Wednesday, December 17, 2008

One Year Later

Life has been crazy busy for us over the past month with work, kids and preparing for our Christmas vacation. I haven't had much time to keep this blog updated. I suspected that would happen, but not so fast. We really are getting back to where we were a year ago (all things considered). That being said, the thought that 'all this' could go away is never far from my mind. Instead of that being a negative thing, I choose to use that as a positive motivator and appreciate everything we do have and how truly blessed we are. We are blessed to have each other, we are blessed to have our kids, we are blessed to have our health (again), we are blessed to have fantastic and supportive family and friends both in our professional and personal lives. I am blessed to have found people through this blog that I wouldn't otherwise have had the opportunity to meet. Blessed by whom/what? I haven't figured that one out yet. I'm working on it, but in the mean time, I don't question...I just accept.



Last Saturday was Dec 13, one year from our diagnosis. We used the opportunity to celebrate with all those who have helped us this past year. We hosted a party and enjoyed the company of our friends until the late hours of the morning. In the depths of treatment, it was hard to imagine what Dec 13 2008 would look like. We couldn't have asked for a better anniversary.

We are taking a well deserved vacation over the Christmas holidays and there is a very good chance I won't be updating this blog until the New Year. So, let me take this opportunity to wish everyone a happy and safe holiday. Merry Christmas to my Christian friends, Happy Hanukkah to my Jewish friends, Happy Diwali to my Hindu friends, Happy Festivus to my Seinfeld friends, and Happy Holidays to all. Everyone, regardless of their belief system, can enjoy the warmth that family and friends bring this time of year. To my old friends with whom I've reconnected over the past year, to the new friends I have made via this blog, and everyone in between...a sincere thank you.

Wednesday, December 3, 2008

3 month check up

For the time being, part of our recovery process is being reminded every 3 months that we are cancer survivors. That reminder comes in the form of a combination of cat/pet/bone/brain/mri scans and/or mammograms. Over time, these scans will become less frequent and hopefully less nerve racking, but for the time being, they are often and stressful.

This week I am in Seattle on business and Linda had a cat and bone scan. As real-life begins again for us, scans and doctor appointments are not always 'convenient', as was this case this week. Christmas came a bit early this year and I received the good news today. All clear...again!

I really wished I could have been there this week for her but, at least from my point of view, cancer is becoming less a focus of our life and more an aspect of it. I think that is healthy. Our circumstances and mindset from last Christmas as compared to this Christmas could not be further apart.

Congratulations babe...you kick ass!

Friday, November 21, 2008

A strange feeling

I don't have much today. No story, no insight, and no words of wisdom...and that's kind of what I'm posting about. I've had a strange feeling of emptiness this week. We've been fighting this for 11 months straight, without any real break. It has defined (and redefined) our life for all of 2008. Almost every emotion and every thought has been about cancer. Most every conversation with family, friends and acquaintances starts with "How is Linda doing?". The highest point and lowest point of 2008 has been about cancer....and now we are done.

I've been looking forward to this week since last December, yet I feel a void. It is truly an odd feeling. I can't quite explain it. For the past year, I've had somewhere to direct all my energy. Focus on the cancer, focus on Linda, entertain the kids so they don't have to deal with it, write a blog entry. Now, although we will never be the same as we were on Dec 12, we have to go back to living. What the hell was that like? I can hardly remember. This cancer has made me a better person, made my family stronger, and made me love Linda more than you can understand. Without the cancer in our lives, will I fall back on old habits? Being an unappreciative asshole. I don't know if I even like 'pre-cancer John'. I'm actually kind of scared.

p.s. - Cancer, if are reading this, this is in no way an invitation back into our lives. Fuck you and thank you (if that makes sense).

Tuesday, November 18, 2008

A slice of humble pie

After all Linda has been through these past 11 months, at the first opportunity post-treatment, she got up at 5:15am and ran/walked 3 miles with her friend. No complaints. I, on the other hand, have been sitting on my ass for the past months complaining of a chest cold, shin splints, and/or a bum foot, pretty much any reason to not run. Needless to say I ran this morning. Thanks for the inspiration.

Friday, November 14, 2008

Step out of the vehicle sir

Today, 11/14/2008, we're done. The last radiation treatment was @ 8:45 this morning and the staff at Texas Oncology had a small celebration for Linda. Very cool. They are almost like family to Linda. I met Linda at Starbucks afterwards for a celebratory coffee before heading to work.

For some reason, I decided to take a different way to work. My usual commute has slowly been infiltrated by traffic lights. I'm sure there is a new one every couple of months. Damn suburban sprawl! The alternative route is longer, but only presents 1 traffic light. You can really fly along 1431. With the sunroof open and Metallica blasting, I cruised along at what some may consider an excessive speed (and what TxDOT definitely does consider excessive). Just as I crested a hill, I saw the telltale sign of Texas State Trooper black and white heading in the opposite direction. Ease off the gas...eyes in the rear view...wait...wait...shit!

Really? Linda's last day of treatment. What a way to sully a great day.

Mr. State Trooper was really playing the part. Mirrored sunglasses and all, although they were more modern than the stereotypical aviator style ones. Intimidating nonetheless. "License and Insurance please". "Step out of the vehicle sir". What the hell...for a speeding ticket? This can't be good.

For once in my life, all my tags, license, and insurance were up to date. Just give me my ticket and I'll be on my way. My inspection sticker was due to expire this month. The jackass who did my state inspection last November put the "11" on backwards, so it jumped out to the officer. As he looked closer, it seems the serial number was garbled. He ran the number back in his cruiser and after about 15 minutes, came back and said the serial number was invalid and that I was in possession of a forged permit. "I'll need to call in my corporal to see how to handle this". Mother %&@^%%#$^&!^. He informed me that with the new emissions testing here in Texas, there are A LOT of forged stickers.

Meanwhile, I sat on the guardrail along 1431 as everyone drove by and checked me out. 2 cruisers were now behind my car, so there was likely extra oogling on behalf of the passers by. Fantastic! Judgmental bastards!

"Sir, we're going to need to issue you a citation". This is getting worse by the minute. I rolled my eyes. "Hold on sir...we believe you, but we need to create a paper trail so that we can prosecute the person who made the counterfeit sticker. You'll just need to subpoena me in court and we'll get this all sorted out". Court? Subpoena? Arrrggg! I wondered for a moment if they'd shoot me if I ran across the field into the trees. Wait a sec...this is Williamson County...first they'd taze me, then they'd shoot me, then they'd taze me again for good measure. Better stay put.

As they peeled off the sticker for evidence, they looked at each other and smiled. "Sir...come here please". Apparently the Jiffy Lube jackass who affixed my sticker didn't scrape off the old one entirely, and left a bit of the old serial number, which overlayed perfectly with the new one. The sticker was good after all, although I was now in possession of a valid, but decimated sticker. I needed a new one this month anyway.

Corporal: Did you write him up yet?
Constable: Yes
Corporal: 3 or a 6?
Constable: 6
Corporal: Make it a 3
Constable: Yes sir

Cool. I'm not sure what 3 or 6 meant yet, but 3 has to be better than 6 right? Were they going to knock some mileage off my speeding ticket? Sweet. This is getting better.

Turns out 6 is a ticket and a 3 is a warning. As an act of good faith for keeping me for a 1/2 hour, they just gave me a warning citation for my speeding. No ticket, no court, AND I didn't have to blow anyone to get out of it! This is back to being a great day!

I tend to be a bit more aware of my karama these days. Was this the scales of fate tilting on my side as a correction for the past year? Or was it another test...do I need to pay this one back? I guess I'll never know for sure where my cosmic tally count sits, but if I try to be a good-egg most of the time, that can't be a bad thing can it?

Linda, I am so proud of you. You are stronger than I ever imagined and you amaze me every day. I will rub your head, bald or otherwise, forever :)

Monday, November 10, 2008

A Moment In Time

I had one of those moments this weekend. For the 8th year in a row, we went camping at Granger Lake for my birthday. It was fantastic. Linda was full of energy and felt great. It almost felt as if the last year hadn't happened at all.

That moment. As the morning sun began to warm the day, we sat on the beach while the kids played at the water's edge. It wasn't hot, it wasn't cold. The dogs ran up and down the beach sniffing everything they could. We had camped here many times, and walked that beach more times than I can remember, but this time was different. I looked over at Linda and she smiled, watching the kids search for fossils and shells. It was absolute contentment, something I hadn't seen from her in a while. I closed my eyes and burned that image into my brain. No matter what life has in store for us, nothing can take that moment away from me. I know she felt it too. We made the weekend last as long as possible. Neither of us wanted to leave.


