Orchid Update

Most of you may recall that Blanche, our lovely orchid plant, had fulfilled her promise of producing beautiful flowers from each and every bud she had when she showed up (a present from my sister). And after all the blooms were open, we resigned ourselves to watching her eventually lose petals from these gorgeous blossoms...

Ooops, wait a minute! She's not done!!

As the photo tries to show, she's started new stems off the existing ones -- one new stem on each of the two she came with.

So, who's the clever girl now?

No Nodalities!

My wonderful sister has this analogy about living with cancer. Which I think I've reported in an earlier posting on this blog...

She says that living with cancer is living on a roller coaster. Sometimes (like after a "clean bill of health" from your doc), it's like the car getting pulled up to the very top of the hill. And before you know it, you're on the downward slope (like the doc saying things like "We were surprised to see that..." or "We'll want to run that test again..."). And the key to maintaining mental health is just to remember that every down is matched with an up and vice versa.

So, after yesterday's disappointment, don'cha know that Deb and I paid a visit to our Ear/Nose/Throat doc, who carefully fondled the entire site around where the primary tumor was found. And he announced that he had found no nodalities.

Which means no bumps in doctor-ese.

Which means that nothing significant has grown in the primary site (that is, my left cheek/jaw/neck area) since treatment started.

As with the last time he did this and found nothing new, there are (at least) two ways to look at this: one, that the cancer is entirely removed and nothing is there to grow. Two, that any growth has simply been retarded by the radiation and chemotherapy.

But at this point, it really doesn't matter. His having found anything would have been devastating. But he didn't find anything. And that's what counts.

Somebody say "Amen!"

A Spiral Chimney

Diane had asked to see the spiral chimney that Deb and I spotted on one of our walks through West Chester. So here 'tis.

We had a nice, if somewhat brief, chat with the current owner of the house, who assured us that the chimney was not original. But she could not recall off the top of her head what the back story was for the chimney. I would have guessed the chimney was a later addition: the folks who had these houses built for them were unlikely to have time for such silliness. (Fortunately for the rest of us, someone else did have the time!)

(You can click on the image itself for a larger version of the photo.)

Change in Plans...

Deb and I drove to the chemotherapy center this morning and, in preparation for the chemo session, I had some blood tests done -- all of which had been strictly routine up until today.

But this morning, my white blood cell measurement was one point two or thereabouts. Before my first chemo session, that measurement had been six point something-or-other. In any case, it was much too low to allow me to do the chemo session.

My chemo doc explained that the effect of the Cisplatin regimen was cumulative, and that we were close to the "nadir" (i.e., low point) of blood count measurements residual from the second session. And that the white blood cell count before the second session was acceptable, but still much lower than the initial six point something.

Bottom line: he would not proceed with the chemotherapy session. And, since we were so close to the end of the radiation therapy sessions, he was simply going to cancel the third chemo session altogether. He reminded us that, at the start of the treatment weeks ago, he had told us that there would be "two or three chemotherapy sessions." I don't recall that, but hey.

He said, "If we proceeded with the back-to-back chemo sessions the way we had planned -- given your extremely low white blood cell count, I could guarantee you a week's stay in the hospital trying to recover." [What he's alluding to is the fact that chemo sessions destroy many types of fast-growing cells in the body, including cancer cells, of course, but also white blood cells. So another chemo session at this time would drive the white blood cell count down dangerously low.] He mentioned that is absolutely conceivable that a poorly thought-through chemo regimen could kill the patient. And that's why they do these blood tests in the first place.

As it was, he told us to take my temperature twice a day and report any signs of fever or chills immediately. And stay away from crowds. And rest a whole bunch.

(But, come to think of it, this low white blood cell count may explain the serious fatigue -- the wet cardboard box thing -- that I blogged recently.)

So we took this information to the radiation therapy doc, who decided to postpone any radiation treatments until my white blood cell count improved. Between the skin cracks and blisters now showing up on my neck -- a direct result of the radiation treatment -- and the ulcer under my tongue, there were numerous vectors where infection could invade my body and I do not currently have enough white blood cells to protect me from serious illness.

So rather than having two carefully timed treatments today -- which was the "one-two punch" plan I'd been looking forward to -- we got bupkus.

Now, assuming that the previous treatments have been fully effective and there are no cancer cells remaining in my body, this is kind of good news. It allows my white blood cell count to begin returning to normal weeks earlier than it would if I had another chemo session and it provides a break for my tongue to do some healing before we finish up the radiation treatments. Which might start up again on Thursday or next Monday or who-knows-when. It all depends on the blood count. And the count necessary for radiation to resume is probably lower than the count for another chemo session.

Still, it's disappointing as well. I want to clobber this cancer stuff and then clobber it again. And no one knows if the previous treatments have been thoroughly effective. So I was really looking forward to the double whammy that today was scheduled to be.

If there is a serious postponement in the radiation, would the chemo doc consider reinstating the third session? Dunno.

I will get scans (PET? CT? MRI? dunno that either...) in a month or so to see if anything is still there and growing. More later...

A Day in the Life

I want to document this -- a typical weekday routine for the last several weeks -- and do it now, since it's likely to change soon. Thank goodness!

The day typically starts around 4:00 AM. I usually need to get up and visit the bathroom around then anyway and while I'm up, I'll open all the windows around the house. The cool, delicious air of the late night/early morning pours in and drops to the floor (being cooler, it's also heavier than the air that's been in the house overnight). Once all the windows are open, there's a natural air flow that purges the entire house -- from the first floor windows, up the stairs, then out the second floor windows. Standing at the top of the stairs, I can feel the breeze that this convectional pressure sets up. It's a blessing from the world to our house and its residents.

With any luck, I can get back to bed and get another hour or two of sleep. I've almost always been up several times during the night, whch means that sleep has come in one- or two-hour parcels for the last month or so.

But I should be awake and moving again by 5:30 or 6:00 AM to get ready for the first feeding via the PEG tube. An early start is important, as it sets the tempo for the entire day.

The food tube feeding happens in 2.5-hour intervals: a half hour for the actual feeding, then two hours for digestion and letting the body prepare for the next feeding. The six cans a day that the doctors recommend times 2.5 hours per can means that the feeding routine encompasses 15 hours of the day. So there's not a lot of room for missing a beat. If we start pressing the schedule later in the day because we're falling behind, a serious case of indigestion is sure to follow.

So we try to make sure I've ingested two cans by 8:30 AM, when we leave the house for radiation treatment. This is pushing the timing a bit and usually results in a mild case of indigestion.

