12.15.11

It's been kind of fascinating to see how the seemingly bizarre can come to seem fairly normal and routine.

If anyone had mentioned to me seven-plus months ago that I'd find myself sitting in a Barcolounger at a clinic in Boston every two weeks getting pumped full of poisons for five hours through a device implanted in my chest, followed by two days of lugging around a purse-like take home pump with tubing that snakes up under my shirt to pump more poisons through said device (I'm currently attached. I always worry that someone on the T or train, seeing those tubes running up under my shirt from a bag, is going to think I'm a terrorist packing a bomb. Perhaps I just don't have quite the, um, look, of a terrorist!) before returning to have the IV tubing disconnected, port flushed, and sent on my way for another couple of weeks, and told me that it would come to seem normal, seem routine, I'd have thought they were crazy. And obviously it is not the norm; most people (fortunately) do not undergo such a thing.

But for someone such as myself who, prior to all of this, had been pretty healthy, never needing much in the way of medical care, certainly not intensive, on-going treatment, suddenly finding myself having to undergo the above... The thing that I've found interesting is how relatively easy it has been to adapt to such things. Changes come around in everyone's lives, positive and negative; new job/loss of job, relocating, new relationships/loss of relationships, marriage/divorce, kids, and yes, health issues too. Some people are great at accepting and dealing with changes; adapting, learning, and growing from them. Others, not so much. More often than not I've been in the latter category, often not accepting, adapting to, or embracing aspects of change until too late. Yet I've been surprised at how seemingly well I have been able to adapt to this- pretty radical- change in my routine, in my life. Much credit for that ease of adaptability must go to my medical team, for taking the time and effort to explain things fully and thoroughly, to acclimate me to what the treatment involves, and for making it as pleasant, comfortable, and seemingly normal an experience as something like that can possibly be. (The worst part? Excepting the sensitivity to cold following treatment, the sheer boredom of sitting there for about five hours, even with TV, books, 'Net access, tunes, etc... That, and the smell; I've come to call it chemo smell. I don't know if it is the smell of the various drugs being used on patients, supplies, disinfectant/cleaning materials, or what, but the clinic has a unique, and odd, smell of it's own.) But also being diagnosed with and facing the illness I have has changed my focus, made me more tolerant and accepting of a lot of things, be they medical procedures, treatments, and everything involved with those, but also human frailties, quirks, and imperfections (tho' it's still somehow easier to tolerate and accept those in others than in myself) and simply not sweating many of the small things that in the past I often would. Saying "life's too short" is a little too morbid; "life's too precious"/"life's worth living" are perhaps more positive expressions.

And really- what choice do any of us have but to adapt to change?

12.07.11

My cousin Cheryl posted the following excerpt on her Facebook wall recently; I thought it was worthy of note:

Top Five Regrets of the Dying
By Bronnie Ware

For many years I worked in palliative care. My patients were those who had gone home to die. Some incredibly special times were shared. I was with them for the last three to twelve weeks of their lives.
People grow a lot when they are faced with their own mortality. I learned never to underestimate someone’s capacity for growth. Some changes were phenomenal. Each experienced a variety of emotions, as expected, denial, fear, anger, remorse, more denial and eventually acceptance. Every single patient found their peace before they departed though, every one of them.
When questioned about any regrets they had or anything they would do differently, common themes surfaced again and again. Here are the most common five:

1. I wish I’d had the courage to live a life true to myself, not the life others expected of me.
This was the most common regret of all. When people realize that their life is almost over and look back clearly on it, it is easy to see how many dreams have gone unfulfilled. Most people have had not honored even a half of their dreams and had to die knowing that it was due to choices they had made, or not made.
It is very important to try and honor at least some of your dreams along the way.
From the moment that you lose your health, it is too late. Health brings a freedom very few realize, until they no longer have it.

