The Chemo Chronicles - Part X

    December is a cold month here. Snow is accumulating, and I can't go for my daily walks, just too damn cold outside.  I watched my neighbor as he took it upon himself to shovel out my driveway.  Great neighbors, knowing my condition and my aversion to manual labour he did what I could not do.   Then the snow stopped and the Ice Age began.  That  was Sunday.  Monday I was forced to venture out to get my pre-chemo bloodwork done.

     Monday was sunny but oh-so cold; thankfully my down-filled jacket kept me warm, although I do tend to leave a trail of feathers everywhere I go.  But let me ask you, if down feathers keep you so warm, why do all the bird fly south?   However the bloodwork was done in a short time, and as I did not not receive any calls postponing my next-day appointment, Chemo #10 was on track.

    Tuesday (it is a chronicle after all) December 14 I showed up  at the Cancer Centre Pharmacy to get my 5FU pump. The pump was not ready again for the 3rd time in a row, but will be in time for me to go home.  For as much that is discussed about the side-effects of the chemo, I find the pump to be what really drains me. But it's only for a few days, and since I did it before I can do it again.  Only two more treatments after this (hopefully). 

     Chair #9 will be my chair for this session.  With the AVASTIN  in addtion to my 'regular' chemo medicine, I'm in it for almost 4 hours.  Fortunately I have my trusty Acer Aspire Netbook beside me-for the past 9 months it is attached to me as close as my IV Port.  I wonder if I should have a USB  port installed in the same fashion as the IV Port! (don't laugh, there are people who are doing crazy implants like that!)  Well I don't really want to become Borg-like, but without my electronic escape I really do feel lost.

     The chemo process is goes off routinely: blood return ok, saline solution, chemo meds and avastin.  Drip-by-drip over a four hour span.  The two shots are administered immediately after my washroom breaks.  This time however my IV pole had all good wheels; some of those poles act like they were shopping carts in a previous life (always one with a wobbly wheel).

     Prior to chemo my breakfast is light, just some Special K and toast and banana.  In the chemo chair I can't tell if it's hunger pangs or I'm going to get sick, the two feelings are both linked and constantly at war within me.  My appetite is the loser however, and I barely eat anything but some soup and a few chicken nuggets when I get home.  I had refused the kind offer from the Hospital for their lunch; I'm brave but not that brave.  Oh, stereotypes of bad hospital food aside, ithe lunch is generally ok, but my tastebuds refuse to accept that what is on my tray is actually tasty.  There's a wisdom that one does not eat one's favorite foods during chemo.  Bland foods seem to be what I can stomach.  In my early days of the chemo process I would sometimes wake up late at night with a craving, and would get up to satisfy that craving.  Lately however I find I need to discipline myself to eat.  Small meals, snacks throughout the day really, I don't eat 'three squares' anymore. (look up British naval history for the reference to 'three square meals', I believe it has to do with the wooden serving plates the men were given. But I digress)  What bothers me more is that I find that I am not drinking liquids. My water glass, a fixture on the table next me remains untouched.  I should be drinking a glass ever hour or two I think.  Water just doesn't taste the same during chemo.  Sometimes I squirt a little lemon juice into it, or supplant it with juices.  But not all juices -anything like OJ or Tomato that is mildly acidic can be painful to drink during chemo, the whole mouth is sensitive.  Make sure your toothbrush is EXTRA-extra-soft, for the bristles can irritate the gums.  Forget flossing unless you enjoy the Steve Martin-Bill Murray dental scene from "Little Shop of Horrors".  Remarkably though, once I've endured my 3 days of chemo within 24-48 hours my normal activities can be resumed.  Were it not for the exrtemely cold weather (and me an ex Northern Ontario lad) I would be walking outside all the time.  Oh and I learned my lesson about physical extertion during chemo time:  Don't.

   My chemo session was nearly over when a new patient sat down in the chair next to me.  Her treatment was about to commence when she pulled out a laptop.  A netbook really.  She noticed I was using my netbook and came over to see if I was able to get on the internet.  As I was happily surfing away, I assumed it was her connection.  She asked if I wouldn't mind looking at her computer, and once I revealed my IT credentials she was so very pleased to have a 'tech suppport' guy right there.  So now the pressure is on me to live up to my self-hype as an IT tech.  Sure enough when I checked it out her IP was acquired by IE7 was not bringing up the login credentials page.  I knew it worked earlier, as I was on my laptop (running LINUX, with Firefox.  Remember that for later)  So I did all the usual Windows things, cleared caches, reset security, the laying on of hands.  Still nothing, I would actually observe the Cisco redirect, but IE7 stalwartly refused to display the page.  I was running out of time as my session was now completed by this time and I really wanted to go home and rest.  Still I had few more tricks up my sleeve; although I run LINUX as my primary OS, my netbook is dual boot (plus I had virtual box installed so I could run OpenBSD or Win2K if I really wanted to).  But I booted up into XPHOME (same as the other netbook) and tried my IE7 out.  Sure enough same issue.  Oh Bother.

   Plan B, where the B stands for reBoot. Back into linux, could the session authentication be down?  Nope, I was in in a flash.  A Flash drive would solve the problem,  fortunately I happened to have a live linux distro on an SD card and a usb-attached card reader (acer's don't boot from SD. Pity)  So I took the liberty of booting in LINUX using the above-mentioned tools.  Sure enough, bringing up Firefox allowed the hospital credentials to be entered and she was able to access her mail sites.  Even after I removed the USB drive the live distro kept working with firefox (although not sure if anything else would work, or for how long).  When I left however it was with the knowledge that I had made someone happy in place where happiness can't always be found.  I will always take the small victories.

    Once home I could feel the energy levels drop, as expected.  Some soup for lunch then a nap.  No supper till later, and no appetite of course, and more worrysome for me, I did not drink much water.  Chemo pills at 9PM, some tv and sleep.  Sleep was hard, the first night on the pump I always feel like I'm going to be sick.  Finding a comfortable position was tough, but lying on my stomach  seemed to alleviate the feelings of nausea.   I don't recall this feeling from my first round, perhaps it's the lack of gall bladder exacerbating my already strange diet during chemo.  Deep breathing helped a bit; perhaps that is why so many cancer patients turn to Yoga to help them cope.  My weekly exercise class (now on hiatus til sometime in the new year) often introduces Yoga techniques, although my approach is more Yogi-Bear like.  Still I remembered the walking through the clouds and another breathing exercise whose name escapes me.  The breathing seemed to be the most effective, and eventually the nausea feelings subsided enough for me to sleep.

    Sleep while wearing a 5FU pump for me is like a chicken and egg thing.  In my first go-round of chemo I would remove the pump from the attached belt and place it on the nightstand.  Invariably I would roll over causing the pump to thud to the ground and pull at my port, waking me up with a start (and an annoying pain, it's a 27" needle thats in me. Or something like that.)  This time I keep the pump in the attached belt, leaving it on and shift it around me as I sleep.  Of course I wake up every time I need to roll over, fear of crushing a bottle full of toxic fluids does that to me.  So I gingerly maneuver the bottle like a mother hen watching her eggs.  My sleep is not deep and restful, but that's what Saturday mornings are for.  And Mondays when at work.

     My sleep was troubled this first night with a recurring dream.  It is the one that starts out with me staring in blackness, wondering when "it" will be all over. That's the bleakest of all my feelings, but strangely coupled with it is my  choice for pall-bearers.  Really, it's something I've thought about almost since I was diagnosed with Cancer.  At first it really  bothered me, later on I would actually think about it as it's a choice that needs to be made.  I like to think I am a pragmatic person, 20 years ago I made the arrangements to pre-plan my funeral.  That's all taken care of,  no additional stress on those around me when that time comes.  However I find the choice of pall bearers a significant one.  I have two brothers and a brother-in-law on my side of the family.  I have her brothers-in-law on her side of the family.  And I have my life-long friends.   I have my choices representing my family and friends.  But here's where I feel uplifted: I have so many choices, so many people I can call true friends.  I am truly comforted by this thought, and I sleep peacefully after that.

    Well the second day of chemo coverage was without incident.   Sleepy at times, hungry too, although mostly small meals. My throat was dry and I found I craved ice cream, that seemed to soothe it and no reactions from the lack of Gall Bladder  were noted.  Although the taste buds chose to make Hagen-Dazs ice cream taste a little off (more like Hagen-Daze) however it did the job.  I managed to focus on some small tasks (like solving 143 tactical chess problems on Chess Tactics, 125 correctly, 4 mouse slips and the remainder were glaring oversights to my game. But I had fun.)

    I was really tired thought and by midnight (after having the pre-sleep nap), I simply crashed,  slept much better through the night and wasn't bothered by any non-optimistic dreams.   Woke up to sunshine, had my pills (Zofran, Decadron and my EuroFer Iron supplement).  The problem with all these pills is that they tend to  bind me up, but lots of water, lots of raisin bran and flax seeds and more water and prunes helps.  Stupid side effects of the medication.