It is Monday morning and Linda starts her last week of radiation today. This week is all about the boob. Her neck and underarm are done so this week they 'blast' the site of the original tumor. Good riddance! As far as the numbers go, we have a 75% chance of never seeing the cancer again. In Vegas, those are fantastic odds. You can play those odds all night long and always come out a winner. When you are fighting for your life, anything less than 100% is hard to accept, but that's just how these things work. Regardless, that moment in time on the beach will be mine forever.

Monday, November 3, 2008

New Appreciation of Triple Negative Disease



A great article regarding the current understanding of Triple Negative Breast Cancer and how to best treat it. If your breast cancer has been classified as ER-, PR- and Her2- (about 15% or all breast breast cancers are TN), then this article is a must read.

"Marina Cazzaniga and her colleagues at Treviglio Hospital, Italy found in the NORA study contrary to other observations, that triple negative patients did not have worse prognosis, in terms of disease-free (DFS) or overall survival (OS), than others in the total cohort of 3515 patients treated in 77 cancer centers in Italy from to 2000 to 2003"

21,000+ turn downtown Austin into a sea of pink

http://news8austin.com/content/top_stories/default.asp?ArID=223459



Sunday, November 2, 2008

Susan G. Komen Race For the Cure 2008

A beautiful day spent with beautiful people. Thank you :)






Thursday, October 30, 2008

Almost There

Halloween is tomorrow and marks 4 1/2 weeks of radiation treatment. Linda's radio oncologist calls her the poster child for radiation. Other than a general 'tan' in the affected areas, there is no tissue damage. No blisters or burns. No pain!

Only 2 more weeks to go and then that's it. Nothing else to do. No more treatments. I'm sure, after spending the past year actively fighting cancer, it will seem strange doing nothing. Unlike the majority of breast cancers (which are ER+ and/or PR+), triple negative breast cancers (ER-,PR-, Her2-) do not have any long term targeted therapies. It really is just wait and see. No Tamoxifen, no Aromasin, no Herceptin. Although there may not be any active treatment alternatives, there are plenty of passive treatments which include eating right, exercise and most importantly, just living life to the fullest.

This photo was taken last Halloween at our annual street Halloween party. That is pretty much how I looked from 1983 to 1992...not much of a stretch for me :)

What's strange to me is looking at us, 1 month or so before our diagnosis, and not having a clue what lay ahead of us. How our life could change from one day to the next. It is also weird to know that Linda had cancer in the photo (hey...quit staring at my wife's boobs!).

When you're young...you're invincible! When you're pushing 40...err...not so much. When your life is turned upside-down by cancer, everything takes on a 'temporary' feel, and I don't mean that in a bad way. That whole 'stop and smell the roses' nonsense begins to make sense. No, I'm not about to put up a motivational poster in my office, but I do find myself spending more time with the kids, more time cuddled up with Linda watching TV, and more time trying things I wouldn't usually do. How can that be a bad thing?

So tomorrow we will have the 2008 edition of our Halloween party, the kids will run amok in the neighborhood, the parents will enjoy a potluck dinner and we will all have a great time. Life is good.

Happy Halloween!

Tuesday, October 21, 2008

Race for the Cure

The whole family has signed up for the Race For The Cure 5K. Linda, myself and the kids will be hitting the streets on Sunday Nov 2nd to help raise money and awareness. We will be running for her local breast cancer support group team. If you'd like to sponsor us, shoot me an email at:

breast.cancer.sux@gmail.com

and I'll let you know how you can. It should prove to be a great day as we give back to the community and friends that have supported us over the past year.

Think Pink!

Wednesday, October 15, 2008

Getting our groove back

With less than 5 weeks left in Linda's treatment, things are going very well. Still some tingling in her hands and feet, some general muscle aches, some redness around the irradiated areas and she has some difficulty getting to sleep. Aside from that, our day to day routine is just that...routine. Work, kids, school, cub scouts, football, camping, Halloween decorations...ahhh the beauty of routine. You really don't miss it until it is gone.

Unlike my hometown, where camping is restricted to 3 months of the year, Texas offers camping 12 months of the year (although it is really too hot to enjoy camping in July & August). In years past, we have camped up to 22 times in a year, almost every other weekend. It is our family time free from life's distractions. Our youngest was camping at 6 weeks old. Camping is definitely our thing. The past year has only given us 1 opportunity and that was even limited because Linda had just finished her first chemo cycle. We booked camping for this weekend and I can't be more excited. Cool nights, campfires, hikes, smores and a cold beer for Dad. Oh yeah!

One thing I've learned over the past year is to not take my health for granted. I've been lucky (genetically or otherwise) this far, but I'm sure the next 40 years will be tougher than the last 40 years. So midway through Linda's treatment I started training. Training for what? Nothing in particular, just to be fit. It is my job, after all is said and done, to take care of my family. I can't do that if I can't take care of myself. 1 hour/day, 5 days/week is not that much but makes a huge difference to my mental and physical well-being. When Linda resumes her running, it'll be one more thing we can share and that's always a good thing.

An important change in me, at least psychologically, is the ability to concentrate at work once again. It is not there 100% yet, but at least I am not a zombie anymore, and as our company achieves more successes, I can feel the energy coming back. I have been blessed with a truly unique company and in particular, an incredible CEO who understands that a company is not simply a collection of people, but really an extended family. My extended family. Our extended family. I am surrounded by the best friends and colleagues anyone could ask for and I owe them a debt of gratitude for their understanding and compassion over the past year. Y'all rock!

Monday, October 6, 2008

Root of all evil?

Very interesting article about leading edge research on cancer stem cells from The Economist.

http://www.economist.com/science/displaystory.cfm?story_id=12202589

"Cancer may be caused by stem cells gone bad. If that proves to be correct, it should revolutionize treatment"

Radiation update

Linda's radiation is going well. The turn around time from when she leaves the house to when she returns is about 30 minutes. The actually irradiation takes mere seconds. Sure beats the day-long visits to the infusion room.

The Xeloda is giving her some mild tingling in her hands and feet (a known side-effect). Adding low-dose Xeloda isn't a standard practice yet (although it is in clinical trials) but if we get the benefit without any serious side effects, it's a worthwhile venture. There are different phases of a cell's division and the phase in which DNA is transfered is called the "S phase". Xeloda extends the "S phase" which increases the chances that a radiation particle will damage the cell DNA, causing the cell to self-destruct.

Linda is upbeat and her hair is finally starting to come back in. She is starting to make plans for a cruise next fall to Puerto Rico and the Virgin Islands. Making plans a year out is a great sign of her emotional recovery. Una cervesa por favor!

Friday, October 3, 2008

A typical atypical mole

A few months back, I suggested everyone go to their doctor and get their skin checked. Skin cancer is the most common form of cancer in the US. For once in my life, I decided to heed my own advice. I looked in my benefits package for the closest dermatologist and made an appointment. I think all my doctors have a last name that begins with A or B because they are the first ones in the list. I'm not too picky. I think most guys are like me. If I ever decide to become a doctor, I'm changing my name to Dr. Aaron Aardvark. That'll keep the patients rolling in.

The office happened to be just down the road from where I work and in a well-to-do neighborhood near the lake. I guess that's where dermatologists will find most of their revenue. At first I wondered if I had made a wise choice. It is my experience that a doctor's office usually has a wide assortment of health related pamphlets which adorn the waiting room tables and office walls. You know, the FAQ and self-diagnostic flyers for disease prevention etc. In this office, there wasn't a single skin cancer pamphlet. Not one. There were plenty of Botox(tm), Rejuviderm(tm) and skin bleaching promotional materials, but nothing 'health' related. I found that odd. They already had my $15 copay, so might as well go through with it right?

For the first time in my life, I was older than the doctor. My GP from when I grew up is still in practice in my hometown and is 75. He is older than my parents and they still go to him. I guess it's the 'older and wiser' thing that gives me some comfort. I guess that's just a symptom of getting older. Every second of every day, there are more people younger than you and less people older than you. Don't get me wrong, he's a good doctor, it's just my own personal hangup about being examined by Dr. Doogie Howser. And another thing. These days, I understand that when women go to see a male doctor, a female assistant/nurse is usually present in the room. So when a guy goes to see a guy doctor, is the assistant/nurse thing a common occurrence? I don't think that my doctor subscribed to the same 'lifestyle' that the real Doogie Howser did, so I'm not quite sure why the 20 something year old female nurse was in the room, but there she was. And there I was in my underwear.