When not actually "feeding" before we leave for radiation, I will be posting something on the blog, clearing the mucus from my mouth (again and again), and trying to calm the pain in my tongue.

Talking has been getting more difficult over the last two or three weeks. The radiation has caused some swelling on the left side of my face, which, in addition to the tongue pain, makes talking more and more of a chore. At this point, I try to communicate with Deb -- and the rest of the world -- using hand gestures and grunting.

The office for the radiation therapy is a pleasant enough space, with a very good coffee machine, open containers of cookies and pretzels and a jigsaw puzzle for folks to work on while waiting their turn for radiation -- or waiting for a loved one who is undergoing treatment at that time. (I can't eat cookies at this point, so I always ask Deb to eat a cookie for me. We stand by the cookie table and deliberate carefully as to which is the right cookie du jour.)

The actual radiation treatment takes only 15 minutes or so, but we often chat with one of the nurses about how the treatment is going. There is a feeling of genuine competence and compassion that permeates the office, which helps offset the negative feelings about the inevitable damage that the treatments inflict on my tongue, my throat and my my skin -- which is currently the color of a well-cooked lobster. And the skin has just started to crack and peel...

Occasionally, there are other doctor visits as well, and we can usually schedule them for shortly after the radiation treatment.

Back home, I will try to tidy up some pile of stuff, or pay bills, or do e-mails, or sit on the porch and read until it's time for the next feeding. Unfortunately, I'm not allowed to lie down for at least 30 minutes after a feeding, so if I want to take a nap, I have to time it pretty carefully. And, if the weather cooperates, Deb and I may take a walk.

The day seems to go by fairly quickly. There are surgical sponges to be replaced at the spot where the food tube penetrates my tummy, and this often involves minor clean-up work around the site.

I try to get in at least one nap -- and am usually successful.

Getting ready for bed takes a couple of hours, as my compression stocking needs a wash, sponges need replacing again, and the food tube needs to be secured carefully with a lanyard around my neck. The temperature and flow of the shower water have to be carefully adjusted so as not to impinge too hard or hot on the food tube site. And I feel the need to hold onto a railing or rest against the side of the shower stall as I'm soaping up and rinsing off. I don't feel terribly dizzy or anything, but a slip and fall in the shower could be a serious issue at this point...

Deb refuses to fix herself dinner until after I'm safely ensconced in bed. So I do everything I can to be horizontal by 9:30 PM.

Geez, reading over this, it sounds like the high point of the day was opening the windows in the early morning. And maybe that's true... Except, of course, for walks with Deb. Those moments are precious.

But other than these wonderful moments, the days are tedious and dull and punctuated with pain (tongue and throat) and annoying routine (clearing the mucus). But they go by. And they're nearly done. And the next chapter is at hand...

C'mon Baby, Take a Walk With Me

...and tell me Who Do You Love?

Old Bo Diddley song...

Trying to assist the digestion of this Jevity canned nutrition stuff, Deb and I have started taking walks around the neighborhood. We try to do so after each of the six cans per day, but we're actually successful maybe three or four times. Which is not too shabby...

We take turns picking a route.

We never go more than 4 or 5 blocks.

We like the alleyways and back yards as much as the house fronts and front yards.

We try to pick routes that will walk us past places we've never seen before. And, since we normally drive past these blocks on our way to or from somewhere, there are lots of places we haven't really seen. Within two blocks of where we live. Where we've lived for several decades, in fact.

We point out interesting architectural features to each other: spiral chimneys, elegant windows, carriage houses we didn't know were there. We pass lovely gardens. We smile at kids playing. We hold hands.

We're in love.

Hold the Pizza

...at least for a while.

Okay, my last scheduled chemo session is this Wednesday, July 29th. And my last scheduled radiation session is (I'm fairly sure) next Tuesday, August 4th. And I had been so focused on these two dates that I had overlooked something rather important:

It's after those two dates that I can start to heal.

First up is my tongue -- which is keeping me from eating solid food of any kind. In fact, even drinking tap water is painful at this point.

Once my tongue is functioning dependably, I can start working my way up through soup, yogurt and scrambled eggs to more substantial food. (There are first-person stories of people who've gone through the same treatment regimen as mine who have taken months to graduate back to a wide variety of solid foods. I don't think that will happen to me, but who knows?)

And once that is well underway, I can start considering when to have my food tube removed. Clearly, I need to be absolutely sure that I can orally ingest all the calories and other nutrients I need before the tube comes out.

And once the food tube is removed, there's some requisite healing time for my tummy -- to close up the holes that the food tube required.

So yes, Tuesday August 4th will be a day of celebration. But the selection of refreshments for the "party" will look a lot like the diet choices of Monday, August 3.

No pizza. Not yet.

A Wet Cardboard Box

Didja ever try to carry something or things in a really wet cardboard box?

No?

Really, no?

Well, here's what happens: the box is a little too... flexible for complete confidence in its carrying ability, but holds stuff okay. Until the glue or tape lets loose. And then everything that was in the box is now on the ground. Bang. Usually there's at least one glass item involved which can now be spoken of only in the past tense.

Doesn't matter how you hold the box -- or should we say, held the box. Everything's going bang.

I'm feeling like that cardboard box. I was getting along okay for most of the week, but yesterday and today: bang. I simply can't get enough sleep. I don't hurt anywhere (except my */^@#& tongue), but just feel completely unplugged.

(Anne told me this would happen. And she should know. And she was right.)

So my blogging may be a bit light for the next couple of days. But hey, we're rounding the final turn and headed for the finish line, folks!!

An Important Missing Piece...

Deb and I had a chance yesterday to sit with a counselor at the Radiation Therapy office. (Have I mentioned before that the folks there really have their act together? It just seems more and more true as time goes on!)

Anyway, it occurred to me as I was sitting down in her office that yes, this was a piece to my recovery that I had been truly missing:

-- I've been following the information, advice and guidance of my doctors as carefully as I could. But that's mainly brain work. As well as common sense.

-- And I've been distracting myself with these wonderful Terry Pratchett books, Soduku puzzles, computer games and other brain-oriented stuff.

But other than Diane's wonderful CD's with Guided Imageries and vocalized Affirmations, I had not been working much on the mind-body connection. That is, using my imagination, my feelings, my soul to come to the aid of my ailing body.

The counselor, who is herself a 20-year cancer survivor, helped me explore this issue, and we talked about the unhelpful thoughts, ideas, and feelings that I've been carrying around with me since I first heard the cancer diagnosis. God bless her, she's even given me a homework assignment to complete by next week: a list of "Ten Things that I Think" in parallel to a list of "Ten Things that I Feel."

