that the Google/Blogspot statistical tools only reports the top 10 countries from which my page has had hits.  I see we have added Malaysia and Georgia, and I would of course like to welcome them to the fold.  Are there others outside of the top 10?  Who knows?  Switzerland dropped off the list, so I know there is at least one country no longer represented on the statistics tools.  Its one page view could not sustain it with such fierce competition from eastern Europe and Asia.  Interestingly, the biggest gains in viewership have been in Russia, now fourth behind the U.S., Canada, and France.  How many of these people got here by accident?  How many were seeking information about cancer?  How many page views are simply the result of programs scanning pages for e-mail addresses in order to generate spam?  I may never know.

Enjoy the transition to December.

Saturday, November 6, 2010


This is just a quick update post, to fill in the details moving forward for those who are interested.  As noted in the last post, I had my last chemo treatment last Wednesday.  Tomorrow (Sunday) will be the last day I take the steroids, so starting Monday I wipe my hands of the drugs all together.  We have scheduled a PET scan about four weeks out.  As I may or may not have ever mentioned (I'm too lazy to read back through to find out either way), I've been getting a shot to boost white blood cell production after each treatment.  The activity resulting from the shot can register as "hot" on a PET scan, so we need to wait until it has worked its way out of my system before doing the scan.

By way of background, and based solely on my limited understanding, a PET scan is one of the more precise tools for diagnosing and staging cancers.  I will be injected with a sugar tagged with some radio-nuclide.  Cancer cells metabolize the sugars at a much higher rate than healthy cells, meaning they take up the radio-nuclide in greater numbers.  I then lay beneath a camera, my cells emit radiation, and the film records the hot spots.  I had a PET scan following the original biopsy, and as is apparently typical for NHL patients, I lit up like a Christmas tree.  The expectation is that that is no longer the case.  We'll meet with my oncologist following the scan to discuss the results.

Assuming everything is a-ok, I'll continue on a routine of maintenance drugs, in which I'll get a dose of Rituximab twice a year for two years.  Sprinkled throughout will be regular checkups with the oncologist, once every three months to start.  We'll do additional scans on a 6 - 12 month basis, and over time the appointments and scans should get fewer and further in between.

In other news, I've signed up for a rehabilitation program that the local cancer center offers.  It basically amounts to personal training.  I had my first session last Friday.  They start off pretty conservatively, and try to keep your heart rate at about 50% of maximum.  So instead of diving right in to speed work, I spent 20 minutes on a tread mill walking at about a 17 minute per mile pace.  I've lost something between 10 and 15 pounds over the course of chemo, a fair bit of which is probably muscle mass.  The program also includes some weight training, which should be beneficial.  My intent is to quickly but safely rebuild.  I have lots of ideas for fitness goals for next year (so called recovery races), but will hold those in abeyance pending a better understanding of where I stand now and what goals are realistic.

Throughout treatment, I have at least managed to get a few runs in towards the end of each cycle (some more than others).  The fifth cycle was the hardest hitting, but C and I were still able to run hilly terrain at Kincaid for 3.5 miles last weekend.  I can't help but think that having maintained some level of activity provided a base which it is now time to strengthen.

So, kind of a dry post, but I thought some of you might be curious as to what the end of treatment means. Enjoy the weekend.

Thursday, November 4, 2010


This was supposed to be an update pre-my last scheduled treatment, but work got in the way.  So instead, it has turned into a post-treatment update.  For those counting, I went in yesterday for treatment number six.  That is six of six, so until someone tells me otherwise, I'm done.  I've had a number of questions along the line of: "So, you're almost there.  Are you excited?"  The truthful answer is, "no, not exactly excited."  Grateful, that I won't be sitting in the leather chair three weeks from now.  Tired of chemo, for sure.  Anxious, perhaps, to see the results of the next schedule PET scan and get the picture proof of remission.  Cognizant that we are talking "remission" and not "cure."  But not really excited.  Not in the way you are excited about an upcoming trip or an upcoming loaf after smelling the bread baking.  Just relieved and ready to rebuild.

Part of the power of administering your own webpage is access to the statistics tools.  The tools largely reveal the expected.  Most of you are in the U.S., and most got here from various mail sites (i.e., someone probably e-mailed you a link to the page).  As of today, there have been 2,116 page views.  I suspect half of those are me, maybe a quarter of them my Mom (unless she got scarred away by the topless pictures some time ago), and the rest are spread amongst those of you who came here deliberately and those who stumbled here by accident.  And there are a few people who stumbled here on accident.  One person Googled "chemo shave" and took the time to read (or at least follow the link).  Whoever you are, I hope you learned something!  A couple (or one person multiple times) got here from a Google search of images on the .ru version of the search site, looking for images of "Alps fog."  I suspect they did not find exactly what they were looking for, but hope they were entertained nevertheless.  Other Google searches were all either looking for this blog specifically or looking for information about the northernmost cobras in the U.S.  The later is a possibility, I guess.  I used to think that there were no snakes in Alaska at all.  Recently, I've read a number of different places that Maine is the only U.S. state without any poisonous snakes.  That suggests that not only is there a snake somewhere in Alaska, but that it is poisonous.  I suspect it is somewhere in SE Alaska, but highly doubt it is a cobra.

