Colorectitude

The Sporting Life, 2011 Edition

2012-01-08T16:54:00.000-08:00

In Douglas Coupland's early 90s zeitgeist-fumbling novel Generation X, the narrator, describes having a "dreary workout regiment" inspired by a section of Andy Warhol's diary where the scrawny artist laments having never exercised. I remember reading this at the time (still have this first edition copy with the green cover) and focusing on the dreary part, not the benefits of exercising. Exercise? That's dreary! Pass.

Fast-forward almost 20 years. I moved to Baltimore from Chicago to live with my now-wife Lisa. Among the embarrassment of riches she's brought to my life was a reintroduction to exercise. I joined the local gym and started a mix of lifting, running, and biking. I could feel the difference, and it wasn't dreary at all if I had the right mix on my iPod. At the same time, my body was doing the weird stuff that turned out be the early symptoms of colorectal cancer (see the rest of this blog for all of the gory details).

2010 - the year of multiple abdominal surgeries, the ostomy bag, the lifting restrictions, etc - was pretty much a wash for exercise. Though I didn't explicitly declare it, 2011 became the year I got sporty.

In my home office, I have a massive metal file cabinet (thanks for selling to me, Sheryl!) with a bunch of running and biking event bib numbers from 2011. I'm not very good at keeping track of finishing times, although the events that had chips or time keepers are posted online and I could dig them up if I wanted. I don't really care beyond having a general sense of getting strong, better, faster. Here's a quick event breakdown and some observations:

St. Patrick's Day Shamrock 5k - With Lisa and Becky. My first event. Downhill and flat with beer at the end.
Port To Fort 6k - Solo. Started and ended at Museum of Industry, where Lisa and I got married. I sweat a lot, but this was epic.
Ride For The Feast 2011 (140 miles over two days) - With a slew of awesome friends. Ocean City to Baltimore charity ride for Moveable Feast. Raised over $1300 and had a ball. Doing it again this year. Donate here!
Bike Jam (36 miles?) - With Becky. Around Baltimore City, which is a hilly SOB. Good ride for getting used to city riding.
Larry's Ride (scheduled 63 miles, rode 59 miles(?)) - Solo. Uber-hilly horse country north of Baltimore. Way over my head. I ended on the side of the road puking from heat exhaustion. Lisa saved me.
Seagull Century (100 miles) - Solo. Around the Eastern Shore of Maryland. Flat, but brutal windy for the last 36 miles. Learned the value of pelotons and saw the famous wild ponies of Assateague Island. Then my butt hurt.
Run For Your Lives 5k - AKA the first ever, anywhere Zombie 5k. There's not enough room on the Internet to fully describe this experience. The idea: awesome. The execution: Babytown Folics. The sponsors oversold the event, causing traffic hell, and gouged the runners/spectators for money or cheaped out at every turn. Actual run was fun, wet, challenging. Results: I survived with one life flag, didn't not get turned into a zombie. Jim Vee saved me from hypothermia.
Restoration Run 5k - With Lisa and Jules. Did this 8am the morning after a wedding reception and Jules had worked an overnight in the ER. Now convinced that running cures hangovers. Benefited Trout Unlimited. Sweet long-sleeved shirt with a trout on it.
Celtic Solstice 5-Miler - With Lisa and Jules in celebration of Jules' birthday. Through Druid Hill Park. Great ending of the year.

Looking at this list now, I reminded of something Lisa told me her father said during the Ride For The Feast after finishing reasonably early (my in-laws volunteer at the rest stops, among one of the many awesome things about them): "I think Bob has something to prove to himself." He was right, of course, but I hadn't really realized it at the time.

Also, since this is a cancer blog, an update on that. All is well. Second cancerversary is early next month, and I have some CT scans and bloodwork. The monitoring moves from every four months to every six months after that.

How should we celebrate the 2nd cancerversary?

Cancerversary

2011-02-17T15:21:00.000-08:00

February 3rd was the one year anniversary of my cancer diagnosis. It's the same day in 1959 that Buddy Holly, Richie Valens, and the Big Bopper's plane crashed in Clear Lake, IA. My uncle Gord used to call me "The Big Bobber" when I was a kid, which could have also referred to my large head for which my mother bought special shirts with buttons to expand the head-hole.

Lisa and I had talked about things to do on that day. Celebrating felt odd, not that there weren't things to celebrate. I'd received the final set of results from the triptych of tests - CT scan, bloodwork, and colonoscopy - and everything is clear and good. I feel great and have started running (treadmill only - stupid weather), which I really, really enjoy. We've signed up for a 5K in March, then there's the Ride For The Feast in May, which will mark my first century ride (100 miles in one day).

My last post garnered two cancer anniversary suggestions: eat a bowl of bran and buy a 50-year subscription to my favorite magazine. As worthy (and delicious) as those are, I feel like doing something that's the exact opposite of what Lisa and I experienced that day (see the first handful of blog post for the blow-by-blow. Short-hand: OH FUCK, then a bunch of snow.)

Well, work and weather decided this for us. I had a trip to Chicago planned for work that week. The idea had been to fly back the evening of Wednesday, the 3rd, and maybe hit one of our local haunts for a much-deserved beverage. As the weather reports started hyping a killer storm approaching Chicago with the blunt force a 50-ton snow hammer, I extended my stay for another day. I usually don't do hotels in Chicago and instead crash on the couch of my condo or with friends, but this time, I'd booked a room at the Hotel Monaco on Wabash for Tuesday night and simply extended it for another day. For some reason - karma, payback for the crap experience I'd had at another Kimpton property in Atlanta the week before (long story short: previous guest drank and refilled the opaque minibar beers with water. Lame and yuck.), or fate - was upgraded to a suite:

http://www.flickr.com/photos/69907266@N00/sets/72157625865971719/

So I rode out my cancerversary alone, trapped in a boutique hotel in downtown Chicago. I hit the local 7-11 for some beer and sat in a ginormous window seat the size of a twin bed and watched the thundersnow and lightning. Surreal. A year before, the two-fisted hit on Baltimore/DC was called Snowpocalypse. A lot of names were thrown around for what hit Chicago. Given the thundersnow's vaguely Biblical/Fortian vibe, last year's name is probably more apt for this storm. I'll never call it this, but my favorite Chicago storm name was Snowtorious B.I.G.

Later, I went out in it and went to the Bean - the mirrored sculpture called Cloud Gate in Millennium Park - which looked even more alien and otherworldly beanish in the blizzard. I wasn't alone. Some poor soul in a yellow vest was there guarding it. I ducked into the passage the runs underneath it to catch a break from the snow. I wanted to take a picture, but I'd left my phone on the recharger in the room. So I took some pictures with my brain, then trudged back to the Monaco. Cold. Sad that my Lisa wasn't with me or waiting for me in that awesome window seat at the hotel. But mostly fortunate. For everything.

Ambient Stress

2011-01-09T08:54:00.000-08:00

I'd like to say that posting more blog entries is a resolution for 2011. This would be like writing a To Do list with "Write To Do list" as its first item waiting to be crossed off, thus giving you the warm, but false glow of completion. The truth has much more to do with shame. If the one of busiest people I know can start and maintain a blog, what the hell is my excuse? Sloth. Good old-fashioned biblical, non-three-toed sloth.

I've been married now for a bit over a month. We are slowing battling our way through the Thank You notes. There have been moments of hand cramps. People have been so generous to us that it's sometimes hard to adequately express how grateful Lisa and I are.

On the cancer front, the first anniversary of the diagnosis is approaching. A recent CT scan showed nothing out of the ordinary. I think I'm still technically under a 10 pound lifting restriction. The four month anniversary of my ignoring that is also approaching. I feel great, things in my nether regions are behaving somewhat differently than before all of this happened, but mostly fine.

Mostly.