Why have I distracted myself this way? Oh, probably because I really haven't wanted to think about having cancer. I haven't wanted to explore my feelings on the subject. And so I bury myself in mental activities that feel pretty good -- and are oh, so familiar.

But the price of these activities is not engaging what may be the most powerful agents available in the quest to be cancer-free. Which is to say, my own internal resources. Anecdotal stories abound concerning how important attitude and positive imagery are to recovery.

When Lisa and Gus were visiting the other week, we started to explore this topic, and I expressed a lack of enthusiasm for getting into this touchy-feely part of therapy. And they said, practically in unison, "Well, you're simply not ready for it yet."

But now I think I am. I am listening to the Affirmations on Diane's CD's more carefully now. And have ordered several works by Joan Borysenko, who works a lot with this mind/body connection. And my prayers have a new tone -- asking new questions, making new requests and giving thanks for new insights.

I feel that I have a golden opportunity ahead in my last two chemo sessions and last full week of radiation therapy. If I'm ever to get the connection firmly established, this will be the time. (And, of course, the time after the external therapies are finished and I will be in remission...)

Connecting to my heart has always been a problematical issue for me. Sometimes it comes so easily. Without thought or effort. And sometimes the door to my heart seems bolted, no, welded shut. I'm beginning to understand that why this is true can not be successfully examined, parsed, analyzed and dissected by my mental facilities. My brain. Heart issues need to be resolved with the heart and by the heart. And with resolution of those issues, a powerful force of healing in unleashed.

And that's what I want. That't the missing piece in my journey to full recovery -- and the best way to avoid recurrence of the cancer.

Prayers are, as always, deeply and gratefully appreciated. Thank you for being with me on this journey.

Hair -- Part 4

Thought it might be time to bring you an update on the Follicle Follies:

-- the chemo sessions seem to have had no effect on my hair. I'm not seeing a bunch of hair left on my comb, my pillow, or the drain in the bathtub. Yay!!

-- the radiation treatments have definitely had an effect. And the rad doc told me this would happen. The beard hair on my chin lines -- all the way from the sideburns to the point of my chin are inactive. And that may be a permanent condition. (No play-on-words intended. Permanent. Hair. Got it? Sorry...) But the mustache seems to be fine. I plan on growing it down over the outside edges of my lip. I used to wear it that way back in college. It's a different color now.

Funny how things work. I'd been thinking about shaving the beard off completely for a year or so. But decided over and over again not to do it, as it would mean I would have to start shaving again.

Solved that one!

Five Wishes

Over the last few months, I've been hospitalized twice, had two major surgeries, and had more doctors visits than I care to think about. And at almost all of these encounters with medical staff, the same question comes up: "Do you have a Living Will?"

A Living Will is a document that details how you wish to be treated and cared for if you are not capable of speaking for yourself.

Now of course, anyone over the age of, say, 75 should have such a document, because almost anything might happen to them to create such a condition: heart attack, stroke, serious fall, Alzheimer's and so forth.

But when you think of it, all of us are often moments away from being incapacitated ourselves. That is, anyone who walks across a busy street, drives anywhere in a car, takes a trip on an airplane, and so forth. I'm sure you can come up with an impressive list of Things That Might Go Wrong In An Instant. You don't need me to elaborate any further...

And the deal is that, should you be in a facility (hospital or otherwise) and not capable of communicating your wishes, if you don't have a Living Will, the staff of the facility legally must do everything they possibly can to keep you alive. And these days, the list of things available to them is impressive. And scary. The notion of "Death with Dignity" doesn't fit well with modern medical technology.

The Five Wishes Living Will is remarkable. It is a simply worded document that covers every aspect you can think of in this regard. It has been worked over by lawyers until it meets legal standards in almost every state in the Union. And filling out the form gives you a wonderful opportunity to examine your own deepest feelings about how you would want to be treated at this time. And a chance to share those thoughts and feelings with those you love and those who love you.

From personal experience, I can assure you that filling out the Five Wishes form should be far from an unpleasant experience where folks sit around looking and feeling uncomfortable. Nope. It is a chance to share yourself and hear your friends and family in a most profound and rewarding way.

And this work should be done while you're perfectly healthy and have some time to think these vital issues through completely. How do you really feel about when you want people to work hard to keep you going -- and when you would want them simply to let you go?

The Five Wishes form is available as a .pdf file at: http://www.agingwithdignity.org/forms/5wishes.pdf I strongly suggest you at least take a look at the form. Much better, download it and work through it in the company of those you love. (They will mail you a hard copy of the form if your computer won't do .pdf files.)

And if you have an aging parent who doesn't have such a form, please download the form and fill it out with him/her.

You owe this to yourself. You owe this to everyone who loves you and would be involved in your care should you be incapacitated.

Please.

Mucus

I've been trying to write this entry for days now. And it's hard because it's icky and frustrating, but the blog would be incomplete without it. Please note that I'm simply documenting what's going on with my body. When I want to whine and complain, I will try to be obvious that that's what I'm doing.

There's something about the radiation therapy that causes my body to produce a heavy, viscous fluid -- mainly mucus, I'm told, but mixed with some saliva. It coats the inside of my mouth, adhering to the roof of my mouth, then coating the rest of my mouth's inner surfaces. Usually, the consistency is not unlike fresh rubber cement, but occasionally it froths up, filling my mouth with glop.

My medical team says it's a fairly common side effect of the treatment. And they've given us a recipe for a weak solution of baking soda, salt and water to loosen and remove the gook -- which works wonderfully well, but the glop often starts to build up almost immediately after its removal. I've gone through gallons of this mixture over the last two or three weeks.

The final step in removal, of course, is a good firm spit into the sink. And this often triggers a stab of pain from the ulcer under my tongue. And given my Dick Cheney Smile [see previous posting of that name], I'm not always that accurate as to where the spit goes. Geez.

(Okay, that last bit probably qualifies as whining.)

I may go for an hour or two with little build-up of this mucus, but then spend the next 3 or 4 hours washing my mouth out every 5 or 10 minutes. I haven't figured out what causes this mucus flow to start and stop. And when I tell my medical team about all this, they just shrug.

I am blessed that the deposition seems to come to a near halt when I lie down to sleep. If it continued then, I simply don't know what I would do to get any sleep at all. (As it is, I'm waking up 3 or 4 times a night to visit the bathroom to pee. And we haven't figured out what's causing that either.)