As I was seated in the chair, the doctor started on my arm and worked his way around my upper body and head. He methodically dictated where the moles were and what they looked like. The nurse dutifully typed them into the laptop as he went. Then he asked me to stand-up so he could check my 'legs and buttocks'. My mind immediately raced to the morning's decision to put on any old pair of underwear. If I had known that a young nurse would be in the room with us, I'd have chosen some newer underwear with some elasticity to prop up my assets. But to my disappointment (and maybe her's too...who knows), I had chosen some war-torn pair out of the top drawer. I'm sure, as a guy, I had previously played this scenario out in my mind a few thousand times (Dear Penthouse Forum, I never thought it'd happen to me but....), but never did the scene end with 'hmmm...this mole here looks kind of strange'.

So there I was, standing in the doctor's office, my butt-crack showing, my 'junk' sadly doing a wholelotta nothing, and a doctor and nurse staring at my back-side ready to freeze the mole, shave it off, and send it to a lab for a biopsy. What the fuck!!!

As a product of the 70s and 80s, I never heard the word sun-screen as a kid. I never wore sun-screen and in fact, I used sun-tan lotion and once cooking-oil (yes, cooking oil) to intensify the effects of the sun. Sounds completely crazy now but that's just what we did back then. I worked as a landscaper most summers with no protection and no shirt. My yearly cycle would be to have a good burn early in summer, let all the skin peel off, then my tan would get darker and darker as the summer went on. I am the offspring of 2 British parents, so how I ended up with such a dark complexion is beyond me. With my long teenage hair and dark skin, my brothers would call me Pocahontas. I never considered myself a risk for skin cancer.

The doctor said it was an atypical mole. I asked if it was a typical atypical mole. He started talking about the ABCDs of melanoma and what to look for.

A = Asymmetry - mole is not symmetrical
B = Border - mole does not have a well-defined border
C = Color - mole has more than 1 color
D = Diameter - mole is bigger than 6mm

Mine was ABC but not D. It doesn't necessarily mean melanoma, but these things can lead to melanoma. After a long 7 days, the biopsy results were back. No cancer, no melanoma, just a mildly atypical mole (on a scale of mild, moderate and severe). He said "It's gone now, no risk, nothing else to do, just come and see me in a year". Whew!

We live in Texas and my kids are covered from head-to-toe when they go out. It just seems the sun is getting hotter and hotter and more dangerous. I'll get a mild burn after about 15 minutes. We aren't messing around.

So I urge you again, go get your skin checked out. You just never know. When I show up at my appointment next year however, I'm wearing a thong and doing some dumbbell curls in the parking lot!

Wednesday, October 1, 2008

Breast Cancer Awareness Month


Linda's port was removed last Friday. Woohoo! In the cancer community, this is a graduation of sorts and quite an achievement. It's nice not to have that reminder there.

To celebrate 'Breast Cancer Awareness Month', Linda starts radiation therapy today. She was tattooed on Monday with permanent marker. She also took her first low-dose of Xeloda this morning. This will continue for the next 6 1/2 weeks. Let's hope she tolerates it well. She's been itching to get back to running but unfortunately, in order to keep the radiation alignment in check, she can't lose any weight for the next month and a half. I have no doubt she'll be running the San Antonio Rock n Roll marathon next year!

Wednesday, September 24, 2008

Is this normal?

We celebrated our 13th wedding anniversary yesterday. What a fantastically normal day. I took the day off work, we had breakfast @ Rudy's, went and caught an early afternoon showing of 'The Pineapple Express' (very funny flick), we did some some shopping, got home to get the kids off the bus, cooked up some chicken on the grill, helped the kids with their homework, took my son to his first Boy Scout pack meeting, got 'em home, put them to bed and fell asleep watching Nova.

Honestly, on Dec 13th 2007, I wasn't even sure if we'd see 13 years. I was in complete shock and I had no idea what the 'C-word' meant. Months? Years? Not a clue. What I can say is that I can truly appreciate a normal day, and how blessed I feel to have the opportunity to do all those things. Carpe Diem.

Thursday, September 18, 2008

The Home Stretch

We met with Dr H. on Tuesday to go over the results of the PET scan and brain MRI in person. Again, all clear! There was some minor uptake around the area of the original tumor in the left breast, but that is most likely cells actively healing the site of the lumpectomy. Nothing to worry about but something we will keep an eye on of course.

Next up is radiation therapy. Studies have proven that radiation significantly decreases the odds of re-occurrence. If the original chemo was the cake and secondary chemo was the frosting, then the radiation is the sprinkles. Who likes cake without sprinkles anyways? The radiation regimen consists of targeting the lymph nodes as well as the site of the original tumor. It is administered 5 days a week for 6 1/2 weeks. That's about 33 half-hour visits to the radio-oncologist over the next month and a half. Luckily, Texas Oncology has an office only minutes from home so the commute won't be too bad (we used their downtown office for chemo as that is where Dr H. has her practice). I suspect I'll have a battle with the insurance on this one. Our insurance considers radiation therapy a 'procedure', which has a $0 copay whereas the provider considers it an 'office visit', which has a $15. $15 isn't bad at all, but when you have 33 visits, $15 x 33 = $465, and that's easily worth a trip to Vegas for the weekend. Does anyone out there have a similar experience with radiation, insurance companies, and co-pays?

"An ounce of prevention is worth a pound of cure", or so goes Dr H's aggressive treatment philosophy. Instead of straight-up radiation, Linda will be concurrently taking a very low dose of Xeloda (a chemotherapy) during radiation. This chemo (hopefully side-effect free) will extra-sensitize the targeted cells. Radiation typically damages the DNA of a cell during cell division. Cells are 'programmed' to kill themselves if the DNA is damaged during mitosis. That is natures mechanism to prevent unwanted cell mutation. There is only a very specific window during cell division when the radiation particle can damage the DNA. The role of Xeloda during radiation is to extend that window so there is more opportunity for the radiation particles to do their dirty work. At least this is my understanding from a 15 minute discussion with Dr H. The Xeloda is taken in pill form the day of the treatment so there are no more infusions, and if the Xeloda has undesired side-effects, Linda can simply stop taking it and continue on with radiation therapy as usual.

More good news...Linda is scheduled to have her 'port' removed next week. It is not a big operation but it is surely a nice milestone to achieve. It's been a long time coming!

Friday, September 12, 2008

Blue Skies and Sunshine

While hurricane Ike pounds our Texas coast, our family has been blessed with Blue Skies and Sunshine!

Official word came from Linda's oncologist @ 4:02pm.

Brain MRI - CLEAR
PET scan - CLEAR

The cancer has not spread and is, in fact, gone!

Thank you, thank you, thank you, thank you, thank you, thank you, thank you, thank you, thank you, thank you, thank you, thank you, thank you, thank you, thank you, thank you, thank you, thank you, thank you, thank you, thank you, thank you!

I'm going to go celebrate with the center of my universe!

John

Thursday, September 11, 2008

Karma

I've talked in the past about my opinion that there is a reason or explanation for everything. Today, the day of Linda's PET scan, something happened to me that I cannot explain. To understand it in context, I have to step back to just over 9 months ago.

A couple days before Linda's diagnosis, she was going about her usual pre-Christmas shop-a-thon. This day, she was at Target picking up some gifts for the kids. For one of his big 'Mommy & Daddy' presents, our son had asked for this huge Tri-Clops remote controlled car (it's pretty cool). If memory serves me correctly, it was about $100. She found one, threw it in the basket with the rest of the yuletide goodies and headed for the checkout. During checkout, one of the items rang up an error and because the error was on the screen, the next 5 or 6 items that were dragged over the scanner didn't register, including the Tri-Clops. Linda pointed out to the cashier that there was an error and after realizing her mistake, she pulled back the items that went through unscanned and rescanned them...except for the Tri-Clops. As Linda loaded the day's booty into back of the car, she thought to herself that the 'Total' was a little light. Sure enough, after checking her receipt, it became apparent that the cashier had missed the Tri-Clops. So here sat Linda in the Target parking lot with a choice. Go home with a 'free' Tri-Clops or return to the store to pay for it. Now before you cast stones, think of everytime your waiter has missed something off your bill (hey...he forgot to charge us for the coffee...cool). Did you bring it to their attention? Or when the shorts you bought at Walmart rang up at less than the advertised price. Did you point that out to the cashier? If you have, then you are a better person than I. Needless to say, Linda decided go home with a 'free' Tri-Clops. Several days later, she was diagnosed with breast cancer.

Were the 2 events related? Who knows? We often joke to our friend, who is a pharmacist at Target, that Target gave us cancer. It has become neighborhood folklore. Over the past 9 months, all of our friends have told us of recently being in a similar situation, recalling that Target gave Linda cancer, and then deciding to do the 'right' thing. It's kind of funny, but it does get you thinking...is there such a thing. Do good things happen to good people (or visa versa)? Does what goes around, come around? Is there a universal balance of good and bad?

So what does that have to do with Linda's PET scan today? Everything!