The days leading by to our appointment with Steve-O to get the latest CT scan results came with ambient stress that slowly increased. Both of us: Bad, strange dreams. I had the aforementioned sloth times 10. The morning of the appointment - 8am, no less - Lisa and I were oddly silent and pensive. Once Steve-O told us everything was good, we almost automatically started joking around again as we read the report's goofy language:

"Gallbladder is present." - Bob to Lisa: "Told you!"
"The pancreas is unremarkable." - Lisa to Bob: "Told you!"
"The appendix is visualized."- Lisa and Bob: "And that's different from 'present' how? Is there a rule about using the same adjective twice or something?"
"The heart size is within normal limits." - Lisa to Bob: "Figures."

It seems painfully obvious in hindsight, but we hadn't tied any of above dread to the appointment and test results. Then again, I can be slow on the uptake. It took me years to realize those "colds" I was getting at the turn of every season were really seasonal allergies easily knocked out with Claritin.

A follow-up colonoscopy happens in a week or so, with the results dropping a few days later. We aren't expecting anything but a continued all-clear. Then a week later, the diagnosis anniversary. What do people do to celebrate/commemorate a day like that?

Our Cancer Half-Year

2010-09-26T09:45:00.000-07:00

A few weeks or so ago, I proclaimed on Facebook that the cancer victory tour was over. The outpouring of support was amazing, but left me feeling a bit guilty. Nothing had actually happened on the health front, more of a mental shift from being someone who had cancer and beat it to being just a normal 41-year-old living in Baltimore, working in Chicago, and getting married in a few months. I never wanted to be defined by it.

The writer David Rakoff uses the term "cancer dilettante" to describe his attitude toward having Hodgkin's during his 20s. That sums it up nicely:

Cancer? Yeah, I dabbled for a half an year. It didn't take.

The jokey pose puts people at ease and signals All Clear without them having to ask, but for me it's also honest one. Most of the time.

At the same time I was diagnosed, our next-door neighbor also found out that she had cancer - a much more serious and wide-spread cancer. We used to chat about how our treatments were going, but it's recently slimmed down to the shorthand of "how are things, things are ok." She's wearing wigs and wraps now and will have maintenance doses of chemo/radiation for the rest of her life.

Another one. I recently spend several days in Bloomington-Normal, IL for work. I didn't have a rental car, so I took a cabs to and from the hotel to the client. Usually, it was the same cab and driver. It's that kind of town. My driver for several trips was a chatty lady in her 50s with no filter whatsoever. She told me about her ex-husband. She told me about Steak and Shake's 3-way chili she had, how tasty is was, and how gassy it made her that night. She told me she wished her ex was around so he would have to smell it under the covers of their bed. I laughed and mentioned that's called a Dutch Oven, but she wasn't paying attention. I hoped against hope that I'd get another driver next time.

On the second trip with her, she pointed to a clinic where she'd dropped off someone for some medical treatment. The cabbie then mentioned that she'd recently had a ileostomy bag. I leaned forward. "Really? So did I."

I suppose that given the number of things she talked about that we'd hit some common ground at some point, but having an ileostomy bag? Neither of us had ever talked to someone who'd had one before. She had had untreated diverticulitis for years. Her takedown surgery was scarcely a month early. She lied to her doctor, telling him she was a dispatcher so go back to work driving and earning tips. By the end of the ride, we were best buddies.

"You still reach for it even though it's not there?"

"Yes! At night . Did you have a one-piece or two-piece?"

"One piece. I had a two-piece fail on me."

"Me too! Then I had a blockage. I was back in the hospital for a week."

"Really?!? I was so paranoid about that."

Even in the realm of having an ileostomy bag, I got off lucky.

One more. This week was the three-month CT scan and post-surgery clinic check-in. All is well, by the way, but spending time at a Hopkins waiting room is hard reminder of my cancer kiddie-pool status. One of the appointments was with Steve-O, who looking at a computer screen commented it was the 6-month anniversary of my first surgery. Lisa and I looked at each other. I'm not sure if it was relief or disbelief, but we were smiling.

Lyndon Johnson Bared His Scars

2010-08-14T13:26:00.000-07:00

I have some interesting scar action happening on my stomach these days. Even with the hair growing back, they are rather prominent. A few days ago, Lisa and I went to a local health club's pool to meet some friends. It's the place where Michael Phelps trained most of his life and still teaches classes. I'm still not allowed to submerge the takedown incision underwater, so I can't swim for a few more weeks. I didn't have a swimsuit on, but I could have take my shirt off and laid on the fake sandy beach area. As I watched the swimmers doing their thing, I remembered my scars.

Other than the medical folks and Lisa, the scars have yet to be seen. make their public debut. A few minutes ago, I held my scanner up to my stomach and tried to scan them. My advice is to never try something like that, ever. Unless you're Andy Warhol and your scanner is named Richard Avedon.

I did a Facebook post a few weeks ago about scars trumping tattoos, which started a brief discussion about people's reactions to seeing pronounced scarification. Several people talked about embracing them as a badge of honor: "Have you been in the shit? Yes, I have." And then it lead naturally to mentioning the infamous Scar Competition scene in "Jaws" between Quint and Hooper. (Note: The video clip cuts before Quint's USS Indianapolis monologue, which I think is the best thing Spielberg has ever written.)

One of my half-jokey responses to scars long before the surgery was that "Scars Build Characters" delivered in the same dismissive, Little League coach tone as "walk it off" and "rub some dirt on it." Or to quote the Team Atomic bracelet on my left wrist: "Harden The Fuck Up." According to Google, "Scars Build Character" is also the name of a play and appears in some modern country song lyrics. I have no idea how this came into my personal lexicon, but there it is, more relevant than ever.

In a few weeks, Lisa and I will be spending five or so days at a house on the beach in southern New Jersey with a group of old friends. It's been a hard year. Some of us have lost parents and I'm not the only one that as battled cancer. Barring a double-dog dare at a bar after a few drinks, the scars won't make their public debut until then. I'm not sure if I'm self-conscious about this or not. When I had the ostomy bag, I kept reading about people going the beach and swimming with them. Yes, mine was temporary, but I would have never, ever considered anything remotely close to this level of exposure and it makes my concerns about people's reactions to the purplish lines, squiggles, and dots written across my stomach seem quaint and prudish.

One more scar note. I don't know what it means, but keep having a two-line poem about scars going through my head. It appears on the album sleeve of a mid-70s Neil Young album:

Lyndon Johnson bared his scars
American Stars N Bars

The Shit Is Alright

2010-08-01T08:29:00.000-07:00

I arrived home from the hospital that Saturday with nine staples in my stomach and a PT drain - the hand grenade - sticking out of a hole below the surgery incision. I found myself instinctively feeling for the ostomy bag for the first few days, especially at night. The grenade was on my right side this time, which made taking a shower complicated. The left-side drain worked out well with our downstairs shower. I could pin it to the cloth shower curtain and do my business. With the right-side drain, I'd need have my back to the showerhead, sort of like facing the rear wall instead of the doors in an elevator.

The solution? I hung one of Frank's old leashes from the upstairs curtain rack. Mondo ghetto and hilarious kinky-looking, but functional. Our friend Joey from Austin was staying with us for a few days, bunking with the Abe Lincoln lamp in my office. We'd forgotten to tell him the deal with the leash before he showered. Joey wisely decided not to touch it or speculate too much about its purpose. This launched half an hour of bondage jokes and potential penalties for "getting the leash wet."

I know I keep using different metaphors to describe the inner-workings of my body and how it's dealing with the cancer, the ostomy, and recovery. Let me introduce another. For the first week, my bowels behaved like an old motorcycle dragged out of a barn and kick-started for the first time in years. Lots of sputtering, strange noises, and not to be trusted on trips further than a few blocks. I was prepared for this in theory. In theory I'm prepared for a lot of things. I'll spare you the details, save one. Lisa and I have a couple of dry erase calendars on the fridge to keep track of appointments, deadlines, and obligations. In the middle of that first week I started doing a daily bathroom visit tally. One 24 hour period: 15 hash marks and I stopped counting.