   There is still some soreness in my chest if I do even non-strenuous physical activity.   In a day or so once the 5FU bottle is removed I should be fine however, and able to build chemo clock #10.  I ran out of PCB boards, so step one is etch a whole new series.  Usually I do 6 at a time, but the way things have been going I might have to increase that number.  Who knew I would have an obsession with tube clocks!?   But I do more than tube clocks, it's the Christmas season, so a LED-based xmas trees needed to be built:

assembled LED xmas tree 16F630 style

 The finished christmas tree project uses a PIC16F630 to make pretty lights blink on and off, on and off, on and off..ok you get the idea. I have LEDS and PCB's and time to make silly things that I enjoy. 

blank PCB for xmas tree

  
  Here's the back of the board, before drilling.  One of the hardest parts of this project was cutting the shape of the PCB to the 'xmas tree' style.  One day I'll get better at it I hope.  This was a fun project, done just two days prior to my chemo.  I spent a chunk of time programming until the wee hours, which might explain why I was so tired the day after!



    Now it is Thursday, the last day of session #10, my pump scheduled to be removed this afternoon.  The bottle is almost exhausted, but I feel much better now.    My weight has gone down to 172.2lbs, but I was only 173.8lbs the day of chemo.  I haven't been this weight since the 80's but my past experience tells me that once I'm off chemo I will gain weight rapidly and keep it on.

    Now that I am free of my cytotoxic 5FU bottle, I can finally sleep soundly and indulge in the comfort of a shower (can only take a bath when wearing the pump).  It's the little things in life which make such a difference in one's outlook.  This tenth round of chemo  was somewhat better than the prior two, no doubt as my body adjusts to being whacked with poison.

   I made it through the process one more time, only two more sessions left.  Then the CT scan in February and we'll see how effective my ongoing treatment has been.   I don't really look for outcomes that far ahead, I endure what I need to endure, and make decisions when the facts are all assembled.  I remain cautiously optimistic about return to my work, about returning to a 'regular' life. 

  So far I have hit all my milestones, have come through the chemos and the surgeries with the best possible outcomes, and remained  positive and focused upon becoming healthy.   My hope is that the New Year will bring me to a healthy conclusion of this ongoing battle.  February will mark one year since the whole process started, with what was once a "routine" physical. Until then, I will enjoy life as best as I can.

Not toKnight dear, I have a headache . . .

     Thus far writing my blog has proved to be therapy for me.  I get to write about the biggest life-altering event in my 51 years and its effect upon how I live and view life.   Since it's all about me,  I can write whatever I wish.   I wish  to write about Chess.

      Through the years Chess has meant for a me a passion, a hobby and lately a diversion to help me balance my thoughts about life.  My earliest chess introduction stems from the legendary Bobby Fischer vs Boris Spassky world championship of 1972.  Now almost 40 years later, this match is remembered not so much for its games but from the struggle of personalities associated with it.  The mercurial Fischer has passed from icon to Mythic Figure to symbolize the lone chess genius able to defeat the world armed with nothing more than brains and desire and ego.  It is a classic Horatio Alger story for the Chess world. 
    
     I played this game with single-minded pursuit in my youth, but by the time I left home at 18 the game and I had become distant.   Years passed, and I played but rarely.   Then with the Internet came the Great Online Gaming community.  I learned that my hiatus from the game didn't interfere with my skills, as I quickly found out I had none.  Also, playing opponents from around the world at 1AM is not optimum.  I was rather disappointed; playing online is like playing against a computer (and sometimes the two are the same).   Playing chess is a social sport, despite the perceived view that chess is for the 'socially distant' members of society.

     After my initial round of chemotherapy finished, and just before my Liver surgery I found myself with some free time.  A couple of things happened,  one is I began to think about the upcoming surgery.  I thought about it a lot.  Unlike my first surgery, which was over in days, I had almost six weeks to contemplate the consequences of any failure.  Worse, I had time to construct many many 'worst case' scenarios if the surgery went awry.   Thinking of all those scenarios was not conducive to my mental and emotional health.  Bike riding was a nice distraction, but a) it's hot out and b) I can't ride umpteen hours a day (yet).  I needed a diversion that would let me enjoy my life and not allow me to think about the herd of tumours rampaging through my body.

     The second thing is I found Chess, or perhaps it found me.  The local Windsor Chess club was holding a series of weekend tournaments at the University of Windsor.   So one fine sunny Saturday morning, I sauntered (because people would think it odd if I sashayed... ) off to the tournament site.   I met the Tournament Director, a very nice fellow who of course encouraged me to join.  Since I was looking for a casual game, the stress of a tournament wasn't exactly what I needed.  I was curious to see how tournaments were run, and the calibre of the games.

    What I found was that the veteran players are very, very good.  Master class, way out of my league.  But the real surprise were the kids:  they are serious about the game and absolutely fierce competitors!  I had an opportunity to play one young man, say 10 years old just before the tournament started.  He beat me.   I lost so badly to him that I wasn't even embarrassed,  merely astonished at how good a 'small child' could be.  He was gracious in his win, we shook hands in the gentlemanly way,  and he kindly offered to play me again.  This time I didn't play him like  a kid.   I admired the way he hung on, hoping for a stalemate as I crushed him, taking all of his pieces leaving him with only a king and no chance to win.  My victory against a 10 year old only showed how much I didn't know about this damn game! 

    Having one's technical (in)abilities highlighted by a child, even an exceptionally gifted one,  is mildly ego-deflating, to say the least.  I would hang out at subsequent chess tournaments, watching, occasionally playing in the skittles room (ie. the room where non-serious chess may be played) and mostly losing.  But I had achieved my objective; by playing chess  I had engaged in an activity which distracted me from my surgery, my cancer and worrying about life. 

    Through the remainder of the summer until the time of my surgery I would venture forth to the local chess club, playing and mostly losing.  In the months after surgery, I would attempt to learn in a more diligent manner, but the second round of chemo would throw me for a loop on occasion.  Not exactly chemo brain  but concentration was difficult.  Apparently the ability to concentrate is a necessary aspect to play good chess...hmmm

     With  the successful completion of my surgery I realized I still wanted to play chess. Given my dismal record against 10-year-olds, I better give some thought to actually studying the game.  Learning is hard, but you have to be alive to learn.  The payoff though is not winning or losing a chess game, but the realization that Cancer be damned, I can still do something challenging, can still accomplish reasonable goals, and most importantly, have some fun with my life.

The Chemo Chronicles - Part IX

     My ninth chemotherapy session was December 1st.  The day started with soft puffy snowflakes.  Recollection of Christmas' in Northern Ontario brought back fond memories of playing in the snow as a kid.  Even to this day, a snowfall can still get me out into the back yard and return to the days of making snow animals

Mr. Bunny, meet Mr. Squirrel

    However the snowflakes didn't stay around very long, but did put me in good spirits.   As in every prior session, I login to the registration computer, pick up my 5FU pump (oops, not ready yet...) and  in this case, picked up refills for my chemo meds.   I wear Mr. Pager until such time as my chair is ready.  Soon enough I am once more in a position where I feel great coming in and just mediocre when I leave.   I explain to my nurse that the last 5FU bottle removal did not have a successful blood return after my visit two weeks prior. I fully expected to have a lengthy session to simply get the blood return thingy working, but was pleasantly surprised when my nurse was able to get it working on the first try!

     I seem to be the only person who ever brings a laptop to these sessions.  Many however have their headphones on, books and magazines are always present, and there are caregivers for almost all the patients.  Almost all patients, as some are solitary.  Sometimes it's just as hard on the caregiver to be there, the support role now usurped by the professionals.   For some it is  hard to watch a loved one undergo the process.  Fortunately for me I am not alone.  Sometimes we talk to the other patients,  encourage each other,  put on our brave face and confidently face down our fears.   We are all veteran of the Cancer Wars.   I have always said that Cancer may kill me, but it won't beat me.  I believe in those words as I believe in myself.

    Returning to the laptop, my virtual escape from the chair is aided by my trusty Acer Aspire One Netbook.  Free WiFI for us patients allows me to write in my journal,  to keep in contact with my family, friends and coworkers, heck I even wrote some shell and Awk scripts for a friend of mine who wanted to move specific files from one directory to another on his computer.  He was most amazed I was writing them from the chemo chair.   Programming from the chemo chair, with an IV hooked up to my port.  Plus I get free coffee and cookies if I want, but alas, during these times I have absolutely no desire for either.

    It seems that the longer I sit in the chair the less my attention span can be maintained.  Of course my nemesis returns each time I have chemo, and for that I have the two shots to take care of the nausea symptoms.  My chemo treatment is more or less routine this time, however I now receive my first session of Avastin, the magic potion to inhibit new growth of blood vessels, so tumours can't find a source of nutrients.  I was quite eager for this, due to the word 'AVAST' in Avasatin.  AVAST of course is Pirate Talk!  Arrrrgghhh Matey, it's now time for Bad Pirate Puns.