So far, I've had visits from the following countries:  United States (2,038), Canada (36 - Hi A and fam!), France (22 - Hi T and A!), Netherlands (4), Belgium (3), China (3), Germany (3), Russia (3), Poland (2), and Switzerland (1).  Of course, this is all just a drawn out request to any of you traveling: Take a laptop or find an internet cafe and dramatically expand the international scope of this blog!  I want to see hits from Burma!  Colombia!  Zamiba!  A Pacific island of your choice (other than Hawaii, which won't register separate from the U.S.)!  We've made good in-roads in Europe, but surely can do better!  Consider it a call to arms!

Of course, statistics can be applied in fields far flung from merely recording website traffic.  Try getting cancer and attempting to learn something about your disease.  It is a little humbling to think you have something that compels people who write on it to develop five-year mortality rates.  Luckily: (1) those numbers are good for NHL patients; and (2) for a disease with an average age at diagnosis of 60, I think a lot of the folks on the bad side of the 5-year bell curve probably had other issues going on as well.  Statistics don't tell you but so much.  Nevertheless, they draw you in, and I've been poking around at average remission rates.  It just creates more questions than answers, though.  Primarily, were the statistics developed using patients undergoing the new post-chemo maintenance regimes?  I guess it doesn't really matter.  I'll just aim for outlier status in any case... on the right side of the curve.  Permanent remission, anyone?

Monday, October 25, 2010

"America's Heartthrob"

Fifth cycle is cycling, and it is time to refocus this blog on what is really important, namely providing pictures from walks I have taken.  Last weekend rolled into town sunny and warm(ish).  C poked and prodded and eventually got me off of the couch (or what passes for a couch in our household... see pictures later in this post).  We drove to Kincaid Park, a park within the city limits with a pretty extensive trail network used for skiing in the winter and walking, running, or biking in the summer.  We spent about an hour and a half wandering around on some of the trails I had never been on that traverse the park's southern border, with views of distant mountains and salt water.

We eventually stumbled upon a bench.  I like to think that every bench I find on a walk or hike was brought  to that location by some eagle scout vying for a merit badge.  Whatever its source, the bench made for some fine napping in the later afternoon sun.

And speaking of napping, it turns out that the fifth cycle has hit me a little harder than the prior four in terms of fatigue.  I spent a good part of the weekend feeling tired and asleep on the couch.  Napping on the couch may not sound like a topic worthy of a blog post, but I like to think the fact that I'm 6'0" and the couch (really, a love seat) sits somewhere around 4'0" makes the napping at least comical, if not truly newsworthy.

Note the expert use of a chair as a couch extender.  This kind of thinking outside the box has really made me realize that the world is my napping oyster.

I've previously described the chemo-infusion room as a room with recliners.  In addition to the chairs, the room comes complete with two tables pushed up against the windows on which people have started doing jigsaw puzzles.  [Are they still called jigsaw puzzles?  I wonder when the last time a puzzle was actually cut by a jigsaw?]  Towards the end of the day during my last infusion, tired of staring into the chemical void, C and I pulled our seats over and puttered around putting pieces into place.  The puzzle presented a stirring scene of horseback riders, mountain streams, and aspens.  Puzzles had been there since we first came in for treatment one, and presumably patients and friends and families had been working away on this (or some other) puzzle since time immemorial.  Nevertheless, one nurse and my oncologist both stopped by at separate times and said, "Huh, a puzzle," as if they had never seen them there.  They both continued, "I haven't done a puzzle since I was a kid."  C and I made the same comment to each other when we first sat down.  While the puzzles themselves were at those tables since time immemorial, I think it was the sight of two people under 65 working them that drew the staffs' attention to them for what was perhaps the first time ever.

Taken by our puzzle experience, and with some time at home recovering on the horizon, we quickly filled our household with puzzles of our own.  Here I am working on a classic from the C family collection, circa 1980.

You'll see that working the puzzle has become all encompassing, and even meals take a backseat to that pig's luscious hair.  I think at this point completing it is really just for the sake of reclaiming our dinning room table.

Saturday, October 16, 2010

Shark Physics

Well, here we are.  It looks as though it has been a while since the last update.  I went in last Wednesday for my fifth treatment.  To those of you who might be counting (e.g. me), that means one more treatment pending.  I spent the last two working days at home, kind of tired, keeping nausea at bay by drinking ginger ale, and giving our Netflix account a workout.  It is days like these that you sometimes stumble upon real cultural gifts, advancements in the arts that frankly make everything that came before seem trite and uninspired.  One such gift is the film "Mega-Shark Versus Giant Octopus," available for online streaming.  I won't try to sum up the plot line here in a few words (although the title does a pretty good job itself).  Suffice to say, it is worth finding not only for its entertainment value, but also for its contribution to science.  I learned more about the geography and biology of the Chukchi Sea in the film's opening scene than I ever learned at the University of Alaska Fairbanks.  There are apparently whole mountain ranges out there that were never discussed in any of my global tectonics classes.  For anyone wanting to delve deeper into the physics of mega-shark, I can recommend the following post:


When we came home from treatment last Wednesday, it turns out a little bird had turned our front door into a forest nest:

It may or may not be visible in the photo posted online, but the forest is replete with inspirational phrases marking the "one to go" milepost.  Thanks little bird (and little bird's helper)!