And when I think about what others go through in their treatments -- the pain, the permanent loss of bodily functionality -- I understand how fortunate I am. This is a temporary condition which should halt completely in a couple of weeks.

There. I've posted this. And I feel ever so much better.

What People with Cancer Want You to Know

Our dear friend Lisa came across the following list in the book, Help Me Live by Lori Hope:

20 Things People with Cancer Want You to Know

1. It's okay to say or do the "wrong" thing.
2. I need to know you're here for me (and if you aren't, why not).
3. I like to hear success stories, not horror stories.
4. I am terrified.
5. I need you to listen to me and let me cry.
6. Asking my permission can spare me pain.
7. I need to forget -- and laugh.
8. I need to feel hope.
9. Telling me to think positively can make me feel worse.
10. I want you to trust my judgment and my treatment decisions.
11. I want compassion, not pity; comfort, not advice.
12. I am more than my cancer; treat me kindly, not differently.
13. I want you to help without my asking you to.
14. I like to be held in your thoughts or prayers.
15. My moods change day-to-day; please forgive me if I snap at you.
16. Hearing platitudes or what's good about cancer can trivialize my feelings.
17. I don't know why I got cancer, and I don't want to hear your theory.
18. I need you to understand if I don't return your call or want to see you.
19. I want my caregiver to take good care of herself or himself.
20. I don't know if I'm cured, and bringing up my health can bring me down.

(So many of you are doing so many of these things for me! Just reading over the list brings your faces and voices to my mind. And if items on the list seem onerous or confusing or contradictory or scary to you, please just re-read item #1. There's a good reason that the author listed that one first!)

Six Cans

Some of you wonderful people out there might be feeling bad that I'm reduced to taking nourishment by food tube. I'd like to take a moment to address any concerns that might be lurking around this issue:

First of all, without the food tube life would be a constant battle to keep my weight up. And one I would be losing. The pain in my tongue is reduced from what it was two weeks ago, but it's still there. And the radiation has limited the movement of my tongue in any case, so that I'm not confident that any solid food I would take orally would "go down the right pipe." And the idea of any serious choking at this point is awfully scary.

This morning, my weight was 166 pounds -- which is an excellent weight for me. And it feels like I should be able to keep this weight for the duration of my treatment.

Second, the nourishment that the Jevity product provides has been most carefully worked out to supply everything that my body needs. Including things like fiber. If I were eating orally, my choices in food right now would focus around "What can I eat?" rather than "What would be the most nourishing thing for me to eat?"

So this just occurred to me yesterday: I am probably "eating" better over this last week or two than I have eaten in years! Now Deb is a wonderful cook and she enjoys the activity -- so that dinners around our house are almost always healthy, delicious and well balanced. But my choices for lunch before my treatment started were... ummm... based on convenience and taste (read: Wendy's or Carmine's Pizza) rather than nutrition.

So I am deeply grateful that this one aspect of surviving well through the treatment regimen is relatively easy and so completely successful.

But please do me a favor and don't ask something like: "Okay Randy, your choice of Jevity or Moo Shu Pork?" Please. Just don't go there.

Ending It All

Diane has requested that I post the date of my last treatment session.

My last Chemo sessions take place on Tuesday, July 28 and Wednesday, July 29.

The Radiation treatments last a bit longer -- looking to take advantage of the potentiating effects that Chemo provides for Rads. And there's just a slight bit of confusion on exactly the last date, but it's somewhere in the range of Tuesday, August 4 or Wednesday, August 5. I'll post the exact date when I know it.

(Diane, thanks for asking!)

Meet the Machine

My radiation machine, that is.

I've blogged elsewhere that this machine makes an MRI or CAT scan machine look like a high-school science project. That's really just for how it looks, mind you. Not what it does. I ain't dissing the scanners. Nope.

And that's because the scan machines look like monster-sized donuts, and they just sit there. You get slid back and forth inside the donut hole as the machine growls, clacks, snaps and spits. Okay, they don't really spit. I just made that up.

But the radiation machine has arms. And, as you lie perfectly still on the table, the machine moves around you.

Take a look at http://www.varian.com/us/oncology/radiation_oncology/clinac/ for a moment. Note in particular the first photo and the last one. (You can, of course, click on each photo for a better view.)

The first photo shows the machine at rest with its two "arms" retracted, but the "foot" piece extended. The bottom photo shows the machine in full use, with its two "arms" extended into working position (but the "foot" piece retracted) and the entire machine rotated ninety degrees to apply the proper radiation dosage at exactly the right spot. Geez, the whole machine twirling around the patient!

Whew!! You know, I'm really glad I decided to post this, because -- of course -- I've never seen the machine in operation. Being rather firmly attached to the table while it's doing its thing.

The actual radiation is released from the large overhead extension. I think the two "arms" and/or "foot" work to position the radiation head exactly for each and every session. For my sessions, the machine is repositioned maybe 6 or 7 times to cover both sides of my neck and face. I believe at least one of the appendages has a camera, so that the technicians running the machine from a different room can confirm visually that the machine is in just the right place.

The routine for my sessions is -- big surprise here -- stored in a computer along with everyone else's routines. I think the software is Windows-based. Because the displays kind of look Window-y and because the technicians had to restart one of the computers before my last session could commence.

What Cancer Cannot Do

(The following was transcribed from a plaque hanging in the office of my Radiation Therapy facility. Author is unknown.)

What Cancer Cannot Do:

It cannot cripple love.

It cannot shatter hope.

It cannot corrode faith.

It cannot destroy peace.

It cannot kill friendship.

It cannot suppress memories.

It cannot silence courage.

It cannot invade the soul.

It cannot steal eternal life.

It cannot conquer the spirit.

PEG Tube Reboot

Well, Deb and I thought we understood how to use the food tube. We'd had a tutorial from one of our wonderful Visiting Nurses and Deb did a feeding for me while the Nurse was there.

I mean, you open the end of the tube, insert a big plastic open-ended syringe, fill it with Jevity (the name of the balanced nutrition liquid we're using), and wait for the syringe to empty. Then fill it again and repeat until a half can of the liquid is safely stored in Randy's tummy.

Turns out that things weren't quite as simple as we thought.

The second Visiting Nurse that gave us a food tube tutorial corrected several of our misunderstandings about the tube and its use:

Those of you who know me at all well will not be surprised that I had looked at my tummy as being basically a biochemical reactor vessel. And it didn't really matter how quickly you inserted stuff into it. And the quicker the better. (Hey, we've all scarfed down a meal when in a rush, right? A few burps, maybe, then you get on with life.) So Deb and I had developed several techniques to speed the flow of this very heavy liquid. Get it down, get it done.