     Prior to this session I had constructed and pre-tested some of my Pirate Puns on a few unsuspecting individuals.   I was actually considering finding a suitable hat, eye patch and parrot, but decorum and common sense won out. Fortunately the Pirate Puns were more-or-less well received:

    "I'm a land-locked pirate, the closest I get to the High Seas is me Orange Juice!"

    "Avastin! That's Pirate Chemo, delivered by me nurse with the wooden leg, Peg!"

     "We're Practical Joke Pirates!  Prepare to walk the prank!"

     "I get all me Pirate boots and shoes from Davey Jones Foot Locker....arrrgghh!"

      When the opportunity presents itself to find humour in the horrible, you go for the humour ever time.  Besides, I'm a glutton for PUNishment...

      My session was relatively uneventful, save for the spate of bad puns.  I tried to indulge in the Hospital-provided lunch (chicken noodle soup and chicken salad sandwich, peaches for dessert) but my appetite was simply not there.  Tired as I usually am after these sessions, I basically get home and sleep.   It seems to me that my past two chemo sessions have taken more of a toll on me than the first round, whether it is due to the surgery, the extended time between sessions or simply the weather and my own mood, I simply don't know.  

      My mood the day after chemo wasn't too bad.  I was up fairly early and content to do my morning routine of email and surfing, when suddenly my iternet at home vanished.   Terry the Techie now took over.  I checked out my DSL modem, my router, my wifi...no sync.  I contacted my ISP, and I tried a different modem. Still no sync.   A  technician was sent over and he confirmed it: No Sync!  So now Bell is involved and a day later after all their tests they managed to actually unhook my telephone line altogether!  So now I had no DSL sync and no voice.   My ISP was quick to work through the problem with Bell, and several hours before I was due to have my 5FU pump removed, a Bell truck rolled up to my house.  

     Inside wiring was ok, but the wiring on the pole was bad.  Squirrels eating the insulation on the lines is the official reason.   However there was a matter of the voice being left unconnected at the remote site after testing my line for DSL sync.   However once the new cable was strung from the telephone pole to my house, the magic of the internet returned, and with it, my telephone circuits.   One of the first things I did was to check my voice mail box...which had a message from Bell repair to call them..

     So for a day and a half I was disconnected from the rest of the world, and I didn't mind it a bit!  All that activity in problem-solving mode did not involve anything to do with the Cancer,  and I felt like I was doing something useful.  That Friday was very busy, for earlier that morning I had a service tech come over to the house to perform routine maintenance on my old, old furnace.  My neighbors Carbon Monoxide detector had recently gone off and they needed to get their furnace replaced.  I don't even own a CO detector - yet.  As soon as I can get out of the house I'm heading to Canadian Tire to pick one up, stat!  Oh, and my 30 year old furnace was tested and is fine, no CO leaks, and while not efficient as modern ones, still heats the house up nice and cozy.

    As the day flew by, all the excitement from the comings and goings of the various technicians was wearing on me.  I was tired, but my 5FU pump still was scheduled for removal at 2PM that afternoon.  No nap for me.   Off to the clinic to have the pump removed.  This time it was a breeze, no problem with the blood return, a record time of 15 minutes from start to finish.  Finally I could have my well-deserved nap later that afternoon.   And I did!

     Six hours after the pump was removed and an hour long nap seemed to provide me with a bit of energy.  I went for a walk, just to the local mail box.  A trip that would routinely take me 10 minutes there and back.   In the past I have commented that a recurring side-effect of the chemo medication are sore chest and arms after exertion.  I know from first-hand experience that any prolonged physical exertion like walking causes me chest pain.  Not the stabbing I'm-having-a-heart-attack, nor the heart-pounding likes it's going to explode, no this is like a compression on the heart.  It's sore, and my arms around my biceps get sore as well.  So for me to walk that distance and not expect repercussions was just plain stupid.   And I paid for that stupidity.   The walk there was not too bad, it was the return trip.  Walk a few steps, feel sore, feel sick, stop, crouch down, wait.  Repeat.  I shuffled more than I walked.  My chest was sore, I was frustrated with my body's inability to cope and angry at myself for being so stupid.   A mere six hours had passed since the pump was removed from me, I know I need at least 24 to feel 'better'. 

     The walk continued, more shuffling, more rest stops.  Ten minutes turned to 20, then almost 30, for a trip that would normally take me five minutes.  I wanted to get sick.  I wanted nothing more than to lie down on someones yard and rest.  It was dark and cold out and stupid me was clutching at my chest, shuffling along,  randomly crouching down to rest.  If someone was watching me they would think that I was having an early start on the Christmas Cheer.  I made it home and as I got inside the house,  I just sat on the basement steps for minutes trying not to cry from the pain.   The rest of the evening was extremely low-key to say the least.  I had yet another nap, only waking up to take my last chemo pill of the 3-day regimen.

     What had started off as a pleasant morning three days prior almost ended in disaster.  My ego overrode my experience, and I paid the price for it in pain.   This ninth session will be remembered more for what I should NOT have done, in this case it would be to not exert myself until I am fully recovered from my session.   The journey will continue, but perhaps at a more sedate pace.

The Chemo Chronicles - Part VIII

     Tuesday November 16th  was a sunny and mild day, weather-wise.  Chemotherapy day.    I had prepared myself for my upcoming session by taking my pre-chemo pills  of Zofran and Decadron.   I  made sure that the sticky tape that would soon cling to my chest  would be in contact only with a smooth surface.  Of all the medical manhandling I have gone through, pulling clumps of hair off my chest when removing old tape is the worst.   I may not have a lot of insight to the whole process but I urge any guy going through something similar to shave first and thank me later.   With the preliminary at-home maintenance completed, I was off to the Windsor Regional Cancer Centre one more time.

     I'm too young to suffer from Alzheimers  (I hope) and with only seven prior chemotherapy sessions, I shouldn't have chemo brain.   Yet there I was at a computer terminal at the Cancer Centre, vainly trying to recall my password to begin the registration process.   I had done this on seven prior occasions, and it was only three months since  I had last performed this minor task.   Two of the yellow-coat-wearing volunteers were spotted.  Easily 20 years my senior, I humbly ask them how to log in to the terminal.   With bright smiles and small words they patiently explained to me the login process.   They've done this a thousand times before,  and are very well versed in working with those that may be technology-challenged.   I on the other hand work in IT.   I'm supposedly a technology-savvy person.  I'm supposed to be a GEEK for cryin' out loud!   Passwords are my lifeblood, I use  dozens of them daily when I'm at work.  I change them at strange intervals, I use arcane and obscure trivia to obfuscate their creation and pride myself on making strong and secure passwords.  Therefore it is very ego-deflating that I should require technical assistance for the very thing that I myself provided in my past life. 

     Well it wasn't long after we got the password figured out that I was able to complete the registration process.   With paperwork in hand I wander over to the receptionist who gives me  a pager.   These pagers are the kind with lots of flashing lights and vibrating effects, the type that are handed out by the hostess of an Applebees to let customers know when their tables are ready.   Unfortunately when this pager  goes off my waitress turns out to be a chemo nurse, and the only cocktail she's serving is chemical.

     Chair #12 and I are acquainted from my past visits.  Our mutual friend, my wonderful chemo Nurse  starts setting up for what will become  my eighth chemotherapy session.    Being once more in the chair after so long an absence brings about a strange feeling of excitement and nervousness.   Then more nervousness as I realize I'm sweating.   I realize that I had forgotten to put on my deodorant that morning.  Of all the things to forget.  At least I remembered to wear pants.   Fortunately it's not too hot in the room and I don't have to worry about offending anyone ( I hope).   I'm frantically going through my mental checklist of all the things I need to be doing during the next few days of my chemo when the sound of the IV pole being wheeled up to the chair shifts my focus to events around me.  I'm being asked to unbutton my shirt, the process is about to begin - one little pinprick and the needle slides through the skin covering my port.  I'm hooked up and the meter is ticking as the magic cancer-killing concoction drips into my veins.

    This is not so bad, I'm comfortable, no longer nervous and my laptop is on the 'net courtesy of the 'Guest Access' wifi.  Because this session is only  eight weeks after my big surgery, I will not be given Avastin this time.  My session will take me past noon however.   In the meantime I settle into my surprisingly comfortable  chair.  These chairs recline, they are heated I believe, and are padded quite well.  My session proceeds as it had in the past, the body remembers what it did last time, even if my brain doesn't!    As I had done in prior sessions,  a magic needle given to me stopped the nausea feelings.  Two needles,  injected in the muscle, one per arm and most of the uncomfortable feelings disappear. 