So dealing with a cancer diagnosis has certainly made me more sensitive to cancer news and announcements.  I've had family members who fought cancer, with both success and sadness.  We have a friend in Anchorage who has been fighting hard for as long as we have known her.  We have lots of friends with close family that have had to deal with cancer at one time or another, again with both success and sadness.  Somehow it never added up to a complete picture in the past.  The number of people who, upon learning that I have NHL, respond with: "My brother just went through that" is startling.  The number of people sitting in the big leather chairs with me on a tri-weekly basis is startling.  The number of newspaper articles in our local paper about celebrities with cancer is startling.  [The number of articles dedicated to celebrities instead of news is also startling, but that is a different rant altogether.]  Now we have learned that another friend in Germany has been diagnosed with colon cancer and is undergoing chemo.  I don't have a grand thesis with which to wrap up this paragraph, or rallying cry to bring us all together in the fight against cancer.  Just an awareness that my experience is far from unique and a sadness that so many people have to go through the uncertainty of a diagnosis and the rigors of treatment.  C and I send our thoughts to Wolfgang and Margret in Germany.

Monday, September 27, 2010

Soup's On

The cyclical nature of chemo has taken me from the highs of a week ago, feeling good and lively, to the lows of the present, feeling tired and weak.  It is part of the dance, a complicated choreography involving me, some cancer cells, and some drugs.  I got in between one and two hours at work this morning, before retiring home for sessions of sleep interrupted by sessions of sitting.  True to form, C will likely rally me for a short walk tonight, after which I'll go early to bed.  Simple living with a foggy head.

It is the unfair burden of the caregiver that more of the household chores fall on C's shoulders during the lows (and probably during the highs, and the pre-cancer years too, but I'll pretend otherwise!).  Luckily, we stumbled upon a time saving recipe in the original Joy of Cooking for soup.  Recognizing that many are pressed for time, I thought I would share it here:

Cream of Asparagus Soup
1 can condensed cream of asparagus soup
1 can condensed chicken broth
1 can condensed cream of mushroom soup
1 1/2 cups milk

Now there is some home cooking!  The truly accomplished cooks among you will have recognized that the above recipe can serve as the blueprint for a whole week's worth of meals.  Prefer a cream of broccoli soup?  Simply substitute 1 can of condensed cream of broccoli soup for the asparagus soup!  Cream of chicken?  Substitute a can of cream of chicken!  Cream of mushroom?  Just cut the cream of asparagus altogether!  I bet if you are really pressed for time you could leave out the chicken broth and cream of mushroom, scale back the milk, and still call it cream of asparagus soup.

In terms of a status report, my onc doc gave us a "your doing excellent" Wednesday at the last infusion.  He can no longer feel the tumor in my abdomen at all.  He pronounced that I've been handling chemo just fine.  We'll schedule a PET scan following the last treatment, but he expects it will show everything in remission.  I expect the same.  So now it is just a matter of muscling through these last three treatments and laying the groundwork for a long, long remission period.  In the meantime, soup's on.

Tuesday, September 21, 2010

Savor the Flavor

It would seem I am at risk of turning this blog into an online hiking photo album.  Another weekend came and went, and we spent another Saturday out enjoying the sun.  The morning was blanketed thick in Anchorage fog.  Tired of the gloom, we drove up to Glen Alps, a near-town trail head up in the alpine.  Part way up, we breached the low lying clouds and emerged into brilliant blue skies.  C let out a squeal and clapped her hands.  Just seeing the sky made it all better.

(House above the fog with Mt. Spur in the background.)

(Fog lapping up on the foothills of the Chugach range.  That is what we lived in the whole of last week.)

We had no real destination to start with, but ultimately set our sights on Ship Lake Pass.  The sun continued to shine, our feet continued to move one in front of the other, and the miles ran away like so many scattering mice.  I did tire, and before long we picked a turn around spot not far from the pass itself.

(Standing where we decided to throw in the towel.  The Peak on the left is the Ramp.  The pass is, well, the pass pictured on the right.)

But we had already come so far!  Our we really turning around?  Yes.  We should stick to our guns.  But is it really that much further?  Should we just soldier on?  Yes.  OK, then.  To the pass it will be after all.

(At the pass, looking into the further reaches of the Chugach.)

(Looking down on Ship Lake in its fall finery.)

So the hike ended up being something over twelve miles, with something around 3,000 feet of vertical gain. It was a good day in the hills, and we were glad for the views.  As we creep up on the end of the third chemo cycle, I've been feeling pretty good, and I'm thankful I could put in a good twelve miles.  I've had more energy than at the end of the second cycle.  I'm not sure what to credit for that, but I will not complain.  C and I went for a run after work today, and the legs felt spry.  I was able to push up to a 7:30 pace and hold it for about a mile.  Not exactly pre-chemo levels, but it nevertheless felt good to pick up some speed and let the legs loose.  And I couldn't have done so at the end of the second cycle.

