Several people have called me and asked why I haven't updated my blog in a long time. It has been largely due to pain, and a lack of desire to pass along bad news.
Several weeks ago, my last CT scan showed that my primary tumor (in my right pelvis) had started growing again. In fact, it had grown 0.5cm along each axis since it had been measured a little over six weeks prior. It is growing into my sciatic nerve and into my sacro-illiac joint. This involvement with the major nerves going to my right leg has made common activities both difficult and painful.
For example, I have to use a special device to put my sock on; walking, and especially going up and down stairs, is very painful; sitting for any length of time (say to write a blog post) is also very painful. Right now I have taken 30 mg of Oxycodone (morphine), along with what is regularly supplied by my pain pump AND a bollus (an extra shot of pain meds) from my pain pump, and I can still only sit here a minute or two at a time.
When my oncologist found that my tumor was growing, he terminated chemotherapy. I am now in the midst of receiving "palliative radiation therapy". This is where you receive lower does of radiation at a time, but you receive it more times.My treatment will be twenty doses of radiation, five days a week for four weeks. Because the pain prevents my from lying still (either on my stomach or on my back) I have been taking the radiation treatment under general anaesthesia. Hopefully they will shrink the tumor enough so that I don't have to continue with the GA.
My pain doctor has largely been playing catchup with managing my pain. As a result, I am going to have an operation called a cordotomy, where they will destroy the pain nerve from my pelvis to my brain. I will no longer be able to feel pain (or hot or cold) in the affected area. I do not know when this will occur.
Because of the pain management issues, Sue and I have decided to at least postpone, if not completely cancel, our trip to London. Hopefully when the radiation and cordotomy are done, we will be able to do the trip.
I largely spend my days lying face down on the bed, propping myself up on my elbows to read. My sister Mary created some foam rubber "butt boosters" which I can sometimes use to prop my tumor off the mattress, so I can lay on my back and watch TV.
I won't deny that there has been a fair amount of crying and wailing through all this. However, I take a huge amount of enjoyment in Sue's and Katie's company. I am still able to appreciate the beauty of a crisp, clear autumn day. I am deeply grateful to my cancer buddy Frank for helping me keep my attitude straight.
Well, I'm going to lie down for awhile. Peace out.
Saturday, October 30, 2010
Wednesday, September 8, 2010
status update September 8,2010
I thought I would update everything went last week.The CT scan showed that the tumors in my lungs are either shrinking or are stable. The pump implant went more or less without incident.The pain along my scars lasted about five days, and gradually went away. I have an appointment who will be managing the pump next, and they will start titrating (tweaking)the dosage.
Julia's and Sam's wedding was a blast, both literally and figuratively. the winds were blowing about 30 - 40 mph, which drove everyone inside the tent, making for a more intimate affair. we left shortly after when the cake was cut and served - natch.
The next day was a lovely brunch At Mary and Mike's house,eating up the leftovers from the wedding.We left early again, as all of the activity was really starting to to get to me.
I almost forgot the biggest surprise. I looked up from my bed, and there stood Andrew behind Katie, with the biggest grins you could have. It really made the weekend for Sue and I.
Julia's and Sam's wedding was a blast, both literally and figuratively. the winds were blowing about 30 - 40 mph, which drove everyone inside the tent, making for a more intimate affair. we left shortly after when the cake was cut and served - natch.
The next day was a lovely brunch At Mary and Mike's house,eating up the leftovers from the wedding.We left early again, as all of the activity was really starting to to get to me.
I almost forgot the biggest surprise. I looked up from my bed, and there stood Andrew behind Katie, with the biggest grins you could have. It really made the weekend for Sue and I.
Saturday, August 28, 2010
Busy week coming up
Having surgery next Wednesday (9/1) to install an intrathecal pump. This is a device which drips a much lower dosage of pain killers directly onto my spine.This will hopefully fix some pain management issues without leaving me feeling doped to the gills.
Also next week I have my next CT scan of my chest and pelvis. Hopefully this will show that the tumors in my lungs haven't started growing again, and the tumor in my pelvis has stopped. I am pretty scared about all this.
Oh, and next Saturday (9/4) is Julia Head's wedding, which I am going to do everything in my power to attend.
All in all a very busy week. The following week I start chemo again.gills.
Also next week I have my next CT scan of my chest and pelvis. Hopefully this will show that the tumors in my lungs haven't started growing again, and the tumor in my pelvis has stopped. I am pretty scared about all this.
Oh, and next Saturday (9/4) is Julia Head's wedding, which I am going to do everything in my power to attend.
All in all a very busy week. The following week I start chemo again.
Also next week I have my next CT scan of my chest and pelvis. Hopefully this will show that the tumors in my lungs haven't started growing again, and the tumor in my pelvis has stopped. I am pretty scared about all this.
Oh, and next Saturday (9/4) is Julia Head's wedding, which I am going to do everything in my power to attend.
All in all a very busy week. The following week I start chemo again.gills.
Also next week I have my next CT scan of my chest and pelvis. Hopefully this will show that the tumors in my lungs haven't started growing again, and the tumor in my pelvis has stopped. I am pretty scared about all this.
Oh, and next Saturday (9/4) is Julia Head's wedding, which I am going to do everything in my power to attend.
All in all a very busy week. The following week I start chemo again.
Thursday, July 15, 2010
Status Update - Not Good
Earlier this week I had a series of tests - CT Scans of my pelvis and chest, and a MUGA to test how well my heart was functioning.
The MUGA showed no problems with my heart. My oncologist had been concerned because the chemotherapy I was taking will eventually damage your heart. This hasn't happened.
The CT Scans of my chest show continued improvement of the tumors in my lungs. For example, one tumor that had been 4 mm had shrunk to 2 mm.
The CT Scan of my pelvis showed that the tumor in my pelvis has grown since May. Specifically, it has gone from 9 x 5.7 cm to 9 x 7.3 cm. This means it is 128% its previous size, an increase of 28%.
As a result, I am going to be starting chemotherapy with a new drug combination on Monday. I will have between six and eight treatments, one every three weeks.
The MUGA showed no problems with my heart. My oncologist had been concerned because the chemotherapy I was taking will eventually damage your heart. This hasn't happened.
The CT Scans of my chest show continued improvement of the tumors in my lungs. For example, one tumor that had been 4 mm had shrunk to 2 mm.
The CT Scan of my pelvis showed that the tumor in my pelvis has grown since May. Specifically, it has gone from 9 x 5.7 cm to 9 x 7.3 cm. This means it is 128% its previous size, an increase of 28%.
As a result, I am going to be starting chemotherapy with a new drug combination on Monday. I will have between six and eight treatments, one every three weeks.
Thursday, June 17, 2010
Status Update
I saw the oncologist today. He believes that the tumor in my pelvis has started to decrease in size. In the words of his PA, "you have to know where to look for it to see it". Before, my butt was definitely misshapen.
