Author: Michael

I had my last chemo treatment (for the time being) a couple of weeks ago. And let me just say, I’d be dancing on a lush green hilltop too if my feet and legs weren’t so swollen from…the chemo.

After going into it with gritted teeth and a strong determination to vanquish the bastard tumor, my chemo run ended with a whimper, with me dragging my body late to infusion appointments because I just couldn’t take the idea of needles and nausea and the horrible smell of that antibacterial swab they use on me. So happy to have that behind me for now.

The reason I am on a prolonged chemo break is because it’s time for surgery. The reason I know this is because I asked my doctors, “Isn’t it time for surgery?” And they said, “Well, look at that. It IS time for surgery.” (That’s really how it happened.)

So this coming Thursday, I will check myself into the Kaiser Oakland hospital and let them dig around my insides.

It’s a complicated six- to eight-hour surgery (you can Google “Whipple procedure”) done by a Kaiser surgeon who I knew very little about until recently. I’ve met him twice and talked two other times, and let’s just say he won’t be reading me a bedtime story as I drift off to sleep before surgery. His terse demeanor is well-known on the hospital second floor. I’m prone to light banter when nervous; he has little time for pleasantries. All of this, along with my aversion to needles and scalpels and long bouts of unconsciousness, has left me on edge (terrified?) about the procedure in recent weeks.

But it turns out, after talking to peers, that Dr. K is also known for something else: being one of the best pancreas doctors in the East Bay. It also turns out, after getting to know him a little, that he is no-nonsense and no-bullshit, but not unfriendly. Just a little bored, perhaps, by having to explain a procedure he has done dozens, if not hundreds of times. If someone is going to extract a tumor from my pancreas and re-pipe my digestive system, it may as well be him. (Dr. K trivia: His daughter was Miss America once. The Miss America.)

I’ll spend a week in the hospital in recovery (assuming no complications) sucking on ice chips and apple juice out of kid-sized boxes, and then at least three weeks at home—not at work, not biking, not kayaking, not doing anything fun.

But…but…after a month of follow-up, clean-up chemo, I will allegedly be cancer-free for the time being. Imagine that.

People keep asking me whether I’m excited by the surgery and finally getting the tumor removed. I’m trying to come around to that. But mostly I’m just looking forward to when it’s over.

[It’s Over, by ELO and featuring Jeff Lynne’s hair]

Are we reaching an inflection point in my treatment? My body is not tolerating chemo well.

I’m not talking about the side effects, which are their own Adventureland ride.  

No, my body’s blood components are recoiling at the pounding they are taking from the chemo drugs. White and red blood cells are normal chemotherapy victims; we are, after all, killing both the bad and the good with this sledgehammer of a treatment. But some of mine are being knocked to the canvas.  

First it was neutrophils, the important white blood cells that chomp up infections like PacMan. They got so low one week—making me vulnerable to infection—that we had to skip a treatment. I was heartened this weekend to see that my neutrophils had bounced back to a low-normal level. Clap-clap!

But today at the infusion clinic, Nurse Shoshana offers a surprise: My platelets, which clot the blood and help prevent us from over-bleeding (and which are actually shaped like plates), have dived headlong off a cliff. Per The Oncologist, we reduced the potency of the drugs today to 75 percent to try to keep the platelet count from going much lower. 

All of this matters because…if I can’t safely tolerate chemo, we may need to more quickly to surgery.  

I dread the thought of surgery even though I know it’s inevitable and ultimately what will cure me. It’s a long, complicated procedure that will knock me on my back for weeks. Frankly, it scares me. If anything, I’d wanted to postpone it until after the holidays. 

But this also raises the question in my mind of how I will be able to do post-surgery chemo—a standard part of the treatment—if I can’t tolerate pre-surgery chemo. 

Again, this is not going according to plan. The chemo is waging a violent war against my good cells, all while we try to wage another war against the cancer. 

Patience is my ally. But as I move through these flaming doors, chemo may now be a new demon. 

[War onWar, Wilco]

Feeling utterly wrecked today, so let’s run down this week’s chemotherapy symptoms.

• Persistent (and perhaps permanent?) neuropathy that has spread to the feet
• Swollen ankles accompanied by purplish skin
• Extreme fatigue
• Shortness of breath on light exertion
• Nausea
• Constipation
• Achiness
• Evening fevers with chills
• Torso rash (didn’t see that one coming)
• Delicate nose membranes that bleed.
• And a cough that won’t quit from a cold two weeks ago

I know, the life of the party.

That’s the worst collision of symptoms so far for me. I had no illusions that this would be easy. Sometimes, however, the cure feels worse than the disease. It’s not, of course. But some weeks hit hard.

On the very plus side, courtesy of loved ones, I now have some really great caps for my naked and chilly noggin, including one that we’ll reveal nearer the winter holiday and another that…well, we’re still pondering its public unveiling.

Next update: Can my body handle chemo or should we jump right to surgery? That’s the topic of the moment.

[Save Me cover by Nina Simone]

I work with good people.

[Gratitude by Earth, Wind and Fire]

The long-awaited CT-Scan of the pancreas was today, and well…someone please tell me how I’m supposed to feel about the results.

“There is a subtle vague very approximately 1.4 cm focal rounded pancreatic head lesion abutting the duct and stent suspicious for the patient’s known pancreatic adenocarcinoma. It was not well seen as a discrete measurable lesion on prior examinations making comparison difficult, but it may be mildly increased.”

Translation: “Whoever did the CT-Scan before didn’t get a good tumor measurement, so we can’t really tell if it’s changed in size or not, but it may have gotten a smidge bigger.”

Well hell.

Con: I really would have liked it to have shrunk. In fact, I expected that.

Pro: The status quo is not horrible, and I’m grateful it has not gotten dramatically worse. Something is working.

What does it mean? The oncologist is viewing this as very vague information. She will talk to the surgeon to get his feedback. The point of my chemo, after all, is to help give the surgeon a good canvas on which to paint. Is he getting what he needs?

Meanwhile, my tumor marker (CA-19-9) number has dropped down into the normal range, which means there are fewer cancer proteins running laps in my blood. A swing in one direction or another can suggest whether treatment is headed in the right direction or not.

That my number has dipped is a good thing, and I will cling to that for now—as imprecise a measure as it may be of my overall health.

In the meanwhile, it’s time to better manage the areas I can control—exercise, diet, sleep, etc. I can punch harder, you bastard tumor.

[Stuck in a Moment You Can’t Get Out Of, U2]

“Hey Siri, show me nearby stores with knit caps.”

[Hair, from the movie Hair]