Now to talk hair.  Hair loss is the most obvious manifestation of chemo, and accordingly always a fun topic of conversation.  Long time readers will recall a prior post with "then" and "now" photos comparing the bearded, full-head of hair version of Scott with the post clippers version.  The truly observant will have noted all along the continued presence of a flavor saver, aka soul patch, aka pretentious patch of hair left behind on my lower lip.  The flavor saver started as a joke, something I would wear to work for a few days and then shave off.  But soon thereafter my hair started falling out, and I decided to save the saver until the bitter end.  The other day, C and I were looking at pictures on the hard drive (remember when you had to do so in albums?) and noted a remarkable change in its appearance.  See for yourself.  Then (first in profile, second straight on):

And now (in a smaller crop):

The vast majority of my pretentious lower lip hair seems to have fallen out.  I knew it had thinned, but didn't really appreciate the degree to which it had done so.  At least I still have my eyebrows.  With eyebrows, the general public is left wondering: Is he a racist neo-Nazi from Idaho?  A straight-edged punk from D.C. circa 1986?  Just a lazy guy who prefers low maintenance hair cuts?  Once the eyebrows go you really take on the look of a chemo-patient, and all mystery disappears.   

I start the fourth cycle tomorrow.  Here's to the approaching 2/3 milepost.

Wednesday, September 15, 2010

The Sun Will Come Out

It feels like it has been a busy two weeks since I last updated the blog.  As previously noted, my parents came to visit.  Concern about their baby's health will prompt even my parents to suffer through the rigors of air travel.  In case you are wondering what became of the green chiles, we whipped up a quick sauce as evidenced by the following picture:

(Stolen without permission from my Dad's Picasa page.)

In addition to the chiles, my folks brought with them more rain.  In contrast, my inlaws came to visit last weekend and brought blueberries and sunshine.  When push comes to shove, I like chiles better than berries, but sun better than rain.  So, we will call it a wash and say C and I had a nice visit with both families.

The sun was actually a very welcome treat.  To those of you who have not been living Anchorage's weather on a daily basis, we have set records this summer for crap.  So having made it through the worst parts of my third round of treatment and with sunny skies beckoning, we headed to the hills last weekend.  On Saturday we walked for four miles or so on the Prospect Heights trials.

We forgot the hand made sign, but I'm holding up a 53 to signify 53 days of chemo.  While those of you in warmer climes may not think it, fall is actually approaching fast:

Having decided that the warm weather and exercise were doing us good, we returned to the mountains on Sunday and made 3.5 miles and 2000 vertical feet up Wolverine peak before I turned us around.  Unsurprisingly, it was turning to fall in the higher elevations too:

Near our high point, with Denali, Foraker, and the whole of the Alaska Range visible in the background:

At our high point, with vibrant yellow tundra countering the glare from my scalp:

And finally, over looking Anchorage with the airport, Mt. Spur, and another hiker all making an appearance:

The warm (meaning 60 degrees; warm is a relative concept) temperatures continued into Monday, but yesterday the fog rolled in.  My best guess is that the sun continues to shine somewhere above the clouds, but visibility in our neighborhood has been cut to a couple of hundred feet.  Its like a balmy January out there.  But as they say, it is better to have sunned and lost than to have never sunned at all.  And the way this summer had been going, we were squarely in the never sunned at all camped a few days ago.  I'm glad the break in the weather came at the right time in my treatment cycle.

As far as I know, I know everyone who has ever laid eyes on this blog.  But this being the information age, and information wanting to be free and all, there is the (slim) possibility that someone out there stumbled upon this page through the power of Google or by dumb luck.  As a newly diagnosed NHL patient, I scoured the web for what information I could glean, and read other's experiences in blogs and forums as a way of getting a handle on what I was facing.  If someone similar is reading this, I should note that notwithstanding pictures of sunny mountains and smiling Scotts, R-CHOP is not all daffodils and Belgian beer.  I feel good this week, but chemo has had its fair share of "This Sucks" moments, perhaps captured by the following picture taken at my second treatment:

And yes, the picture is sideways.  I like to think it is an artistic way of capturing the sideways feeling of bright orange liquid pumping into a valve on your chest, but really it is just that I'm too lazy to open the file in an editor and rotate it.

To wrap up this post (and get myself to bed), I'll just toss out a hello and thanks to T&A in Olivet, France for a CD that just arrived in the mail.  Several years ago, C and I traveled through Europe and spent time with T&A in France and Switzerland.  We spent a night (or two?) with A's family in a small town outside of Geneva.  We spent the nights with A's grandparents with a window overlooking vineyards, and the days at A's parents house, a traditional looking alpine chalet, watching chickens run through the yard.  One sunny, comfortable afternoon, C and I were sitting on the back porch.  Upstairs, A's brother and a friend had picked up some instruments.  The air smells clean, there was probably raclette in the oven, and guitar and accordion music spilling over the balcony.  It is a nice memory, and the playing was very good.  A's brother and band mates have now finished what is being referred to as a "pre-pre-production" version of a CD, and we just got a copy.  Many thanks.  The music is cheerful and will remind us of relaxing days in Switzerland.

Thursday, September 2, 2010

Three Down

I received my third treatment yesterday.  That is the third of six.  Depending on how you look at it, I'm half way through.  The alternate view is I will not be at the half way point until I surface from this batch of side effects.  Either way, we're that much closer to bidding adieu to the leather chairs (aside from occasional tuneups, which are limited to one of the 5 primary chemo drugs and should have limited side effects).