This didn't stop me from leaving the house or starting work the following Tuesday (yes, it's from home, but taxing none the less), but made for some miserable days. By Thursday, I managed to get most of a night's sleep uninterrupted and Friday felt strangely normal. Had things really stabilized? Other than attempting Greek Tacos at Golden West on the Avenue, I'd being blanding my diet up - pasta, rice, bread. Now, decided to open it up. No real issues.

The following Tuesday was my first post-surgery clinic appointment. I wanted three things out this: 1. removal of the PT drain. 2. removal of the staples. 3. Info about the lifting restriction, which was at an annoying 10 pounds. The paperwork we received when I got released said two weeks at 10 pounds, which would be awesome and knowing my surgeon, was probably wildly inaccurate.

When Lisa and I walked out the clinic appointment, it was the first time in four and a half months that I didn't have foreign object sticking out of or attached to my body. Staples removed and drain pulled. Lifting restriction at 10 pounds for another month, then 20 pounds for a month or so after that.

To say things are stable on the bowel front is probably a 90% accurate statement. Weird shit shit still happens, but I'm comfortable enough to going on longish hikes and to start traveling again for work in the coming week. All in all, not too bad. I have an overwhelming sense of being incredibly fortunate in how this all played out. They found something amiss on Feb 2. Today is August 1. Six months later and I'm cancer-free and within spitting distance to being back to normal.

On Farting, Pooping, and Leaving

2010-07-22T10:39:00.000-07:00

The idea of clear liquids is a bit of a misnomer. Beef and chicken broth aren't exactly clear, but after a day or so of ice chips, I'm not going to question this. The hospital's liquid meals tend to be brown - iced tea, coffee without cream, apple juice, and broth. I inhaled everything except the Jell-O, which wasn't brown, but 80s Day-Glo green and yellow and too sweet for human consumption.

~~Ice/water until I start belching~~
Clear liquids until I start farting
Solid foods
In the hospital until I start pooping

After a day of clear liquids, I still hadn't farted. Every doctor and nurse who stopped by to poke, prod, and probe me asked about it in some way or another. "Have you passed gas yet?" was a favorite, as was the soft-eyed look of sympathy when I said no. I knew that I was right on recovery schedule, but the cumulative effect of having everyone ask had an impact. Ok! I'll get my taxes done! It's only January 7th, but I'll do it already!

But wanting to fart and being physically able to fart are two very different things after a takedown from having an ostomy bag. The bowels have been asleep and the muscles gone unused. As Lisa snoozed on the foldout chair/bed, I started playing with the hospital bed's controls, looking for way to get gravity to help out. I raised my feet and lowered my head as much as possible and waited. I thought I felt some movement, but nothing happened. Then I tried the opposite. Same results. Nothing.

The next morning (Friday) I had the IV taken out, which made getting up and around much easier. Gone was the magic button of pain meds, replaced by oxycontin pills. Lisa had gone back to the house to take care of the cats and go into work for a few hours. Another round of brown food arrived and was dispatched. As I got up to do the morning walkabout on my hospital floor, it happened. I cut the cheese, passed wind, dealt it and smelt it, dropped ass, built a Dutch oven, pulled my own finger, did the one cheek sneak, let out a squeaker, passed gas, did the gas face with my butt, broke wind, and passed gas.

~~Ice/water until I start belching~~
~~Clear liquids until I start farting~~
Solid foods
In the hospital until I start pooping

It was too late to get my lunch menu changed. My friend Jen, the person I'd met Lisa through, was in town for a wedding and stopped by with a book: The Ghost Map by Steven Johnson. The bookmark with it said: "Here's a book about poop. For a champion pooper." It is a great book about poop, cholera, and how bad ideas survive in the face of better evidence. While we were talking, the nurse brought me crackers. Saltines and graham crackers.

~~Ice/water until I start belching~~
~~Clear liquids until I start farting~~
~~Solid foods~~
In the hospital until I start pooping

A greatly anticipated dinner arrived and disappointed. Some chicken something with green beans and more brown liquid. I picked at it while Lisa ran down the hospital food court and got me a 6-inch Subway Turkey sandwich with chips and a cookie. I'm not a fan of Subway at all, but anything as a first solid meal in four days was going to taste pretty good. Maybe even Taco Bell.

With real food in the system, there's only two options for it to go: north or south. North is bad and potentially very painful. South is good, but no fun and entirely necessary. My system broke south Friday evening with a vengeance. Repeatedly. Lisa and I were prepared for this with Baby Wipes, one of the truly great innovations of the 20th century.

~~Ice/water until I start belching~~
~~Clear liquids until I start farting~~
~~Solid foods~~
~~In the hospital until I start pooping~~

I woke up Saturday morning with every intention of being told I could go home. However, a nurse came in and told me that my potassium was low. Before I knew it, I was being hooked back up to an IV line with a bag of potassium juice. I knew I'd lost some vital body fluids, but was I so lacking in potassium that I really needed a drip? Can't I just have a banana and call it good? Within a minute or two, my hand started aching. It felt as if my bones were shrinking. And then on fire. I quickly called the nurse, who brought me a bag of ice for my hand and reset the IV to dilute the mixture. Lisa and I worried that this would keep me from being released.

A doctor came in and frowned when he saw the IV. I explained about the potassium and shook his head. "You want that removed? Do you wanna go home?"

Um, yes.

The doctor chalked up the IV to an overzealous RN. He turned off the IV and arranged for some potassium pills. A little bit after noon, I was signing the release forms. Like with the first surgery, I decided against having a wheelchair and walked out with Lisa handling my backpack. Three and a half days and I was out.

On Belching

2010-07-16T03:15:00.000-07:00

My last solid meal before surgery was Monday evening. Homemade hot dogs with a hint of garlic lovingly stuffed by our friend Leslie and washed down with beer. God bless America. A long two days later, I'm hungry and sucking on all of the ice chips I can get. The path back to those hot dogs is roughly as follows:

Ice/water until I start belching
Clear liquids until I start farting
Solid foods
In the hospital until I start pooping

This is all about getting my system up and running again, which for the most part is out of my hands. Had I spent my formative years at mediation, circular breathing, and yoga, I might have some deeper level of body control. I didn't and don't, but I can control the amount of fentanyl I get through the magical button controller dangling beside my bed. Green light means go and a friendly tune plays. Who says video games don't teach us anything?

This is the balancing act though. Fentanyl dripping into my IV line numbs the pain, but also slows down my system. The slower my system, the longer it'll take to move to real food. On the first day, the pain won and I was hitting the button pretty hard. I also got it in my head that I was going to do a walk around the hospital floor, which I did with the vengeance of an early morning mall walker. It was good, but left me weak, belching, and nauseous. Belching!

~~Ice/water until I start belching~~
Clear liquids until I start farting
Solid foods
In the hospital until I start pooping

Bring on the brownish liquids of the sugarly and salty varieties!

The First Step

2010-07-12T09:45:00.000-07:00

The day before surgery I got a call from Hopkins. The location of my surgery was being moved from the Cancer Center to main hospital. I'd had little to no interactions with the main hospital, but I didn't like this. I asked if I'd be doing my recovery time in the Cancer Center and I was told this was "a good possibility." I didn't like that either. Cancer Center meant private room; probably main hospital didn't. The Cancer Center is posh, as in new Vegas casino posh. The main hospital is much less so, as in old Strip casino much less so.

Lisa and I reported to the GOR (General Operation Room, at least I hope that's what it means) and I went into prep. This was the other side of Hopkins - the Hopkins of Jules, our ER doctor friend who has an ever-expanding collection of fucked-up stories about her patients' fucked-uppedness. I'd yet to experience this.