    It was past noon when I was finally untangled from the IV Pole and it's array of now-empty bags.   A complimentary lunch showed up just then:  mushroom soup,  tea, juice and an Egg Salad Sandwich.   I like egg salad.  Except I make mine in the Northern Ontario way:  using  Miracle Whip instead of Mayo.  Thus whenever I bite into an E.S.S. made anywhere else, I'm disappointed.   I miss the tang of the Miracle Whip.  This  particular hospital-cafeteria provided E.S.S. was no exception, but as I was hungry I ate it anyway.   Later that night I would come to regret that decision.   A regret that would last through the next week.   Unfortunately I would form an almost Pavlovian trigger between Egg Salad and certain other actions.

     Just prior to my lunch, the final chemo process of installing the 5FU pump was performed.   My 48-hour friend was secured to my IV Port and my eighth chemotherapy session was well and truly on its way.  The session would be considered complete when the pump was removed two days later.  In the meantime I had to make sure I would take my meds at the proper times.  I would miss the final pill on the final day, but overall I did pretty much everything I needed to do for the chemo process to work.  Now that I was wearing the pump my energy level went way down, as expected and I would find that the old sensations of sore chest and arms would return when I did even mild physical activities.  Napping and watching tv were the highlight of my 'daze of chemo'.

     I stoically endured the nausea feelings, occasionally popping an anti-nausea pill.   This managed to stave off most of the unpleasantness of the initial chemo barrage, but alas for me, it was incomplete.   Trying to sleep  I was roused after midnight by soreness in my chest.  I coudn't get comfortable.   I hurt.  I was also thinking of the Egg Salad Sandwich I had some 12 hours prior.....

     When I returned to bed, I was considerably relieved, somewhat lighter, and the chest soreness virtually gone.   Perhaps the lack of a Gall Bladder also exacerbated the chemo+ESS issue, but from that point on for the next week or so, even the thought of Egg Salad would cause me to gag.  I can eat scrambled eggs fine however. Weird.

      I can report that after this solitary bout of nausea I was successful in avoiding the majority of my other annoying side effects.   The days passed, I was not losing weight, eating was not problematic, but drinking water was.   I needed to supplement the water with juices and ginger ale (Canada Dry, eh).  Water never seemed to satisfy the palette but I just had to force myself to drink.  Dehydration is not a good thing.

     At the appointed time I went to see the folks at the clinic who would  take care of removing my  5FU bottle.   This turned out to be the most interesting part of my chemo session for a couple of reasons.

    One reason was that a senior nurse was instructing a junior nurse (terms are relative of experience, not age!) on how to properly remove the 5FU pump.  Not a problem, I don't mind being the teaching dummy. 

     The other reason was due to my blood return not working. Again.  This is turning out to be an annoying and ongoing issue.  As the clinic I was at does not have the same technical resources to deliver the chemo equivalent of 'Liquid Plumbr' to unclog whatever was clogging me up, a more energetic approach was tried.   

      The typical approach involves turning ones head and coughing.  Or raising the arm on the same side as the Port while coughing.   The flush of the port has always worked, they just can't bring back any blood (and when they do they nicely put it back in again!)  I started feeling sorry for the two nurses as heroic measures and experiences and tricks-of-the-trade were applied.  What typically is a half-hour process extended to over two hours.  In the end I was sent back to the Cancer Centre  bearing documents that attested to the fact that this well was a dry hole.   Hopefully there's no dynamiting in my future.  The removal of the pump officially completed Chemo Session #8 for me.  Only four more to go after this.

     Aside from the no blood return thing and the ESS incident, my session was remarkably boring.   I was even able to begin drilling a PCB that will constitute Chemo Clock #8.  My life is boring.  My life continues, how great is that!

Rebuilding - Part II

      It's now near the end of October, 2010 and my story thus far has me recovering from Liver surgery.   My old energies are returning,  and as always pointed out to me on numerous occasions, I had MAJOR SURGERY less than six weeks ago!  My expectations that I should recovery "soon"  are simply not going to be met.   Patience heals just as well as frustration, and can be somewhat more relaxing.   The end of the month sees me visiting my Oncologist for the first time since my surgery, and we discuss What Happens Next.

     What Happens Next is simple:  more chemo.   The resolution of the CT devices can't show tumours under a certain size.  As a precaution I am scheduled for five more rounds of chemotherapy.  It turns out that the effectiveness of chemotherapy diminishes with continuous usage, with 12 sessions being classed as 'best bang for buck'.  Personally I am all for arming my white blood cells with high-tech lasers and plasma guns and whacking the cancer cells in hand-to-hand ("flagella to flagella?") combat.  Until that happens chemo is my route.

     Since I had seven session prior to my liver surgery, I can "only" have five more using this current suite of drugs.  Should I require further treatment, other drugs would be substituted and chemo would continue with those.   Hopefully this will not be necessary.   My next round of chemotherapy would commence Tuesday, November 16th of this year.   Once more I had a plan,  and I could continue on with life.

     Before I could have chemo though, I needed to have my IV Port flushed.  Seems that after chemo #7 the blood return wasn't returning.  So I had a session in the chemo chair  where  coughing, agitation and tap-dancing routines were attempted in order to cause the blood return to work.  Since my high-tech flapping-about failed,  the heavy artillery were called in:  chemical equivalents of Liquid Plumbr and the Roto Rooter guy were used.  About an hour later the blood return  was checked and yes, I had blood.  Life is good.

     The interval between my Oncologist visit  and eighth chemo  session is about three weeks, so I had some 'free' time on my hands.   I made darn sure I got in my walking / bike riding / chess playing and any other 'Terry' activities I could before being whacked by chemo.  In particular I celebrate Halloween, usually by sacrificing a pumpkin. Or two.  Or in this case about 7.   Prior to my surgery friends of mine decided my barren front  porch could use some dressing up, so they  showed up with 10 or so bright orange pumpkins and took the liberty of my not being home to 'decorate' the front steps.

     Since I was only able to give about three of the damn things away, I was left with a mound of pumpkins.   No, I do not care for pumpkin pie either!

    I do not like pumpkin pie,

    If I eat it I will cry.

    There is something about this putrid colour

    gastronomic discretion,  better part of valour

    it's a fruit with the consistency of pudding

    that sends my taste buds a-running

    In the Pie Canon there are only the following Holy Pastries:

      Blueberry, Apple, Peach, Cherry, and more Blueberry

    Pie digression aside,  I am now left with numerous pumpkins and Halloween is right around the corner.   One Jack-O-Lantern is plenty, seven is just a lot of work.   So I decided to make my "Pumpkin-O-pede"

pumpkin-O-pede

     A work of art (and if I were Art I'd change my name...)

    Halloween was quiet and cold, only about 30 kids showed up.  Guess it was up to me to finish off the left-over candy.  Which  really was unfortunate timing, as I had decided to make a dental appointment before I started chemo again.  Yet another medical appointment forthcoming...

     Oral health can actually be quite critical during the treatment process.  Effects of treatment can alter taste perceptions, and cause mouth sores which provide a vector for bacteria to enter the body.  Negative fun.   Due to sensitivity of the mouth and gums, alcohol mouth washes are verboten, the normal practice is to rinse with baking soda dissolved in warm salt water.  Flossing can be dangerous during the treatment time as well, simply because of cuts to the gum.   I had missed my last Dental appointment since it as in the middle of my last round of chemo, and  I wasn't about to miss the "fun" twice!

     Fortunately my dentist had an opportunity to see me well before my treatment date, and in short order I was in the dental chair for routine checkup and cleaning.   Turns out my oral health is fine, another small victory.    A question was posed during my exam however:  could X-rays be taken, as they had no new ones of me for a few years?   I hesitated,  just wondering how much radiation a person like me is exposed to over the course of their treatment.  I don't think there is a standard for such things however,  but given the previous history of CT's and Xrays (and more to come), one more dental Xray every 3 or 4 years wouldn't change much.   With that clean bill of health for my teeth I could now assist in the disposal of the last of Halloween candy.  And I did.

     In constrast to the cool Halloween,  our November weather this year defied  the norm.  I kind of relate to that concept.  Warm when it was supposed to be cold, bright and sunny when it should have been overcast and snowy.  A late Indian Summer one week and I was even able to ride my bike a few times.  Just biding my time to start chemo, so you know something dumb would happen, and it did:  I sneezed.   Not your regular "ah-choo, sniffle-sniffle" sneeze, but one that started from somewhere near the Earth's core and continued building momentum during it's entire transit through me.   I pulled something deep in my stomach, maybe a muscle.  Maybe a hernia.  I needed to make sure all my internal organs were present.  It was a painful sneeze.   It hurt.  A lot.  During the early parts of my recovery from surgery, a sneeze or cough would cause intense pains, but they were momentary.  This persisted for three days.  Sitting was uncomfortable, but walking was no problem.  I could sleep fine, but waking up and crawling out of bed was painful.  I saw my family doctor.   The Terry of years ago would have pretty much ignored it assuming it would just get better, eventually.  Now every ache sends me running to the doctor. Sigh.