Luckily, the Vuelta de Espana (Tour of Spain) bike race is underway.  It gives me something to relax to while shaking off the fogginess and leaden tongue.

Short post today.  Just a celebratory nod to the passing of time.  Some moments you want to last a life time and others can't expire fast enough.  My last treatment is on November 3rd.  I feel a little like a kid staring at December 25th on the calendar wondering if Christmas will ever really come.

But the really good news is that the chemo seems to be doing what it is designed to do.  Previously swollen lymph nodes are undetectable.  The other good news is that my blood counts were good this round.  I have a blood draw every three weeks prior to a treatment to analyze various parameters of my red and white blood cells.  Prior to the second treatment, my white cell counts were on the low side of borderline.  As such, I've started getting a shot to boost production, and it seemed to work.  Counts were good; treatment a go.

Monday, August 30, 2010

Cure What Ails You

Back between schooling, I spent a couple of years living and working as an environmental consultant in New Jersey.  Those years were characterized by a continual down sizing of vehicles.  I arrived in the Garden State, wild-eyed and green behind the ears, driving a Nissan 4wd pickup.  I eventually traded the truck in for a Hyundai hatch back with gas mileage and handling better suited to Jersey's roads.  And in the end, I sold the Hyundai and decided to live carless and carefree for my remaining months in Princeton.

I had a six mile commute to work, and daily shouldered clean work clothes on my back as I turned to my bike for day-to-day moving to and fro.  One day on my way to work, I was cruising through a residential neighborhood and spotted another cyclist ahead of me, apparently also heading to work.  He was on a too-small bike with an un-lubed chain, wearing work boots, and shouldering a lawn mower.  As near as I could tell, every property owner in the greater Princeton area had an immaculate lawn and beautiful garden, and not a single owner ever tended to his or her own lawn care needs.  Clearly the gentleman ahead of me played at least a small role in that care, and probably had a job that day at one of the houses up the street.

Of course I did what comes naturally.  I shifted to a larger gear, increased my cadence, hunched lower over my handle bars, and started quickly closing the distance between me and my new "rabbit."  It didn't take long, and after awhile I passed the other cyclist in great haste with a short wave and a "good morning," which may or may not have been audible over the great roar of wind I imagined my wake was kicking up.  It wasn't too much longer before I (figuratively) stopped to think, "Geez!  Do you really feel the need to race a guy hauling a friggin' lawn mower?"

And the answer?  Well, not so much race, but yes, apparently I do feel compelled to chase down my rabbits. On reflection, I don't attribute this to an overblown sense of competition.  I didn't feel like I had beat the other guy at anything, particularly since he didn't even know he was playing.  But I do like the challenge of catching someone in front of me.  It provides a focus to push harder than I otherwise might.  Today in races, whether running or biking, where I comfortably cross the finish line in the middle to back of the pack and win nothing, I spend the entire time reeling in whoever is in front and push a little harder because of it.

All of this is just a lengthy lead in to the fact that now it is frustrating to go out for a run and feel like I'm incapable of reeling in anyone.  The rabbits all bound away up the trail.  As noted in a prior post, during the first treatment cycle I recovered and was able to put in a final run at a pace near my pre-chemo running pace. I didn't really reach that point this time.  We went for a run last Sunday, and while I was glad to get out and glad to be running, I never felt like turning the legs over at a higher cadence.  Nevertheless, I hope and plan to maintain some level of running in the weeks still remaining.

My folks are up and visiting in Alaska.  I have said for years that New Mexico green chile will cure what ails you.  Now I have a chance to try to prove it.  Mom and Dad packed 14 pounds of frozen roasted green chile, and so long as my stomach continues to tolerate it, I plan to eat my fill.  I'll see if it fixes any of my ailments and allows for rabbit chasing again.

Tuesday, August 24, 2010

Welcome Back

"Hey, Scott is back!"  I may be paraphrasing a bit (albeit only a slight bit), but that quote more or less sums up C's reaction last Saturday.  Saturday was the day I resurfaced from the dopey chemotherapy haze.  By resurfacing, I mean my personality, sense of humor, and other components of our day to day reactions have come back into play.  This was actually a day later than occurred during the first cycle.  Last time it happened on Friday, and C was expecting and looking for "giggle Friday."  Well, giggle Saturday will just have to do.

Resurfacing notwithstanding, I'm still a tired puppy.  Sunday might illustrate the degree to which we have become, well, pretty boring.  ("Become boring?" some might ask.  "As if that is a new development!")  Friends K, Big W, and Little W called up on the telephone to announce the imminent delivery of a smoked chicken.  (As an aside, thanks for the smoked chicken!  Delicious!)  Big W got a smoker sometime back, and did what comes natural to any smoker owner: he smoked a load of ribs and four chickens.  One of the chickens got directed our way.  K calls at 7:30.  Mind you, C spent the day feeling a little under the weather and planned an early bedtime.  I seem to have an early bedtime regardless by virtue of getting tired early.  C answered the phone, and while I can't be certain how the exchange went, I assume it went something like this:

K: "Hey, I'm going to bring you a chicken!"
C: "Tonight?"
K: "Yea, we'll be over pretty soon."
C: "Pretty soon?  Like in fifteen minutes?  I'll be asleep at 8:00.  I mean your chicken sounds great and all..."
K: "What are you? Six?"

