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.