    Turns out the doctor didn't find a hernia, or anything really wrong,  as after a few days the pain was completely gone and everything worked as it should (as well as it did before the sneeze at least).   The doctor was duly impressed with my mighty ability to sneeze in such a powerful fashion.  From then on I decided that I should only use my power-of-sneezing for the good of mankind. 

    Recovering from the Great Sneezing Scare, I was feeling  all-around OK.   I was as strong and confident as any time during my Cancer journey (heck I even cleaned the gutters...twice!).   I was veteran of the chemo wars, I knew what to expect.  The day prior to my chemo  was full of encouraging messages, support and hope from friends and family.  All expressed confidence in my ability to handle what was coming,  reinforcing my resolve.  

     Tuesday, the 16th of November dawned bright and cool.  My lesson learned from prior experience, breakfast was light, no coffee and lots of water to drink.   My spirits were good as I arrived at the Cancer Centre, and soon I was being seated in the special chairs they have for us patients.  IV bags were set up, and my nurse was checking orders for this round of treatment.  As needle pierced thin skin covering my Port,  my journey resumed it's course, forward, one more time.
 

Rebuilding - Part I

       Colon Surgery.  Seven rounds of chemotherapy. Liver Surgery and Gall bladder removal.  I had undergone my hardest battles with Cancer, so I should be optimistic, right?  It is amazing what the human spirit can endure, but it was not without cost.  For me it was the realization how frail emotionally I had become.  The physical body was slowly recovering, the healing enhanced by simply being out of the hospital.  My emotional state was characterized by a series up highs and lows, with the additional struggle that my ability to concentrate was virtually non-existent.  During this time it was truly the 'Daze of my life'.

     It was time to put my mantras, cantrips and hard-won observations into practice:   live as best you can, when you can, however you can.   Finding the victories in the little things:  walking a little longer, feeling a little stronger, breathing a little better, and, not letting my emotions overwhelm me, let it go when I could not cope.  I'm generally not prone to being the overly-emotional type,  but there are times when I would remember a singular experience and be overwhelmed, and the tears would flow.

     Routine returned as the remnants of the physical surgery were removed.  My usual  daily activities re-asserted themselves; taking my weight and temperature daily, recording the days activities in my journal, even the occasional insight as to what it all meant.  Writing he in my journal even  helped improve my concentration and organizing of my thoughts.  Wish I would have learned this habit while I was still in school!  Perhaps however my 'best medicine' was the season of Fall itself.   My walks were usually accompanied with my trusty Kodak Digital Camera (perfect for people like me who can barely spell "photo-gaffe") Trees of golden and  red hues, maples on fire in the early-morning sunlight.  Reminders of my boyhood in Northern Ontario, where miles and miles of unending colours would entertain me on the bus rides home from school.

      The walks became longer and my mood got better.  I had many projects on the go waiting in my workshop, I have opportunities to do things, hopefully I would find the discipline to return to thinking of things other than the Cancer.

     Canadian Thanksgiving had come and gone, and I have determined that the last time I had Thanksgiving dinner with my  family was when I was 17.  Now my parents and grandparents are long gone, my brothers and sisters are scattered around the province.  It is doubtful the family will ever celebrate this particular holiday together in this way in my lifetime.   But life goes on and I go with it.

      A significant event occurred with the passing of Thanksgiving:  my birththday.  Turning 51 closed off that significant chapter of my life known as "The Big Five-Oh".  My personal birthday present to myself is an HP 35S RPN Calculator.  More calculator than I will ever need,  a programmable,  hearkening back to the days of the classic HP's of the 70's rather than the future 'all thumbs' wipe & touch devices that are so common now. 

     Treating myself was nice, but my best gift was being able to pass on my experiences to others.   I was only out of the hospital two weeks when I was back in - visiting a friend, undergoing his surgery for colon cancer.  Thankfully his path does not follow mine.  We shared our experiences, bonded in only the way that cancer patients can.  Humour as always can be found anywhere:  while sitting and chatting with my friend his nurse stopped in.  There was a double-take as she recognized me from my earlier stays there, delighted that I was only visiting.   Helping others is a great way to snap out of the moping and emotional morass I'd sometimes find myself in. 

     Hope is also what I was able to give to another friend.  The great part about undergoing all these wonderful medical procedures is that I lived through them!  Having someone to talk to who has experienced first-hand the wonders of modern medicine can be reassuring to someone anxiously awaiting the process.   In this case I am able to allay the fears my friend was having about his upcoming colonoscopy.   In return, he has reported a clean bill of health!   Sharing my experiences has been a wonderful feeling for me, being able to hear the stories of others reassures me that I am not alone.
  
    An observation a friend of mine once made to me, although pertaining to a technical problem seemed to fit within the struggles I was currently undergoing.   During attempts to fix an ongoing technical issue at work,  I would vent my frustrations to my friend  citing all my failures to fix this particular problem.  Eventually it did get fixed, and his comment to me was if I noticed how suddenly and  spontaneously it "resolved itself" and just worked normally like it always did?

   It sure seemed like someone "flipped a switch", as my physical, mental and emotional health returned to normal.  The curious thing is I cannot pinpoint any specific time or event that would correspond with when it happened!    All I can say for certain is that sometime before Halloween I was more like my old self.  Maybe it was my visit with my Oncologist to discuss further treatment options.   Or maybe it was because of my artistic Halloween pumpkin creation.   As October drew to a close,  I met with my Oncologist to discuss What Happens Next.   Maybe that's what my fear has been all along.

Liver & Onions - Part V

     It's Tuesday, Sept 28,  a lifetime since my surgery on the 22nd.  I'm walking now.  Indeed my primary recreation is now walking.  My squeaky-wheeled IV pole and I are a familiar sight wandering around the hospital.   Wearing two Johnny shirts, clad in socks and booties, attached to an IV, wandering down to the quieter floors to get some exercise.  Speed walking, as best as I can.  I race down the deserted Administration hallways, my IV pole rattling and squeaking.  Presently there's a group of administrative types, four women outside of  doorway.  I am asked what room I am from.  I am asked if I am looking for something?   Was I lost?  Hugely amused I indicate that this is therapy for my surgery.  They are surprised to find out my Liver surgery was so recent and I seemed to be quite active.  One lady, a nurse, noted I was actually flushed, meaning my heart and lungs were getting a proper cardio workout.  I can move when I walk, even wearing only hospital booties on my feet, there are few who can keep up with me.  I am cheered by their encouragement. 

     My walk is boring but necessary.  I walk, get tired, go to my room, nap. Get up, walk some more, drink lots of water.  My sinuses are getting stuffed up, I've been in this hospital too long.  Getting restless, I start to watch movies on my netbook.  I fall asleep quicker and earlier.  Exercise, even this small amount, saps my strength.  But I eat, and the food stays down.  My IV comes off, it's been on my dominant hand the past three days, it's a relief to be free.  Now the only thing I have tethering me are my two JP drainage tubes.  One will come out before I leave these facilities, the other will be removed by the outpatient care nurse.  My adventures within the hospital continue though.

     More walking, this time sans IV pole. I am free to move my arms, to generate the cadence that is my norm.  I am speed walking down the administration corridor again when I see  a security guard watching me.  I pass by the elevator, turn and retrace my steps.  I do this several more times.  Now there are two security guards, pacing me.  One asks if I am doing some sort of test.  Without stopping or breaking stride I indicate that I'm simply walking for the exercise.  The guards are relieved that I am not some lunatic randomly meandering through the hallways.  There is no randomness in my walk, as for the former well that's open for debate.

    Humour in a hospital; two days in a row I'm stopped by various folks concerned with my strange behavior.  I am actually happy now, for I have seen my surgeon and he has asked if I want to go home!  Yes!  I am scheduled for discharge that Wednesday.  First there remains a small matter of removing some staples and one of the JP drainage tubes.   My adventures continue, this time with the help of the student nurses.

    Throughout this latest hospital stay I was visited by many student nurses (male and female) and all were caring and considerate.  And so very very young.   I repeated my history many times, I had my vitals taken routinely, with the occasionally balky BP  cuff just popping off and seeing the chagrin of the student who had to figure out how to handle these minor annoyances.   The last day proved to be the most adventurous, as actual procedures were to be performed on the unsuspecting patient!

     My surgical incision runs completely along my rib cage, and had about 14,000 staples in it.  The first job is to remove every  other staple.  Fairly simple, the staples are snipped then pulled out with a smooth motion.  That's the theory, and it worked great when the teaching nurse did it.  The students who followed  did ok, no problems.  The interesting part was the replacement of the covering.  I think that she used about 18 miles of packing tape.   The second procedure was the removal of one of my JP drainage tubes. 