Linda was done her scans by 1pm. I had planned to meet her for lunch but she was literally still radioactive from the isotope injections and barium smoothie she drank. We thought it prudent not to go out in public for lunch. Instead, we'd make some tacos at home. I stopped of at HEB to pick up some lettuce, tomatoes, taco mix and such as well as some potted mums (one of Linda's favorite flowers) for my Honey. At 2pm, the grocery store is pretty quiet so I was in and out. As I loaded everything into the car, I thought something's strange...that wasn't the right total. Lo and behold, the mums didn't ring up. It was an instant of clarity in a 9-month long haze. You've got to be kidding me? On Linda's PET scan day? Is this a test? I can't explain it and won't even try to. It just happened because it was meant to be, no reason needed. I'll let you figure out what I did with those mums.

Tomorrow will be a sunny day!

Wednesday, September 10, 2008

Faith

Diagnosis, fear, anger, love, depression, chemotherapy, anticipation, optimism, isolation, uncertainty, surgery, pain, sympathy, grief, compassion, more chemotherapy, and hope.

It has taken a long 9 months of active treatment to get to this point. Tomorrow is a huge day. I can't even begin to express the feelings I am having. As much as I have been building tomorrow in my mind, it will be anti-climactic as we won't get the results until Friday (at the earliest) or next Tuesday (at the latest). At some point between now and then, we'll learn if we have been able to keep the cancer out of the rest of Linda's body. I'm trying to think of something insightful to say, but I can't. For once, I am at a loss for words.

Thank you to all the people who have sent prayers, positive vibes and/or good will. I may not have a traditional belief system, but I do have faith. I have faith in humanity. I have faith in friends and family. I have faith in Linda. I have faith that good things happen to good people. We have done everything we can and I have faith that tomorrow will be a sunny day.


Saturday, September 6, 2008

You go girl!

Linda attended her support group this week (for young breast cancer survivors) and was saddened to find out her friend, who is a stage IV survivor, discovered brain lesions after noticing some facial numbness. After further discussion with her group, it was revealed that IF triple negative (ER-, PR-, HER2-) breast cancers spread, they statistically tend to metastasize in the brain.

The next day, Linda was at the oncologist's office demanding a brain scan as part of next week's lab work. A PET scan covers the body from the neck down and does not include the head. A separate scan is needed for the head and not typically done unless symptoms exist. Linda left the office with an order for a brain scan on the same day as her PET scan (September 11).

Firstly, I'm glad Linda is back with her group. I can notice a positive change in her demeanor when she attends these meetings. Over the past few months they have occurred during her low cycle and she was unable to attend. She was on her feet for this one and it sure made a difference. Secondly, I am extremely proud of her for taking control of her treatment. She was not taking NO for an answer and was not leaving that office without a brain scan order. Slowly but surely I'm getting my Linda back. You rock babe!

Linda's friend needs your help. Please send your prayers and positive thoughts her way and let's help her get through this difficult time. Thank you.

Thursday, September 4, 2008

You booked your PET scan for what day?

September is a busy month around our household. In addition to new school year activities, both kids have their birthdays in September (Linda is usually in a very festive spirit around Christmas, I'll let you do the math...LOL), and we celebrate our wedding anniversary (13 years) in September also. So that's 3 days out of the month that are off the table for appointments. That leaves 27 perfectly good days to schedule a PET scan. Sept 8th, great, Sept 14, that'd be perfect, Sept 15, fantastic. So when did Linda schedule her PET scan?.....9/11. Uhhhg!

So...for us, September 11th will no longer be a day of sadness but we plan for a day of celebration. The 1st annual 'Clear PET Scan' day.

Tuesday, September 2, 2008

Advice needed: Preparing for a PET scan

Linda finished her chemotherapy last Thursday and Labor Day presented us with a nice long weekend to recover. She was definitely exhausted all weekend but was able to putter around the house for a few hours at a time. The primary side effects are wearing off and hopefully by week's end, she'll be up and about for the whole day.

Our next major event will be a PET scan in about 3 weeks, prior to radiation therapy. Linda had CAT and bone scans prior to chemo but that was 9 months ago. Everything turned up clean then, and in all honesty, I didn't realize the implications of the test. This time however, I am all too aware of the importance of the PET scan results. Remember the 'longest 2 days of my life'? I'm pretty sure the wait for the PET results will top those 2 days. It is still weeks away and I am already stressed about it.

A question to anyone who can offer advice: How do you cope with the stress of it? More importantly, how can I help Linda cope with it?

Friday, August 29, 2008

Why are manhole covers round?

I have been blessed and cursed by an analytical mind. The way I see it, there is a solution to every problem and an explanation to every mystery. We may not see it (yet) but the answer is there. As long as I can remember, my mind has churned at solving real problems as well as trivial pursuits.

The simple task of walking from my home office upstairs to the kitchen downstairs to get something to eat typically involves several billion calculations. First, wait for a time when my computer is busy doing something, don't want to waste spare cycles. Wait a sec, my daughter's field trip authorization form is right here too, but I don't have a pen. Should take the paper with me to sign or should I bring a pen back from the kitchen. Hmmm...where is her backpack? She'll need this form in the morning...I think it is near the front door...what makes the most sense and where should I sign it to be the most efficient. I need a beer too. Import or domestic? That dictates whether it will have a twist off cap or not, which means I may need to think about a bottle opener. Oh I think I left that in the garage last time I was working on a game. Crap, that is way out the way...does my daughter's backpack have a bottle opener on it? That'd be great. I know they make Reef sandals with a bottle opener on the bottom. What a great invention. I wonder if they have a patent on that? Let's Google that, but before I do, let's see why imported beers don't have twist off tops. Is that a law, federal or state? Wonder who invented the twist off top? Remember pull tabs? Those were replaced with the pop-tops we have today. I wonder if you really can buy a wheelchair by collecting a garbage bag of aluminum pop-tops? Let's go hit Snopes.com and find out. Look at that, turns out Thomas Crapper did not invent the flush toilet after all. Funny, in London, manhole covers have the name CRAPPER right on them. How ironic. I wonder why manhole covers are round? Turns out that is the only shape that makes it impossible for the cover to fall down the hole. That's pretty cool. See, there is an answer to everything. Much to Linda's chagrin, my mind never seems to figure out how to incorporate "there is a basket full of laundry here at the bottom of the stairs, maybe I should take it upstairs" into my equations. There may not be an answer for that one...LOL.

If you have a brain wired like mine, you know exactly what I'm talking about. If you don't, then you likely think I'm a bit crazy, and I'm not sure I can disagree. With that as the backdrop, I have been thinking a lot about cancer and 'why?'. Not 'why me?' or 'why us?' but 'why cancer?'. What role does cancer play in the big picture? I can't seem to wrap my head around it.

I can understand a virus. It is contagious, it moves from person to person, typically having a delayed onset of symptoms so that the current host is at least healthy long enough to spread the virus to the next host. I'm sure over that last billion years there have been virus variations that killed their host on contact. Guess what? Host 1 doesn't live long enough to spread to Host 2 and the virus doesn't get to spread its DNA (nature's prime directive). End of the line for that virus' lineage. Natural selection over millions of years makes sense. I can get my head around that.

So what about cancer? It is not a 'modern' disease. Although I'm sure pollutants and man-made environmental factors have increased the incidence of cancer and other disease, they are not the sole cause. Cancer predates man. It has been around for at least 100,000,000 years, as evidenced by recently discovered dinosaur fossils showing signs of cancerous bone tumors. I suspect it was around long before dinosaurs too. Unlike a virus or bacteria, cancer is not a foreign invader, it is home grown. It is our own cells and DNA gone awry. The Human Genome Project has mapped out our DNA and cancer researchers can point to certain genes and say, 'in some cases, this gene X suppresses cell activity Y but in cancer cells, this gene is defective and that, in combination with this protein over-expression Z yields a 34.7% chance of XYZ. That's very cool, but still doesn't explain the 'why'? Is it possible that cancer, like other genetic mutations, is simply part of natural selection and the evolutionary process? Some genetic mutations yield eyes on the front of the head for predators and eyes on the side of the head for prey, and natural selection dictates which traits go on to survive. That makes sense. Are those same genetic mutations responsible for cancer? Well, they've been there in some form for a long time so I have to assume they have some purpose. But what? I guess when we figure out the 'how' and 'why' we will have a cure. There is an answer and there is a cure, we just need to find it.