2. I wish I didn’t work so hard.
This came from every male patient that I nursed. They missed their children’s youth and their partner’s companionship.
Women also spoke of this regret. But as most were from an older generation, many of the female patients had not been breadwinners. All of the men I nursed deeply regretted spending so much of their lives on the treadmill of a work existence.
By simplifying your lifestyle and making conscious choices along the way, it is possible to not need the income that you think you do. And by creating more space in your life, you become happier and more open to new opportunities, ones more suited to your new lifestyle.

3. I wish I’d had the courage to express my feelings.
Many people suppressed their feelings in order to keep peace with others. Many developed illnesses relating to the bitterness and resentment they carried as a result.
As a result, they settled for a mediocre existence and never became who they were truly capable of becoming.
We cannot control the reactions of others. However, although people may initially react when you change the way you are by speaking honestly, in the end it raises the relationship to a whole new and healthier level. Either that or it releases the unhealthy relationship from your life. Either way, you win.

4. I wish I had stayed in touch with my friends.
Often they would not truly realize the full benefits of old friends until their dying weeks and it was not always possible to track them down. Many had become so caught up in their own lives that they had let golden friendships slip by over the years. There were many deep regrets about not giving friendships the time and effort that they deserved. Everyone misses their friends when they are dying.
It is common for anyone in a busy lifestyle to let friendships slip. But when you are faced with your approaching death, the physical details of life fall away. People do want to get their financial affairs in order if possible. But it is not money or status that holds the true importance for them. They want to get things in order more for the benefit of those they love. Usually though, they are too ill and weary to ever manage this task. It is all comes down to love and relationships in the end. That is all that remains in the final weeks, love and relationships.

5. I wish that I had let myself be happier.
This is a surprisingly common one.
Many did not realize until the end that happiness is a choice.
They had stayed stuck in old patterns and habits. The so-called ‘comfort’ of familiarity overflowed into their emotions, as well as their physical lives. Fear of change had them pretending to others, and to their selves, that they were content. When deep within, they longed to laugh properly and have silliness in their life again.
When you are on your deathbed, what others think of you is a long way from your mind. How wonderful to be able to let go and smile again, long before you are dying.

Life is a choice. It is YOUR life. Choose consciously, choose wisely, choose honestly. Choose happiness.

Not trying to be morbid- I don't appear to be on death's doorstep yet. (Whew!)  But there are many thoughtful insights in the above passage, applicable even moreso to those with the time and the health to do something about them. None of these mean anyone has to give up their everyday lives, the seeking to strive and thrive in the larger world. But sometimes- and I know I have, and probably sometimes still do- we can lose sight of some of the above; easy enough to do when pressed with the demands of daily life. Achievement and success certainly have their place. And it's not about being excessively touchy-feely; many people are uncomfortable with that. But seeking to balance achievement and success with some of the above would seem to leave us in a- what?- more fulfilled, more enriched, more human life and experience, both when people have the time and health to do so and also when, facing the end, to be at greater peace with the choices, with the life, we've all tried to live.

Before I close I'd be remiss not to give an 'attagirl to my sister-in-law Margaret, who was just recently declared cancer-free after a year of, at times quite grueling, treatment. Congratulations!

12.03.11

I've been thinking a lot about the recent child sex abuse situations at Penn State and Syracuse. Beyond the anger and disgust over the obvious- that children were abused at the hands of adults, especially adults considered responsible pillars of their respective communities- the fact that both cases involved athletics also angers me. I'm not naive; I know fully well that there can be- and are- vile, degenerate, amoral people in all walks of life. But these cases, particularly given the reputations of Penn State football and Syracuse basketball as relative paragons of virtue in the sometimes-seedy world of big time college athletics... To me these allegations are far more distressful, far more damning than the more-typical allegations and violations surrounding recruiting, admissions allowances, illegal payments to athletes, academic violations, etc... due to the perverse nature of the allegations as well as the fact that they weren't done to gain any competitive edge but instead because someone in a position of power and authority used their power and authority for selfish, abusive, perverse ends, harming the victims, their families, and their respective programs and universities.

