Catching Up

WWFD? Or, What Would Francis Do? Where the heck did that come from, you ask. Well, I gotta admit that this is from an old event, but corporate mail seems to take awhile...

Way back in September I attended a party that was in appreciation for the pivotal figures in our implementation of the computerized medical record. No, I was not a recipient, merely a participant, Any way, during the party I had a chance to talk with a group of the project's nursing reps, and they introduced me to the term "WWFD". Evidently it means "What Would Francis Do?" and it had become their standard approach to any problems that they faced. Needless to say I was 1)Humbled, 2)Honored, 3)Secretly proud, and 4)Irreverent.

The very next weekend my family and I were at the Castro Valley Street Fair and I stumbled across a stall that would create License Plate surrounds on the spot. Needless to say my irreverent side took over and just as a joke I had one created that had "KPHC" across the top and "WWFD" across the bottom.  Well, it turns out that this joke gift I mailed to the project is now posted on the wall of their clinical leader, and photos are floating all over the corporate intranet.  I guess it’s my 15 minutes…

So, on with the updates.  I had the Neck to Nuts CT a bit over three weeks ago.  All of the tumors are stable/shrinking—the ones in the right kidney are now classified as cysts—except for the lung tumors.  Evidently they are multiplying and growing.  The CT also showed a small pleural effusion (fluid pooling in the space between your lung and ribs) at the base of the left lung.  Needless to say my Onc was not happy--nor was I.

As a result of this finding I underwent a Thoracentesis (stick a needle through your chest, feed in a plastic tube, then suck out the fluid) 2 weeks ago.  The results were pretty normal, except for the presence of cancer cells.  On this tap they took out 175cc, not a whole lot.  Unfortunately, one week later I was very short of breath with exertion; so after a chest X-ray I was back in the Interventional Radiology lab where they took out 1700cc of fluid.  When she saw this, the only thing that Robin could say was “wow, ten times the last one”.  Thanks Robin.  Next Tuesday I am due back in IR to see how things are progressing.  As for how I feel, I haven’t felt this good in weeks.  As I used to tell my students, “Air goes in and out, blood goes round and round, oxygen is good”!.

The weirdest part of the experience came when I saw the tube from my back plugged into the vacuum bottle.  It struck me that after about 20 years of assisting on procedures like this—and feeling sorry for the poor bastard that we were treating—now I was the poor bastard being treated.  Very strange feeling.

As a result of the CT scan result and the effusion a bunch of stuff has changed.  First, my chemo has been changed to Temsirolimus; this is similar to Sutent, but is a weekly intravenous infusion which I receive every Wednesday morning.  Also, my Onc has referred my to the Riverside facility that administers the Interferron and Interleukin 2 therapy—with luck we will hear from them next week when their specialist returns to the US.  Pending the results of this referral, and the response of my effusion, the nephrectomy has been put on hold.

Looking back over the last few weeks, I am pretty chagrined to realize that I had no idea what was going on with my lungs.  Like I said earlier, I feel better now than I have in weeks, but a part of me is certain that I should have caught this earlier.  You have no idea what it is like to feel anxious with every breath, weak with every movement, and confused all the time.  And to think that I chalked it up to the side effects from the chemo!  Ah well, live a little, learn a little.

The side effects from the Temsirolimus are pretty limited; most of the effects are zero tolerance for spicy/sour foods and oral sores.  The biggest problem is the nausea and vomiting that hits on the second day after the infusion…yes, that is right now, and the porcelain god has received his due as I type this.  Bloody annoying; and tastes like crap to boot.  With luck it will end tomorrow, and I can get back to eating and drinking.

Well, that is about enough for one night.  Time to go huddle the throne and pray for the morning.

Be well.

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A Bit of Good News

It has been awhile, and for that I apologize. What with Christmas and appointments and side effects I have basically ignored everything. But, there is good news.

First, let's review the Bone Scan results...nothing new there, except that what I thought was a fracture in my right foot way back when truly was. Yep, dropping a motorcycle on your foot will break the foot. The scan confirmed all of the existing mets and found nothing new. Damn good news.