     A fourth year student nurse was shown how to remove the sutures around the drainage tube.  We had our sterile field, we had the tiny scissors and the removal technique.  What my novice nurse did not quite realize that when pulling out the tube you do so in one fluid, continuous motion.  I ended up doing a lot of deep breathing during this process.  One of the oddest sensations is the removal of the tube.  It's not exactly painful, but not pleasant either.   It's about 11 miles long and looks like a tapeworm.  Perhaps I exaggerate somewhat.  But it's a relief when it's out.  After they pack me up in more tape I am ready to get dressed.  Wearing real clothing, I notice that my clothes are tight.  Turns out I am so full of liquid that I walk out of the hospital at 180lbs, the most I have weighed these past six months.  But that weight doesn't last long, and every two hours when I return home I return some of my gains.

     Home, familiar and comfortable.  Well eventually it would be.  I still have a drainage tube in me.  This is my Nursing 101 lesson, as I would have to measure the output volume and drain  the tube myself.  Two days of this and I notice blood.  I panic, call the clinic, and a nurse calmly reassures me that a a trace is ok.  My volume does not increase appreciably, meaning the tube can now be removed.   With the removal of the tube I figure I will be able to sleep now.  Not so fast, there's still a fair amount of fluids in me.  Sleep walking to the bathroom every 2 hours, oh joy.  But it's my bathroom at least.  In a few days my weight drops noticeably.  Clothes fit better but the packing on my tummy seems to keep my breath short.  It is a relief when the staples are removed. Still more packing. Still short of breath.  I walk, as much as to get exercise as to breathe.   Now that I am home I find that the relief I sought simply crashes down on me.  All my emotional barriers have eroded, and I can go from calm to teary-eyed in a moments notice.  I am grateful to be alive.  I am thankful for all the care I have received, but in the back of my mind is the question:  "Will this be enough?".


   

Liver & Onions - Part IV

      Room 623A will be my home for the next 7 days.  I had come through Liver surgery with positive news:  the margins of the 'good' side of the liver were clear,meaning that they think they got all the 'bad' side with it's tumours out of me.  Additionally I won the bonus round I suppose, as I discovered I no longer had a gall bladder in me.  Apparently this is normal for this type of surgery.  A two-for-one deal.   Several years ago a routine ultrasound (checking for kidney stones) found gall stones, but they never really bothered me.  I guess they'll never bother me any more.

     My next challenge would be to duplicate the efforts of my first surgery: sit up, walk, pass gas, poop, eat clear fluids, eat soft foods, eat real food.  I had done this before I knew what to expect.  Only this time it was harder, a hell of a lot harder.  There lots of reasons for this, my surgery was huge for one thing, I was under for 7 hours.  I had my gall bladder removed in addition to the tumour-affected kidney lobe.  My blood work was all over the map and I would be on an IV for 7 straight days as fluids and chemicals were constantly being pumped into me.  By Saturday my general appearance would begin to resemble the Michelin Man, I was puffy and full of liquids.   My two JP drainage tubes worked round-the-clock.  Whatever was being put into me seemed to just come right back out.  Plus I was zoned out half the time I was there.  For whatever reason the anaesthetic and pain meds, plus my general weakness completely sapped my strength and will.  Physically I was able to do a few things, like get out of bed and into a chair.  Mentally I just could not muster the energy to care.

     Sleep was elusive during my time in hospital   For me the strangest thing was when I would close my eyes and try to rest.   Disturbing images would always come, I never got to go into a deep sleep.  The meds from the epidural, the post-anaesthesia, the tons of chemicals I was receiving by IV were all making me better and worse at the same time.   Sleep was so difficult to come by, I would have these intense vivid images.  Landscapes that moved and morphed into dark, disturbing images.  I would feel like I was drifting downwards into an opening into the earth that would narrow the further I went.  I would force my eyes open and wonder what the hell was going on.  It would happen every time I closed my eyes, for days.  Sometimes I would drift off to sleep, as the body can only take so much.  It was never deep sleep until after the epidural pump was removed on Sunday, five days after my surgery. 

     My expectations of following the path of my last recovery probably kept me from asking for help, especially in the sleep department.  My doctors were following the process, I couldn't eat anything until Friday, and you know how I feel about Jello for breakfast. Jello for lunch. Jello for supper.  From Friday til Sunday Jello and Juice were my dietary staples.   When I did dream in those fitful sleeps I thought of nibbling on toast, eating bread, something with a solid texture.  Never have I felt so weak, and the depression was lurking behind the veil of my soul, I could feel it coming on.  The hardest battle I will have ever fought was not to heal my physical body, but to master my emotions and feelings.   My concentration and 'emotional armour' were in ruins.  I had to endure this experience with only the belief that the bad times don't last forever.  Those late nights of being alone with my thoughts were the most difficult of my life.  Now as I write this some two months after the fact, I still experience bouts of depression just recalling those events.   Getting through it took all my strength.  And I could not have done it alone.  The nursing staff, doctors, my family my friends.  I needed all their strength and support for this one.

     Food.  I was hungry, but I couldn't stomach another damn Jello.  My physical strength had deserted me.  I could muster up the energy to get out of bed, to sit in a chair, to shave.  But I needed the incredible kindness of my nurses to help me wash my hair, help with sponge baths.   Sitting in a bed, surrounded by curtains while trying to do a sponge bath is hard.  Bending down to wash when you have had abdominal surgery is hard.  I would have difficulty just putting on the booties on my feet.   Water dripping all over, never quite getting that 'shower clean' feeling.  Can't shower, you have an incision running the complete length of your ribcage.  You can't even stand up without assistance. Those staples keep pulling, and the miles of surgical packing around it don't help you breathe too well.

     Food.  I was weak.  I was urged by my doctors to walk.  I was urged to pass gas.   My doctors were concerned that my chemistry was too low.  I would be given constant IV's to replenish chemicals.  I would be given fizzy drinks of the same chemical to supplement the IV.   My call bell was used frequently as I alerted the nursing staff that one more IV bag was on it's last  few drops.  Constant IV maintenance. Constant recording of vitals. Contant drainage of the JP tubes.  Constant meds and shots.  No sleep. No solid food.  Depression was just waiting to come out.   That Sunday I had my Epidural removed.  Sunday through Monday morning I would surrender to that depression, for there was no longer any defense that I could use.

     I forgot the words to my theme song, "The Mary Ellen Carter", a song I knew by heart since the 1980's.  I couldn't think of the verse or refrain.  The images I would see when I closed my eyes to sleep disturbed me so much I was going to ask for a sleeping pill. But I forgot,  my memory and concentration were gone.  I tried doing the times tables in my head.  My degree in Mathematics did me no good at all.  I would get as far as the 'five times' and then forget. I would start again, 1x1=1, 1x2=2, 1x3=2... there was simply no ability left in me to concentrate, to think, to do anything but despair.

     At some point I ask if it's all worth it, do I want to continue with this life or not.  Surrender the body,  surrender the soul, surrender all you have become, admit you are not who you think you are.   Learn to live with what you are becoming.   Hard choices.  Rationality is not to be found in a hospital during the hour of the wolf.    The epidural detoxify must be working, sleep is not far away, the body will repair itself in time, hopefuly the rest of me will too.

     Sunday passes into Monday.  My very first colon surgery was  marked by the physical pain as the epidural was removed from me.  This surgery, the epidural was of no help for my emotional pain.   But I made it through, and I would recover.

    Food.  Monday I ate 'soft foods' for the first time.  The results were nothing short of spectacular.  I had energy to walk.  For the first time in almost six days I was able to walk, unassisted from my room down to the nursing station.  I would repeat that trip, extending it to the remainder of the floor.   I would be recognized by the nurses from my previous visit, some six months ago!  The joy of walking is the joy of independence. Albeit I'm walking with an IV pole still attached to me.  But I'm walking. I'm eating.  I sleep hard for the first time, short duration, by my roommates wife comments that it's as if a switch has been thrown.  I'm animated, alive, moving, and sleeping soundly.  My roommate himself had a bad accident that crushed his muscles in his legs.  The pain must be intense but he's stoic, has family and friends to help him through it.  He and I finally have some talks after five days, when I'm cognizant of reality once again.  It helps to have someone to talk with who is undergoing the 'Hospital Experience'.

      Speaking of the 'Hospital Experience' things got better after I ate real food that Monday.   My doctor was amazed for it was the first time he saw me out of bed (well if he'd come more than once a day he'd see this weak creature sitting in a chair).  My downward slide had come to and end however.  Once there was something solid to eat my strength and spirits returned.  Once I could walk I could regain a taste of independence and freedom, I was motivated to get better and get out of that Hospital.  My thoughts turned to getting home, to a shower, sleep in my own bed, wear my own clothes.  I was healing where it counted most: my emotional and mental state.  There are now two journeys I am following on my path to recovery: the physical and the spiritual.  Guess which one was harder. 