Again, I don't believe that I'm especially naive. I'm aware that anyone- or anything- has the potential to be corrupted. But I've always sort of believed that athletics, especially amateur athletics, is something that should be more pure, more- what?- wholesome, more good than most other spheres or institutions in our society. Religion is another. But as has been seen with the Catholic Church sex-abuse scandals now we are seeing here; underlings abusing their positions of power and influence and their higher-ups turning a blind eye toward or attempting to cover up for them in an effort to protect the image of their respective- and formerly respected- institutions. It serves to create distrust toward the majority of, take your pick, priests or coaches who are doing and always have done the right things, creates antipathy toward the Catholic Church, Penn State, and Syracuse, or more broadly toward religion or college athletics, and creates cynicism about things that ought to be considered good.

And they all brought it upon themselves.

11.23.11

I believe I've put my finger on the thing that aggravates me the most about the whole cancer thing; the lack of control I have to affect and/or master something going on within my own body.

About 10-11 years ago I lost a lot of weight that I had put on over the preceding decade or so, roughly 120 lbs. It took effort, it took time, but by my consistently maintaining an eating regimen that worked for me (higher protein/lower carbs, if anyone is interested) and consistency in (and increasing as I became more fit again) an exercise regimen I was able to do it. I mastered my weight; my weight didn't master me. Similarly, if I wish to increase my muscle mass and strength, increase my speed running, etc... through my efforts I can do those things. If I suffer an injury- a torn ligament, broken bone, or something else- through my efforts (along with medical help as needed) I could rehab and recover from that injury, my efforts would play a significant role in recovering. I would be able to recover. Unlike some things in life our bodies ought to be something that we can exert control, exert discipline, over.

But the cancer... it's not as if I can tweak my diet, step up my workout regimen, rehab my colon or liver and eventually overcome it. Diet and exercise are good things in keeping me healthy and stable, in hopefully prolonging my life or at least the quality of it for as long as possible. Even sitting in a Barcolounger every two weeks and getting pumped full of poisons for 5 or so hours won't allow me to overcome, master, and defeat it; at best it will keep it at bay for as long as it is effective. And that is what is frustrating, what pisses me off; that there is nothing I can do to master and control something going on within me. I guess I'm more of a control freak than I thought.

Nevertheless, on this day before Thanksgiving I do have much to be thankful for. I feel a helluva lot better than I ever imagined I would be feeling six months ago; I feel perfectly fine. Feeling good enables me to maintain a normal life, the life I was leading before I was diagnosed. Those are good things. I'm thankful for the medical care that I am receiving; I have some great, and very talented, people working on my behalf. And I'm thankful for- and still humbled by- the interest and concern and compassion I've received from so many good people whom I'm blessed to call family and friends. So Happy Thanksgiving- and Beat Sharon!

11.14.11

It was six months ago this evening that I found out I had cancer and underwent surgery to remove a cancerous growth and have a piece of my liver biopsied. It would be a few days later that I was told the extent of the cancer, and a week after that when I got the full diagnosis, recommended course of treatment, and typical prognosis. Many of the particulars of that day and night are still a blur; I remember undergoing the CT scan that discovered the growth as well as the lesions on my liver (I also remember throwing up the contrast solution afterward) I remember a nurse coming back to tell me the results, that they were likely cancer and that the obstruction in my colon needed to be removed, that evening (I only found out recently that I was also a lot closer to, well, not making it than I knew at the time) I remember receiving the Anointing of the Sick (ie, Last Rites) and I vaguely remember being wheeled into what seemed a very dark operating room. And I remember thinking this all wasn't too good.

The first month was the worst. I still wasn't quite sure of how things were going to turn out, I still had an ileostomy pouch (a result of the colon surgery), and I was facing the prospect of chemotherapy and all that that might entail. I underwent a second surgery toward the end of June (to reverse the ileostomy, and to install a port-a-cath device in my chest through which to administer the chemo drugs once I commenced treatment.) July was better, as I began to regain some stamina and strength (and weight.) The beginning of August I underwent another CT scan (without throwing up!) as well as blood work to determine the extent of my cancer just prior to beginning treatment. It had advanced since May.