Embrace your early bedtime, I say!  The revolution may not be televised, but had certainly better be over by dinner time.

In other news, the hair loss seems to have stabilized.  I'll be interested to see what that means.  Do I have the hairs that survived the first round of chemo, but are waiting to fall prey to the second?  Or do I have the hairs that laugh in the face of poison and will ride out the whole circus?  Are my eyebrows safe?  I'm guessing no, but time will tell.

Monday, August 16, 2010

Blueberry Fields Forever

Today's distraction from chemotherapy came in the form of a lesson in micro-investing.  A couple of years ago, I watched and enjoyed two documentaries about mountain biking: Off Road to Athens and 24 Solo.  Last year I learned, probably as a result of putting my e-mail address on one too many spam lists, that the film makers were working on a new film project following Team Columbia at the 2009 Tour de France.  The film makers were seeking micro investors.  In short, the film makers requested a donation of $100.  In exchange, an investor would receive a free DVD and repayment of the $100 once production was done and costs were recouped.  I figured, why not?  I liked the first two movies, was very interested in the new one, and wanted to see the film made.  At best, I would get an approximate 30% return on the investment (cost of the DVD); at worst the project would fail, my money would disappear, and I would be staring in the face of a reckless expenditure.

Well, today the postal service delivered a copy of the film on DVD and a check for $100.  Assuming the check clears, we've got a best case scenario.  Anyway, I was glad to have played a (minor) role in helping the film along and look forward to the movie (which, by the by, has been well reviewed).

Slow days in the fighting lymphoma realm.  If the first two cycles are any indication, the days following an infusion are characterized by a fair degree of listlessness, sprinkled with liberal doses of napping.  Yesterday we broke routine to join Family C-T up at Glen Alps for some afternoon berry picking.  Despite appearances at our house, the mountains captured the first sunshine Anchorage has seen since... April?  It was a short walk and a good afternoon, although I again had to nap when we got back home.  I spent a few hours at work today, and will spend a few more hours there tomorrow.

C and I went for a short walk in the rain this evening.  As we were headed home, we passed two kids on bikes peddling around an alley.  One kid coached the other, explaining: "As you peddle, do a pop-a-wheelie, or whatever."  I thought I would include those words here now because I think each of us can learn a little something from his wisdom.

Friday, August 13, 2010

Male Pattern Baldness

WARNING.  The following blog post contains gratuitous male frontal nudity, graphic hand gestures, and words and images with no redeeming social value.

It is starting to look like we have a dog in the house.  Hair is everywhere, and the rate of loss is accelerating.  For those curious, chemo drugs indiscriminately attack fast dividing cells in the patient's body.  Those include the cancer cells themselves, but also healthy and normal cells that play an integral part in your daily life.  Cells in your bone marrow, where red and white blood cells are churned out on a regular basis, leading to low levels of both and accompanying fatigue and immune system concerns.  Cells in your mouth, resulting in mouth sores.  And other cells, including hair cells.  Head hair is the fastest growing, most active hair on the body, and as such is the first of the hairs to take the hit.  As of yesterday, mine had really thinned in the front and on patches on the side, and I was leaving piles of hair over any surface that I bent over for a passing moment.  It was time to get rid of it.

Lovely wife C was in charge of running the hair clippers, and we retired to the bathroom for some grooming.  Lets recap.  Day 1:

Careful observation of the above will reveal the following: ample head of hair, perhaps in need of a haircut.  Day 23:

Again, careful observation will reveal the following: tendrils of a spider plant that doesn't get enough sunlight. Oh, and the hair is gone.  "But," you might cry, "you promised male frontal nudity and obscene finger gestures!"  That I did.  All I can say is it must have been the prednisone (a steroid) and a classic case of "roid rage" that interrupted what should have been a just another session of sitting on a stool having my head shaved.  Part way through the grooming, I suddenly rose and tossed the stool aside like it was made of cotton candy.  Shock and fear registered in C's face as she dropped the clippers and backed out of the bathroom.  She was able to capture this picture before I ran from the house:

Was I angry at cancer?  Did my last blog post trigger memories of teen angst?  We may never know.  My memory of the event is pretty hazy.  Suffice to say the police found me some hours later in a tree.  They were able to subdue me using crowd control techniques gleaned from ex-Russian secret police and returned me home where C was able to finish the shave.  Needless to say, the events of the day left me tuckered:

The head stubble will continue to fall out, but at least the level of mess is better controlled.  I have a pretty high chance of losing the rest of my hair too: eyebrows, arm hair, chest, etc.  The clippers may make another appearance to control that loss as well.  If there was any fairness in the world, the weird old-man ear hairs that have made an unwelcome appearance on my head would have been the first to go, but I'll bet they weather this whole storm in tact!

Wednesday, August 11, 2010

Grace Under Pressure

Some years prior to 1984, I had taken a keen interest in the relentless beat and jangle of guitars that amounted to (then) modern rock-n-roll.  I recall dragging my Dad to a hardware/general store, Gambell’s, and buying (or more likely having Dad buy for me) a 7” inch single of Pat Benatar’s “Fire and Ice.”  I still have that single sitting in a closet.  But my interest in the power of rock must have reached a frenzied pitch in 1984, because the only reasonable explanation for the following events is a lot of whining and nagging on my part.