Thursday, August 28, 2008

A Great Day


6 infusions of TAC .......... $48,000
12 infusions of EP .......... $96,000
days since first infusion.... 240
ringing the bell ............ priceless

Wednesday, August 27, 2008

Cancer, cancer everywhere

Okay, I'll admit I'm a bit obsessive/compulsive. Not the 'all shoes in the hall closet must be straight and parallel, separated by no more 2 inches but no less than 1.5' kind of OCD, but more of an intense focus. My obsessions ... errr ... interests have ranged from harmless to productive and most who know me know I usually have a 'hobby' going on. I've busied myself in the garage for the past 6 years (off and on) restoring old video games & pinball machines. Before that, I did geocaching for a couple years, and before that, photography for a year or two. Of course, Linda and the kids have BEEN my life for the past 15 years. My company and my passion for software has also received a good deal of my mind's focus. Although Linda would surely disagree, maybe I'm not all that obsessive/compulsive after all. Up until our diagnosis, it had been a healthy blend of family, professional growth, and solitary hobbies. (Don't get me started on email and Facebook)

Now, my life is consumed by cancer. Everywhere I look, cancer. Every time I think, cancer. I have a hard time remembering what life was like before our diagnosis 9 months ago. I'm sure I was happy about something, angry at someone, sad about something but these days it is all about cancer. I am happy Linda's chemo will be done on Thursday. I am pissed off that cancer stole the summer of 2008 from our kids, I am scared shitless about Linda's PET scan in 3 weeks, and I am sad because...well I am just sad. There are small moments in the day when I don't think about it, for maybe 5 minutes, but invariably the cancer creeps back into my thoughts. Even the exhilaration of plummeting 3-4 storeys down a water slide at Schlitterbahn is tainted by the fact that Linda couldn't come with us because she is extremely sensitive to sun during chemo. That's is OUR park and OUR tradition and the fucking cancer took that away from us. I haven't spent any time this summer in the garage tinkering with pins and my ability to concentrate at work has been haphazard at best. I try my best to keep the big 'what if' thoughts out of my head, but on bad days, they eat me from the inside. I'm sure a psychologist would say these are normal reactions and blah blah blah blah, and I'm sure they are, but that doesn't make them any easier to deal with. True to my OCD tendencies, my life has become cancer.

You know when you buy a new car and as you're driving home from the dealership, all of a sudden, it seems EVERYONE has the same car. It's kinda like that with cancer. It seems every week I learn of someone else whose fighting cancer. My best-man's mother was diagnosed with breast cancer weeks after our diagnosis. A dear friend, who I have a great deal of respect and affection for, was diagnosed with cancer a couple weeks ago. A blog friend's sister was diagnosed with breast cancer last month, and just this morning, a friend from high school related to me that a member of his extended family was diagnosed with breast cancer. It is a club that turns out to be not very exclusive at all. My immediate and extended family has had its fair share of cancer, especially on Linda's side who lost her father to multiple myeloma. Cancer really is everywhere. Do me, yourself, and your family a favor and make an appointment to see your family doctor or specialist today. Do not ignore that funny looking mole on your back, do not put off that annual mammogram, and guys, that 10 second visit with Dr. Finger may seem uncomfortable, but in the end (pardon the pun), you'll be a hero to those who love you.

Wednesday, August 20, 2008

A tale of 2 husbands

A quick trivia question:

Your wife has been diagnosed with breast cancer. Do you?

a) bang your videographer
b) offer a $1,000,000,000 bounty on a cure for breast cancer

Former presidential hopeful John Edwards decided that the best way to deal with all the emotions that come along with being a breast cancer husband is to have sex with the woman who was documenting his presidential aspirations. The fact that he is a politician probably means he threw away his ethics long ago, but that doesn't excuse his actions. It is one thing to be a maggot in your professional life and another to be a maggot in your personal one. As much as I revile John Edwards, I can 'understand' his behavior. Surviving breast cancer exerts an enormous pressure on all aspects of your life, including your relationship with you wife, your relationship with others and your relationship with yourself. Bonds that are strong become stronger and bonds that are weak break. In a time of crisis, John Edwards chose to remain loyal to himself and satisfy is own insecurities as opposed to remaining loyal to his family who undoubtedly needed him more than ever. Sadly, having great moral character is no longer a requirement for becoming President, but I suspect his potential nod for veep has been compromised. The 24 news cycle has brought forward numerous talking heads discussing how common marital infidelity is during a health crisis. This may explain it, but definitely does not excuse it.

Mike Dewey on the other hand, a local business man, chose a more productive means to deal with his breast cancer crisis. He started a nonprofit foundation, The Dewey Foundation, and specifically offered a one billion dollar reward for a cure for breast cancer. It is called the Victory Project. You may question his ability to raise/offer $1B, but you can't question his devotion to his wife and family. Did some of the same thoughts and insecurities run through his mind at some point? Does he love his wife and family more than John Edwards? Is he a better person than John Edwards? Likely, yes, and yes. Thank you Mike Dewey for being a 'good guy'.

Saturday, July 19, 2008

Terms of use

As expected, Linda gave me hell for the 'Post Op' post. Hahahaha. It's all good though.

I really appreciate all the positive comments I have received about my ramblings. It really does make me feel good and allows me to get some of this off my chest. One rule of thumb is that you can't talk to me in person about this blog. Emails and comments are fine (and welcome) as I am much more comfortable as a keyboard commando than I am in person. Seriously, I get pretty uncomfortable talking about this and am liable to run away screaming or start sobbing uncontrollably depending on the day. I'm sure you don't want that :)

I've almost caught up to 'present day' at which point my ramblings may get a bit more scattered and less composed as I'd have had less time to think about what I want to say. The blog dates will be more reflective of when I post as opposed to artificially back-dating the posts to get a top-down presentation and flow like I've done up until now.

Thanks again and keep reading...

John

Monday, June 16, 2008

Welcome

Okay, Facebook has really crappy blogging apps so I've chosen to use Blogger to write my blog, but have them imported into Facebook (where all my friends are) using notes. Let's hope this goes over well. This also let's me share with friends who refuse to join the Facebook Borg.

Knowing how un-anonymous the internet is, I'll try to keep this as anonymous as possible sticking to first names only and no kids names. If someone actually reads this and comments, please follow that rule of thumb. If you are here, you probably already know me anyways.

I've never 'blogged' before, or really shared my feeling publicly for that matter. A recent change in our life circumstances has prompted me to reach out and share our journey. Why blog? I hope it will be somewhat cathartic for me. I hope that someone, somewhere who is in the same situation can benefit from my experience and maybe help me get through this journey too. I also spend a good deal of time discussing our situation individually with friends and family and so hopefully this can act as a means for friends and family to stay up to date with how Linda, the kids and I are doing.

Today marks the 6 month anniversary of our life changing event, so my next post will chronicle how we got from Dec 13 '07 to Jun 13 '08.

The Diagnosis

Christmas around our house is usually pretty chaotic. Planning usually starts around Nov 1 (Linda has been known to buy Christmas decorations in July). I have 8 huge rubbermaid tubs of 'stuff' to unload from the attic every Christmas, and every Christmas there is a new tub. Lights, reindeer, inflatable snowmen, spotlights...you get the picture. I think Linda makes up for the lack of snow in Texas by trying to cover the lawn with decorations. It is absolutely Linda's & my favorite time of the year. To be honest, we really don't need lights around the house because the glow from Linda could light the world at Christmas.

So the week of Dec 10 was shaping up to be a standard pre-Christmas week. Aside from the gifts that Santa brings, Linda races back and forth between Target, Kohls, JCPenny making sure the kids, and the pets, all have an equal amount of presents (she is really crazy that way). This week, she was finally going to get that mammogram. You see, back in September, Linda had noticed a lump in her left breast, but it would come and go. She saw her doctor who assured her that it was probably some hormone related fibroid mass. She said that when she had a chance, to go get a mammogram so they would have a baseline to measure against. Linda was 38 at the time so within a couple years she would start having yearly mammograms as the literature suggests. The visit to the lab was uneventful (if you can call having your boob squished to the size of a pancake uneventful).

Tuesday the 11th, Linda called me at the office and said her doctor saw something to be concerned about on the mammogram. They asked her to come in so they could do a biopsy on the mass. They call it a fine needle core biopsy. They stick a needle into the mass and with a little 'pop', they suck out a bit of it. They do this a couple times around the area. It is done right in the doctors office.

At this point, I was concerned, but not overly so. There is a history of these masses in Linda's family so this was just going to be one of those. She's 38 years old for Christ's sake. Linda called me after her doctor visit to see where I was on my way home from work. Turns out I was only 3 blocks or so ahead of her so I would beat her home. I met her at the door as she got out of her car and she started to cry.