    The bleak days of my recovery were starting to fade away, optimism was returning with my new-found strength. I once more  looked forward, my Journey Onward Yielding again taking me from despair to hope.

Liver and Onions - Part III

      Humour is my most effective weapon during my cancer battles.   For instance when I decided to go ahead with my liver surgery,  I promptly announced that I did not want to wake up in the recovery room to the smell of onions.   Now the title of this blog might make some sense.   Incongruity is a wonderful thing for dissipating  some of the overwhelming potency of stressful situations.   I didn't say they were good jokes, nor are they meant to entertain anyone but myself (much like this blog).

      So the lazy days of summer have come to a close.  Fall is my favourite season and I had bittersweet feelings for undergoing surgery at this time.   Some dark thought long entertained by me prior to my cancer:  not when I would pass, but in what season.  Fall I want to enjoy.  Fall heralded not only a change of season but a new beginning, likely because of my many years in school.  My job changes also have occurred around this time of year.  So for me,  the Fall was the start of a new adventure.  One always starts off a new adventure with optimism and hope. 

     Surgery day, Wednesday September 22nd.  Another early morning start, there are no other surgeries before mine.  There is only one such procedure in any given day.  My sleep the night before, as expected was light with lots of anxious glancing at the clock to see if I had overslept.   Surgery itself was scheduled for 8AM, as always it seems.  My morning routine that day was spare, showered, dressed, no breakfast.   I would bring only  my wallet with my Health Card.  No phone, no extra clothing, no computer.  What I needed most that morning  was what I brought within me.    I was calm, perhaps because of the by-now familiar process.  The mechanics of the registration, the relocation to the surgical-preparation floor where I would change my street clothes for a Hospital gown, no longer be Terry McAlinden, but MCALINDEN, T -- PATIENT.   I write from memories of that time, and find myself overwhelmed in emotion, literally unable to read what I write through blurred vision.  At the time of the surgery I remember being outwardly calm, for had I not gone through this process once before and emerged with mind and body more or less intact?  I could do this again.  That was the plan.   Always back to the plan, this helped my resolve time and again.

     The experience of being in a Hospital gown and booties, with my freshly-inserted IV in the back of my hand are still vivid.  External noises are muted as I focus my concentration inward.  Calm on the outside, nervous on the inside.  Waiting is the worst.   My nurse is  aware of my nervousness and the small talk we make while this or that is being done to me helps.  I didn't have a medical entity beside me, I had a person compassionate and kind who genuinely cares about me. 

    Accompanied by family and my nurse we walk to the OR room.  I'm given a bed that will serve as the vehicle which brings me into the surgical suite.  Until then I am covered in warm blankets.  I am cold. The chill is not all from the air conditioning.  More waiting.  Enough of being nervous, just get this show on the road I think to myself.  Bemused that I am bored.  Nothing to read. No computer, idleness as a distraction to surgery.  The incongruity momentarily amuses me, but the thought is fleeting.  My OR surgery nurse introduces herself.  My Surgeon stops by, and marks a large 'X' on my right leg with a marker.  I won't see him again until after my recovery.  The rails are now up on the bed, I'm being moved.  I murmur my goodbyes, and I feel the bed glide down the corridor and we go through the doors to the surgical room.

     Have I mentioned how cold it is in these surgical rooms?   Colder  now as I am slid off one bed and roll onto the operating table.  Have I mentioned how narrow they are?   I am remembering the exact feeling six months prior.  Everyone is masked,  I can't tell my doctor from the anaesthesiologist.  Oh, she's the one having me sit up as the epidural is placed into my back.  My "HappyDural" I tend to call it.  My glasses are removed and I lay down. Someone is talking, wonder when this will star----

     ICU is my first conscious memory.  Sleepy, someone is talking to me. I am hugged, people are glad I am awake.  My awareness is slow to return.  Questions are asked, and my answers are found satisfactory.   In the back of my mind there's something I want to ask.  I can't think of it.  I sleep some more.  I wake up as my vitals are being checked.  The process repeats, how often I do not know.   My nurse comments that I am a light sleeper.  The radio is playing the same annoying song every time I wake up. Katy Parry's "California Gurls".  Beach boys did it right the first time.   Wednesday has turned to Thursday morning, and I am alert.  I made it through a major surgery once again.  I sleep yet again, feeling the emotional relief envelope me.

     Barely 24 hours after surgery I am being asked if I can sit up from my bed in the ICU.  My monitoring equipment shows I have OK blood pressure. I sit up. Immediately I collapse back to the bed, my blood pressure dropping.  Dizziness passes, the nurse indicates that my BP is already back to normal, and we try again. Slowly.  I can stand, on very unsteady legs,  but my body is not listening to my wishes.  My nurse has me, I do not fall.  I walk, the five steps to the nursing station.  I turn and walk back.  It's true what they say:  10-step programs are hard!

     Walking those ten steps  permitted my release from ICU to my bed on the sixth floor, where I once spent 7 days in my previous life.   My scheduled length of stay this time was for 8 days.  I fully anticipated that the process would more-or-less follow what I had gone through before.   Life is not so predictable, and I would encounter challenges that would take all my strength to overcome, and force my self-perception to change once again.

Liver and Onions - Part II

     There were two visits to the office of my Internal Medicine specialist.  One was for a heart test called an echo-cardiogram, and of course the other visit was to discuss the results of this test.  More tests simply to determine if I am healthy enough to endure a procedure to help destroy the results of a life-threatening disease.  So how did I fare on the echo-cardiogram?  Very well, of course!

      My follow-up visit was just as good.  When I asked if everything was fine from  the  echo-cardiogram, the response he gave me was I was better than fine, I was good!  In his words I was a 'good candidate for liver surgery'.   Praise like that might make me blush.

     I was actually quite content that day, as the mornings good news put me in optimistic spirits.  During my bike ride later that afternoon I  witnessed a rather spectacular sunset.    I was enchanted by the juxtaposition of the fiery red setting sun, and the brilliant silver of a rising full moon.  Naturally I did not have my camera with me, but that memory  will always remain.  There was just under a month away from my surgery.  Fall was coming, but the remaining days of Summer would be filled with physical and mental activities.  The nights were usually untroubled, faith and emotion were still under my control.  Not that I didn't have worries.  In particular I was concerned by the estimated time of the surgery, possibly 6-8hrs, significantly more than my colon surgery.  Sometimes I would have those flights of fancy that the tumours were all gone, that I wouldn't need surgery, and everything would be better.  Well it's good to dream.

      Except for one more CT and the pre-admission, I would have almost no further interaction with the medical community for the month before surgery.  Physically I was feeling optimistic, I was riding and walking, I felt I had some strength and stamina.   Later, I would  wish I had more mental and emotional stamina.  The emotional armour in particular would take a major beating.

     The week before my surgery my doctor informed me that the last CT still showed the tumours shrinking, and that the liver embolization was working. Positive news only could help my mood.  By now however I was thinking more of the 'what-if' scenarios.  It bothered me how much I was bothered by the upcoming surgery.   My honest fear however was that even if the surgery went flawlessly, even if there were no complications what if it wasn't enough?  What if the cancer would still remain, what more could be done for me? Would there still be a plan to save me and give me hope?  It was  getting more difficult to remain distracted.  Eventually I would have to face the questions and decide for myself how to handle it.  For now however I played chess, I rode my bike, and I kept active as much as I could.  The big day was getting closer, I was as ready as I would ever be.

Liver & Onions - Part I

      Summer was almost gone, my chemo for this round was completed, and the future had one big yellow post-it note affixed to it:  "Liver Surgery" is all it said.  Shortly after my sixth chemo I was sent for a  CT exam.  I drank a concoction known as 'RediCat', in order to enhance the contrast I suppose.  The claim on the bottle was that it had some sort of berry flavor.  I did not realize 'chalk' was a member of the berry family.   After the exam I was advised to drink a LOT of liquids to flush out the contrast material.  Now I had three CT scans in my life, including this most recent one.  This was the first time however that I was alert and conscious through the process.  Nothing really exciting happened, so I guess I would have been bored during the other two if I had remained awake!

     The CT itself was positive in a good way, showing that the tumours on my liver had noticeably shrunk.   Unfortunately continual chemo was not a solution as there would be a point of diminishing returns.   The plan was and still continued to be surgery to remove a section of the liver with the tumours.  First however would be the consult with the surgeon, as detailed in my previous post.

     As a result of meeting with my new doctor, I was scheduled for both a liver embolization and another consultation with an Internal Medicine specialist.  A liver embolization is a day surgery, and by now anyone reading this blog knows all about Terry & Day Surgeries....here I go again!