But Lori the Nurse explained that one's stomach is actually living tissue, with some very definite opinions as to what should show up inside, when it should show up, and how quickly it should show up. How about that? Quel surprise!

So Deb and I had to abandon several of our clever techniques to follow a more sedate routine. But the good news is that Lori said we could aim at ingesting a complete can of Jevity per "feeding" rather than just a half can. So that the entire "eating" procedure really takes less time out of the day.

During the transition in techniques, I lost another pound or two. But that's one of those "one-step-back-two-steps-forward" thingys.

"I Hope You're Feeling Better Soon!"

This notion has been expressed to me on numerous occasions in the last few months -- either face-to-face or on a greeting card. And every time someone does that, it lightens my heart and reminds me that people do honestly care about my well being. Thanks to everyone out there who has said this or thought this.

But with cancer treatment, there is another way to look at "feeling better," as described to me by my chemo doc. (His off-duty activites include practicing yoga and mixed-martial arts. But not, I think, at the same time...) He explained the function of chemo and radiation therapies in terms of his martial arts training.

He says that, in a one-on-one competition (like either M-MA or cancer treatment), your objective is to hit your opponent again and again, softening him/her up and preparing her/him for a knockout blow. So with chemo, for example, you whack the cancer cells with some powerful toxin which kills and/or weakens those cells, but of necessity weakens your healthy systems as well (i.e, red and white blood cells and bone marrow). Then you allow those healthy systems to recover somewhat, but whack the cancer again with more toxin as quickly as possible. You simply can't wait for your systems to recover fully, as that might allow your cancer cells to re-establish themselves as well.

The upshot of this is that your healthy systems will degrade over the course of the treatment as your cancer cells are destroyed. If the therapies are well designed and fortune smiles on you, you should recover most or all of your previous capabilities and capacities, while the cancer never returns.

I've found this pugilistic metaphor helpful as my treatment progresses. I am not nearly as concerned as I might otherwise be as my strength diminshes and side effects of the treatments become more onerous. It's a requisite price I'm paying, and there is an end date to the treatments. And I have every expectation that I will be as healthy after all this is over as I was before the cancer started up.

So thanks again for wishing anyone and everyone "I hope you feel better soon." It's a thoughtful thing to do. Because what you're really saying is "I care." And you can't possibly know how helpful such a spoken thought can be.

Something that I'm learning, thanks to you.

A Visitation

A week or two ago, in the middle of the afternoon, I was lying on my bed enjoying the getntle breezes wafting through the room and feeling very much at peace.

Through my closed eyes, I sensed a brightening, which I attributed to the sun coming out from behind a cloud. When I opened my eyes, I was surprised to see that the "real" light in the room hadn't changed. I closed my eyes again, and experienced the same brightening.

Through my closed eyes, the light resolved itself into an oval of pure white light located down by my feet and slightly off to the right of the bed. The light moved closer to my body and I felt it "touch" me, bringing a cleansing and healing feeling that was wonderful.

I opened my eyes which, in retrospect, was probably a mistake. The light wasn't there any more, and did not return when I closed my eyes again. And it hasn't returned since, although I have asked it to do so on many occasions.

The experience has, however, provided me with a pair of Visualizations that I have found helpful. In one, I envision a fine-screen mesh that penetrates my body at my head or foot and "combs" me from one end to the other, removing unwanted cells and other detritus from my body as it goes.

In the other, I imagine the effects of my radiology and chemo treatments exploding these unwanted cells. Bursting them rather like popping bubble wrap. And the leftover parts and pieces of these cells are completely harmless.

There Will Be an Answer -- Ulcer Ease!

I've posted several times that one major challenge at this stage of my therapy regimen is the ulcer under my tongue. The X-rays used in my radiation treatment scatter off a filling in one of the molars on the lower left side of my mouth. (This is likely the same filling that has caused some uncertainty about the location and size of the primary tumor, as it is located in the same area. The word "unfortunate" comes to mind..) The scattered X-rays have been beating up the under side of my tongue, creating the ulcer.

I have an amazing variety of mouthwashes now, including a concoction that all my docs refer to as "Magic Mouthwash." But none of them could give me any reasonable relief from pain. And I'd prefer not to take a pill which would provide all-over-my-body pain relief, when the only distressed area is the size of a dime located right... here.

Anyway, I've mentioned this condition to my chemo doc and my E/N/T doc, but their suggested remedies were not helpful. Not even the "Magic Mouthwash."

But a nurse at the radiation treatment facility gave me a small bottle labeled "Ulcer Ease," that really seems to do the trick.

Whew.

A Half Pound

I've posted that probably the biggest challenge through this stage of my therapy regimens is keeping my weight up. For the last two weeks, I've watched my weight drop -- a pound one day, a half pound another, two pounds on yet another day.

Part of the problem has been that Deb and I were looking at the PEG food tube as an ancillary source of nourishment. (We were often told: "The food tube is there in case you need it." And we probably took that statement too literally.) And taking food orally was difficult and quite painful because of the ulcer under my tongue -- and the fact that I had zero appetite.

(It's been a funny situation, that. My sense of smell is quite good lately, and the aroma of fresh popcorn or my neighbor's steaks sizzlilng on his grill has been most pleasant. I love to smell these things, I just don't care to eat them.)

So over the last three days, Deb and I have changed our focus totally on nourishment. It's now all about the PEG tube. I'm supposed to take six cans of this carefully balanced nutritional mix per day, at a half-can per "feeding," at 45-minute (or more) intervals. And it's taken a couple of days to work out the best, fastest to do this dependably.

And as of yesterday, I think we've finally hit our stride. We finally got all twelve feedings in, starting at 6:30 AM and winding up at 8:30 PM.

This morning, with no small feeling of trepidation, I stepped on the scale. Yesterday's weight was 166. This morning, it was 166.5. My first weight increase since June.

It's only a half pound. And goodness knows that may be water weight or something else. But for me, this morning, it's a sign of hope.

Deb and I are facing down challenges one after the other. Each one seems daunting, but we face them together, with a clear vision of life after all this is over. And we move forward.

Somewhere there's pizza with my name on it.

Summer Camp Juggling

I just finished teaching a five-day juggling course. It ended yesterday. It went like this:

Every summer, the West Chester Friends School offers several weeks of day-camp activities -- for their year 'round students and other kids from the neighborhood. The Camp provides an opportunity for the students to stay connected over the summer with their fellow students and their teachers, who form the core of the Camp adult staff.