My hemoglobin is still somewhat low (9.2). It will be rechecked prior to my next scheduled chemo treatment on 6/21.
The oncologist wants to do one or two more chemo treatments after this next one. You may recall that the original plan was to stop at six. The main chemo drug I am getting (carboplatin) has a tendency to rot your heart if you take it more than six time. He is sending me for a MUGA scan to check how my heart is doing, as well at a CAT scan on my lungs and pelvis, prior to a potential 7th course of chemo.
My hemoglobin is still somewhat low (9.2). It will be rechecked prior to my next scheduled chemo treatment on 6/21.
The oncologist wants to do one or two more chemo treatments after this next one. You may recall that the original plan was to stop at six. The main chemo drug I am getting (carboplatin) has a tendency to rot your heart if you take it more than six time. He is sending me for a MUGA scan to check how my heart is doing, as well at a CAT scan on my lungs and pelvis, prior to a potential 7th course of chemo.
Where I've been for Three Weeks
It's been a long three weeks since I lasted posted, and I am sorry about the delay. I won't say I've been busy, per se, but it has been an eventful three weeks.
My adventures in the medical world started the day after I started my last round of chemo (June 2nd). All that afternoon I was feeling wonky. For example, I distinctly remember standing in front of the open refrigerator, trying to remember what I was looking for, and then realizing it was my sneakers. Most days I can recall that footware is seldom found inside large kitchen appliances, but not that day.
About 4:30 or 5:00 that afternoon I started shaking uncontrollably from the cold. I was sitting in my office in front of the computer, shivering and shivering. I didn't want to move. I didn't want to call for help. I just shivered and tried to get warm.
Sue got home around 5:30 and found me. I remember getting into bed fully dressed, shoes and all, and pulling the covers up and finally feeling warm. I then slept until about 7:30. Sue got me up and took my temperature, which was 103.5. She called the emergency number for the oncology clinic, and they told me to go to the hospital.
I don't remember much about the next two days. Mostly, I slept. They put me in a private room in the cardiac ward because I was immune suppressed. They tested everything: urine, blood, feces. They sent me for a chest x-ray to confirm I didn't have pneumonia. They were unable to find anything that was causing an infection (My oncologist later said the fever was probably from a bone strengthener I received as part of my chemo). I received fluids and antibiotics intravenously. They let me go home that Friday.
For most of the next week, I slept. I would get up in the morning, have breakfast with Sue or Katie, and then "nap". I would nap from 8:00 until 11:30, have lunch, and then nap from 12:30 until 4:00. I would have dinner and then go to bed around 8:00 PM.
Finally I called the doctor's office Friday afternoon and asked if all this sleeping was OK. The nurse checked my last blood sample (taken the previous Wednesday) and said that my hemoglobin count was "low". If a normal hemoglobin range is 14 - 16, mine was 7.5. She scheduled me for a transfusion the next day. I got two units of blood and felt somewhat better.
This past week I have still been lethargic, "unable to get off the couch". I still napped two or three hours each day. I couldn't do anything more exacting then reading or watching television.
So anyway, that's my excuse for my tardiness in posting. Hopefully I will have less of a reaction to my chemo this next time. My oncologist says that he is planning on cutting the dose. Let's see how that works.
My adventures in the medical world started the day after I started my last round of chemo (June 2nd). All that afternoon I was feeling wonky. For example, I distinctly remember standing in front of the open refrigerator, trying to remember what I was looking for, and then realizing it was my sneakers. Most days I can recall that footware is seldom found inside large kitchen appliances, but not that day.
About 4:30 or 5:00 that afternoon I started shaking uncontrollably from the cold. I was sitting in my office in front of the computer, shivering and shivering. I didn't want to move. I didn't want to call for help. I just shivered and tried to get warm.
Sue got home around 5:30 and found me. I remember getting into bed fully dressed, shoes and all, and pulling the covers up and finally feeling warm. I then slept until about 7:30. Sue got me up and took my temperature, which was 103.5. She called the emergency number for the oncology clinic, and they told me to go to the hospital.
I don't remember much about the next two days. Mostly, I slept. They put me in a private room in the cardiac ward because I was immune suppressed. They tested everything: urine, blood, feces. They sent me for a chest x-ray to confirm I didn't have pneumonia. They were unable to find anything that was causing an infection (My oncologist later said the fever was probably from a bone strengthener I received as part of my chemo). I received fluids and antibiotics intravenously. They let me go home that Friday.
For most of the next week, I slept. I would get up in the morning, have breakfast with Sue or Katie, and then "nap". I would nap from 8:00 until 11:30, have lunch, and then nap from 12:30 until 4:00. I would have dinner and then go to bed around 8:00 PM.
Finally I called the doctor's office Friday afternoon and asked if all this sleeping was OK. The nurse checked my last blood sample (taken the previous Wednesday) and said that my hemoglobin count was "low". If a normal hemoglobin range is 14 - 16, mine was 7.5. She scheduled me for a transfusion the next day. I got two units of blood and felt somewhat better.
This past week I have still been lethargic, "unable to get off the couch". I still napped two or three hours each day. I couldn't do anything more exacting then reading or watching television.
So anyway, that's my excuse for my tardiness in posting. Hopefully I will have less of a reaction to my chemo this next time. My oncologist says that he is planning on cutting the dose. Let's see how that works.
Thursday, May 27, 2010
Status Update - Good News!
I just met with my oncologist, and we went over the results from my latest CT scan:
There are still some obstacles to being cured: the tumor in my pelvis would need to be removed (which would be very difficult right now), as well as the tumors in my lungs. I expect that my life expectancy has gone up, at the very least.
Happy Memorial Day!
- The tumors in my lungs have have shrunk 60% - 70% since the last CT scan on April 4th
- The large tumor in my pelvis is the same size. However, there is a pool of fluid on the inside of the tumor, which is caused by necrotic tissue. This indicates that the tumor is dying from the inside out
- Removal of any remaining tumors in my lungs
- Removal of the tumor in my pelvis
- Some surgical repair of my pelvis, which is fractured. This would reduce the pain in my buttocks
There are still some obstacles to being cured: the tumor in my pelvis would need to be removed (which would be very difficult right now), as well as the tumors in my lungs. I expect that my life expectancy has gone up, at the very least.
Happy Memorial Day!
Friday, May 21, 2010
A Jim Dandy
My sister called a couple of weeks ago. "I'm coming to see you".
"Coming to Michigan on business?"
"I'm going to be in the area, and I thought I would stop by and see you."
I subsequently learned that she was going to be in Harrisburg, PA. Harrisburg PA is NOT "in the area" for Ann Arbor. It takes about 10 hours of driving to go from my house to my sister's house in NJ. Harrisburg is about 2 hours into the ride - only 8 more hours to go!