I actually thought she may have hit a dog or cat on her way home and was upset about it. I really must be a moron because the 'c' word hadn't even entered my mind before this point. Not at all. This was just going to be one of those women-doctor-female-
voodoo things that some pill will take care of. It had always been that way in the past and this would be no different. Well, as you may have guessed, this was different. The surgeon who did the biopsy confided in her that, even before the results of the biopsy (which were due back on Thursday), he was pretty sure this was cancer. Fucking cancer ... and I wasn't even there for her when she first heard the 'c' word. Nice husband eh? Linda drove all the way home from the doctor's office, even called me to make sure I was okay, and never let on. It was only when she got home did she start crying...and my tears weren't far behind. This really sucked. This really, really sucked.

The next 2 days, waiting for the official biopsy, were by far the longest 2 days of my life. There had to be a mistake. I was convinced of it. This was Linda after all. She was training for a 1/2 marathon and was regularly running 10 miles on Sunday mornings. She was in the best shape that I had ever known. Eating well and exercising 5 times/week. For those 2 days, I was a mess. My eyes would well-up in my office, in my car on the way to/from work, pretty much everywhere. I prayed to God to make this better. I prayed to God to give me the cancer instead of Linda. I told God I would go to church every Sunday for the rest of my life if He made Linda better. I talked to God more in those 2 days than I have ever in my life. This may seem like a normal reaction to most people, but you see, I don't have a God. I'd done fine for 38 years without a one, but I can tell you I was looking for one desperately in those 2 days. If He was there, he wasn't listening. We got the lab results that Thursday.

I've probably been called useless several times in my life, but I don't think I've ever 'been' useless...that is until Dec 13, 2007. I'm not quite sure what the right thing to do when the love of your life, the center of your universe, your source of strength breaks down and sobs "I don't want to die". That moment is etched in my mind for eternity. I'm not sure what I said, probably something stupid like "Don't worry, we'll be fine". I do know what I thought though. "I don't want you to die either". This really, really, really sucked.

The initial clinical diagnosis. Invasive Ductal Carcinoma. 2.5cm mass in the left breast. 2-3 lymph nodes involved. Stage IIB. Moderately aggressive histological grade 7. ER-, PR+, Her2-, non-metastasized. In layman's terms, at least to me, a middle-of-the-road breast cancer. It will take some work (chemotherapy, surgery, radiation) to get rid this, but the battle is winnable. (more on the treatment in a later post)

We decided to tell the kids later that same night. I think we did it the the right way. Right for us. All huddled up on our bed, like we've done many times watching movies at night. We all cried. As much as it sucked, I will forever cherish that moment of bonding we all had.

Our journey had been set. We came to accept this was the hand we were dealt and we would get through this as a family. We still had Christmas to celebrate, it is afterall, our favorite time of year. And how did Linda cope...she planned and hosted a Christmas party for all our friends and neighbors...she is a superstar!

The Treatment (part 1)

Having spent the first 28 years of my life north of the 49th parallel, I, like many Canadians, came to believe that health care in the US was made up of pharmaceutical lobbyists, greedy insurance companies, and long lines of uninsured people being kicked out of emergency rooms because they couldn't pay...at least that's the way they portrayed it in the CBC after-school special I saw :)

Seriously though, it was a big factor for us when deciding to move to the US in the late 90s. We grew up with decent "free" health-care, so moving to a place with privatized medicine and big, bad insurance companies was something that gave us pause for thought. Our first serious experience with it came when our 1 year-old son began losing weight, vomiting 4-5 times a day and regressing in his motor skills. The doctors performed a series of tests for hearing, balance, vision etc. If the word 'cancer' doesn't make your knees drop out from under you, then the words 'brain tumor' when used in reference to your 1 year-old son surely will. All those tests turned up negative and after a few more months, we finally had a diagnosis of Celiac Disease. CD is a genetic auto-immune disease which affects as many as 1 in 122 people, most of whom go undiagnosed and spend a life of unexplained stomach/digestive problems. Because the symptoms of CD often mimic other diseases, mean time to diagnosis is 11 years. After a GI tract biopsy (the gold standard for CD diagnosis) we had our diagnosis in 4 months. The course of treatment was quite simple. Stay away from wheat, barley, rye and oats for life. Considering all the shitty hands we could have been dealt, this was an ace-high flush. 5 years later, our son is a healthy, thriving boy, and except for our references to "good-belly" (food that is gluten-free) and "boo-boo-belly" (food that contains gluten), you'd never know he has CD. I cannot say enough about the quality and timeliness of the health-care we received. From his pediatrician who initially diagnosed him to his pediatric GI specialist who treats him, we have had access to the best health-care and caring professionals the world has to offer.

We wanted to tackle Linda's breast cancer head-on, as quickly as possible, as anyone would. We were scheduled for chemo to start less than 3-weeks after her initial diagnosis. Because there was a spread to the lymph nodes, chemotherapy wasn't an option, it was a necessity. Chemo is known as a systemic therapy because it treats the whole body. Surgery and radiation are known as local therapies because they treat the affected site (her breast and lymph nodes). The only real choice we had here was the order of treatment. Surgery first, chemo second and radiation third or chemo first, then surgery followed by radiation. With the doctors help, we chose the latter because of a couple reasons.
  • There was a risk that the cancer cells had made their way past the lymph nodes and into the rest of the body. Her diagnostic scans (cat scan & bones scan) had shown the cells hadn't metastasized anywhere else but free floating cells were always a possibility. Early chemo would kill those bastards if they were out there.
  • Having chemo before surgery (known as neo-adjuvant therapy) also allows the doctors to watch the tumor and see how it responds to the drug cocktail.
With that decision made, next up was the "Power Port". Being an avid gamer, I was pretty sure this was an accessory for my XBox. Turns out it is an under-the-skin catheter that runs from the upper right chest (in Linda's case) under the collar bone and into (or near) the heart. This allows the chemo to be administered at a much quicker rate and to be diffused into the bloodstream quicker due to the proximity to the heart. A standard IV injection tends to "burn up" the veins. Nice thought eh? So just before New Years, Linda had the port "installed" at the hospital during an outpatient visit. Strangely enough they don't 'knock you out' with a proper general anesthetic, they just give you goofy gas (same stuff you get when getting your wisdom teeth out). In true Linda fashion, she managed to wake up during the surgery. Long enough to feel a burning in her chest and hear someone say "...she's awake...", then knocked back out. She has a strange knack of being in the "1%" of the "this only happens in 1% of the cases". This knack is so fine tuned that during our immigration health checkup, she actually got a mild case of German Measles from a rubella vaccine. No shit. She has her own CDC record of the event and was home-quarantined for 3 days. Some crazy odds like 1 in a million. I like to call her "patient zero".

I'm pretty sure there was some discussion about doing tequila shots in her port that New Year's Eve. We were glad to be done with 2007 and looked forward to 2008, especially Jan 2, her first cycle of chemo.

Pick Your Poison

Chemotherapy, as I see it, is an contradiction. On one hand, it is the culmination of 30+ years of intense scientific study, hundreds of thousands of hours of clinical trials and observations, harvested from obscure sources like rain-forest plant roots and a tried-and-true systemic treatment for many, many forms of cancer with millions of life-saving success stories. On the other hand, it is a poison. Designed to kill...indiscriminately.

Unlike targeted therapies such as Tamoxifen and Herceptin, which specifically attack cancer cells (or at least the mechanics common to some cancer cells), chemotherapy attacks all cells in the body. Usually injected, sometimes ingested, chemo travels to all parts of the body fed by the circulatory system and wreaks havoc wherever it goes. Although it isn't targeted to specific cells, chemo typically targets a specific cellular function or functions and jacks with it in order to cause the cell to die, whether a cancer cell or otherwise. The functions that it most commonly attacks are the cell division functions. Lo and behold, most cancer cells are dividing like crazy, that's what they do. So when the chemo is present in the body, it messes with those cells that are dividing rapidly, effectively killing them, and leaves the other cells (which aren't dividing) alone. So you may ask, isn't that targeting the cancer cell? Not really, because there are other cells in the body that are rapidly dividing too such as cells in the mouth, stomach and intestine, hair cells, nail cells etc. Guess what happens to them? Guess what the major side-effects of chemotherapy are? Wicked nausea, mouth sores, hair loss, blackened finger/toenails. Tingling in your extremities is also common because of temporary nerve damage. Throw in the inner workings of a woman's body (even in a healthy woman, that stuff is balanced precariously), hormones, hot-flashes, eye-of-newt, toe-of-frog...you can understand why Linda's first round of chemo caused some apprehension for both of us.

Chemos often work better in combination, almost like a one-two punch, or in Linda's case, a one-two-three punch. They are chosen based on the type and behavior of the cancer cells present in the tumor. Her regimen: Taxotere, Adriamycin and Cytoxin, collectively known as the TAC regimen. The drugs are administered sequentially in one sitting (takes about 5 hours in all), then repeated every 3 weeks, for 6 cycles.