And many of you know that the School gym is where our just-for-fun juggling group, the Turks Head Jugglers, practice twice a week. At no charge. And some of you know that I'm a member of the Board of the School. So with all that interconnectivity, it's made perfect sense that I should conduct a juggling course for the Day Camp.

I love to do this, in part because it gives me a chance to bring out all my juggling props for the kids to work with: scarves, balls, rings, clubs, Chinese yo-yo's, flower sticks, spinning plates, contact balls, poi swings, chatter rings, and... oh, I'm sure I've forgotten two or three things...

Anyway, last year, my group was comprised of five boys, each of whom had a rather different agenda for being there -- and it took quite a good deal of energy on my part to keep everyone focused and having fun. It was gratifying and I enjoyed it, but it was tiring. And that was last year, when I was in good physical shape.

This year, I committed in the spring to doing the same course, but started to get serious reservations as my cancer therapies started to kick in: would I have the energy? would it be foolish to handle props with a bunch of kids while my immune system is so compromised?

I knew I could simply call Leslie (the Camp Director) at the School and tell her please to cancel the course. There would be some disappointment and lost revenue to the School, but no recriminations and a complete understanding. If you feel you can't or shouldn't, well, that's what you feel. That's the way things work at West Chester Friends School.

But I really really wanted to do this. Not just because I love to watch kids learn to juggle. Not just because I love to help them get that next trick. Not just because I feel a deep sense of gratitude to the School for sponsoring the Turks Heads. Not just because I wanted to help the School's revenue stream. Not just because the kids I would work with are some of the most wonderful kids I've ever met.

All of that to be sure, but it's come to me lately that my teaching juggling feels like a true Calling. And by doing the course, I would underline and reinforce a vital part of my path to recovery: I am more than my disease. And I will not allow the disease to bring me to a halt. And I plan to be here long after my disease has left.

Leslie found two teenagers -- both of whom had been students at the School and both of whom juggled pretty well -- to act as assistants for the course. And, since I had to bail out of several sessions during the week, this proved to be a vitally important part of the course's success.

And the class turned out to be five perfectly charming girls. Each of whom was amazingly self-confident and self-directed, patient, helpful, enthusiastic, and co-operative. (Interesting occurrence: When initially handing out juggling scarves, I asked them: "Okay, who wants a pink scarf?" and none of them wanted one! None of them! Special girls? I guess so!)

In short, I could not have asked for a better situation. Leslie provided the adult supervision to augment the two teenagers' work and everything fell into line.

From Monday on, we had aimed at doing a brief show for our fellow campers and parents on Friday. And by Friday, each of the girls had identified specific props that they wanted to use. As a group, we laid out how we wanted the show to go-- who would use which props and what tricks they would demonstrate; what the performance order would look like; what they would say to introduce themselves and their performances; and yes, they would bow to the audience when they were done.

And everything went beautifully on Friday afternoon. Leslie and I just sat against the wall and watched as the girls went "on-stage," one after the next, and did a lovely job. Each of the two teenage assistants had a support role in making the girls look good, and they did just fine as well. Some of the tricks, it might be said, were not all that impressive to the audience, but a number of tricks elicited genuine "Wow!" from their fellow campers and parents.

It was a wonderful moment.

I wouldn't have missed it for the world.

More Than Halfway... Kinda...

When I finished my second round of chemo last Wednesday, it occurred to me that I was "Two down and one to go" with that part of my treatment. That's more than halfway!

Dude!!

But the truth is that this second round took a great deal more out of me than the first one did. I've been extremely tired, shaky, and dealing with a touch of nausea -- none of which applied after the first round. I'm also 12 pounds lighter, because I'm not taking in calories as quickly as I'm expending them. "Eating" -- if you call draining a can of carefully prepared nutrition into a tube into your tummy -- has become a real chore. Keeping my weight up is now the primary challenge of the therapeutic regimen.

Still the numbers don't lie: two-out-of-three is two-out-of-three.

And this morning, at rad therapy, a doc pointed out that I was doing my 19th treatment that day -- out of a scheduled 36. (Or maybe 37, there's some small debate about that...) And that is more than halfway as well!

Double Dude!!

But the above proviso applies here as well: life looks like it may get more uncomfortable in the weeks ahead. The skin on my neck now looks and feels like it's been badly sunburned and it requires a layer of special ointment to keep it okay. And my throat is swollen -- which makes eating solid food all but impossible. (The PEG food tube is not an optimal way of ingesting nourishment, but thank goodness it's there and it works!) Oh, and the ulcer on my tongue is still quite painful.

But I remind myself that I am walking a path that thousands of people have walked before. And that the treatment regimens available today are much advanced over what was available just years ago. And that I have the love and support of so many people around me. AND that my wonderful spouse continues to provide every possible bit of support and caring that I could ask for.

And writing about all this; knowing that you, dear reader, are with me on this journey, is an enormous help.

Please know in your hearts that this is true.

An Apology...

The other day, I posted a piece that used the term "shooting myself" in the title. It concerned my using hypodermic needles to inject Lovenox (a blood thinner) twice a day to help control and eventually dissolve a blood clot in my leg. The procedure was going well and, after a blood test, I was told to stop doing the injection, as a pill-based medication should be adequate from then on.

I was feeling very good about the blood test, and may have been over-exuberant when I posted the piece. And less-than-wise by using the term "shooting."

If I caused any of you dear readers a moment's concern about my actually shooting myself, I do apologize. I want this blog to be informative and fun, but certainly not a cause for alarm on anyone's part.

We still friends?

Three Cheers for Diane!!

It had been mentioned to me on several occasions that using a "Guided Imagery" technique for dealing with my disease, discomforts, and therapies could be quite helpful.

As I understand it, this is similar to what Sharon suggested some time ago: Her image about recovery from my neck operation was in terms of "blue-collar worker" cells of my body, wearing tiny little hard hats, scampering about the incision area, encouraging each other to rebuild healthy tissues quickly. And getting paid extra for their hard work! Perfectly lovely image that I enjoyed using -- back during that part of this journey.

But Sharon and I couldn't come up with an equivalent image for chemotherapy or radiation therapy. Because during these treatments, there is so much "collateral damage" -- destruction of perfectly healthy cells in the pursuit of the cancer cells. The only image that I could come up with was the house-to-house warfare that we see portrayed in movies and such: kick down the door and spray the inside room with bullets. And wait for the smoke to clear to see what you've accomplished. Not really a supportive, healing image, but that's what chemo and rad therapy feel like sometimes!