The prep room is a series of curtained off beds. No privacy for the moments leading up to what might possibly be one of the most traumatic events of a person's life. Lisa and I were a bit nervous, but we'd been counting down the days to this. We wanted to be there. The poor woman to the left of us most certainly didn't want to be there, and we got a full blast of sadness (drug abuse history, slurred speech from a stroke, bipolar, lashing out at the nurses and doctors) mixed with humor (a piercing she wouldn't let anyone remove except by her boyfriend, who couldn't get it out either). Jules' joke about this situation is that the other people aren't really patients. They are there to distract you from your own impending surgery, if your insurance covers it.

I don't remember much after kissing Lisa goodbye and being wheeled into the operating room until I woke up in recovery. The room in the Cancer Center was available, so I was taken on a long ride through the halls from the main hospital to a comfy spot a few doors down from where I'd stayed during the first visit. Lisa was there waiting or came in right away, I can't remember which right now.

It all went off perfectly. I had some pain, a temporary PT drain on my right side, and nine wicked-looking staples in my stomach where the stoma used to be. Now I needed was to learn how to poop again. You know what the first step is, right?

Learning to fart.

Recovery

2010-07-07T12:06:00.000-07:00

Out, sleepy, watching Germany v Spain. Easy isn't the right word, but
I can't think of a different one.

Cleared For Takedown

2010-07-04T07:03:00.000-07:00

I've been joking about "learning to poo again" as part of the recovery process post-takedown surgery. Well, it seems that I still know how. Things suddenly started happening Sunday evening via the traditional channel. I knew this wasn't unheard of - the colon still produces mucus, it's gotta go somewhere - but very disconcerting. Imagine your home phone started ringing after you've canceled service and the receiver is boxed up in the basement. And it keeps happening all night. That part worried Lisa and I.

Jules was working an overnight at Hopkins ER, so I texted her. In the morning, she got back to me, delivering the soon-to-be-classic line: "The rectum keeps its own counsel." It seems that shit, or mucus, really does just happen.

This was a lovely start to a week was chock full of doctor appointments and procedures. Tuesday was the all-day event, starting at 7:30am for a sigmoidoscopy. This is basically a colonoscopy by a different name. You stick a camera up my butt and I don't care what you call it, just hurry up and finish. Please!

The last blog post delved into the strangeness of looking at live action footage of your innerspace. This scoping was different for a couple of reasons: 1. I decided to forgo the twilight so I was fully awake and feeling it all. 2. I knew what things in there looked like before. If there was anything new or odd, I'd be seeing it and could ask questions.

As the camera started doing its thing, I couldn't decide which analogy I liked more: my colon as the musty wing of a British manor house closed off for the winter or as a sunken ship being explored in a mini-sub created by that jackass director James Cameron. The latter is more visually close, but something about Victorian furniture covered with white sheets seems more elegant and metaphorically correct. Shut down for a bit, then opened up again once the cobwebs and dust bunnies get swept out.

The glint of metal in the shape of the letter B surprised me. I immediately thought of that horrible story about the doctor that carved his initials on a patient's scar, but my surgeon's initials are NA. Then I thought of B for Bob, and then I realized it was a staple. This was the site of the dissection. I have no frame of reference, but it looked good to me.

Being a day like this and everything else is downhill. Even a foul-up that made me have two bloodtests instead of one and almost made Lisa late for a meeting was OK. The news we were positive news from the surgeon and the physician's assistant. Surgery date was held for July 7th, time as of yet unknown.

The next day I had an appointment with Steve-O, the medical oncologist. This was sort of unrelated to the takedown, more of a 3 month follow-up from the surgery to look at the CT Scan, do some more bloodtests, and discuss the results. As the nurses took my vitals, one of them had a clip from the CBS Early Show on from that morning. It was about a pancreatic cancer vaccine developed at Hopkins. One nurse knew him from frequent visits, and quickly told his story: stomach pains led to a Stage 4 pancreatic cancer diagnosis. Nightmare scenario. Steve-O appeared on the screen, talking about the trial and how it worked. (Steve-O appears 1:30 in the clip)

A few minutes later, Steve-O came.

"Just saw you on TV," I said. "They were just watching it up there."

Steve-O sighed. "Then I'll stay back here."

For insurance reasons, the CT Scans are done at Union Memorial, so I have a CD copy of it that I physically delivered to the surgeon the day before. A report was supposed to accompany it, which I wasn't given. Lisa is much better at questioning bureaucracy and hectoring them into getting their act together, meaning that I should have listened to them and called Union to get the report faxed over to Hopkins. So Steve-O had bloodtest results, which were good and clear, but needed the CT Scan report, so the visit was a partial one.

Later that day, Hopkins called with the time for the surgery: 7:30am on Wednesday, July 7. Be there for prep at 5:30am, liquid diet the day before. Steve-O emailed while I was sitting on the porch on an internal conference call with my team in Chicago. The report appeared and showed no abnormal findings. I was clear and the takedown was set. I told my team what had just happened, added a "Suck It, Cancer" for good measure.

Looking Inside

2010-06-19T11:58:00.000-07:00

One of the few positives of the whole cancer experience has been being able to see live footage from inside my body. I've always taken the internal functions and structure of my body for granted; stuff goes in, stuff comes out. Lather, rinse, repeat. This changes when you're laying on a table watching a camera snake through your system in technicolor. Huh. I always pictured things less, um, scrunched up...that's a nice shade of pink though...Whoa, what the fuck is that? It was the tumor, looking decidedly out-of-place, jaundice and red-splotched. The camera paused briefly, then attacked it like a snake, taking biopsy samples and tattooing the sickly yellow flesh with black ink before slithering back out.

This was several months ago, but I find myself thinking about this often. I'll never be an expectant mother, but I imagine that mine was the exact opposite feeling of an ultrasound. I'd watched the enemy going about the business of growing its mass and trying to kill me. It's gone now. I assume frozen or pickled at Hopkins for further study. See you in hell!

The X-ray and contrast work done last Friday was an entirely different experience. Art film versus first-person shooter. As I lay on a table, a black-and-white X-ray monitor showed a dark plume of gastrografin (a barium substitute) enter my colon while the doctor took pictures. The table tilted and moved, and I rolled around as the doctor ordered to change the angles and get better shots. The darkness spread. I think I saw the spot where the surgery took place - a uniform ring among the asymmetrical where the tumor and surrounding colon had been. If they were looking for leakage, I didn't see any. It was hypnotic. If they'd let me, I would have watched that monitor all day.

It Begins Again

2010-06-11T07:11:00.000-07:00

With reversal surgery in less than a month away, the battery of doctor's appointments and tests has begun again. So many familiar sights, sensations, and sounds! The white Styrofoam cup with spiked Crystal Light, the slowly spreading warmth of the IV of contrast dye, and the squeaky, cello-like riff from the hospital library's CD burner as it writes images of my pelvis. I suppose there's some comfort in this.

There are some new things on the horizon before the reversal surgery involving, well, my butt. Since it's only being used for decoration, sitting, and pants support right now, the tush is well-rested and ready for its close-up, Dr. DeMille.

And unlike Norma Desmond, I've gotten smaller, dropping between 15 and 20 pounds since the first surgery. It's plateaued, and despite my clothes being a bit droopy, I'm pretty happy with the weight loss part of this. However, my surgeon seems to think I've lost a lot more than that and wants me to bulk up some more. OK...I'm eating healthy, but I'm not exactly avoiding calories either.

Case in point: neighborhood stand-by The Golden West Cafe has a special called "Chef's Revenge", a mystery menu item described only as "NOT FOR VEGETARIANS!!!" The nature of the revenge reportedly changes daily. The evening I ordered it, revenge took the form of three thick pancakes layered with cheese and fried eggs and covered with chipped beef roughly the size of your grandmother's Sunday church hat. It was delicious, and not being a competitive eater, I only made it through a bit over half. The scale is still holding steady. I may get grief from the surgeon, but I'm trying. Honest!