Six months out, and a little over three months of treatment, I feel pretty good. Apparently I've been able to tolerate the chemo very well thus far, with minimal adverse side effects (mostly the sensitivity to cold that I've mentioned previously) and the treatments have had the desired effects, no new growths and the existing tumors have shrunk appreciably in size. Physically I feel fine- as I tell anyone who'll listen, if I didn't know that I was sick I wouldn't know I was sick. No pain, no fatigue. Last week I finally got back up to a little over 7 miles on my morning runs, back up to 40-45 mins of cardio at the same levels I was doing prior to May. I'm still a little weaker lifting but getting stronger nonetheless. My energy level and appetite are both good. I feel pretty damn good, a credit to my medical team, and maybe a bit to myself. If you had asked me six months ago if I thought I'd be feeling this good, this well, this normal I'd have said no.

It still seems unreal to me at times; you know these things can occur but you always tend to think they will happen to the other guy or gal, not you. It does give one pause to ponder things. More than anything else these last six months have given me such a greater appreciation of people. The genuine interest and concern I've received from so many people has been humbling; I still feel as if I'm undeserving of such kindness from so many. I've come to appreciate and care about people far more than I ever have in my life, with far less cynicism than I've often had in the past- there really are a lot of very good people in this world. In that regard I'm blessed.

I realize that I'm on the clock; hopefully it won't wind down too quickly. But six months out from a truly horrible day I'm feeling a helluva lot better, physically and emotionally, than I ever thought I would be feeling.

11.03.11

I've had a few people recently suggest that I look at my illness and all as "living with cancer" vs. "dying from cancer." Granted, while in some ways it is simply semantics there is also a significant difference between the two; moving on and forward with and continuing one's life as fully as possible as opposed to resigning oneself to one's fate and simply awaiting it's arrival. Ultimately the end result will be the same (as it will be for everyone, whether they have a serious illness or not) so it would seem better to, as much as possible, making that time more enjoyable, more rewarding, more fulfilling, to try and live as full and normal a life as one can. It's not about throwing all cautions to the winds or being a "free spirit" (two things I've never been accused of!) but trying to get as much out of and just appreciating each day and the people in it as possible, what some refer to as "living in the moment."

Apparently I'm doing well, considering. Before my most recent treatment session a key blood marker that the oncologists check (CEA; it gives them a decent idea of, take your pick, the progression of the cancer and/or the efficacy of treatment without having to do a CT or other scan) was 62. Just prior to starting treatment back the beginning of August it was 960, so it's currently about 16 times less than it was three months ago. (Ideally, in a healthy adult it should be at/near zero, but... ) And again, as importantly I feel well, healthy, and energetic and don't seem to be suffering any seriously adverse side effects from the treatment thus far (apart from the sensitivity to cold that I've mentioned... and it's frustrating because I've never been sensitive to cold in the past- hell, I lived in this lovely condemned building while in college-

but the recent colder weather has been uncomfortable for my early morning runs. Whaddya gonna do...)  My doctors seem pleased with the results, as have I.

10.18.11

One other comment re. sports and athletics. For me watching and- especially- participating in athletic endeavors has always let my mind be still; the only thing I'm thinking about or concentrating on is the event, game, workout at hand. They've always been my main way to clear my thoughts, clear my mind.

I haven't read a lot about most of his policy proposals yet but I was astounded to read about GOP Prez candidate Herman Cain's bout with cancer, 1, 2, 3. Leave aside the politics if you wish; back in 2006 he was diagnosed with stage 4 colon cancer that had metastasized and spread to his liver. Sound familiar? It's now 2011 and he's still around- maybe you folks will have to put up with me for awhile yet...