I grew up in Socorro, NM, about 75 miles south of Albuquerque.  National touring acts included stints at Tingley Colusieum at the Albuquerque fair grounds, and at some point I decided that I wanted to join the sweaty masses of people, throw my arms in the air, and just flat rock out at a concert.  Only whining and nagging can explain my Dad agreeing that, yes, he would take me to a show.   I could pick the next band that I wanted to see, and he would drive me north, chaperon me, suffer through parking, excessive volume, horrible acoustics, and the drunk and stoned masses that were sure to appear.  I clearly got the better end of the deal.

Fantastic!  Not weeks after getting the green light, Ozzy Osbourne announced a tour date in Albuquerque, with Motley Crue opening.  The Albuquerque Journal even had a big write up on the show, featuring a quarter-page photo of Motely Crue.  This was it!  I marched the newspaper article into my dad, pointed proudly, and announced that we needed to get tickets, and soon!  He took one look at the Crue, and replied, “Nope.  Pick something else.”  Crickey, can’t a kid get a break around here?

No worries, though.  Quick on the heels of Ozzy and the Crue, Rush announced a show in Albuquerque.  Yes, Rush would do nicely.  Apparently finding nothing immediately and undeniably offensive about Rush, Dad agreed this time.  Money was spent.  Tickets were bought.  (And for anyone comparing ticket prices, past and present, I think they were $12.).  And then, miracle of miracles, Van Halen announced a show.  Tickets went on sale and sold out immediately.  They announced another show.  Again, the whining and the nagging must have reached fever pitch, because my Dad said, “Yes, you can go to that too.”  Thankfully the Rush concert hadn’t happened yet.  If it had, there never would have been a second.  We got tickets to Van Halen, and I suddenly felt like the coolest sixth grader in town.

Both bands filled the coliseum, both bands were as loud as you would expect, and Dad hated every minute.  Many years down the road, he critiqued the concerts as follows:  “Rush at least just came out, played their noise, and left, without all of the swearing and stories about sex, booze, and drugs, but there was way more pot at the Rush show too, so I don’t know which one I hated more.”

So what?  What does this have to do with anything?  By now you’re probably thinking, “Geez, I waste my valuable time to get an update into your HEALTH, man, and all I’ve got to show for it is this waltz down memory lane?”  Well, as it turns out, the chemo room has portable DVD players.  I frontloaded our Netflix cue with a concert film by Rush from that 1984 tour (although not from the Albuquerque show).  So while the poisons pumped, I again rocked out.  I still like Rush, although in truth I can’t remember the last time I reached for a Rush CD (or MP3 file).  But the concert was quite dated.  I’m sure the band members look back today and shake their heads.

Chemo infusion two has come and gone.  We’re killing cancer here, people.  Probably be an early night tonight, and then start the prednisone pills tomorrow.   The hair is definitely on its way out.  We’ll have pictures after the shaving!  Hmmm… If I can find a flat bed scanner, maybe I could post a parade of my hair styles over the years.  This won’t be the first time my hair has been taken down to the scalp (albeit only for half my head!).

Monday, August 9, 2010

Of pesto and shrimp

We have a veggie subscription from a farm out in the Valley, and amidst the sea of lettuce and assorted greens, we sometimes get a bunch of fresh basil.  We had basil and some shrimp we bought at the farmers' market on hand about three weeks ago, the day prior to my first chemo session.  At the time, I had no idea what to expect with regards to appetite, nausea, and other side effects, and thought we should have a tasty dinner the night before.  Sort of the last supper.  So down came the food processor, in went the basil, pine nuts, and other ingredients, and out went big bowls of pasta with shrimp and pesto.  It was tasty stuff.  We ate and enjoyed.

In the days that followed my first infusion, I maintained a healthy appetite, but was cautious about what went down the gullet.  The pasta stayed in the fridge.  It just didn't sound appetizing.  I thought maybe it had something to do with the garlic and strong flavors.  C helped herself to the leftovers, and in time the pasta left our fridge entirely.  (See, I told you I might digress into fridge contents eventually.  Who knew it would happen so fast?)

Days passed, and the thought of pesto still made me feel unsettled.  I didn't really give it much thought.  Late last week, I was reading a runner's cancer blog, detailing his attempts to maintain a running schedule throughout chemotherpay.  Part way through, he noted in passing his experience that the food he ate the day before getting chemo fell forever into disfavor.  "Whoa," I think, remembering the pesto.  "There might be something to this."

Rest assured, I am determined to make sure that pesto gets back into my good graces.  But C and I are giving some real thought to what I'll eat tomorrow.  No sense in taking any unnecessary risks and forever alienating myself from a particular favorite or dietary staple.  You hear people throw out the last meal hypothetical all the time ("One last meal, what will it be?"), but I've never really considered what foods I could live without.  So what will it be?

Saturday, August 7, 2010


Hello to friends, family, and anyone else who happens to stumble across this collection of words.  I've threatened for years to start a blog for the sole purpose of detailing the contents of my fridge on an hour by hour basis.  Alas, that blog never came to fruition.  I may at times take a long diversion into that subject, but really the intent here is to post updates as I push through chemotherapy.