On Jan 2, we showed up at Texas Oncology ready for the unknown. If you know Linda at all, you know she plans everything to the nth degree. Lists upon lists of things, plans, backup plans, alternates to the backup plans. There is no doubt we could have camped out in the infusion room for a few days with everything Linda brought with her that day. Every imaginable scenario had to be covered. Flood, drought, famine etc. Blankets (both thick and thin), shoes, slippers, sweaters, 2 ipods (one for me, one for her), sandwiches, fruits, vegetables, cold drinks, hot chocolate, books, the latest grocery checkout line finds of People, US, Ok, Star and others (sorry, those are my secret guilty pleasure), a newly acquired day planner of dates/times/schedules/metric conversion charts...oh and yes, a duck.

The duck is an inside joke between her and her girlfriends, who now call themselves her 'breast friends'. At some point in time, it resided in a lakehouse the girls rented for a weekend getaway. But now, over the past year, the duck has been found randomly by one of the girls in their kitchen pantry, bathroom, freezer, tree or other surprise location.

So Linda, facing the greatest uncertainty of her life, still lit up the room with her trademark smile and brought along a duck for a little comic relief in as much to say "Don't worry guys, I'll be fine". If that is not courage, I don't know what is.

The Treatment (part 2)

The 'infusion room' sits on the top floor of Texas Oncology's brand new building near the center of the city. You park underneath and take the stairs or elevator to the 2nd floor. Linda always chose to use the stairs. To her, it became a benchmark to see how badly the chemo was kicking her ass over the next 4 months. To me, it was just a reminder of how out-of-shape I was. Emerging from the stairwell, you are presented with a large, nicely decorated reception area. To the right, administrative booths and further down the hall, exams rooms. To the left, scheduling booths, a pharmacy and further down, the 'infusion room'.

Unlike what I had expected, it is not a depressing place...and I don't mean the decor or lighting, I mean the people. You'll find people there from every walk of life, and every age: Big burly guys, little old ladies, a young lady listening to her ipod, someone watching Jerry Springer, and a 39 year old woman fighting breast cancer. I think by the time people get to the actual chemotherapy, they are past the initial cancer shock and are anxious to get going with their treatment. Now don't get me wrong, no one wants to be there, but if life's journey sends you down this path, this place seemed to be, at least to me, a place of hope and not despair.

Prior to any treatment, we always saw the oncologist (the cancer doctor). Linda managed to get one of the best oncologists in the city. Although very clinical, Dr. H. has an incredible ability to reassure you. She would always explain what our options were and what we could expect. She directed treatment but never dictated it. She has just the right balance of professionalism and compassion. Blood-work was also a staple of every visit. They had to make sure Linda was healthy enough to poison.

The infusion room has 4 sections. Each section is separated by a half wall. Each section has 8 chairs, with 4 chairs that face the other 4 chairs. It has big windows on 3 of the 4 walls making the room nice and bright. For every 2 chairs, there is 1 overhead TV (above the heads of the chairs that face you). Aside from eradicating the cancer from her body, the primary goal of every visit was to secure access to the remote control for the duration of her stay. There was no way that Linda would allow someone else to control her TV viewing destiny. As you can see in yesterday's photo, even before starting any chemo on her first visit, Linda had already seized control of the remote.

For all the build up, the anxiety about the treatment, the unknown, the first infusion went very well. They hooked up bag #1 (which I think was the C) and it dripped away for a couple hours. Linda really didn't notice anything at all. #2 was the A. This is a bright red liquid that is manually injected into the port by the infusion nurse. Adriamycin has the potential to be very bad for your heart, so they inject it slowly by hand to watch your reaction. The nurse sits there with a big ass syringe and slowly, for 20 mins, injects the red chemo. They call it dessert. If they pump it in too fast, you may get a headache, but that's usually it. After the A was the T. It too dripped away uneventfully for a couple hours. I don't know what I expected, but it wasn't that. I think I asked Linda "how do you feel?" every 10 minutes or so for our entire stay.

Armed with a day-planner-full of anti-nausea prescriptions, we drove home and sat outside that evening as we usually do during school breaks (it was still Christmas break for the kids). The neighbors came by one by one to see us, almost incredulous to the fact that Linda was outside. I doubt the words were actually spoken, but I know Linda and I for a moment thought the same thing..."this chemo stuff is easy"...ohhhh shit!

The Fallout

New advances in cancer research are not only confined to the prevention, detection and treatment of cancer, but also include huge changes in the world of anti-nausea drugs. Next to the cancer-fighting capabilities, the next thing most people think about when they hear chemotherapy is the debilitating nausea. I know we sure did. As little as 10 years ago, that may have been true but 'big pharmaceutical' has made huge strides in that area. In 99% of the cases, nausea has become a non-event in chemo treatment. Sure there are many other side-effects to chemo to keep you occupied like extreme tiredness, nerve damage, hair loss etc but the nausea, in 99% of the cases, is non-existent.

You may recall how the 1% rule applies to Linda. Man, did she get sick after that first round. The slide from "I don't feel a thing" to "I'm getting sorta crampy" to "Get me the barf bowl" only took about 2 hours. It was full-on. It was so intense that Linda ended up back in the infusion room the next morning to get re-hydrated via IV...and again the next day. Even though Linda was on Kytril, Decadron and Phenergen, three very good anti-nausea meds, the doctors had grossly underestimated the Linda 1% factor. This is the same woman who gets sick reading in a car, sitting sideways on a bus, watching me play a video game and nearly vomits on the 'Barnstormer' kiddie ride at Disneyworld.

After 3 days, Linda started to recover from the chemo as it left her the body. The nausea subsided and Linda was coming around again. I can't really explain what she went through, only she could, but in the big picture, it was worth it. For those 3 days I busied myself doing all the laundry (I was pre-instructed on how not to mix whites & colors), cleaning the house (Honey, the dishes go this way in the dish washer, not that way), corralling the kids, and checking in on Linda every 5 mins. I know I couldn't 'fix' her pain, but I sure as hell could make it easier for her. It's pretty much a blur, kinda like when you bring a newborn home from the hospital for the first time. On the plus side, 'the unknown' was behind us now. The doctors took out the 'big guns' for the next round. Emend, Aloxi, and Ativan and they would prove to be a huge difference, but before we could get to Round 2 we had to face the inevitable: Hair Loss.

Chemotherapy doesn't actually kill the hair follicle (which is why the hair loss is only temporary), it just messes with the hair cells when they are dividing at the root under the skin. Those new hair cells are extremely fragile, so in 2 weeks, when the hair grows up past the skin, it simply snaps off.

Many women choose to shave their heads as an act of empowerment over the cancer. Earlier that year we had watched Robin Roberts of 'Good Morning America', recently diagnosed with breast cancer, shave her head on TV. Little did we know we would be faced with the same situation only months later. For Linda and I, it was a practical matter. There was hair everywhere. On the pillow, in the shower, on the couch. You could literally pull out a chunk of hair just by clutching it. I've known Linda for 16 years and in that time, she has never liked her hair. Too thick, too thin, too curly, too straight, too light, too dark, too gray, too short, too long. As fate would have it, in the months leading up to this, she was finally happy with her hair. Go figure!

Even though it was a practical matter, it was still quite emotional. Linda's friends had suggested she have a hair-cutting party with wine & cheese. It was too personal a thing for her to do that. This was our battle. The four of us, as a family, armed with the Wahl buzz cut kit I has bought earlier that day at Target, began to shave off her hair. The kids took their turn as we worked our way down from a #3 to a #1/2. After 15 minutes we were done. It is the not the physical act of shaving your wife's head that is emotional, it is the realization that you can no longer deny the fact that your wife has cancer. Every morning, we would be reminded of our fight. After a while I think we got used to it, if that is possible. Linda's friends threw her a hat and scarf party. Everything from "pretty hats" to "skull and cross-bone do-rags". Not only did it allow her to cover her head, but it gave her more reasons to buy more purses to accessorize with (someday I should write about Linda's purse 'issues').

This is kind of an aside, but Linda's bald head turned me on. No, not in a gay-Telly-Savalas kinda way. You really can't get much closer mentally, spiritually and physically than shaving your wife's head in the shower.

In public, like it or not, a bald head on a women is like a neon-light saying "I have cancer". You get the strangest reactions from people. Honestly, most people are too busy with whatever they are doing to even notice. Some people will be extra nice and a bit sympathetic. Some people just stare like there is a neon-light on your head saying "I have cancer". One evening we took the kids to Gattiland, an all you can eat pizza place with arcade. As we were eating, a couple sat down next to us and began to eat. He looked over at Linda, whispered something to his wife, she looked over, then they got up and changed seats. Are you fucking kidding me? Hey jackass, you can't catch cancer! For one moment, I wished cancer was contagious because I would have had Linda get up and give that bastard a bear-hug.