     A liver embolization procedure consists of sticking a needle into the liver to divert blood flow.  Also to check the oil I think.  A liver embolization procedure is classified as a day surgery, meaning you are in and out in a day, unless of course there are complications.  Considering that the liver is the second largest organ in the body and has about a million blood vessels attached to it, there is a chance for nasty things to occur.  Deciding to worry about the what-ifs won't cure me.  I have faith in my medical team, and faith in myself, and that's enough.  Onwards once more to my favorite hospital.

     Thursday morning of August 12th I get up at 5:30AM, preparing for my 8:00AM surgery.  Which means be at the hospital for six and wait around in nothing but a Hospital Gown and socks for two hours.  I know the routine well enough that I am no longer nervous at the prospect of sitting in a room full of other similarly-attired folks, it's just something to be endured.  Finally my turn comes and I am brought to the surgery prep & recovery room.  Being able to get into a bed is a welcome relief;  I  can get warm blankets and finally stop shivering.   It must be due to the cold days of August I tell myself.

     Being warm and comfortable lasted about 10 minutes.   My nurse appeared with a razor in hand.  "We need to shave you" she said as preamble to explaining how the embolization procedure would go.  Apparently it's snaked through a large vein starting from the the groin.   Guess where I needed to be shaved.   Pleasant conversation ensued during this process, and yes I was cold, why do you ask?  A deft touch and no razor burns at least, for what was yet another novel experience for me.  From then on it was more hurry-up-and-waiting, til finally, one and a half hours after my scheduled time I was wheeled down to Radiology.  Deja Vu, it was the same place for my Port surgery some six months prior.  IV was hooked up and I was out like like the Leafs during playoffs.  Woke up hours later in the same bed that I started from that morning.  I did learn something however, that a Liver Embolization is done through the side of the abdomen, and not through the groin.   So now I have some additional personal grooming and a neat hole on my right side.   No side effects, no complications and no pain.  And I was hungry.  A stop on the way home at McD's and all was right with the world.  Then another nap!

     There was less napping and more bike riding in earnest, as I wanted to build up my strength and stamina for the upcoming surgery.  My clock building took a hiatus since there were no more chemo sessions, but I found a  neat little novelty  in making LED Life circuits.  Therapy through blinkin' lights...

LED Life -Random Patters based on precise rules!

     Although all my pre-surgical procedures proceeded at a measured pace, I still had time on my hands to think about the future.   Here's where being mentally prepared comes in handy - if you start thinking about bad things then all you will think about are bad things!  As my surgery date drew closer I finally resorted to the cantrip that I will simply go to sleep during my surgery and if I wake up,  that's great, and if I don't, well I wouldn't need to worry anymore!  The long lead time between the end of my chemo and my surgery worked against me in this way.  Physically I was gaining strength and endurance.  I rode my bike all the time, I ate well enough that I was gaining weight at roughly a pound a week and keeping it on.  But the mental game can effectively negate all positive changes if those what-if thoughts are allowed to run unchecked.  So I started to keep those thoughts in check, literally, by playing chess.

     In my first year of university I found myself as the nominal president of the student-run chess club.  The other positions of secretary and treasurer were filled by the remaining two members of said club.  Sadly my brief University chess career lasted until my first tournament, where I ended up 3rd out of 3 competitors.  My passion for the game was inspired like many others,  by Bobby Fischer.  Passion  had diminished to a pastime, then to an occasional interlude.  Finally it was non-existent.   During the early days of the internet, online chess seemed interesting but failed to hold my attention or respect.  Playing a person is infinitely preferred to playing a computer.  My time off allowed me to once again pursue my passion from  days-gone-by.

     Found out that the local Windsor chess club would meet for tournaments several times during the summer, and I often hung out there.  Never entered the tournaments themselves however, due to the fact that my game sucked.  I did find it therapeutic to play actual live people on occasion.  For the most part, got my butt kicked.   But as a wise man once told me, if I'm thinking about chess (or anything else), then I'm not thinking about that THING that's always there.   Yeah I'm talkin' 'bout you, Cancer sweetheart!

    Summer was drawing to a close, with days getting noticeably shorter.  Another CT was booked for the end of August (my fourth) to verify that the Liver Embolization was working.  A visit to the Internal Medicine specialist would happen shortly. And of course, my surgery date was now fixed for September 22nd.  As I was often fond of saying, "the excitement continues to build!".

Interlude - Part II

     For seven weeks I would have no further chemo treatments.  A break of almost two months.  My weight would steadily increase.   I rode my bike and walked to build up my stamina and strength.  My days were filled with activities, I built clocks, I played chess, I didn't think about the future too much.  That would change as I progressed through the medical process once again.   First to come would be the meeting with my surgeon.

     When I was first diagnosed with Cancer, the surgeon who performed the initial colonoscopy  also performed my colon surgery.  It was a blow to me when he left Windsor for brighter opportunities abroad.  His associate however was lauded as the best for liver surgery, and my case was being handed over to him. Kismet. Karma. Kool.   Whatever happens to me I have to admit that in my life I have never experienced as many traumatic events with as many positive outcomes.   My meeting with my new surgeon would be deceptively mild and somewhat entertaining.  The entertainment was due to the medical students present during my initial exam with the doctor.

     Now in my short-yet-intense experience with our medical system I have met and been examined and treated by a number of medical students.   The day I met for my initial consult with my surgeon about my liver there were two bright-eyed and eager individuals that were keen to practice their skills upon my person.  More manhandling.  Actually man-and-woman-handling would be more accurate, as there was a representative from each gender, and that's the entertaining part.

     A clinical physical exam is not designed (usually) to embarrass the patient, and we all assume that doctors maintain a certain detachment when performing these exams.  During the course of my exam the male student did most of the poking and prodding.  As the abdominal exam progressed there was a natural  tendency to meander 'more south' to see the handiwork of the previous surgeon.  Some clothing reshuffling was done to accomplish this, and I noticed that the female med student was observing the process in an oblique fashion.  I couldn't resist pointing out that while she may be preserving my dignity, as a patient I would be much better off is she knew exactly what was going on.  Fortunately for both of us the exam didn't last much longer and all were saved from any further awkwardness. 

     Ironically in a few weeks during my subsequent hospital stay, I would be visited by many med students and nurses-in-training. In one particularly well-remembered incident I would have four fresh young female faces looking down at me and not being  at-all shy about poking and prodding me.  But I digress.

     Back in the exam room the doctor explained that the liver surgery was big and complicated, but I was young and strong. Yay me.   A pre-procedure called a liver embolization would first be performed to reroute some blood flow from the bad lobe of the liver to the good lobe.  I would also be sent to be assessed by an internal medicine specialist.  Oh boy another doctor, that would make five different ones in about 7 months.  Another CT would also be done to validate the liver embolization.   It had only been six months at that time since my first colon surgery and I was beginning to recollect my emotions from that time.  One more I would be thrust front and centre in our medical system.  Once more I would undergo a surgery that would remove more than just a physical part of my being.  I didn't realize it yet, but the upcoming surgery would affect me far more than my prior one.

     My post-chemo interlude officially ended when the pre-procedure for the liver embolization was performed.  While the hospital setting was now familiar and comfortable,  my cancer journey was still taking me places I'd never been.

The Chemo Chronicles - Part VII

     If life is a game show, then I am in the bonus round.  Or at least I got a bonus  treatment.  Turns out that while waiting for surgery to be set up I could squeeze in one more round of chemo. 

    To coin a phrase I've discussed my regular chemo sessions "ad nauseum", so to speak.  Session number seven on August 6th was nothing different than the others that proceeded it.  My energy was good, my appetite was great, I made homemade biscuits  that weekend.  Just a boring session.   The only hiccup I would have was during the 5FU pump removal - no blood return after the disconnect.  My 'turn and cough' routine was not enough to get it working.  I had this chemo thing down pat, but was now thinking about the upcoming liver surgery.

     One cannot have surgery immediately after chemo.  For one thing I was being treated with Avastin, a chemical that inhibits the growth of new blood vessels and would totally screw up the healing and recovery process.  My original surgical date was moved from Sept 16th to Sept 22nd, giving me roughly five weeks from the last  session  to my surgery.  Hopefully enough time for the effects of the chemo chemicals to not interfere in the surgery.

     Surgery.  My second cancer-related surgery would be the biggest of my life.  I was feeling so very confident after passing through my chemo process that initially I was not concerned.  However as I went through the medical process that confidence would be tested. Liver surgery is a big deal, much bigger than my original colon surgery (which was hard enough to get through).  With tumours on my liver however, my options were limited.  Chemo alone could not remove them (although they did shrink).  Up to now I've accepted all the risks and rewards that the treatment was giving me.  Up to now I had followed my plan.  I had to be true to myself, to continue to find the courage and means to follow through with that plan.  

     Following the plan began with meeting my surgeon.  My journey was still mapped in well-charted territory.  My hope was that it would not turn into my own personal Odyssey, I had no desire to experience the medical equivalent of  Scylla and Charybdis.