Background:  On May 27, 2010, I learned that I had Non-Hodgkin's Lymphoma (NHL).  To anyone interested in the details, my lymphoma is a follicular type, grade 1/2, stage 3/4.  I probably should have started this blog immediately after learning I had cancer and left a record of the frantic days there following.  And who knows, I may yet recount some of those days.  But the long and the short is that the heads of state conferred and prescribed for me a drug cocktail known far and wide as R-CHOP (five different drugs).  NHL is reputed to respond really well to this particular blend of poisons.  By "respond well," I mean that everyone expects six rounds of R-CHOP to put my cancer into remission.  By "respond well" I do not mean "is cured by."  The shitty part of the story is that my style of NHL is incurable.  I can reasonably expect that it will pop its head up again sometime in my future.  My plan is to make sure that the remission lasts a really, really long time.

Chemotherapy:  The logistics of chemo can vary widely depending on the cocktail you are sipping.  In my case, I am on three week cycles.  On day one, I go to a room stocked with nine leather recliners and sit while a parade of drugs is dripped into my system.  On days two through five, I take pretty large doses of another drug by pill at home.  Then I have sixteen days to let the drugs do their worst.  Then the cycle repeats itself.  As noted above, in my case the cycle should repeat itself six times.

July 21, 2010:  Cycle one started for me on Wednesday, July 21, 2010.  The day before, I popped into the catheter lab at Providence Hospital to have a Medi Port installed.  The Port is basically a small titanium cup with a tube running several inches.  The whole contraption is placed under my skin, sealed away from the weather, my sweat, and curious passerbys.  The tube is merged in with a major vein near my neck using techniques of modern medicine or witchcraft--I'm not sure which.  The cup sits on my chest.  The intent is to give nurses and others a direct line to apply their poisons.  One of the five drugs I take as part of the R-CHOP cocktail is pretty nasty stuff that the powers that be will not apply in a regular arm IV.  If the drug were to end up outside a vein, it would reportedly eat away at tissue and muscle.  The Port minimizes those risks.  While I appreciate the utility of the Port and would just as prefer not have to contend with nurses seeking veins in my arm each time they need to place an IV, I still haven't completely come to terms with the new bulge under my skin.  Frankly, it kind of surprises me.  It is not the sort of thing that I thought would bother me.

But on with the show.  Come Wednesday morning, lovely wife C accompanied me to the chemo room.  Below, at home and getting ready for come what may.

The first day of chemo is the longest.  One of the drugs, Rituximab, has to be given slowly the first time to gauge for allergic reactions.  We got to the doctor's office at 10:00 and didn't leave until 5:30, the bulk of that time spent in a room, in a chair, looking at other cancer patients.  I sat next to a man in his fifties or sixties.  He used to play drums in a bar band back in the pipeline days.  Did that for a number of years, until his cocaine habit landed him in jail.  I have no idea the crime committed, but he found Jesus and a wife, and all in all was an entertaining companion.  C probably has a clearer memory of his stories, though.  Because of the allergy concerns, I was given a hefty dose of Benadryl as a precursor to the Rituximab, and frankly was pretty loopy for a good while.  Eventually though, the last drip of drug made its way into my neck vein and I was unhooked and set free.

Days that followed:

Those drugs packed a punch.  I was pretty well laid out Thursday and Friday.  On Saturday, we walked with some friends a couple of blocks to a local park to let our friends' kids burn off energy.  I needed a nap when we got home.  The anti-nausea medications worked pretty well for me in this first cycle, but my head was in a fog and I was really tired.  I was also quite jittery.  My eyes were vibrating, my mouth felt weird, and I didn't do much of anything.  C worked tirelessly around the house.  While she disagrees with me every time I say it, I'm pretty sure this whole process has been and will be harder on her than me.  It would be impossible without her, though.

I went back to work on Monday.  It was a day too soon.  My mind wasn't working, and lawyering ain't rocket science but it takes some noodling with the head.  I was exhausted by noon.  My head slowly cleared up as the week went on, but half days were all I could manage until Friday.  C and I got out for some walks and some very short runs.  Picture post one run below.

I got stronger the following week and started feeling near-normal.  C and I got in a four mile run one day and got out on our bikes for the first time since chemo started:

August 7, 2010:  That brings us up to date.  You may note that the beard is gone in the picture above.  That has nothing to do with chemo and everything to do with buying the cheapest beard trimmer that money can buy.  Lesson learned, and the mangy results left me no choice but to start over (or not).  However, I think the chemo is starting to have an effect on my hair.

If you look closely in the picture above, you can see a pile of loose hair that has accumulated in my puzzle book.  Those hairs appeared over the course of just a few minutes, and just doesn't seem normal to me.  If you don't want to strain your eyes, I'll provide a detail below.

Yea, that isn't normal.  I'm wondering how long the hair will last.  I just paid for a haircut a week ago.  I wonder if they give chemo-refunds?

Anyway, the next cycle starts in three days.  I go next Tuesday for a blood draw.  The good doctors have to make sure my white- and red-blood cell counts haven't tanked to a dangerously low level before letting me take the second dose.  Then on Wednesday, C and I get another lovely day in the leather chair.

So plenty of babbling for a first blog post.  I have no idea how frequently I'll update this.  Feel free to leave comments or questions.  I'll try to address anything that needs addressing.  In the mean time, don't take any wooden nickles.