State Of Blog, State Of Health

2010-05-31T09:22:00.000-07:00

As you can see by the month's break between postings, I've been struggling with the blog; its purpose, the goal, its usefulness, its lifespan. The original idea was it would be strictly a way to get news about the cancer out there so Lisa and I didn't have to tell the same story over and over. This was great when things were actually happening every week. Post surgery recovery then moved into the new temporary normal where news was either unfit-to-print (ostomy bag issues) and too-boring-to-print (why can't I find a pharmacy that carries 2" Eiken seals and takes my insurance?). I did enjoy writing for writing's sake again, but I couldn't find a rhythm to posting and found myself reluctant to address things outside of the cancer. Would it come off as self-absorbed, or was just a way to justify my own laziness? But what's more self-absorbed than posting on your blog about your own internal struggles with your blog's purpose? Blah, blah, blah.

So here's what's going on:

Cancer front - I have a date set for the take-down/reversal of the ostomy: July 7th. Basically, it works like this: Colon gets sewn up, shoved back in, the hole closed up, then I, as the surgeon told me, learn how to poop again. It's a 3-to-4 day hospital stay that I'm hoping will again be in the luxurious cancer section of Hopkins even though I no longer have cancer. In the run-up to the surgery, there are a series of appointments and tests that look to be simple when compared to the dreaded bowel prep. I'm not yet sure how this will affect work and travel yet. I'm guess it'll depend on my ability to learn how to poop again.

Ride front - The Ride For The Feast was a great success, raising over $250,000. Lisa, Team Atomic, and the rest of the riders kicked ass despite a bad headwind on day one. I was designated the keeper of a prosthetic leg that one of the riders needed at the different pit stops.

Home front - A few weeks ago, we lost our dog Frank. He was an old, old fella and was gratefully being boarded at the vet when he had a seizure and lost his ability to stand. It was a very hard decision to put him to sleep, but ultimately the right one. It's still hard not having him around. Since I only knew him in his twilight days, I'm fascinated by the stories of Frank's wild years when he chased tall blond lady dogs and appeared in the non-so-famous painting Dogs Shooting Dice.

Wedding front - Haven't written about this at all yet beyond the Suit Guy. Things are plugging along. Catering remains the big unknown, although we are plotting ways to circumvent the wedding-industrial complex. Given the recent food truck trend, Lisa and I are joking about having them all in the parking lot a few hours into the reception. Stay tuned....

Welcome To The New Temporary Normal

2010-04-25T15:17:00.000-07:00

A few days ago marked one month since the surgery. The new temporary normal has kicked in, which is like the old normal but with some key differences. More peanut butter, vitamin water, and pills. More time thinking about body functions and bathrooms. Less caffeinated coffee, more half-caff. Less lifting. No work travel, no gym, no yoga. If I had to put a percentage on it, I'd say that things are 82% regular normal.

The regular normal was spike up into the mid-80s to low-90s percentile with the return this weekend of our dog from his time at Lisa's parents place in Wilmington, DE. Frank is at least 16 human years old - blind, mostly deaf (mos def!), senile, and prone to walking in circles and bumping into things. Sweet and shaky on his feet. Lisa jokes that he's more like a crotchety uncle looking for his copy of Racing Form and a stogy than a dog. He can't do stairs very well and weighs 17 pounds, which made him staying here with my lifting limitation problematic.

Travel to Chicago and Michigan is in the works, which I'm increasingly less nervous about as my comfort with the bag and its wily ways grows. As always, I am of mixed minds about traveling back to Chicago. I do miss my co-workers and being on the ground at the office and looking people in the eye versus trying to read their voices. But my life is here in Baltimore. I guess I'm lucky to be able to pull off the telecommute. One thing that I've learned in these past few months is that I'm lucky on a lot of fronts.

Double Whew! For Now

2010-04-14T16:28:00.000-07:00

Two momentous doctor appointments this week. Monday morning was with the radiation oncologist to discuss the pros and cons of blasting me with gamma rays. Before the appointment, Lisa fired up our new juicer and made a delicious beet-orange concoction for breakfast. By the time I hopped up on the table for the poking, prodding, and deep breathing portion of the visit, my ileostomy bag slowly filling with blood red fluid from the morning's juice. I didn't notice, the doctor's assistant say anything, but Lisa pointed it out, laughing.

I should point out that something else had appeared during my surgery that is a cause for concern. A few bumps of mesothelioma were found, completely unrelated to the colorectal cancer. The surgeon removed them, did a hard search for others, then sewed me up. This commonly occurs in the lungs due to asbestos exposure. My little guys were down by the prostate. How they got there, who knows? So this added bit of strangeness is yet another variable in the equation.

The doctor came in and seemed to be more concerned with the mesothelioma than the colorectal cancer. He asked about asbestos exposure as a kid and lamented the lack of hard data about my situation. Basically, he told us that there was no hard data to support doing radiation in my case. Close observation was the recommendation. CT scans every three months for a year.

Whew!

He wasn't sure about the possible use of chemotherapy and suggested we make an appointment with the medical oncologist. The doctor wanted to see how the scar was healing. I lifted my shirt. He saw the bag, now looking like a pint of O positive.

"How long as it been bleeding like that?" the doctor asked, frowning.

Lisa and I laughed. "Beet juice," I explained. "The assistant didn't say anything about it."

The doctor smiled. "You know, we should mess with her. Play along."

He poked his head out the door and called the assistant in. Lisa turned away to hide a grin, and I tried very hard not to laugh as I held my shirt up.

"We're going to have to get him to the ER. He seems to be hemorrhaging, says he's feeling lightheaded."

The assistant's face dropped and eyes widened. I couldn't hold it any longer and started laughing. We all laughed a lot. It felt great.

That afternoon I made an appointment to see the medical oncologist - Steve-O, Little Steven, etc - for Wednesday morning. There was no hi-jinks with Steve-O. He sat down and talked about how on the fence he was about my case and possibility of a two-for-one treatment for the colorectal and mesothelioma, but I couldn't get a sense for where he was landing. He was presenting two sides, walking through the decision-making process they'd gone through, but not answering the key question.

I finally asked: "To be blunt, this means no chemo, right?"

"Yes. Close observation."

Double whew!

Returning To Work

2010-04-11T06:59:00.000-07:00

I'm back on the job tomorrow (after yet another fateful doctor's appointment). Truth be told, I've missed it and have been keeping tabs on the work email. Normally, I travel back and forth between Baltimore, Chicago, and Bloomington-Normal, IL (aka the Blo-No) a few times a month. This has been the longest time between trips and the longest time off I've had from working since some dry patches during the freelance years.

I have restriction on the amount of weight I can lift for six to eight weeks after the surgery to prevent a hernia: 10 pounds. 10 measly pounds. I get the risk, but can't we make this a progressive thing? Four weeks - 20 pounds, etc? This makes the travel for work tricky. Even checking a bag means lifting it on to the scale, out of the luggage carousel, and most importantly, up three flights of stairs to the Chicago condo. We've been considering shipping a bunch of clothes to Chicago ahead of time - some client-facing, some everyday office stuff - and traveling with the laptop and a few small things only.

It's all TBD based on the discussion with the radiation doctor and our decision about whether or not to go that treatment route and what the schedule will be. I am hoping to get a trip in end of April or beginning of May regardless. The telecommute works very well for most things. What makes it work is periodic time on the ground with the co-workers and clients.

The Game That Moves As You Play

2010-04-06T15:00:00.000-07:00

The pathology report from the surgery is back and it's very good. No lymph nodes affected, an awesome margin...

However...

The tumor itself was bigger than they had thought, than had been revealed by the CT scans, MRI, and ultrasound. 4.5 centimeters (that's 1.7716535433 inches) of cancerous fury that managed to make itself T3 instead of a T2. What this means: it broke out and hit some muscle, kicking my cancer into Stage II instead of Stage I. Stage II means that radiation is back on the table as a possible course of further treatment.