The one pain in the ass side effect I've had from my chemo treatments is an increased sensitivity to cold, especially my fingers and face (and lips, mouth, and throat when I drink something cold for about a week or so after treatment.) It sucks when I go out for a run in the morning- and it's not even all that cold, I'm talking mid/upper 40's to low/mid 50's)- and my fingers sting and /or cramp up a bit and my face stings and gets numb, especially the tip of my nose, and forehead, cheeks, chin, lips... I wear gloves when the mornings are cooler and that helps, and I suppose I'll have to get a ski mask or something to wear once it gets colder/winter. (A ski mask like this?

Dirty Harry references are appropriate for any occasion... )

10.05.11

As anyone who knows me knows, sports and athletics have always been a big part of my life. Whether participating or watching they have always brought me enjoyment and satisfaction on many levels. It's not that I can't or don't appreciate other endeavors; literature in it's various forms, music, and films often bring me enjoyment as well. And I can appreciate that there those are who find enjoyment in other realms: art, sculpture, theatre, dance, and more. But to me there has always seemed something pure (for lack of a better word) about sports. Sports and athletics are probably the closest we come to a meritocracy; background, pedigree, connections really don't count as much- think Division II Chadron State Danny Woodhead vs. Big Ten Minnesota Laurence Maroney. Demonstrated excellence is what is valued and what matters most. Opportunity and success don't depend upon an editor, a critic, judge, or committee making a subjective judgement; if you perform better than the other guy or gal, you'll be on the team, you'll win, or at least out-perform others in, the race, match, or game. With few exceptions, success is easily quantifiable- you ran, swam, or cycled faster than the others, you lifted more weight, you scaled that peak; you, or your team, scored more points than your opponent. While innate talent and genetics are helpful, consistent hard-work and training, consistently trying to improve in ways small or large, are as important and, if not always easy to accomplish, they are easy to identify (add some speedwork, tweak your lift, shoot more free throws, etc...) And to me the most enjoyable are team sports; seeing five, six, nine, eleven individuals working as a unit, each fulfilling their role as part of the overall group, to me it's one of the most enjoyable things to watch or to participate in.

Alright, so it's not that profound- whaddya want for nothing?!

9.23.11

Heard on sports radio yesterday morning (can't remember which station) Brian Billick, on Bill Belichick: "It's not just what you know but what you can impart to others that matters." (Billick was impressed with how Belichick does just that with his players.)
Not necessarily earth-shattering but I found it an interesting observation. I was struck by the truth involved in that statement, its relevance to so many endeavors, on so many levels. Knowledge or learning- including experience- that cannot be or is not shared with others, that cannot be or is not offered to others, is useless. Worth pondering...

I received some good news on the medical front this morning. I had a CT scan done yesterday and one of my oncologists notified me this morning of the results; no new growths or tumors were detected, and all of the existing tumors had shrunk appreciably in size since my last CT scan back before starting chemo. From what they tell me shrinkage is the best possible outcome of several (there could have been new tumors, the existing tumors could have grown in size, or there could have been no change.) So apparently the chemo is having the desired effect so far. While it doesn't change the ultimate prognosis- unfortunately my cancer is deemed incurable- it is positive news nonetheless. Just as importantly, I feel fine- feel great actually- physically, so in that regard the cancer really hasn't affected me so far.

I've yet to watch any of this yet but it is Must See TV for me:
Bill Belichick: A Football Life

9.15.11

A good opening win for the Pats Monday night! The offense looked to be in mid-season form; Brady spreading the ball around at will, great play from the tight ends and wide outs. The running game was quiet but effective, Danny Woodhead and Benny Green-Ellis coming through. The O-line stepped up BIG time, particularly given the lack of depth coming in and the injury to Dan Koppen (Dan Connolly did an outstanding job moving to center.) The defense needs to step it up bit; they gave up a lot of yardage to Reggie Bush early, and Chad Henne (!) was able to pick the secondary at times, a concern as the Pats face a more effective passer in the Chargers' Phillip Rivers this week. But a solid win going into the home opener this Sunday.