But Diane (who is a classmate at my Meadville school, that I would like to blog about sometime...) recently sent me not one or two, but three CD's of Guided Imagery that could not be more appropriate: one to be used with chemotherapy, one to be used with radiation therapy, and one for support for the caregiver(s) surrounding the patient.

I listened to the chemo CD today during my treatment session, and it was wonderful. And (for all my fellow Meadvillians) the concepts and presentation fit just beautifully with the ideas and techniques we're working with in School. The CD suggests that the Imagery becomes stronger the more you listen to it. And that's easy to believe.

My chemo sessions tend to last roughly 4 hours. And I take a Terry Pratchett book (of course!); a Soduku book; and the Lance Armstrong book, It's Not About The Bike with me. But now I can put the paper down, switch on the CD, and find a better rest, a better place to visit, with an invitation to take a more active participation in my own healing.

Diane, thank you ever so much!!

I May Not Have to "Shoot" Myself...

...any more.

Treatment for the blood clot in my leg has involved two drugs: a pill (Coumadin) and a self-administered injection (Lovenox). Thus, I had been "shooting" myself with Lovenox for 4 or 5 days, twice a day. It took a bit of training, but it turns out to be rather straightforward -- and completely painless. You pinch some skin at your "love handles" so that you have an inch or so of "adipose tissue." (And doesn't that sound better than "fat"?) And lift it a bit to make sure you don't have any muscle tissue in your grasp. Then you wipe the area clean with an alcohol-swab, and take the syringe and plunge it straight down into the skin. And there is absolutely no pain!! Amazing! Press the plunger all the way, pull the needle out and you're done!

The trick with treating serious blood clots is to thin the blood enough to allow the clot to clear itself without thinning the blood so much that it won't respond adequately to cuts or bruises. And there is (no surprise here...) a "magic number" that tests look for to confirm that your blood is at just the right thinness. When you've achieved that -- using the two aforementioned drugs -- the doc takes you off the Lovenox and continues you on the Coumadin for a couple of months or so.

AND on the first blood test to check on my blood thinness (which happened yesterday), the results showed that I had plonked onto that magic thinness number almost exactly. So no more "shooting" should be necessary.

Another small victory. We count 'em all, thank you.

Blood Clot Update #1

Y'know, it's funny. Sort of. Here I have what might be a life-threatening blood clot in my right leg, and it feels to be the least of my worries...

Anyway, I don't think I've mentioned that this clot is actually the second clot that I've been carting around. I discovered the first one in my left arm several weeks ago while Deb and I were in West Virginia. Felt like an embedded pencil. I think I picked it up from an injection which was part of an MRI exam. At least that's the only unusual thing I've had happen to my arm in a long time.

The arm clot was -- and still is -- superficial and doesn't present anywhere near the potential harm that the leg clot does. But the treatment prescribed for the arm was warm compresses. No meds at all. And aspirin was 'way off-limits because of the chemotherapy that I'm doing. But after several weeks of warm compressing the heck out of my arm, I could feel no change in the "pencil in my arm."

However!! Since I've started taking medications for the clot in my leg, I've been using the one in my arm as an indicator as to what might be happening to the one in my leg. And I'm happy to report that the arm clot has decreased diameter from feeling like a pencil to feeling like a spaghetti noodle. Still hard -- and a thick noodle, but a noodle nonetheless.

So progress up in the arm suggests progress in the leg. Did everyone get that? It's a really good thing!!

Hair -- Part 3

Or, as the old adage has it: "Hair today, gone tomorrow."

I was wearing a dark blue T-shirt yesterday, and was surprised to look down and see it had a light coating of hairs sprinkled across the front. And they were obviously hairs from my beard. I brushed them off, but the sprinkling was back in an hour or two.

Later, when I pulled ever-so-gently on a group of still-embedded hairs, a dozen or so came off in my hand. So I stopped pulling on them.

Since I haven't had chemo in several weeks now, I can only assume that the process was started by the radiation treatments.

I don't think there's been any effect on the hair on top of my head, and tugging gently at my mustache hairs does not result in any being pulled out. So it's just the chin stuff.

My rad doc told me this might happen -- and that the chin stuff would probably grow back, since the radiation dosage in that area is fairly light. But the hair along the side-chin lines is, he thinks, a thing of the past.

Not that any of that really matters much -- not in comparison to the other physical issues that are on the horizon. But I thought you might want to know.

Second Round of Chemo Starts Tuesday

Tuesday, July 7th, starting at 9:00AM, I'm back for my second round of chemo.

If this seems like quite a delay from the first round (which happened back in mid-June) I would agree -- and I asked my chemo doc about it. He reminded me that there are dozens of different chemo regimens available, and the doc in charge makes a choice depending on the type of cancer involved, the current status of the cancer, the overall health of the patient and so forth. He applauded my interest in being as "aggressive" as possible (although I was actually just looking for clarification). But he told me that "high-dose platinum" chemo (which is what I'm doing) takes such a toll on the healthy cells of the body that it takes this long for the body to recover to the point that it's prepared to handle the next set of dosages. And of course, I will take his word on it and be thankful for the break.

Quite frankly, dear reader, I'm anxious and frightened about these upcoming weeks. The effects of both chemo and rad therapies are cumulative. And although I started all this in pretty good health, my internal resources are not today what they were two or three weeks ago. And a number of my medical team members have tried gently to alert me to the fact that the second two weeks tend to be a lot more challenging than the first two.

Now I know that:

-- I have excellent medical support.

-- I have the care and love and enthusiastic support of so many people.

-- I'm still probably in better shape than many others who have successfully walked this path.

-- That there is an end point to the discomfort not that far away and the promise of complete recovery and a "clean bill of health."

-- Maybe most importantly, I have the constant and most comprehensive care and support and love of my wonderful wife -- whose birthday last Friday I forgot...

But every now and then, all this doesn't seem to be enough. And I just get scared of what the next two weeks might bring and I start to get angry and fall into a victim mentality...

So I try to pray and meditate and stay centered and breathe and that helps a lot. And I try to stay in the essence of the moment and not worry about things I can't affect and that helps. And I pick up my latest Terry Pratchett novel (I'm now the proud owner of 7 of them -- and three of them are still unread!) and that helps a lot. And I think again about all the people -- literally around the world! -- who are staying with me on this journey with caring and love and that helps a lot. And then I weep a bit and that helps some. And it's all rather like a summer storm: after it passes, there is a profound, almost sacred peace.