In the intervening time I also had an MRI of the Brain and Spine--to check the results of the CyberKnife treatment--and all of the lesions have gone from small and dense to diffuse and larger. Before anyone freaks out, this is GOOD. As the lesions are treated and die they will result in some inflammation of the surrounding areas, and the tumor core will be "attenuated" on the scans. This has all happened; so things are good. The plan is to wait for another three months and see what happens.

As for the left thigh pain, that has been confirmed as a mets. I am currently undergoing full radiation therapy to the thigh for this, and should be done in about eight days. Seems to be working, as the stress related pain in my thigh is gone. Course, there is a downside, as my left leg feel decidedly weaker. Ah well.

That brings up an odd experience. The rad techs swore that I would noitice nothing, but yesterday when they blasted my leg every hair stood up like they were all charged...so much for them saying that "non-ionized" radiation has no ionizing effects. Of course, the techs think that I am nuts, but I know what I saw and felt.

Monday I have the Neck to Nuts CT; so we will see what the rest of my body is doing. Assuming that the scan shows a positive progression in the tumors, I will then have the Primary Tumor in my left kidney removed. Here's hoping.

As for the side effects; food sucks, but I am still keeping my weight stable.

If it were not for Robin and the kids I would probably have given up by now, but I cannot let myself do that. They are my life.

Happy New Year to all, and to all a good night.

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A Preliminary Reading

Well, today was the Nuclear Bone Scan. For those not used to the terminology, that basically means that I was injected with a material that binds to the active cells in the bones and emits particles that a fancy geiger counter can "see".

Granted, that is a horribly simplified explanation, but it works. The "camera" simply sees radioactive decay particles and plots them. Over time, you end up with an outline of the bones and some other areas. The brighter the area, the more decay particles. The brighter the area, the higher the probability of cells that are running at a fast metabolic rate. Again, a simplification, but it works.

So, on to my reading of the scan. First off, the only reason that I can guess at this is having a bit of the theory, and a bit of experience in seeing these scans--the fruits of many years working in the Emergency Department.

From what I saw, the left Femur (thigh) lesion is confirmed; whether cancer or a bunch of cells fixing a fracture I cannot say. The Kidneys are definitely a hot spot with some funky dark spots on the left. A good friend tells me that the dark areas probably mean that there are dead areas in the left kidney. The other interestingly bright area is in the region of the bladder; not surprising as the nucleotide is cleared by the kidneys and at the end of the test I was desperate to pee ;)

So, all in all, not too bad a scan--as far as I can tell. I'll get back when I see the real reading. Moving forward I am looking at going to the Orthopaedic Oncologist for the femur lesion; and then off to the Urologist for the left kidney removal. With luck this will all happen by the end of January, but I am not looking forward to having a titanium rod shoved into my thigh. Ah well, what is, will be.

On the chemo front the side effects are not too bad this time. The GI stuff is a bit of a bother, but seems better today.

Not too much on the home front; we are looking forward to tramping thru the forest this weekend and picking out a Christmas tree. With a bit of luck we will even manage to get it decorated this weekend. Speaking of that, what in the world do they tell kids now a days? My daughter is deathly afraid that a "real" tree will catch on fire, and that says that we have to get a "fake" tree. Ah, don't get me started. They can't sing Silent Night at their Winter Festival, but they can sing O Hannukah. Yet another symptom that the Judeo-Christian origins of the US are being sundered, and the States are dead. All hail the Politically Correct interpretation of (dis) reality!

Anyway, enough depressing stuff. Today was a good day. I am alive, the family is alive, and we are all healthy.

Two quick notes. For those who have been reading this blog, I have good news and bad news about some of the people that I have mentioned.

Last week my Aunt Noelle passed from this earth. She fought a long and valiant fight against some disease that they still cannot diagnose. She was a wonderful person and has enriched the lives of all of us that knew her. Noelle, I will miss you. Say hello to momma for me.

As for my office mate, he is doing well, and evidently living without a kidney is not too bad. According to all of the work-ups he has no metastases and should be fine. Let this be so.

Please pray for them both during this holiday season.

Be well, and remember that it is the little things that count. Read more!

Thanksgiving Update

First, let me be the first to wish you all a Happy Thanksgiving. Many of us get so wrapped up in our lives, and the sheer commercialism of this time of year, that I think it is wise that we all sit back and reflect on the true meaning of this Holiday.

