Happy New Year!

I’ve been a bit delinquent in updating my blog lately, so here goes. My systemic health remains good. A visit to the cancer center on Monday for a clinical exam found nothing of concern. It had been 6 weeks since my first “routine” exam back in mid-November 2008. This was the longest period in 3+ years between hospital visits and the extended length of time between visits feels great. My next “cancer” exam visit will be in March and will include a CT scan of the head and neck. I have other visits scheduled at the cancer center, some as early as next week, but it is to work on a new mouth prosthetic device, one that they think may be more comfortable than the existing device. I’m still struggling a bit with some minor ailments which include pain, shoulder mobility, and most recently cold feet. The cold feet are probably a result of peripheral nerve damage from the chemo. I’m seeing a shoulder specialist tomorrow and will probably follow through with a minor shoulder procedure and physical therapy later this month. The bottom line is that I’m spending a lot less time on health issues.

I’ve shifted my time to reading and have two book recommendations. The Longest Winter and The Snowball. The former is the true story of an 18 man platoon during the last year of World War II. They fought at the Battle of the Bulge and helped change the course of the war. For those that survived and were not captured they endured unbelievable conditions as POWs. The latter is a 1,000 page authorized biography on Warren Buffett. This isn’t the first Warren Buffett book that I’ve read, but it is the most engrossing. I’m not quite done with this one yet. Both books provide deep insight into humanity and are inspirational. To change subjects, if you haven’t seen it yet, I highly recommend Slumdog Millionaire as one of 2008's best movies.

Thanks for checking in and take care of yourself.

December 13 2008

Two years ago on December 13 2006 I received terrible news of a major cancer recurrence. Last year on this date, I wrote about that day in 2006 and said that I hoped to be able to write about it again the following year. Well, against big odds, here I am. Health wise I should be thankful. I have had no evidence of disease for 14 months. I feel thankful, but not without reservations. This disease/treatment (yes, I’m still on chemo and other medications) has zapped my energy and makes me feel like I have the body of someone 25 to 30 years older than my actual chronological age. It’s wearing and frustrating. On the other hand, I’ve had some great experiences this past year. I’ve enjoyed good times and visits with family and friends. I’ve seen a few good movies and read some terrific books. I’ve been trying to think longer term, but am currently stuck in somewhat of a physical and mental rut. One doctor this year said I was being too hard on myself. Her intensions were good, but it angered me (you probably had to be there) and pushed me to an improved state. This past year has been better and easier than the year before. I’m committed to figuring out a longer term plan for myself next quarter and making 2009 better than 2008.

Enjoy the holidays. Thanks for checking in and take care of yourself.

"Routine" Checkup Report

I saw my chemotherapy and supportive care doctors earlier today. Based on my physical exam which included blood work and vital signs accompanied by a decent amount of poking, prodding, and listening, they say I'm in good shape. That makes it 13 months with no evidence of disease.

My chemo doctor does not want me to start back up on the Avastin. I'm okay with that for now. My next appointment will be scheduled for January and my next scan with be in the January / February time frame.

After talking to my supportive care doctor and her team about my current concerns, they gave me some tips and thoughts on how to transition from a full time cancer patient to a new healthier normal from a mental perspective. I'm taking their wisdom and experience under advisement... in plain English, that means I'm thinking about it.

Take care.

More Medical Marvels

Here’s something you don’t see everyday. A team of doctors and researchers used stem cells from a patient’s own bone marrow to grow and then implant the new wind pipe in the patient. The beauty of this is that the host body (in theory) will not reject the transplant due to it coming from the cells of the host. This was done in 2005 and the results so far have been successful. See URL…

http://www.msnbc.msn.com/id/27790019/

This ties into a political marvel as well. President-elect Barack Obama said early last week that as soon as he took office he would void the Bush presidential directive banning federal funding for stem cell research. I know many people view the issue (embryonic stem cells) behind the issue of stem cell research difficult, but I applaud our new president for his swift action on a prior executive decision that I personally found unconscionable. How many lives could have been saved if federal funding for stem cell research had been provided during the Bush years? We'll never know.

I’m at my cancer center today. It is in some ways my first “routine” checkup. I hope it stays routine and will provide an update within the next few days.

Thanks for checking in and take care of yourself.

Medical Marvels

Here’s something new in the field of treating head and neck cancer. The November 8 2008 issue of The Economist magazine had an article on the use of nano particles being used in human trials at three Texas medical centers for treating head and neck cancer. 80 trillion particles are injected into one’s blood stream and they find their way to one’s tumor leaving your healthy cells alone. They find your tumor based on the unique properties of the tumor’s blood capillaries. The nano particles are then heated and the tumor dies. The article goes on to say that in lab experiments on mice the tumors disappeared in 10 – 14 days without any noticeable side effects. Here’s a link to the article…

http://www.economist.com/science/displaystory.cfm?story_id=12551598

It all sounds so promising. I hope we hear more about this as the human trials unfold.

As for me, things are okay. No new health issues. To wrap up a loose end from an earlier post, my health insurance company contacted me today and agreed to pay for my ongoing Avastin chemo treatment. It took a great deal of work on my part (with help from a few family members – THANK YOU) to educate the insurance company about my case and their contractual commitment. On the negative side, the action of my insurance company two months ago disrupted my then ongoing chemo cycle. What this means to me is if my cancer does come back, I’ll never know if it was due to this disruption, but I’ll always wonder. On the positive side, they did the right thing by now agreeing to continue with the treatments. It will be interesting to see if my doctor wants to go back to my prior chemo regimen or continue with the current wait and see approach. I’ll take his lead on this.