One thing that is difficult for me to accept is that there is not more that I can do pro-actively in terms of fighting my illness. It's frustrating that the most beneficial, or effective, thing for me to do is to simply sit passively in a Barcalounger while I get pumped full of poisons every two weeks. Yeah, I run and workout and eat a healthy diet and try to get decent sleep but, except for the rest/sleep part, my doctors don't seem to put much emphasis on the efficacy of anything I can do to help myself. They're glad that I take care of myself but there doesn't seem to be much connection between what I try to do having any tangible, real effects upon the course of my illness. It's not that I don't have confidence in them or that I don't believe that the chemo regimen has positive effects; I do. But it is maddening that it seems there is little I can do on my own, or in addition to what the medical people are doing for me. I'd like to be able to do more, not simply be dependent upon the- very good, and greatly appreciated- efforts of others.

Having said that, I feel good. Honestly, I feel great. I'm in no pain; I wouldn't even know I was sick had I not been aware of it previously. With the exception of the increased sensitivity to cold I've had no appreciable side effects so far from my chemo (no excessive fatigue, no nausea et al, no hair loss, my blood counts seem to be normal, my appetite is good- even if I'm burning a lot of it off.) I'm back up to 6.5 miles/morning for my run (have to add some intervals/speed work soon, try and lower my mins/mile a bit again.) I've been getting in some good, and consistently good, lifts and am back up to 40-45 mins/cardio session after my lifts. (I'm often a bit reluctant to share some of my personal successes, not wanting to come across as a braggart or arrogant.) In a way I keep waiting for the other shoe to drop, keep waiting to suddenly feel sick, feel like I have stage 4 colon cancer, but right now I feel as well physically as I ever have, I don't feel limited at all. I really do feel good, and there is so much out there that I really want and need to do, for others as well as for myself, for as long as I have the time and the health to do so. Feeling good does beat feeling bad.

I do have a CT scan scheduled a week from today. Some previous blood work from a few weeks ago indicated that one marker that they use to try to determine the efficacy of chemo treatment had dropped appreciably- a little more than half- after only two treatments (that's a good thing.) So the CT scan will- hopefully- give them visual evidence that the treatments are working, that the tumors are slowing, stopping, or- ideally- shrinking in growth (and hopefully that no new ones have appeared.) We shall see.

9.07.11

Looking mean as hell, circa fall '82...

8.25.11

I received news earlier today that a guy I worked with in college died, apparently by his own hand, and in a particularly gruesome manner. I don't believe I had seen or talked to him in probably twenty years or so but we hung out quite a bit while we were in college; a regular guy, a good guy. Obviously I don't know the circumstances surrounding his demise, what may have caused him to- apparently- take his life and in the manner he did. But if the accounts are true something somewhere along the way went very wrong; regardless of the circumstances it is a shame to think of the guy that I knew being as troubled, as desperate, as devoid of hope- or as angry- as apparently he was that he would do himself in, and in that manner. Perhaps it seemed the best option to him. But sad. Very sad.

A good friend recently wrote me the following: The message that I keep getting is to slow down, enjoy the moment, and appreciate the people in your life. So true. While I'm not necessarily seeking to slow down (yet!) two things I've increasingly been trying to do are to enjoy the moment, to try and take pleasure and find fulfillment as best I can in any particular moment, and most importantly to appreciate all of the people in my life; family, friends, acquaintances, and more. A kinder, gentler Vito? Maybe. It may sound sappy but it is both a blessing and an honor to have so many good people in my life; I hadn't always appreciated just how blessed and honored I was. People- and life- are more precious, more fleeting, than I sometimes realized, worthy of the time and effort to embrace and to revel in them as best I can. As my football coach used to say: "You never know when it's gonna end."

I love you guys- now get out of here... (another Jim Mitchellism.)

8.14.11

"Ultimately, faith is a walk- a journey toward greater understanding."
- George W. Bush, Decision Points (I'm currently reading this.)