When people learn that you have cancer, they want to do things for you: drive you to chemo or doctor's appointments, make tasty treats, give you books on how to lick cancer by changing your diet. My next door neighbor actually mowed my lawn for me - which mortified me to no end. (A man who can't take care of his lawn is hardly a man at all, is he?)
Two days before Mary was scheduled to arrive, she called again. "I went on Friendly's web-site and found the closest one to your house. What kind of Fribble do you want?"
Mary and I share an abiding love of Friendly's. Whenever I go to NJ, a stop in Friendly's is always on the agenda. For example, when my nephew John got married, Mary and I convinced our families to stop at Friendly's, where we got Friendly Franks and ice cream. Please keep in mind that this was on the way to an Italian wedding reception, a bacchanal not seen since Roman times, and you will realize how ludicrous this course of action was.
Now, I happen to know that the closest Friendly's is about an hour away. I contemplated what a Fribble would look like after an hour in a hot car.
"Mary, it'll melt."
"I've got a cooler. I figured I could get some dry ice or something."
I pondered this a moment, and said "You know, what I would really like is a Jim Dandy dish".
The Jim Dandy is the ultimate expression of the ice cream confectioner's art. Five scoops of ice cream, three toppings, a banana, whipped cream, chopped nuts and topped off with a marachino cherry. It is presented in a glass bowl not unlike a heavy duty brandy snifter, shouting to the world that this is no ordinary confection, but five thousand calories, a diabetic coma, a root canal and a heart attack all rolled into one. I figured that at least the glass bowl wouldn't melt.
Two days later, Mary arrived at our house. From her insulated lunchbox she pulled a strawberry Fribble. And then, from her knitting bag, she pulled a Jim Dandy dish.
"It's still got Friendly's crud on it!", she said brightly. She then went on to tell the following story, while I sucked contentedly on my Fribble:
"I asked the woman at Friendly's if they ever sold Jim Dandy dishes. She brought one over and set it down in front of me, and went off to make the Fribble. She came back a couple minutes later with the Fribble. She looked at me, and then at the Jim Dandy dish that was still on the counter. 'You don't get it, do you?', she sighed."
My sister is as straight as an Eagle Scout and church camp. She is not meant for a Life of Crime.
"Get what?"
"'They'll never miss it. Do you have a bag to put it in?'" I held up my knitting bag. Two seconds later, it was in the bag, and I ran out the door. The whole way to the Michigan border, I looked in my rearview mirror, waiting for the police car's flashers."
Two gallons of premium ice cream - $10.
One pint of strawberries for strawberry topping - $2
One bag of chopped nuts - $2
Organic bananas - $4
Marachino cherries - $6
Whipped cream - $3
Having your sister drive eight hours out of her way, and embark on a Crime Spree in Ohio to bring you a dirty dish - priceless.
"Coming to Michigan on business?"
"I'm going to be in the area, and I thought I would stop by and see you."
I subsequently learned that she was going to be in Harrisburg, PA. Harrisburg PA is NOT "in the area" for Ann Arbor. It takes about 10 hours of driving to go from my house to my sister's house in NJ. Harrisburg is about 2 hours into the ride - only 8 more hours to go!
When people learn that you have cancer, they want to do things for you: drive you to chemo or doctor's appointments, make tasty treats, give you books on how to lick cancer by changing your diet. My next door neighbor actually mowed my lawn for me - which mortified me to no end. (A man who can't take care of his lawn is hardly a man at all, is he?)
Two days before Mary was scheduled to arrive, she called again. "I went on Friendly's web-site and found the closest one to your house. What kind of Fribble do you want?"
Mary and I share an abiding love of Friendly's. Whenever I go to NJ, a stop in Friendly's is always on the agenda. For example, when my nephew John got married, Mary and I convinced our families to stop at Friendly's, where we got Friendly Franks and ice cream. Please keep in mind that this was on the way to an Italian wedding reception, a bacchanal not seen since Roman times, and you will realize how ludicrous this course of action was.
Now, I happen to know that the closest Friendly's is about an hour away. I contemplated what a Fribble would look like after an hour in a hot car.
"Mary, it'll melt."
"I've got a cooler. I figured I could get some dry ice or something."
I pondered this a moment, and said "You know, what I would really like is a Jim Dandy dish".
The Jim Dandy is the ultimate expression of the ice cream confectioner's art. Five scoops of ice cream, three toppings, a banana, whipped cream, chopped nuts and topped off with a marachino cherry. It is presented in a glass bowl not unlike a heavy duty brandy snifter, shouting to the world that this is no ordinary confection, but five thousand calories, a diabetic coma, a root canal and a heart attack all rolled into one. I figured that at least the glass bowl wouldn't melt.
Two days later, Mary arrived at our house. From her insulated lunchbox she pulled a strawberry Fribble. And then, from her knitting bag, she pulled a Jim Dandy dish.
"It's still got Friendly's crud on it!", she said brightly. She then went on to tell the following story, while I sucked contentedly on my Fribble:
"I asked the woman at Friendly's if they ever sold Jim Dandy dishes. She brought one over and set it down in front of me, and went off to make the Fribble. She came back a couple minutes later with the Fribble. She looked at me, and then at the Jim Dandy dish that was still on the counter. 'You don't get it, do you?', she sighed."
My sister is as straight as an Eagle Scout and church camp. She is not meant for a Life of Crime.
"Get what?"
"'They'll never miss it. Do you have a bag to put it in?'" I held up my knitting bag. Two seconds later, it was in the bag, and I ran out the door. The whole way to the Michigan border, I looked in my rearview mirror, waiting for the police car's flashers."
Two gallons of premium ice cream - $10.
One pint of strawberries for strawberry topping - $2
One bag of chopped nuts - $2
Organic bananas - $4
Marachino cherries - $6
Whipped cream - $3
Having your sister drive eight hours out of her way, and embark on a Crime Spree in Ohio to bring you a dirty dish - priceless.
Thursday, May 20, 2010
Status Update
It's been a week since I finished my last chemo. I have been religious about various mouth rinses, and I have had minimal mouth sores as a result. I have been struggling with gastro-intestinal distress, but Pepto seems to have helped that.
My sister came last weekend, and she, Sue and I went to Mary James' party for her daughter Lucy. Lucy is getting married the Saturday after I finish my last chemo, in a sunrise ceremony in a park in Chicago. A good time was had by all at the party, and I ended up with a bunch of choclate covered strawberries.
I hope to go see Percy Jones and the Olympians: The Lightning Thief at the dollar movie today. This movie, if nothing else, wins the award for most awkward movie title. I have to hope that it will be worth a dollar...
Painting continues to drag on. The painters did the master bedroom and bath. When Sue came home she realized that they didn't mix the paint right, and that the wrong paint was on the walls. So the painters are coming back next week to repaint the walls in the master bedroom and bath. Hopefully with the correct color paint this time.