That's it for today. Thanks for checking in and take care of yourself.

Fixing Myself - One minor ailment at a Time

I actually felt good today. Not just physically good, but also almost free of anxiety. Cancer brings on a lot of anxiety. Every ache and pain feels like a cancer recurrence. Two weeks ago I began the journey of trying to understand every physical issue that was bothering me. It’s a long list and I’m going to talk about each one. So, for those who don’t really want to read about someone else’s minor health problems, there is no need to read any further. But, for those of you that are in my situation or are helping someone like me, this may actually be instructive. In order of what has been bothering me physically, here goes. 1) A change in vision. 2) Lateral arm movement and shoulder pain. 3) Fatigue and always feeling cold. 4) An acute pain in my jaw that seems to happen about once every 4 months and lasts for 24 hours. The mind plays funny tricks on cancer patients. Being paranoid is not too strong of a term to describe it. Every one of these could be caused by some serious disease. I decided to attack each of these individually two weeks ago and to get some answers.

1) Vision – I had my eyes checked. My prescription glasses had not changed in decades. My eye doctor confirmed following my exam that my vision had deteriorated a little, but he saw no signs of eye cancer or eye nerve cancer. He prescribed a new pair of glasses in the 20/40 range. My anxiety about my eyes is now gone. I also have a new pair of glasses and my vision with glasses is 20/20.

2) Lateral arm movement and shoulder pain – I visited my family doctor. It was my first visit with him in over 3.5 years. I told him my concern about ALS (Lou Gehrig’s disease) or MS since it was attacking both arms and shoulders in a similar fashion. I asked to see a neurologist. He suggested an orthopedic surgeon. After listening to his reasoning, I agreed with him. I saw the orthopedic surgeon. He first did a full set of shoulder x-rays. Based on those findings he did an extensive MRI on each shoulder. We then discussed the results. He sees a slight tear in the tissue between my ball and socket in the shoulder on the right side and stiffness in both. Although he can’t rule out MS or ALS with this type exam, he felt strongly based on other patients that this was an orthopedic problem and not a neurological issue. He thinks a 10 minute procedure under light anesthetic, some shots into each shoulder and forcing a breakup in the stiffness via arm manipulation in each shoulder would do me wonders. I’m not ready for that, but I’m now anxiety free about this being a serious disease.

3) Fatigue and always feeling cold – I’m still on a daily chemo pill. My last chemo IV was August 18th (2.5 months ago). I really thought I should be feeling much better than I have been lately. While visiting with my family doctor he did some blood tests. He called and said one test showed a slow thyroid. My TSH (Thyroid Stimulating Hormone) was at 15. It should have been between .5 and 5. There is an inverse relationship between the count and a hyper versus slow thyroid. The higher the count, the slower the thyroid. I looked up “slow thyroid” on Google. The first sentence in the first site I visited said the primary symptoms of a slow thyroid were fatigue and feeling cold. I began a thyroid replacement medicine yesterday. They say it could take a few weeks for it to kick in. But, I’m no longer anxious about these symptoms. This is a very plausible explanation. One other point on this issue. When I received radiation treatment in mid 2005, my radiologist said that the radiation could actually cause thyroid problems and possibly even thyroid cancer 20 years down the road. At the time, I understood the risks and went forward with the treatment plan.

4) An acute pain in my jaw – I visited a local ear, nose, and throat doctor referred to me by my family doctor. Although my care at MD Anderson is superb, I wanted a really fresh set of eyes on this and a few others facial pain issues. After listening to me describe my symptoms, he described TMJ. TMJ is basically a facial muscle pain that can bring on the exact pain I was feeling. It is caused by trauma to the jaw which could be the result of an accident or surgery. We also talked about a way to address chronic pain left over from my July 2006 surgery. It is a nerve blocker medicine. If this nerve blocker medicine works I could then begin reducing and maybe even eliminating some of the stronger pain medicines that I take daily. I began this new medicine today. It too will take a few weeks to figure out if it works. Again, with a plausible explanation for the acute pain, my anxiety level is far reduced.

Here are the lessons to take away from the above. Break the problem down, address each methodically, seek appropriate specialists, and be proactive. I can’t tell you that there is not something seriously wrong with me. But today, I feel like a real weight has been lifted off of me for the first time in over 3.5 years. I don’t know how long this optimism will last, but it is so very welcome. I’m looking forward to the physical results of these new drugs over the next few weeks.

I hope this was helpful. That’s it for now. Thanks for checking in and take care of yourself.

Scan Results

I’ll make this brief. The scan results for both my chest and head & neck showed no evidence of cancer. My next appointment will be in 4 to 6 weeks for a follow up. The last detectable cancer was removed from my body surgically on October 18 2007. That means I’m half way (1 year) through a period of “no evidence of disease.” If/when I hit the two year mark at this time next year without a recurrence, it will mean that I’m in remission. I think this is a great thing. But, as Gust Avrakotos (played by Philip Seymour Hoffman) in Charlie Wilson’s War said of the Zen master's statement, “we’ll see.” I’m just recently beginning to think longer term. More on this later as my thoughts and plans crystallize.

That’s it for now. Thanks for checking in and take care of yourself.