In support of Linda's follicly challenged head, some of her girlfriends joined the Sinead O'Connor tribute for a day. Many people wonder what they would look like bald. My genetics predisposed me to some cro-magnon-like appendage on the back of my skull that I like to refer to as the "bottle-opener". Turns out Linda has a very nice melon. Smooth and round. A childhood accident has carved an "L" scar on the back of her head which was hidden for 30+ years. It will soon be covered again with wavy brown hair but for now it serves as a nice monogram.

The Grind

...and so went our lives for the next 4 months. TAC chemotherapy every 3 weeks for 6 cycles. As is much possible, it almost became routine. With the new anti-nausea meds, the poisonings became bearable.

Wednesday was a visit with Dr H. and chemo day. A quick blood test would make sure Linda was well enough to receive her treatment. I'd leave her in the chair with her blanket and remote control and head off to work. I'd pick her up again around 3pm. One of our friends would make sure the kids got off the bus ok and take care of them until we got home. With no immediate family in town, we really came to appreciate the good will of our friends and neighbors who all wanted to help in whatever capacity. Knowing she'd be out of commission for a few days, Linda would try to finish her chores as it usually took a few hours before the 'blahs' kicked in. By 7pm it was time to tuck her and the kids in for the night.

Anyone who knows me knows that I am not a morning person. My biggest adjustment to the new routine was getting up at 6am to get the kids ready for school and putting them on the bus on Thursday mornings. I never knew people were actually up and about that early in the morning. Who would of thought? Hell if Linda could endure 4 months of chemo, I could surely endure 1 morning every 3 weeks right? They don't just sell those 'Super Dad' coffee cups, you have to earn them! On the agenda for Thursdays was as a quick visit to get a Neulasta shot. Neulasta helps the body create more white blood cells.

By Friday, Linda would usually be feeling better, enough so to get the kids ready for school and bring me my cup of coffee in bed in the morning (did I say that I love her?). We normally took the first weekend after chemo pretty easy. The other 2 weekends of the cycle were the standard 'how do we entertain our kids?' weekends of movies, camping and such. Linda actually had her chemo (and recovery) scheduled around the weekends to make sure the kids and I were impacted as little as possible.

By midweek the following week, Linda would go in to check her "levels". Chemo affects both blood cell types. The red blood cells carry oxygen around the body and when they are low, you feel tired and sluggish. White blood cells fight off infections. Both of theses cells end up being depleted during chemotherapy. About a week after treatment is when you are at the bottom of your cell roller-coaster and although you feel great (relatively speaking of course), your body is very prone to infection. Linda would avoid going to public places during this time and carry a little bottle of hand sanitizer with her.

Compared to round1, rounds 2 and 3 were a cake walk. After the first round, the tumor in Linda's breast and lymphs nodes began to break up and started to feel mushy. After the second round, the tumor was almost non palpable in her breast and nodes. After round 3, you could no longer feel the tumor at all. Just a small crescent shaped bump of scar tissue from the original biopsy. The nature of Linda's tumor made it extremely sensitive to this regimen of chemotherapy. The choice of pre-surgery chemo also began to show its merit as we could see that the TAC was doing its job effectively.

Chemotherapy has a progressive, cumulative effect on the body. You never bounce back to where you were before the round. Although the nausea effects are the same for each round (now under control), the tiredness builds and builds. By the time Linda had 4 rounds, in mid March, the chemo was taking its toll both physically and psychologically. She stayed in bed for 4 days straight after the 4th infusion. She couldn't even stand. She collapsed in tears one day on the bed saying "I can't take this shit anymore". She is a very strong woman but had finally came to accept that this chemo was kicking her ass. Although the physical strain had taken its toll, I believe at this point it was the psychological aspect which really affected her. Her friends, with whom she trained for the marathon, were now running the marathon. Friends were basically continuing on with their lives and she really felt left behind. It was really tough on her. I guess before you come up, you must go down and I think this was the bottom. As a typical guy, I tried explaining logically why she was feeling this way and that, in fact, no one had abandoned her and everyone was still there for her. Well 'logic' and 'woman' go together like oil and water. I think when I simply acknowledged that she had every right to feel this way did she start to feel better. The fact is no one can be upbeat all the time. My 'bottom' would come a couple months later when, after Linda's treatment, I started to acknowledge what a toll this was taking on me.

But before I get into that, Linda was starting to feel better and we could see the light at the end of the tunnel. Linda needed some shopping therapy...and not just any shopping...cranial prosthesis shopping!

The New Do

Somewhere down in clause 2.2.3, subsection 2a of our medical insurance, under "Durable Medical Equipment", you'll find an entry for a Cranial Prosthesis. Do they really have to call it that? If it just said "Wig", wouldn't every English speaking human understand what it meant. The insurance company website has green fields with trees, patients (sorry...members) laughing, doctors in white jackets and some tag-line about caring, compassion, health...blah, blah, blah. I don't know, it just seems kind of hypocritical to me to talk about all that big corporate compassion shit, and still, they expect you to feel good about getting pre-approval for a "cranial prosthesis" for your wife. Just call it a wig! That way, I can go to the pamphlet (that I had never read up till this point) and go to the index of "Shit I'm covered for", under W, and see Wig = "Up to $500". That'd be so much easier.

Don't get me wrong, our insurance has been fantastic (fingers crossed) and nothing in Linda's treatment has been denied (fingers crossed) and we get to go see who we want, when we want. Still, the word "Cranial Prosthesis" in subsection 2a, under "Durable Medical Equipment" in clause 2.2.3 made me realize that we are just a number in some vast private health-care system and, aside from our team of oncology doctors who really do care about us (more specifically Linda), we are a series of claims and "explanation of benefits" forms to the industry. One of my biggest fears is that someday the insurance company computer will flag us as 'non-profitable' (which I'm sure we already are...I've seen how much this treatment costs) and we will be denied. That day hasn't come, but if it does, we've always got that passport with the Queen and Maple Leaf on it as a safety net.

From the day Linda first lost her hair, the option of a wig was always on the table but it took her 3 months of do-rags before she finally decided she wanted one. I think she just got fed up with all the awkward staring. So with a prescription in hand and a girlfriend by her side, off they went to the wig shop. As a side note, it was a good idea to take a woman along for advice. Don't ever ask a guy if something looks good as he is programmed to always say 'yes', even if it looks like a group of sparrows nesting on your head.

Linda would kill me if I posted some of the photos of the hair she tried on that day. The fact that she thought it'd be funny to have us draw all over her head before she went to the shop is phenomenal. In true Linda form, she thought of the kids and I first and turned what was probably a difficult thing for her into a fun activity for everyone else. (btw I Photoshopped my kid's names out of the photo).

Linda got her wig and wore it for a couple of weeks. She donned the do for a few 'occasions' where a do-rag wasn't quite appropriate. You must realize that in April and May, the temperatures in Texas are already in the low 90s so having a nylon/polyester wig on your head isn't all that comfortable. Also, the hairstyle wasn't quite the same as her own, so Linda never felt comfortable wearing it. In the end, Linda was more comfortable in her do-rag and preferred the awkward looks of 'that lady has cancer' over the awkward looks of 'that lady has really bad hair'.

The Bell

As you enter the infusion room, there is a small brass bell on the wall to your right. Everyday someone rings that bell. The room is normally pretty quiet so a clanging bell easily gets your attention. That attention is well deserved. Every single person who rings that bell has had their own "Dec 13", a life changing day where a doctor told them they have cancer. Every single person who rings that bell has endured the painful side-effects of some cancer related treatment. Every single person who rings that bells hopes it is the last time they see that bell.

Linda may have missed out on the half marathon she was training for, but on April 16th, she finished the first part of her triathlon. It was her time to ring that bell.


(click 'View original post' if video doesn't display)

Like the big suck that I am, I got pretty choked up that day. Truth be told, I tear up during the ASPCA dog abuse fund-raising ads on TV so tears on my cheek are no monumental event, but this was big. For a small moment, we could declare victory. There are no guarantees in this fight, and Linda still had surgery and radiation therapy to go, but this felt good and sounded sweet.

You can hear Linda at the end of the video clip saying "We did it". From holding her hand for comfort during the first infusion to not mixing whites and colors in the laundry to proudly watching her ring that bell, we did this as a team (even though I was literally the 'water boy ' through most of it). We are stronger because of it and every day I am thankful to have Linda by my side.

With the help of friends and neighbors, we threw Linda a surprise post-chemo party. Friends, kids, presents, cake, and balloons (everything pink of course) were waiting for her when we got home that day. She finally cried.