My brother Gerald is supposed to come visit for a few days next week. More on that later.
My sister came last weekend, and she, Sue and I went to Mary James' party for her daughter Lucy. Lucy is getting married the Saturday after I finish my last chemo, in a sunrise ceremony in a park in Chicago. A good time was had by all at the party, and I ended up with a bunch of choclate covered strawberries.
I hope to go see Percy Jones and the Olympians: The Lightning Thief at the dollar movie today. This movie, if nothing else, wins the award for most awkward movie title. I have to hope that it will be worth a dollar...
Painting continues to drag on. The painters did the master bedroom and bath. When Sue came home she realized that they didn't mix the paint right, and that the wrong paint was on the walls. So the painters are coming back next week to repaint the walls in the master bedroom and bath. Hopefully with the correct color paint this time.
My brother Gerald is supposed to come visit for a few days next week. More on that later.
Tuesday, May 11, 2010
Me in the Four-Star General's Hat
By popular demand, here is a picture of me in my four-star general's hat.
Here is the backstory: in my first blog posting, I mentioned that I needed a hat, and that I had asked my cancer buddy Frank to see if his daughter Natalie (who is an officer on an AWACS for the Air Force) to see if she could get me an unusal unit baseball cap. Natalie replied that the Air Force doesn't have unit hats, although she sent a very cool AWACS hat.
It turns out Frank's neighbor is a retired four star general. He was generous and gracious enough to order two fitted four-star general caps. The result is pictured above.
I must admit that I rarely wear these. I never served in the Armed Forces, and I am somewhat concerned that wearing the hats would be somehow disrespectful to those who did serve.
But it is an incredibly cool hat. Eat your hearts out!
Friday, May 7, 2010
Battling cancer
It seems that everyone I talk to wants to talk about "battling cancer". This evokes a mental image of a knight in shining armor facing off against a hideous dragon labeled "cancer". The battle is usually described as a heroic encounter, and the incredible bravery of the cancer patient is invoked.
I personally think that this is a crock.
You don't battle cancer, people. Cancer is a condition that happens to you. You then throw yourself into the maw of the medical establishment, who subject you to any number of indignities, including: pumping poison into your veins so that your hair falls out; bombarding you with radiation until your flesh burns and slicing you open like the Thanksgiving turkey and scooping out bits that you had previously been well, attached to.
Primarily, your job as the patient is to cooperate and suffer. You can comport yourself with dignity and equanimity, trying not to bite the heads off the people around you. You do this as you gradually waste away (or not). I guess if you can pull this off, it can be heroic - facing your fate resolutely. But it's not a battle.
A battle implies that you have some say in the outcome. Really, the only say that you have is to follow the instructions of your doctor, and what attitude you have while you do it. If it's a battle, then you are the battlefield, not a combatant: it's mutant cells against your doctors.
I dislike this metaphor because it implies that the cancer patient is somehow responsible for the outcome of their treatment. This is true up to a point, but only to a point. Mostly, it seems from my perspective that the outcome is largely out of your hands, and you are along for the ride.
I have struggled to come up with a different metaphor, but I haven't found one yet. Perhaps it is more like a sea journey in a small boat. You can set your sails for your destination, but if the seas and the winds don't cooperate, you aren't going where you want to.
I personally think that this is a crock.
You don't battle cancer, people. Cancer is a condition that happens to you. You then throw yourself into the maw of the medical establishment, who subject you to any number of indignities, including: pumping poison into your veins so that your hair falls out; bombarding you with radiation until your flesh burns and slicing you open like the Thanksgiving turkey and scooping out bits that you had previously been well, attached to.
Primarily, your job as the patient is to cooperate and suffer. You can comport yourself with dignity and equanimity, trying not to bite the heads off the people around you. You do this as you gradually waste away (or not). I guess if you can pull this off, it can be heroic - facing your fate resolutely. But it's not a battle.
A battle implies that you have some say in the outcome. Really, the only say that you have is to follow the instructions of your doctor, and what attitude you have while you do it. If it's a battle, then you are the battlefield, not a combatant: it's mutant cells against your doctors.
I dislike this metaphor because it implies that the cancer patient is somehow responsible for the outcome of their treatment. This is true up to a point, but only to a point. Mostly, it seems from my perspective that the outcome is largely out of your hands, and you are along for the ride.
I have struggled to come up with a different metaphor, but I haven't found one yet. Perhaps it is more like a sea journey in a small boat. You can set your sails for your destination, but if the seas and the winds don't cooperate, you aren't going where you want to.
Status Update
I had a meeting with the oncologist yesterday. The good news is that tumor in my pelvis appears to have shrunk. I am pretty much done with all chemo side effects. Next round starts on Monday, May 10th. <yea.>
We got the oncologist to talk about Life after Chemo. It seems that one of the tumors in my lungs is pretty inoperable - it would require removal of at least the lobe it is in, if not the entire lung. He doesn't think that they will want to do that. They also aren't going to want to operate on the pelivic tumor if it has grown into the sacrum. This is because it would (a) cause paralysis (b) require a colostomy bag for the rest of my life (c) require rerouting my ureter so that it emptied into the colon, and thence to the colostomy bag.
So the bottom line is - if the tumor in my lung isn't gone after the last round of chemo, they aren't going to operate. Instead, I would get two or three months off, and then they would start me on a different kind of chemo. The only way that they will operate on the pelvis is if the lung tumor is gone, and if the tumor isn't in the sacrum.
On the other hand, if the tumor is gone in the lungs, and the tumor in the pelvis has retreated from the sacrum, they will operate within weeks of the end of chemo. He even used the "C" word. (CURE) Wow.
We got the oncologist to talk about Life after Chemo. It seems that one of the tumors in my lungs is pretty inoperable - it would require removal of at least the lobe it is in, if not the entire lung. He doesn't think that they will want to do that. They also aren't going to want to operate on the pelivic tumor if it has grown into the sacrum. This is because it would (a) cause paralysis (b) require a colostomy bag for the rest of my life (c) require rerouting my ureter so that it emptied into the colon, and thence to the colostomy bag.
So the bottom line is - if the tumor in my lung isn't gone after the last round of chemo, they aren't going to operate. Instead, I would get two or three months off, and then they would start me on a different kind of chemo. The only way that they will operate on the pelvis is if the lung tumor is gone, and if the tumor isn't in the sacrum.
On the other hand, if the tumor is gone in the lungs, and the tumor in the pelvis has retreated from the sacrum, they will operate within weeks of the end of chemo. He even used the "C" word
Thursday, April 29, 2010
Status Update
I had chemo a week and a half ago. Every time I have chemo, it runs me down a little bit further. I have been sleeping a lot - naps in the morning and afternoon. BTW - from 2:00 - 3:00 is officially naptime, so please don't call then.
I am pretty weak. I just tried to carry my hand truck up from the basement. A year ago I would have picked it up with one hand, and run up the stairs. Today I was wheezing for breath by the time I got up the basement stairs.