There are gifts here.

Crutches Revisited

I am informed that playing Tarzan on crutches is dangerous and immature.

Duly noted.

Equipment Maintenance

The other day, I noticed that the pads on top of my crutches -- the ones that fit in my armpits when I use them -- were cracking rather badly with age.

So today, I got some new ones and put them in place. They look so much better -- and may well offer some additional cushioning when in use.

Y'know, "walking" with crutches can be a rather elegant form of transportation. A little remindful of cross-country skiing. On a flat, dependable surface, you can "throw" the crutch tips out a considerable distance; get a good, firm plant ; pick your weight up on the handles; and swing your feet out maybe five feet or so from their initial placement (I haven't actually measured the distance. Yet.). And moving easily across a crowded floor or moving up or down staircases takes careful planning but is a joy when it works well. Yeah.

Hmmm...

Does anyone out there get sentimental about his/her crutches?

So Much Depends on Where You Focus...

Don'cha think?

A Poem -- courtesy of my sister

Martha sent me this:

Serenity
(after a session of chemotherapy)

Beyond the window there
three trees -- two maples and a fir,
a patch of grass, a honeysuckle
bush not yet in bloom.

They are doing their great work:
anchoring the earth and breathing in
and out to give a great gift to the air.

In here I share the silence that is theirs.
I light a pure white candle
and let it, too, proceed
to do its work: to shine in silence,
gather peace for me
in its soft radiance
from all four corners of the room.

I make a cup of tea and break
a wondrous scone
a friend has made.

In silence, too, I have my work
to do. Breate in, breathe
out, ask blessings on my body's earth,
and ask for grace to give my own give
back to the holy air.


-- Sr. Eileen Lomansney, CSJ Ballston Lake, NY

My Latest Hospital Overnight

Going to the Hospital to have the blood clot issues looked after -- especially when I understood the potential seriousness of the condition -- was a no-brainer. I needed meds and monitoring.

And armed with what I thought was Newfound Enlightment about Hospital Overnight Survival, I tried to settle into resting -- and gratefully accepting sleep if it decided to show up, but not counting on it.

My roommate was a rather boisterous type, which made this strategy seem even more like a good idea.

Turned out that he was a tennis fan (like me), and so the two of us could keep our TV's tuned to Wimbeldon. No conflict -- and great tennis!! And he decided to turn in for the night at the same time as I did. So both TV's went off at almost exactly the same time.

And our room was sufficiently far from the Nurses Station that the night-long chatter was significantly less noticeable than my previous two stays.

And it turned out that he slept quietly and deeply. As I did.

Goes to show.

Something Else to Celebrate!

Deb and I just got back from a visit to my E/N/T doc -- the first I've seen him in a month or so. Of all the docs I've met on this journey, he's my favorite.

Anyway, after some gentle commiseration about my blood clot issues, he did a rather thorough job of feeling my left cheek and upper neck -- where all of this started months ago. After he was done he told us:

"Your parotid feels just fine. [i.e., there's no new sign of tumor growth at the primary site] One of our big concerns some time ago concerning additional surgery was that this cancer might have been such a fast-growing variety that it might get ahead of us [this is my term -- I forget his exact words...]. And clearly that's not happening. Now, that may be that the radiation and chemo are suppressing it or it may be that there's nothing there to suppress. But as of this moment, everything feels fine. When we're done with your treatments, we'll re-image you and go from there."

So we're not saying that I'm clean. Not yet. And not by a long shot. But the best that can be hoped for is what's happening right now.

I've also had some serious pain associated with sores in my mouth which, I understand, were caused by scattered radiation bouncing off a filling in one of my molars. And the doc prescribed two medications that should bring down the swelling and pain significantly.

Skyrockets, anyone?

Me and My Blood Clot

It felt like a muscle strain in my right calf. And I've pulled and strained and banged around most parts of my anatomy over the last 60 years or so that I didn't give it much thought.

Okay, granted it lasted for several weeks -- which was certainly unusual, but with the nervous anxiety I've been dealing with, there was a sensible rationale for a long-term muscle strain. At least I thought so...

But Monday morning, I found that I couldn't put any weight at all on my right leg. So I hobbled to the back room to retrieve my crutches and negotiated my way down the stairs to breakfast. (You do have a pair of crutches in your back room, adjusted to your height and arm length, don't you? Geez, I've pulled mine out of storage, it seems like at least once a year for the last 10 or 12... But I digress.)

So Deb, the crutches and I made our way to my 9:00 AM radiation treatment. When Joan, one of the super-est Super Nurses I've ever known, came in to the waiting area to say "Hi," she took one look at the crutches and said "Those are yours?" I confessed. She said "Don't move. Dr. Ochsner [not my normal rad doc] will be here shortly." And she disappeared.

When Doc Och (please don't tell him I called him that!) showed up, he asked two or three questions and then said: "Get your radiology treatment now, and your next stop is Chester County Hospital. I'm writing up a 'stat' scrip for an ultrasound on your leg. That will get you past any waiting line-up in the Emergency Room. And I'll have them phone the results to me immediately. You should expect to be admitted then and there."

The ultrasound showed positive for a DVT (something like "Deep-Vein Thrombosis") or blood clot extending from halfway down my thigh to halfway down my calf. They started me on a drip-bag of blood thinner shortly afterwards (Heparin?), and it took an hour or so for a room to be ready for me. Not too shabby!

The drip-bag-thinner-therapy lasted until morning (and please remind me to tell you what a relatively pleasant experience this last overnight at the hospital proved to be!), when it was terminated in favor of a injection (Lovenox) and a pill (Coumadin). I'm now giving myself Lovenox injections twice a day(!) for the next week or so, and will be taking the Coumadin for the next 4 or 5 months. After that, things should be back to normal. Oh yes, and I'm wearing a compression stocking almost full time as well.

It seems that blood clots are a not uncommon side effect of chemotherapy, but no one had mentioned this to me and I hadn't come across this in any of the literature I'd read. The danger here is that part of the clot breaks loose, travels up the vein and then gets lodged in a lung, an eye or the brain.

I'm still totally dependent on my crutches to get around, but the nurses told me to expect that. Maybe 4 or 5 days...

Three useful metaphors:

-- "just another bump in the road"

-- "the roller coaster took another unexpected drop"

-- "just keep putting one foot in front of the other."

It's times like these when I think so fondly about all of you out there in cyberspace -- reading this, pulling for me, making suggestions, telling me stuff that helps so much to keep me balanced.

God bless you all.