I'm not an especially church-going person. If I attend Mass six times a year that's a lot (though I did receive absolution back before I had my first surgery in May so I got that goin' for me, which is nice, to quote the inestimable Carl Spackler!) On occasion I will stop into a church if I have the time and inclination for a bit of reflection, meditation, to offer prayers for others, to simply sit in the silence and solitude. I do pray most every night before bed. I believe in the existence of God and I try to live my life according to Christian principles (sometimes better than other times) but the practice of religion doesn't play a major role in my day-to-day life. It didn't before I got sick and it really hasn't since being diagnosed. I don't say that to be condescending toward those who do; I respect their commitment, their faith. I've had several people offer prayers for me recently, which is obviously appreciated. Being confronted with a sudden, unexpected, and quite serious illness has given me- would seem to give many people- pause to consider their faith, God, an afterlife, etc...

Like anyone I've had my share of ups and downs, successes and setbacks, delights and disappointments. In terms of the negatives, while they're obviously not enjoyable I've tended to view them as parts of life, no better or worse than most peoples'. But to have something such as this come totally out of the blue it is difficult to make sense of it, to easily accept it as that's life. I'd been told that God doesn't judge or punish us in this life, part of the whole freewill/repentance/redemption thing. However this recent diagnosis has me feeling at times as if God is punishing me- now- for some transgression, some sin, something...

Yet there are also many people who are struck down with illness seemingly for no cause or reason. The six year old daughter of one of my fraternity brothers passed away last December after a lengthy battle with cancer- she certainly never hurt anyone, did anything wrong, she didn't earn or deserve her illness, her fate. And the converse is true as well- there are many people who commit vile, evil deeds yet lead long, healthy, many times productive and prosperous lives. Getting back to the faith aspect; do these things make God an aloof, capricious Being, playing us for saps? Are we saps for being believers? Is religion, is faith simply a crutch, a way to give the illusion of meaning to randomness?

In a way this parallels my for every effect there is a cause/for every question there is an answer thing. To my mind there ought to be at least some discernible reason as to why things happen. Or to why innocent, or at least relatively harmless or benign, people suffer while many who aren't as innocent, harmless, or benign often do not.

I wish I could find some definitive answer, some meaning, some understanding. I suppose I'll have to be content with faith.

8.01.11

Guilt. Regret. Two things I've been dealing with since I was diagnosed with cancer a little over two months ago.

Guilt. Guilt over what all of this is doing to people I care for and about very much, the worry, the fear, the inconvenience this has put, is putting, and will put upon them because of me. First and foremost my mom; at her age she doesn't need any new, or added, troubles or difficulties in her life, certainly nothing of this magnitude. She's had- and has- health issues of her own, she doesn't need mine. In addition to my illness she has concerns and worries about my sister-in-law's health (she was diagnosed with- and has been undergoing treatment for- breast cancer since late last year) and the stress that is putting on their family. And my brother, who has enough on his plate dealing with his wife's illness, trying to keep things relatively even-keeled with their kids as well as with his job, life, etc... as well as worries about our mom's health. The last thing he and they needed- especially right now- was for me to also become ill. And my sister as well, having to travel to Massachusetts from her home in the Caribbean on short notice, twice; once for me, once for my mom's recent illness (which I wasn't able to fully manage because of my medical issues.) The stress on her- worries about our mom as well as me, as well as the work and financial stresses of having to fly up here on such short notice... Had I not gotten sick this would have been one less stress on my mom, my brother would only have to worry about his wife's condition, and I would have been able to handle things fully re. my mom so that my sister wouldn't have had to have done so. The facts that I didn't ask to get sick and that- apparently- I did nothing to bring on my illness do little-to-nothing to ease the tremendous guilt I feel for the stress and worry I'm putting on/adding to my family. They don't deserve it.

Regret. What's the line from My Way: "Regrets, I've had a few... ?" I have a few. Some of them I've alluded to previously, mostly related to how I treated many people in the past. But with perhaps one other exception most of my regrets are along the lines of the Mark Twain quote: "Twenty years from now you will be more disappointed by the things that you didn't do than by the ones you did do." Disappointment, regret over things that I didn't do, didn't pursue- academically, athletically, career-wise, relationship-wise, interests, travel, more- than over (most) things that I did do, including things I did that were screw-ups. And now to be looking at what appears to be a time-shortened window of opportunity to pursue/do many of those things...