Side effects continue to be pretty minimal. My mouth sores are back, and I have been having problems with diarrhea. This is because the chemo attacks the fast growing cells - like your mucus membranes, the skin in your throat and mouth, and yes, the lining of your gut. I have been struggling to keep my weight up.
On the plus side, I went to see Mark Knopfler (from Dire Straits) at the Michigan Theatre the other night with my brother-in-law, Peter. I had gotten advance tickets through the fan club. I am pretty sure I got the first seats sold - on the aisle, first row. Mark wasn't feeling well, and sat on a stool directly in front of us. It was absolutely wonderful to be able to watch his guitar playing at close range.
The other big news concerns home improvements. Katie is moving home (tomorrow!), and we decided to get her room painted. One thing led to another, and now we are getting the whole upstairs painted. This has used up a lot of what little energy I have, preparing rooms for the painters.
I am pretty weak. I just tried to carry my hand truck up from the basement. A year ago I would have picked it up with one hand, and run up the stairs. Today I was wheezing for breath by the time I got up the basement stairs.
Side effects continue to be pretty minimal. My mouth sores are back, and I have been having problems with diarrhea. This is because the chemo attacks the fast growing cells - like your mucus membranes, the skin in your throat and mouth, and yes, the lining of your gut. I have been struggling to keep my weight up.
On the plus side, I went to see Mark Knopfler (from Dire Straits) at the Michigan Theatre the other night with my brother-in-law, Peter. I had gotten advance tickets through the fan club. I am pretty sure I got the first seats sold - on the aisle, first row. Mark wasn't feeling well, and sat on a stool directly in front of us. It was absolutely wonderful to be able to watch his guitar playing at close range.
The other big news concerns home improvements. Katie is moving home (tomorrow!), and we decided to get her room painted. One thing led to another, and now we are getting the whole upstairs painted. This has used up a lot of what little energy I have, preparing rooms for the painters.
Saturday, April 10, 2010
Status Update
I actually feel pretty good today. Sue & I did the taxes, and I was able to sit in my Aeron chair for hours with no discomfort at all. The only problem I have is that I have a bad case of chemo mouth. I have several painful sores which make eating very difficult. I can't eat anything at all acidic. For example, I made spagetti sauce the other day, and it just burns.
On a lighter note, I received some "covers" (hats) from my cancer buddy, Frank. These include two authentic four-star general "covers". One is a bush hat that is a little big, and the other is a garrison cap that is too tight. Finally, Frank's daugher Natalie sent me an E-3 hat. This is all just in time, as my hair is just about gone.
On a lighter note, I received some "covers" (hats) from my cancer buddy, Frank. These include two authentic four-star general "covers". One is a bush hat that is a little big, and the other is a garrison cap that is too tight. Finally, Frank's daugher Natalie sent me an E-3 hat. This is all just in time, as my hair is just about gone.
Friday, April 9, 2010
A Medical Adventure
The other day I went to the hospital. I had three things to take care of:
The first thing that they did was hook up an access to the port that I have installed in my chest. I actually have two ports, just above my right breast, and they allow them to pump things into me under pressure. They tell me that pumping contrast dye into the stuckee under pressure is the bee's knees for getting high resolution pictures.
While she was hooking me up, the technician asked me if I had an infusion scheduled for after the CAT scan. If I had an appointment, she could leave me "accessed", so they wouldn't have to do it again. I said that I didn't have an infusion, but I did have a blood draw. She said they could take the draw through the port. I told her that they didn't want to do that. She said that they just didn't want to "access" me (what a verb!), but if I was already "accessed", they would do it. I had her call over and confirm all this with the blood draw lab.
A small side note about ports, for those of you fortunate enough not to use them. Getting "access" is a pretty involved process, involving actually hooking a line to the port, flushing it with heparin, confirming that blood will actually come back through the port, and flushing with saline. All of this involves connecting and disconnecting syringes to the "main line", and then injecting fluid, or drawing fluid, through the port.
Anyway, they did the first CAT scans, and then hooked me up for the infusion of contrast dye. I was told to expect that it would "feel warm, like you feel when you pee yourself" (lovely!). At the end of the scan, they flushed the line and then hooked up a syringe filled with saline to the line. They left the syringe dangling from the line, where it swung and bumped like Winnie-the-Pooh going down the stairs (bump, bump, bump).
(I should also note that I had little or no discomfort in this whole process. This is a huge improvement over what I experienced previously. Suffice to say that the previous scan seemed to take an eternity, and that I was screaming in pain by the end).
I dressed myself carefully, mindful of pulling the line out of my port. I decided to run the line on top of my T-shirt, and to leave off my hoodie. I put my coat over the ensemble, so as to avoid frightening random passersby.
I then walked about 1/4 mile to the blood draw lab in the cancer center. (bump, bump, bump).
Now the blood draw folks are a rather madcap lot. For example, when I approached the desk to check in, they allowed as how the lab was closed. "No problem, I'll wait".
"Until Monday"
"I'll wait." I really love these guys, and I am more than happy to play along with the gag.
They took my ID card and parking ticket, and sent me into the lobby to wait. I walked over and took a seat (bump, bump, bump).
A few minutes later they called my name, and I went back and had a seat at the blood draw station. I opened my shirt and showed them my syringe, dangling from my main line. The phlebotomist was visably shaken. She went away for a consult.
Within a minute or so, I had about six people standing around me, shaking their heads. One of them allowed that "they've done this before". A battle-scarred LPN about my age took over, promising that she would "call over there" when she was done with the blood draw. A couple more flushes, blood draws, etc., and I was done. In the whole ordeal, the only thing that hurt at all was when they took a large piece of clear tape off my port. I waundered off to pick up my prescription.
I don't have any moral or great wisdom from all this. I just found the whole experience rather humorous.
- I had to have a CAT scan, chest and pelvis
- I had to have a blood draw
- I had to pick up a prescription
The first thing that they did was hook up an access to the port that I have installed in my chest. I actually have two ports, just above my right breast, and they allow them to pump things into me under pressure. They tell me that pumping contrast dye into the stuckee under pressure is the bee's knees for getting high resolution pictures.
While she was hooking me up, the technician asked me if I had an infusion scheduled for after the CAT scan. If I had an appointment, she could leave me "accessed", so they wouldn't have to do it again. I said that I didn't have an infusion, but I did have a blood draw. She said they could take the draw through the port. I told her that they didn't want to do that. She said that they just didn't want to "access" me (what a verb!), but if I was already "accessed", they would do it. I had her call over and confirm all this with the blood draw lab.
A small side note about ports, for those of you fortunate enough not to use them. Getting "access" is a pretty involved process, involving actually hooking a line to the port, flushing it with heparin, confirming that blood will actually come back through the port, and flushing with saline. All of this involves connecting and disconnecting syringes to the "main line", and then injecting fluid, or drawing fluid, through the port.