We have an appointment with the radiation oncologist on Monday, but according to the surgeon, the game now seems to be about decreasing the chances of re-occurrence. Radiation will help this, of course, but comes with its own issues and risks. This was not the news we were expecting to receive. After two months of emotional whiplash, Lisa and I are pretty much spent and tired of having our expectations of how this is going play out blown to pieces over and over. Fucking cancer.

As the band X once sang: "This is the game that moves as you play".

Recovery Days

2010-04-05T06:36:00.000-07:00

Stairs and the fear of them proved to be extremely unfounded. Within hours of returning home, I was going up and down them without pain. This was a huge relief. Other movements like sitting upright, sitting down, bending over, picking things up, etc. came easily. Not bad for having a 7-inch incision running up my middle and hanging a right around the bellybutton. When I moved here, I joined Meadow Mill Health Club. I think abdominal work is a big factor in a rather easy recovery.

I got word via Jules (with permission from my surgeon) that the pathology results have come back negative for the cancer beyond the area removed by the surgery. We are hoping an appointment on Tuesday will deliver definitive answers to these questions:

Does "negative" mean this is over but for the healing up and ileostomy reversal?
Is it too early to set a date for the reversal procedure?
How long does the procedure take? Is this an outpatient procedure? How long will recovery take?
Can I drive now that I'm off the meds and in no pain?
How much can I lift without danger? Does this amount increase by the week?
When will travel for work be possible?

I'm not going to detail my life with a temporary ileostomy bag, but I will answer any questions anyone has. My two cents so far is that it'll pretty manageable, although I'm waiting for some sort of highly-public and gross bag malfunction event to occur. In the short jaunts out, all has been well.* Like other things I've talked about, those curious for visuals can Google.

BTW, if you wanna some fun reading, Google "phantom rectum". Why this phrase hasn't yet been taken by a Florida grindcore band is a mystery to me. Best medical term/band name since Dry Socket.

A few days ago I stopped taking the oxycodone when I realized that it was only making me foggy and tired. I'd stockpiled New Yorkers, but couldn't make it through a Shouts and Murmurs piece without losing interest. The ouchy moments are short and fleeting, mostly when expanding my library of post-surgery movements with classics like Picking Up Pen Fallen Under Table and Catching Fridge Door With Toe Before It Closes.

So how am I spending my recovery days? I'm taking walks, watching The Wire, reading, light housework, futzing about, as well as taking care of insurance/short-term disability business, which is like a part-time job. There's one more week of this before I'm back to work. I've been monitoring work email and fighting the urge to jump in. Stupid work ethic.

*Shortly after writing a draft of this, I had a semi-public event occur without a comedic factor. Lessons: don't experiment with bag types; find one you in trust and go with it.

Hospital Best - Worst List

2010-04-02T08:03:00.000-07:00

Johns Hopkins Kimmel Cancer Center took amazing care of me and generally rocked, but even four-star hotels have two-star moments. Here's a list of the good, bad, and the ouchy:

Bests

Lisa - My rock.

Part of stay - The room. I had my own room! Good size, quiet. Comfy foldout couch that Lisa crashed on for the first two nights. Free wifi!

Medical device nickname - The hand-grenade. The plastic suction device attached to tubes used drain excess fluid. Guess what it looks like?

Nurse - The one taught me how to turn off the IV machine thingy when it got pissy (see below).

Visitor - All of them. Becky, Jules, Leslie, My Mom, Krista, Penny, Jane. You all rock! Even when you made me laugh and it hurt.

Day - Saturday. The turning point. Most of the tubes went away.

Food - Whipped potatoes.

Pain controller - The epidural. The friendly beeping like a slot machine after hitting the button, the cold feeling when it dripped its numbing goodness... Awesome!

Worsts

Room "perk" - TV. Basic cable, $10 a day, bad reception on the few OK channels, no channel guide info, remote control circa 1967 Eastern Bloc.

Room feature - Clock. Sounded like a someone smacking their gum with every tick. Lisa dispatched it.

Medical device - IV machine thingy. Touchy, prone to loud beeping in the middle of night for no reason. Nurses hated it, Lisa and I hated it. If it had a mother, its mom would hate it.

Medical routine - 3am blood tests.

Nurse - Me: (being wheeled to my room from recovery) "When is the tube coming out of my nose?" Nurse: "Someday." Thanks.

Food - Jello.

Surgery and Hospital Stay

2010-03-31T11:50:00.000-07:00

So this is how it all landed. I did need the ileotomy bag after all. The tumor was too low in the colon to risk it. They looped a bit of my colon out of my stomach and slit a hole for the sweet, sweet colon juices to empty into a bag. I remember waking up after the surgery, feeling for something not-of-me down there, finding it, and thinking "Well, that sucks." Then: "Ouch!" And then: "Where's Lisa?"

I had opted for an epidural for the pain, but it hadn't been hooked up yet. Surgery meant 6 hours in stirrups. (my sister, vet of 4 C-sections, thought this was funny.)

Time is a funny, elastic thing, doubly so in the hospital. I'm sure that the time it took the nurse to try to get the epidural working, failing, grabbing another plastic machine to compare with the first one, another nurse to notice her struggling and helping, also being confused, then fashioning a work one out of two epidural machines was probably only 10 minutes. But it was 10 minutes delivered drop-by-drop. For sheer physical pain, this was the worst of it.

I finally got to the hospital room maybe 7pm. Lisa crashed on the foldout couch. Counting the epidural as a single thing, I had nine places where I was attached to devices or tubes. Good times.

The hospital days all feel like a blur now.

Each day got better, with a few bad moments oddly timed for maximum audience. Example: First time I tried to sit up and walk, the "Pain Team" came in and asked some truly ill-timed questions ("How would rate the responsiveness of nurses and staff?") as I broke into a sweat, felt nauseous, and had to lay back down.

Lisa stayed the first two nights. She was my rock. My Mom and sister flew in Saturday night, which was awesome. Becky, Jules and Leslie visited and made my laugh. Lisa's Mom and Aunt Jane visited on Sunday too. I re-watched most of the first season of The Wire on a laptop. Lisa and I played five turns into a Scrabble game before I got too tired for it.

The number of devices and tubes coming in and out of my dropped to its current count of two - the ileotomy and a drain. Oxycodone replaced the epidural for the pain.

I got out Monday around noon. For some reason, I thought all hospitals required patients to be taken out in wheelchairs. It wasn't the case with me. I walked out with Lisa, Jules and Leslie. Mom and Krista pulled up Lisa's car. Five days and some change, and I was going home.

Today's goals

2010-03-26T14:14:00.001-07:00

Written on the white board in hospital:

1. Breathing exercise
2. Walk
3. Pain control

Later added:

4. HTFU (Which means Harden The Fuck Up)

All went well

2010-03-25T07:10:00.000-07:00

Most things are ouchy. Am tired. Bob sleep now.

Once More Unto The Breach, Dear Friends, Once More

2010-03-23T19:29:00.000-07:00

I have the cleanest colon in Christendom, the best doctors at one of the best hospitals in the world, an awesome, beautiful lady and a slew of great friends and family. Fuck you cancer!

Stupid Ideas I've Had About Cancer #2

2010-03-22T15:51:00.000-07:00

#2 - Cancer followed me home.
A few days after being diagnosed, I was Googling around on colorectal cancer and stumbled into one of the alternative cancer treatment sites. This one focused on ginseng and garlic cures, but there's a galaxy of other sites with recipes, treatments, methods, and processes. Years before, I'd spend some time trolling these sites while researching my long-suffering and as-yet-unpublished novel. I gave one of my characters - a paranoid, institutionalized flower child gone to seed - terminal prostate cancer. He's convinced that he knows of a natural cancer cure that will only work if he manages to avoid radiation and chemo. As a stop gap during his quest for a cure, he gives himself meticulously mixed coffee enemas using the bunked Gerson Therapy method.