And what is Thanksgiving about? For me it is a time to remember all the blessings and benefits that we all have in our lives. A time to share those thanks, and whatever else I can, with family and friends. Some of us have more, some of us have less, but we all have something to share and to be thankful for. For myself, I am mainly just thankful for the fact that I am alive and relatively healthy, and that I am blessed with one of the best family's around. Both blood and "adopted". I truly could not be going through this so easily without the support of all. Thank you.

Now, on to the update stuff. Today I went to see the Onc, and to get another infusion of the "Bone Juice". My doc--and the whole team--are quite happy with my current situation. The current plan is to resume the chemo on next Tuesday, and after the cycle is over to run a complete battery of tests. So sometime in early January I will have another set of Brain and Spine MRI's, as well as the neck to nuts CT. After the tests are done I will be off to RWC and Stanford for my follow up appointments for the Craniotomy and CyberKnife. Also, after the tests I will be scheduled for the removal of my primary tumor. Yep, time for the Radical Nephrectomy (Kidney removal)! Seems kinda odd to be excited about another surgery, but I like the idea of treatment progressing. The only drawback is that I will have to be off work again for a few weeks. Ah well, I don't know anyone who died of boredom; so I doubt that I will.

Hopefully the next few days will not be as rough as after the last bone juice infusion; but what will be, will be. The Onc team all had some ideas to try out, so I am hopefully applying their suggestions.

Turkey day should be pretty quiet; we have some friends and my brother bringing food and spending the day with us, so that will be a big help. Of course, stubborn cuss that I am, I insisted on cooking the turkey, stuffing, and gravy. So, come hell or high water, that is what I will do. Besides, I did most of it today. All that is left is plopping the bird on the barbeque or into the oven...

Last of all, I have a special request. A good friend of mine--he stood with me when few would--recently underwent surgery and the pathology report came back this week. Turns out the two of us have another thing in common; we both have Renal Cell Carcinoma. His prognosis is rather better than mine--thank God they found it relatively early. Anyway, I am sure that he and his wife and kids would benefit from your prayers as much as me and mine have, so please remember him.

Thanks again to all of you; and remember that Thanksgiving is about sharing your bounty and being thankful for what you have. Sometimes a hard thing to do, and this year has been harder than most, but I am positive that we all have at least one thing to be thankful for. For myself, many more that one.

Be well. Read more!

Catching Up With Reality

OK, I have to send out an apology to a bunch of people. Evidently some people worry about me, and when I don't post here they email my family to find out what is going on...

Sorry all. I let myself get so caught up in returning to work that I forgot about everything else.

Things are going pretty well with this cycle of the Sutent. Amazingly enough, it seems that Benadryl is quite effective at staving off the side effects. Since day one of this cycle I have been taking 50mg of benadryl in the morning and at nighht. For me this dosage causes no problems, but it has sure kept the side effects down.

I am currently ending week four of this Sutent cycle, and I only just experienced the metallic taste side effect on monday. As for the funky oral swellings, they have not arisen this time around. All in all, this has been a good cycle.

Let's see, catching up on the rest of things...you have no idea how good it feels to be working. Of course, it probably helps that people seem downright ecstatic to see me, but the personal satisfaction of doing something to earn a buck really helps the old self esteem.

I finally finished all the dental work and started the pamidronate infusions. Boy, do those make you feel like crap. I basically get to write off 2 or 3 days after every infusion. Luckily they are every 4 weeks, so it is not too bad. As long as it keeps me from having pathologic fractures it will be worth it...

***WARNING: POLITICS SPOILER***
The craziness of this state's and country's electorate never ceases to amaze me. Millions of people get caught up in a movement to effect "change". So they all march like lemmings to the sea (in this case the promised land--as interpreted by Obama and Soros), They vote that chickens deserve what are basically an extension of HUMAN rights to the animal kingdom (what ever happened to being fruitful, multiplying and having dominion?); while at the same time they reject a similar dubious extension of "human rights" to fellow humans. Go figure.

Well, the majority of the public has spoken, and they deserve what they will get. As for the rest of us, BOHICA.

As one of my favorite authors says, "Despair is a sin. And bad tactics".
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