Anyway, they did the first CAT scans, and then hooked me up for the infusion of contrast dye. I was told to expect that it would "feel warm, like you feel when you pee yourself" (lovely!). At the end of the scan, they flushed the line and then hooked up a syringe filled with saline to the line. They left the syringe dangling from the line, where it swung and bumped like Winnie-the-Pooh going down the stairs (bump, bump, bump).
(I should also note that I had little or no discomfort in this whole process. This is a huge improvement over what I experienced previously. Suffice to say that the previous scan seemed to take an eternity, and that I was screaming in pain by the end).
I dressed myself carefully, mindful of pulling the line out of my port. I decided to run the line on top of my T-shirt, and to leave off my hoodie. I put my coat over the ensemble, so as to avoid frightening random passersby.
I then walked about 1/4 mile to the blood draw lab in the cancer center. (bump, bump, bump).
Now the blood draw folks are a rather madcap lot. For example, when I approached the desk to check in, they allowed as how the lab was closed. "No problem, I'll wait".
"Until Monday"
"I'll wait." I really love these guys, and I am more than happy to play along with the gag.
They took my ID card and parking ticket, and sent me into the lobby to wait. I walked over and took a seat (bump, bump, bump).
A few minutes later they called my name, and I went back and had a seat at the blood draw station. I opened my shirt and showed them my syringe, dangling from my main line. The phlebotomist was visably shaken. She went away for a consult.
Within a minute or so, I had about six people standing around me, shaking their heads. One of them allowed that "they've done this before". A battle-scarred LPN about my age took over, promising that she would "call over there" when she was done with the blood draw. A couple more flushes, blood draws, etc., and I was done. In the whole ordeal, the only thing that hurt at all was when they took a large piece of clear tape off my port. I waundered off to pick up my prescription.
I don't have any moral or great wisdom from all this. I just found the whole experience rather humorous.
Results of CAT Scan
Well, I received the results of the CAT scan, and they are... mixed. The tumors in my lungs have all shrunk significantly - going from 6mm to 4mm, things like that. The tumor in my pelvis, it appears to have either stayed the same or possibly grown some. Specifically, they think that it is growing into the sacroilliac joint.
In the cover letter to the CAT scan, my doctor's PA, Katie, said that the tumor was "Grossly stable". She also said that I should be encouraged because the pain level in my hip was down so much. (Which it is - I can almost cross my right foot over the left knee. Four weeks ago, I couldn't move my right foot toward my left knee without excruciating pain).
So I don't know what to think. I am glad that the tumors in the lungs are shrinking. I am certainly glad that the tumor in my pelvis isn't causing me the pain it was. I am hoping that while the tumor in my pelvis isn't shrinking in size, it is shrinking in mass. That is the only explanation that I have for why it doesn't hurt nearly as much as it used to. The only other explanation that I have is that it is interfering with the nerves so much (especially the sciatic nerve) that it is blocking the pain. However, I don't appear to have other neurological issues - weakness, numbness, etc.
I have an appointment with my medical oncologist on Thursday the 15th. Maybe he will be able to shed more light on the situation then. In the meantime, I am taking what comfort I can in the news
In the cover letter to the CAT scan, my doctor's PA, Katie, said that the tumor was "Grossly stable". She also said that I should be encouraged because the pain level in my hip was down so much. (Which it is - I can almost cross my right foot over the left knee. Four weeks ago, I couldn't move my right foot toward my left knee without excruciating pain).
So I don't know what to think. I am glad that the tumors in the lungs are shrinking. I am certainly glad that the tumor in my pelvis isn't causing me the pain it was. I am hoping that while the tumor in my pelvis isn't shrinking in size, it is shrinking in mass. That is the only explanation that I have for why it doesn't hurt nearly as much as it used to. The only other explanation that I have is that it is interfering with the nerves so much (especially the sciatic nerve) that it is blocking the pain. However, I don't appear to have other neurological issues - weakness, numbness, etc.
I have an appointment with my medical oncologist on Thursday the 15th. Maybe he will be able to shed more light on the situation then. In the meantime, I am taking what comfort I can in the news
Monday, April 5, 2010
Status Update
I was very tired today, after probably doing too much yesterday. I spent most of the day lying on the couch, reading The Big Short and napping. My butt is sore, but I do not know if it is because I did too much yesterday, or for a more sinister reason. I have an MRI this Thursday, so hopefully by the end of the week I will know better how I am progressing.
ObamaCare, Evidence Based Medicine and Me
The cornerstone of ObamaCare is something called "Evidence Based Medicine" (EBM). A recent New York Times article stated that fully half of the two thousand odd pages of the recently enacted healthcare bill dealt with programs of research to reduce the cost of healthcare by use of EBM.
EBM attempts "to apply the best scientific evidence gained from research to medical decision making". It "seeks to assess the quality of evidence of the risks and benefits and treatments (including lack of treatment)" (Wikipedia, Evidence Based Medicine). In other words, it uses a risk based model in determining treatment options. This results in protocols, or clinical treatment plans, being developed which address the higher payoffs first, and then the next highest, etc.
Notice that when they are assessing risks, they are using a combination of probability (what is the likelihood that a diagnosis is correct) and outcome (what is the impact if the diagnosis is correct). They are not looking at what the potential worst outcome is and treating that first. My own case clearly illustrates this point.
When I presented myself to my Primary Care Physician, Dr. X, my symptoms had all of the hallmarks of a problem with the sacroiliac joint, which is the joint where the spine and the hips come together. The doctor did a brief (approximately ten minute) examination where he asked me to describe the pain and where it was, did a neurological exam (looking to see whether nerves were directly being affected) and palpated the area, looking for masses which he did not find.
The protocol for treating had several steps: first, a combination of anti-inflammatory drugs and physical therapy for a period of months. If this is not successful, assessment and treatment by a spinal specialist. The spinal specialist also has several treatment options, including direct injection of affected areas with steroids to improve mobility, mobilization of the joint and more advanced imaging.
Now a much clearer diagnosis could have been found by ordering an MRI. This would likely have definitively shown where my problem lay. Why wasn't an MRI taken? Because the cost of the MRI was not justified by the likelihood that impact was as severe as mine turned out to be.
The MRI that finally diagnosed my cancer cost approximately $2000. While literally millions of patients with my symptoms go the doctor each year, a very, very, very small fraction turn out to have cancer. I have found statistics that suggest that there are fewer than 1000 adult cases of osteo-sarcoma in the US, and only a fraction of those would have had symptoms that matched mine. A larger population of patients with severely herniated or ruptured discs present (approximately 2%), but they typically present with neurological symptoms that I simply did not have. There are other problems that can present with similar symptoms, some with dire impact, but again they are very low probability events.