I wrote all of this years ago at a time when I didn't know a soul who had cancer. I needed fuel for the narrative's engine and cancer worked. This stupid thought has occurred to me a few times: I'd played with cancer and now, years later, it had followed me home. Of course I know that cancer is not a stray puppy, the creepy guy from Strangers On A Train, or a non-denominational tumor-shaped golem I've conjured. I know that giving a character I've created cancer has absolutely nothing whatsoever to do with my later coming down with cancer. At all. I know this.

Indulge or Purify?

2010-03-19T06:40:00.000-07:00

Counting down to the 48 hours of prep time, during which I'll be on a liquid diet and be one increasingly grumpy SOB. At least there will be coffee for this one (no cream), so no caffeine withdrawl. Lots of ginger ale, lots of popsicles, lots of water, lots of bathroom time, along with lot of Lisa patience and solid food guilt.

To help with the cleanse (not to be confused with the trendy one with cayanne pepper-orange slurry), I'm taking something called Golytely (get it?) to help the process. Here's to hoping that the people responsible for that name will be hitting beer bongs of Gotlytely in a corner of Hell with Port-a-Potties and a lazy cleaning crew.

I am of two minds about how to approach food and drink in the run up to the Big Starve and surgery. Indulge or purify?

"Do both!" offered Lisa, equal parts funny and unhelpful. But she's sort of right.

The doctor instructions were not to change up my routine whatsoever. Nice to hear, but it played into the increasingly surrealness of having cancer serious enough to slice me open while I felt great and continued to eat and drink and exercise as if nothing was wrong. I know that I'll be feeling the full impact of this in a matter of days, but right now, there's no moment of sacrifice to mark the new reality.

Example: at one point in my life, I drank vats of Diet Coke. I saw Morgan Spurlock's Supersize Me. I stopped drinking all carbonated beverages unless as a mixer or as ginger ale during the recent bowel preps.

This cancer has yet to offer a similar moment. It will. Soon.

Stupid Ideas I've Had About Cancer #1

2010-03-15T19:37:00.000-07:00

#1 - Cats can smell it.
I was laying on the couch watching television. Probably a show about UFOs where they try to be scientific, but can't quite hide the crazy. One of the cats - Uncle Bud, the big orange tabby - climbed up and sat on my lap. This was unusual. Swifty, his smaller brother, did this all of the time, but never Uncle Bud. A thought flashed. Uncle Bud knows! He can smell it!

I think this is real thing, but only with dogs. And there was an episode of The X-Files where some genetic mutant was sniffing on Scully's cancer. I watched him to see if he was paying my tumor zone any special attention. He felt asleep. I eventually booted him when I had to visit the bathroom. That was the only time Uncle Bud has sat on my lap. If he can smell my cancer, he's not a fan.

Story So Far, Part VIII

2010-03-15T08:16:00.000-07:00

Lisa and I are list-makers. We have our own Wiki of To Do Lists of wedding tasks, home improvements, places to visit/things to do. Terribly geeky, but awfully useful. Thursday night we made a list of questions for the preoperative meeting. We'd assumed that on Friday we would be talking to the surgeon and get the answers to vital questions: how long I'd be in the hospital, how long the recovery would take, what the dietary restrictions would be, and so on for a number of pages. The surgery was in 12 days and we needed figure out what to tell our companies regarding time off, backfilling our roles, and so much more.

But this wasn't that meeting. This was a chat with the anesthesiologist and hospital admission folks. And yet another round of blood tests, plus an EKG. Nice folks, but we needed some answers. They came later that afternoon. The surgical oncologist - the toughest of the three -called and I was able to pepper her with questions. Everything seemed reasonable, aside from the ridiculous suggestion that I don't work for 6-8 weeks after I get home. Two weeks, sure. Two months? I work from home already.

When I got to the questions about the ileostomy, she dropped a bomb of her own. She wasn't planning on giving me an ileostomy unless the surgery went less than really well. She was going to draw it up on my torso, just in case, but was giving me about a 10% chance of needing the bag. The risk is possibility of suture leakage, but reversing it later had the same sort of risk. With no radiation in the mix, the percentages were heavily in my favor.

Long-term game plan V (best case scenario):

Surgery to remove the tumor on 3/24.
Recovery.

Long-term game plan V (worst case scenario):

Surgery to remove the tumor on 3/24.
Ileostomy and "bag" for 3 months.
Reversal of ileostomy and recovery.
Discovery of lymph nodes being affected.
Post-surgery adjuvant treatment of radiation and chemo.

Story So Far, Part VII

2010-03-14T10:50:00.000-07:00

The MRI was scheduled for Wednesday morning. If you've never had one, imagine laying very still in a tube with headphones on that mute, but don't completely block out, the Japanese noise-rock band living next door. A preoperative meeting was scheduled for Friday morning and the radiation simulation was still on the calendar for Friday afternoon, just in case. And we had a tentative surgery date - Wednesday, March 24th. All of this was dependant on the MRI results, a CD copy of which I delivered from Union to Hopkins as soon as a copy was burned.

The three doctors needed to confab at something called The Tumor Board about the results let us know their prognosis, hopefully before Friday to save on doing a simulation setup that may not be used and to save Lisa and I from yet another day of uncertainty.

The radiation oncologist - the scrapper - called Thursday evening. The MRI showed the lymph nodes were clear. The doctors thought the risk of not doing radiation/chemo was worth it.

Long-term game plan IV:

Surgery to remove the tumor on 3/24.
Ileostomy and "bag" for 3 months.
Reversal of ileostomy and recovery.

Story So Far, Part VI

2010-03-14T08:38:00.001-07:00

Around 24 hours later, Lisa and I were back at Hopkins to talk to the medical oncologist. For some reason, I thought his first name was Steve, when it was actually Dan. So Lisa and I now referred to him has Stevie, Steve-o, Little Steven, etc. as we waited for him to come in. So far, we'd met with three Hopkins doctors and speculated about which one would be the best street fighter. The surgeon, she would be the toughest. The radiation guy looked to be a scrapper. Steve-o was solid and wouldn't back down. A good team.

Steve-o came in and dropped a bomb on us. By his estimation, it looked as if there would be no radiation/chemo. Lisa and I looked at each other.

What?

Lisa later told me that she assumed that Steve-o had gone rogue and that we'd have to weight conflicting recommendations to figure out the next steps. He quickly told us that the three doctors had spoken the night before and this was the current thinking. Steve-o showed us an online tool where you put in variables like age, gender, and tumor stage and it calculated percentages of complete recovery, recurrence, and longevity with and without using radiation before surgery based on 5 years of patient data. For me, there we no difference at all. Radiation did nothing for me, in fact, it was a greater risk due to the exposure.

My little tumor hadn't gone T3 yet, which means that it hadn't breached the outer wall of the colon and hit the lymph nodes. One more test, an MRI, was needed to confirm this, but we could be cautiously optimistic that the lymph nodes were clear. Steve-o complimented me for going to the doctor when something funky was happening instead of waiting and complimented my doctor's instincts in doing the colonoscopy. If we'd waited until summer, the tumor might have gone T3 and needed radiation.

Long-term game plan III:

MRI to confirm lymph nodes aren't affected.
Surgery to remove the tumor.
Ileostomy and "bag" for 3 months.
Reversal of ileostomy and recovery.

Story So Far, Part V

2010-03-14T07:34:00.000-07:00

Between the snow and Presidents' Day and laboratory sloth, the process had ground to a halt for mid-February. My original biopsy slides were in Texas and pathology MIA. I left phone messages that started calm and reasonable and ended with me shouting "This is unacceptable!" My insurance was pretty good, but they wouldn't cover certain tests being done at Hopkins, so I was back at Union Memorial for another CT Scan and eventually a MRI. Each time, I got CD copies burned and dropped them off at Hopkins myself to avoid any bureaucratic logjams or SNAFUs.

The snow slowly receded and the process was back on track. We met with the radiation oncologist with our printed lists of questions and pens to take notes. Lisa and I were keen to get some hard facts and we got them. The cancer and tumor was staged: Stage I, T2, with no evidence lymph nodes being affected. Translated: pretty darned good, this had been picked up early.

Long-term game plan II (with more detail):

Do a simulation for targeted radiation (pinpoint tattoos around the torso, a custom form to lay in, something called a "clamshell" to protect vital assets, etc).
Find a cryogenic facility to deposit "my guys".
Radiation with chemo for 6 weeks.
6 weeks of recovery.
Surgery to remove the tumor and any lymph nodes affected.
Ileostomy and "bag" for 3 months.
Reversal of ileostomy and recovery.

The radiation oncologist also mentioned the possibility of avoiding radiation altogether given the size, location, and lack of lymph involvement. He gave us the pros and cons, and it seemed to Lisa and I that radiation and chemo, despite the risks, was the best course of action to clean house. I was young and could handle it. Better to do it right, right now, then kick it down the road. This was March 4th, a month and day after I was shown the picture of the tumor.

Story So Far, Part IV

2010-03-14T06:51:00.000-07:00

The first meeting at Johns Hopkins happened on the following Tuesday, on the one day respite between the 1st and 2nd Snowpocolypse storms. The surgical oncologist and her team very clear about what was happening and what needed to happen based on the limited evidence. There's comfort in procedure and process. Lisa is a long-time tech writer and even more of a process dork than I am. Still, the amount of information was staggering, which the doctor readily admitted as our eyes glazed over. There were to be more blood tests, another CT scan, rectal ultrasound after that, and then possibly an MRI in the short-term.

Long-term game plan I:

Radiation (no chemo) for 6 weeks.
6 weeks of recovery.
Surgery to remove the tumor and any lymph nodes affected.
Ileostomy and "bag" for 3 months.
Reversal of ileostomy and recovery.

The second storm was rolled in as we left Hopkins. Lisa dropped me off and bravely went to her office, battling brutal traffic both there and back. I hiked to the store for supplies. I had a list of things that needed to get to Hopkins from the original tests, but the facility with my report and pathology was closed until Friday. The process was choked in feet of snow and there was nothing to do up dig out from the next storm, watch episodes of Homicide, and laugh at the local news forecasters trying in vain talk about the snow in new and interesting ways after 5 days. I had planned to post another snow picture of the cars buried under snow, but it looks so much like the first snow pic except for the snow piles in the back.

Story So Far, Part III

2010-03-08T18:45:00.000-08:00

"So are you going stick with Union Memorial?"

Our friend Jules asked us this the evening after they found the tumor. She's a doctor at Johns Hopkins. Her husband Leslie is a bio-statistician at Hopkins. We hadn't had a chance to think too much about it yet, but we would obviously going to Hopkins as at least a second opinion. We quickly set up an appointment at Hopkins for early the next week, but kept the CT scan appointment at Union for Friday.

I spent Friday morning drinking Crystal Light spiked with radium dye. The snow started that afternoon and didn't stop until Saturday evening. The totals varied by area, but I'd estimate we got 28 inches.

Snowpocalypse 2010, part one.

We were finally able to leave the house Saturday as the sun was going down. Up on the Avenue, we met newly-installed Baltimore Mayor Stephanie Rawlings-Blake after she did a TV interview as a phalanx of snow plows rumbled behind her. A nice piece of political theater, our friend Kathy noted.

We managed to dig out the cars and collaborated with the neighbors on doing the alley. Lisa needed to get to work and we both needed to make the Tuesday meeting at Hopkins. Side streets never saw a plow and main streets were down to a single lanes. Getting anywhere took twice as long. People unaccustomed to the logistics of snow removal were making me stabby by shoveling snow into the street and alley or moving snow into a place where it they'd have to shovel it again. Amateurs.

Over the weekend, Lisa and I had decided that we were going with Hopkins. The people at Union were nice and probably very capable, but Hopkins is, well, Hopkins. If I really did have cancer, then duh: Hopkins. I'll go off-brand for things like dishsoap, Swiffer pads, and trashbags, but a tumor in my colon. Hopkins.

Story So Far, Part II

2010-03-07T15:16:00.000-08:00

Colonoscopies are a breeze, it's the "bowel prep" sucks. A day or so on a clear diet of non-red, non-purple liquids, a slurry of laxative and Gatorade, a surly disposition, and some serious hunker-down time in the bathroom. They've used this sort of thing at Gitmo. Enough said.

On the morning of February 3rd, Lisa dropped me off in Towson for the procedure, which takes a few hours. She headed to work and waited for the nurses to call and tell her I was done. On the way, Lisa picked up coffee somewhere. I hadn't had any in 30 hours.

I'll spare you the colonoscopy details. For the curious, a Google image search on "colonoscopy" should set you up nicely.

When I woke up, the doctor who performed the procedure immediately showed Lisa and I a picture he'd just taken from inside my colon. I have a copy of it. Google will have to help with this again. Suffice it to say, it was obvious where healthy colon ended and tumor began. What wasn't obvious was the size of the thing.

The doctor was refreshingly blunt; his years and years of experience told him it was cancer. The biopsy would most likely confirm this. This was a bit before noon, and he had already set up an appointment with an oncologist at 4pm that day.

The details of the rest of the day are hazy. I think we went home. I drank that coffee and ate a sandwich. We cried. Lisa called and texted people. I think we lay in bed. We told ourselves it would be OK.

The oncologist at Union Memorial was also a nice, blunt doctor. He drew a picture of my insides (the first of many - I wish had kept them all), explained the difference between the rectum and the colon, and talked about how colorectal cancer is now treated versus a few years ago. He said a lot of reassuring things about my age and general good health and the survival rate being really really high. He thought my sisters should get checked out. An appointment for a CT Scan was set for Friday, February 5th.

Story So Far, Part I

2010-03-06T08:12:00.000-08:00

There are so many potential places to begin telling this story. Any of them will feel arbitrary, so let's start on an arbitrary day in November 2009. The first Wednesday, the 4th. According to my Outlook calendar, I'm in Bloomington, IL taking to clients and flying out of Midway back to Baltimore that night. I don't remember this day, but I can guarantee that these things were happening (in no particular order):

I was tired.
I was excited about getting engaged over Halloween.
I was worried about work.
I was worried about selling my condo.
I was anxious to get home to Baltimore.
I was wondering why strange things were appearing in my stool.

According to texts I sent Lisa that night, my flight was delayed due to a lack of flight attendants, I ate some chocolate, I had a Jack & Ginger, the flight was almost empty, I landed, took the shuttle to the BWI's Blue lot and drove home to be with my gal.

The 6th item on this list had been happening for a month or so. I chalked it up to a combination of items 1, 3, and 4. When the holidays ended and the 2010 To Do list was made, it included finding a Baltimore general practitioner. In the middle of January, I saw a doctor highly recommended by Lisa and her friends who has an office a three minutes walk from our house. During that walk, I stayed on a conference call with some co-workers, said my piece about compromising too much with the client, dropped a joke about work causing me an ulcer as I opened the clinic's door and hung up.

I liked the doctor. I liked being able to say no to many of his questions: no smoking, no drugs, no medication, no family history of serious illness. When I described what was happening, I self-diagnosed it as stress. He seemed to agree, but listed other possibilities. I don't remember them now, other than cancer, which I dismissed immediately. Cancer didn't happen in my family. We were a heart disease/stroke kind of folk.

The doctor scheduled a colonoscopy for the beginning of February, and Lisa and I flew to San Francisco for a week's vacation that rocked and ruled. One day we rented a Zip Car to get Lisa and bridal committee member Laurel to a dress shop while I sat in the car on 24th St in the Mission and talked to the endoscopy place about what they called the "bowel prep". I still have the notes I scribbled about which colored liquids were OK when and the words "maralax + gatorade mix".

This was one of the few sunny days of our visit, I was looking forward to reading in a coffee shop, then lunch at a place called the Old Clam House.

I didn't know what Maralax was and I didn't care.