It is simply extremely costly to MRI every patient presenting with my symptoms, on the off chance that they might have cancer. Say that 1% of population of the US presents to their doctor with lower back symptoms in a year. This would yield a population of three million people. Let's say that 250 cases of osteo sarcoma could be found this way. That means that the cost of finding those cases would be ((3,000,000/250)*$2000) or twenty-four million dollars each. It is much cheaper to treat the most likely cause and see if they get better. If they don't, then treat the next more likely cause, etc. I would bet that it is only when you get multiple standard deviations from the mean that you get to cases that require the MRI to diagnose and treat. The savings are, quite simply, enormous.
(Please note that I am making a lot of these statistics up - I have no idea how many patients present with lower back pain each year, nor do I know what percentage of those cases turn out to be cancer. The actual number will differ wildly from what I have shown here, which is strictly for illustrative purposes).
The fact is that I went completely through both tier one (Physical Therapy) and tier two (examination and treatment by a spinal specialist) before they got to the point where my Primary Care Physician decided to get an MRI, and that is only because he found me writhing in pain on his examination room floor after he kept my waiting for an hour. During that time I was examined by no fewer than four doctors, not including the ones who examined the x-rays that the spinal specialist had taken and the physical therapist who treated me. In addition to the x-rays, I also had several ultra-sounds, none of which found a tumor the size of a medium potato.
A more aggressive doctor might have ordered the MRI anyway, particularly when I reported repeatedly that my pain was increasing week-to-week, despite treatment. It is very likely that if the MRI had been taken at the beginning of my treatment, my cancer would not have metastasized, nor would it have grown into my sacrum, both of which would have had dramatic impact on my current prognosis. In other words, if I had been treated by what ObamaCare and EBM would consider a "bad" doctor, one who runs unnecessary procedures, both my life expectancy and my quality of life would be a lot better right now.
So how do I feel about all this? First of all, I recognize that I am, first and foremost, incredibly unlucky. The odds of someone my age getting what I have gotten are really spectacularly low. I recognize that treating with an MRI would be prohibitively expensive. $24 million dollars will pay for an awful lot of health-care for somebody. Yet, at the same time, I recognize that I am a hidden part of the cost of ObamaCare and EBM. Some people are definitely going to get sicker and die that wouldn't otherwise because of EBM. However, I also recognize that a vastly larger population are going to be treated and get well that otherwise would not. The payoff to society is clear.
So I feel resigned to my fate. I am not particularly angry at my doctors for not giving me an MRI sooner, because I feel that I understand the reasons why they didn't. I am just very, very unlucky. I do question whether they should have examined me sooner when physical therapy failed, though.
And yet, and yet, I look out the window on a beautiful Spring morning, and I wonder, what if?
EBM attempts "to apply the best scientific evidence gained from research to medical decision making". It "seeks to assess the quality of evidence of the risks and benefits and treatments (including lack of treatment)" (Wikipedia, Evidence Based Medicine). In other words, it uses a risk based model in determining treatment options. This results in protocols, or clinical treatment plans, being developed which address the higher payoffs first, and then the next highest, etc.
Notice that when they are assessing risks, they are using a combination of probability (what is the likelihood that a diagnosis is correct) and outcome (what is the impact if the diagnosis is correct). They are not looking at what the potential worst outcome is and treating that first. My own case clearly illustrates this point.
When I presented myself to my Primary Care Physician, Dr. X, my symptoms had all of the hallmarks of a problem with the sacroiliac joint, which is the joint where the spine and the hips come together. The doctor did a brief (approximately ten minute) examination where he asked me to describe the pain and where it was, did a neurological exam (looking to see whether nerves were directly being affected) and palpated the area, looking for masses which he did not find.
The protocol for treating had several steps: first, a combination of anti-inflammatory drugs and physical therapy for a period of months. If this is not successful, assessment and treatment by a spinal specialist. The spinal specialist also has several treatment options, including direct injection of affected areas with steroids to improve mobility, mobilization of the joint and more advanced imaging.
Now a much clearer diagnosis could have been found by ordering an MRI. This would likely have definitively shown where my problem lay. Why wasn't an MRI taken? Because the cost of the MRI was not justified by the likelihood that impact was as severe as mine turned out to be.
The MRI that finally diagnosed my cancer cost approximately $2000. While literally millions of patients with my symptoms go the doctor each year, a very, very, very small fraction turn out to have cancer. I have found statistics that suggest that there are fewer than 1000 adult cases of osteo-sarcoma in the US, and only a fraction of those would have had symptoms that matched mine. A larger population of patients with severely herniated or ruptured discs present (approximately 2%), but they typically present with neurological symptoms that I simply did not have. There are other problems that can present with similar symptoms, some with dire impact, but again they are very low probability events.
It is simply extremely costly to MRI every patient presenting with my symptoms, on the off chance that they might have cancer. Say that 1% of population of the US presents to their doctor with lower back symptoms in a year. This would yield a population of three million people. Let's say that 250 cases of osteo sarcoma could be found this way. That means that the cost of finding those cases would be ((3,000,000/250)*$2000) or twenty-four million dollars each. It is much cheaper to treat the most likely cause and see if they get better. If they don't, then treat the next more likely cause, etc. I would bet that it is only when you get multiple standard deviations from the mean that you get to cases that require the MRI to diagnose and treat. The savings are, quite simply, enormous.
(Please note that I am making a lot of these statistics up - I have no idea how many patients present with lower back pain each year, nor do I know what percentage of those cases turn out to be cancer. The actual number will differ wildly from what I have shown here, which is strictly for illustrative purposes).
The fact is that I went completely through both tier one (Physical Therapy) and tier two (examination and treatment by a spinal specialist) before they got to the point where my Primary Care Physician decided to get an MRI, and that is only because he found me writhing in pain on his examination room floor after he kept my waiting for an hour. During that time I was examined by no fewer than four doctors, not including the ones who examined the x-rays that the spinal specialist had taken and the physical therapist who treated me. In addition to the x-rays, I also had several ultra-sounds, none of which found a tumor the size of a medium potato.
A more aggressive doctor might have ordered the MRI anyway, particularly when I reported repeatedly that my pain was increasing week-to-week, despite treatment. It is very likely that if the MRI had been taken at the beginning of my treatment, my cancer would not have metastasized, nor would it have grown into my sacrum, both of which would have had dramatic impact on my current prognosis. In other words, if I had been treated by what ObamaCare and EBM would consider a "bad" doctor, one who runs unnecessary procedures, both my life expectancy and my quality of life would be a lot better right now.
So how do I feel about all this? First of all, I recognize that I am, first and foremost, incredibly unlucky. The odds of someone my age getting what I have gotten are really spectacularly low. I recognize that treating with an MRI would be prohibitively expensive. $24 million dollars will pay for an awful lot of health-care for somebody. Yet, at the same time, I recognize that I am a hidden part of the cost of ObamaCare and EBM. Some people are definitely going to get sicker and die that wouldn't otherwise because of EBM. However, I also recognize that a vastly larger population are going to be treated and get well that otherwise would not. The payoff to society is clear.
So I feel resigned to my fate. I am not particularly angry at my doctors for not giving me an MRI sooner, because I feel that I understand the reasons why they didn't. I am just very, very unlucky. I do question whether they should have examined me sooner when physical therapy failed, though.
And yet, and yet, I look out the window on a beautiful Spring morning, and I wonder, what if?
Friday, April 2, 2010
Status Update
I completed my second round of chemo on Wednesday, when they removed the portable infuser. I continue to have little or no side effects from the chemo - very little nausea, a little dry mouth, tired. Other than that I am fine. My appetite is OK. I continue to be plagued by plumbing problems that I need not go into here.
My spirits are pretty good. I am starting to look forward to "life after chemo" (which is likely to mean "life during surgery"). My own personal prediction is that I will be done with surgery sometime this Summer, which would hopefully mean I would be up and around in early fall. How about that.
I think that the tumor continues to shrink in my right buttock. I noticed this morning that it was easier getting my pants and shoes on. I am really gaining an appreciation for the little things in life.
I am thinking of making a bucket list - anyone have any ideas? I know that I would like to see several natural sights that I have put off over the years, and there is a trip I would like to take with Susie. All of these seem a little shallow. Perhaps I have to stop watching Morgan Freeman movies.
My spirits are pretty good. I am starting to look forward to "life after chemo" (which is likely to mean "life during surgery"). My own personal prediction is that I will be done with surgery sometime this Summer, which would hopefully mean I would be up and around in early fall. How about that.
I think that the tumor continues to shrink in my right buttock. I noticed this morning that it was easier getting my pants and shoes on. I am really gaining an appreciation for the little things in life.
I am thinking of making a bucket list - anyone have any ideas? I know that I would like to see several natural sights that I have put off over the years, and there is a trip I would like to take with Susie. All of these seem a little shallow. Perhaps I have to stop watching Morgan Freeman movies.
Tuesday, March 30, 2010
Status Update
I am doing remarkably well. I had one of my chemo treatments yesterday (Carboplatin), and I am experiencing no side effects other than some fatigue. I am currently wearing my portable infuser for the other drug, whose name I cannot recall. I get that off tomorrow, hallelujah!
I possible reason for my bounciness is that I am on a mega-steroid, which will wear off in a couple of days. I will keep everyone posted.
I possible reason for my bounciness is that I am on a mega-steroid, which will wear off in a couple of days. I will keep everyone posted.
Saturday, March 27, 2010
Losing my hair
"Stop that!", Katie demanded laughingly. She was driving me to an appointment with the audiologist (I had temporarily lost some hearing, and they wanted to set a baseline), and I had pulled a clump of hair out of my head and showed it to her. I do this periodically because I know it freaks her out, and it's fun to watch.
When I was growing up, hair was a very big deal. For the longest time, I had been forced by my parents to wear a crew cut, which was cruel and unusual punishment in the 60's. As soon as I could, I started growing my hair, and I didn't stop until a run-in with the laws made me. At that point I had beautiful light brown hair falling to my mid-chest.
Now my hair's falling out. I don't really care about this, other than several practical concerns. First, of all, how much is going to fall out, and in what pattern. I don't want to end up with some mutant hairstyle. I think that I will shave it all off first. Second, I am assured by my cancer buddy Frank that my chemo therapy drug, Cisplatin, makes you more susceptible to sunburn. Now Frank has a wonderful, swarthy Mediterranean complexion. If he burned under Cisplatin, I am going to crisp like a french fry left in the fryer too long.
I am going to need a hat.
I hate hats. I actively avoid wearing hats, even in the wintertime. Mostly this is because of my large, Charlie Brown style head. One of my fondest moments from high school was when the senior class adviser was measuring me for cap and gown for graduation. She announced, soto voce, to the entire senior class "Peter, you have the biggest head in the class." Hilarity ensued.
Anyway, it is next to impossible to find a hat that actually fits. With baseball caps, I am always flying on a wing and a prayer, the size expander on the last notch, grimly holding on for dear life. They are always too tight, making my head feel like Tony Soprano has it in a vise.
The average hat is also either way too dressy or way too banal. I like a slouch-brim fedora; they make me feel like Humphrey Bogart. But they look incredibly stupid with jeans and a flannel shirt, my typical uniform de jure. Baseball caps are typically insipid. I do not want to provide a free billboard to some person, place or thing.
What to do, what to do, what to do-waka-do?
I called Frank and asked him to get in touch with Natalie, his daughter who is an officer in the Air Force. She flys on AWACS. As such, I am betting that she runs into all different kinds of units. I asked Frank to ask Natalie to find a unit baseball cap from an unusual unit in the Air Force. I can't wait to see what she finds.
I just hope it fits
When I was growing up, hair was a very big deal. For the longest time, I had been forced by my parents to wear a crew cut, which was cruel and unusual punishment in the 60's. As soon as I could, I started growing my hair, and I didn't stop until a run-in with the laws made me. At that point I had beautiful light brown hair falling to my mid-chest.
Now my hair's falling out. I don't really care about this, other than several practical concerns. First, of all, how much is going to fall out, and in what pattern. I don't want to end up with some mutant hairstyle. I think that I will shave it all off first. Second, I am assured by my cancer buddy Frank that my chemo therapy drug, Cisplatin, makes you more susceptible to sunburn. Now Frank has a wonderful, swarthy Mediterranean complexion. If he burned under Cisplatin, I am going to crisp like a french fry left in the fryer too long.
I am going to need a hat.
I hate hats. I actively avoid wearing hats, even in the wintertime. Mostly this is because of my large, Charlie Brown style head. One of my fondest moments from high school was when the senior class adviser was measuring me for cap and gown for graduation. She announced, soto voce, to the entire senior class "Peter, you have the biggest head in the class." Hilarity ensued.
Anyway, it is next to impossible to find a hat that actually fits. With baseball caps, I am always flying on a wing and a prayer, the size expander on the last notch, grimly holding on for dear life. They are always too tight, making my head feel like Tony Soprano has it in a vise.
The average hat is also either way too dressy or way too banal. I like a slouch-brim fedora; they make me feel like Humphrey Bogart. But they look incredibly stupid with jeans and a flannel shirt, my typical uniform de jure. Baseball caps are typically insipid. I do not want to provide a free billboard to some person, place or thing.
What to do, what to do, what to do-waka-do?
I called Frank and asked him to get in touch with Natalie, his daughter who is an officer in the Air Force. She flys on AWACS. As such, I am betting that she runs into all different kinds of units. I asked Frank to ask Natalie to find a unit baseball cap from an unusual unit in the Air Force. I can't wait to see what she finds.
I just hope it fits
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