The challenge is to if not eliminate at least ameliorate the guilt and the regret. I suppose it's easier to work on the regret. I can't change the past, I can't have a do-over but I can make better effort at not adding to my regrets, I can more fully pursue things that are of importance to and that bring some personal fulfillment to myself and to others, endeavor to, as much as possible, not be disappointed in twenty years- or twenty months- by the things that I didn't try, didn't do, didn't pursue, to make better effort to hit each day at full speed while I still have time and health to try and do so. More difficult will be trying to deal with or lessen the guilt. Short of a miraculous cure this whole thing is going to continue to be stress and worry and inconvenience for those I care about regardless of how well I bear up. The fact that I didn't intend to bring this upon them (or upon anyone) provides little consolation...

I'm scheduled to begin chemo Wednesday.

7.22.11

Hottest day of the year- I ran this morning, worked out this afternoon.
Fuck cancer.

7.16.11

I finally was able to run this morning- first time in about 2 1/2 months. I had a few doctors' appointments yesterday and one of the- good- things they all were able to say was that I could resume running (and likely start lifting more in another week or two.) I did resume doing some cardio earlier this week as well as some light/dumbbell lifting; while I expected to be weaker on the weights I was shocked how much cardio conditioning I had lost in such a relatively short time. As for the run this morning... much shorter than I had been doing, and s--l--o--w; I felt like I was running in slow motion, or quicksand, or something. Rubbery legs, too. I suppose I can say that I did have two fairly significant surgeries over the past two months (including one three weeks ago) and, oh yeah, I have cancer, too, but I have to step it up. Hopefully as I'm able to keep at it I'll regain some stamina and strength fairly quickly. Still, it felt good to be out there this morning!

As for the doc appointments... re. my surgery they removed the staples I had in and said everything looks good. Re. the cancer- they have me scheduled to start chemo 8/3. I'm not really looking forward to it. I do understand the logic behind their seeking to treat me but (as even they acknowledged) in the short/mid term the chemo is likely going to make me feel worse than I do currently (on balance I feel pretty good right now.) There are a whole host of possible/potential side effects I may/likely will experience (my sis-in-law gave me several pertinent questions/issues to ask about- thanks Margaret) from the treatment, all of which can vary in length, severity, etc... (curiously, for my regimen right now one of them should not be much/any hair loss- one positive, as I still have a decent head of hair!) The goals are to shrink, stop, or slow the growth of existing tumors and hopefully prevent spread/further growths from occurring for as long as the regimen is effective so that I won't experience (for as long as possible) the worst effects of the cancer itself, as well as to try and prolong my leading a reasonably healthy existence, again, for as long as possible. All things I certainly would like to see. But I have to admit that right now, given how I currently feel, there is an aspect of the cure is worse than the disease thinking in my mind even as, again, I do understand the logic and all re. treatment.

But whaddya gonna do...

7.07.11

For obvious reasons I've been giving increased thought to the on-going healthcare debate. My politics tend to be fairly libertarian; I believe in limited- and limiting- government. Generally speaking I tend to see government-run programs as bloated and inefficient, frequently lending themselves to abuse. I tend to place greater confidence in the private sector to get things done more effectively and efficiently. But my illness has given me pause to consider, to realize, that necessary, needed healthcare needs to be available to all, regardless of means. While there are areas where legislation can help (portability issues, for instance) I'm still not convinced that either Massachusetts' RomneyCare nor the federal ObamaCare programs are the best ways to deliver and ensure that care for all. Providing greater incentives- increased tax breaks and the like- to institutions, individual physicians, and insurers, to treat and to cover those of limited means, health savings accounts with tax benefits for individuals and families, increased competition among and options to individuals and families of insurers (including across state lines), increased options in purchasing medications and supplies, and as always increased efficiency throughout the entire system might help better serve to provide necessary treatment for all who need without the levels of taxation and bureaucracy that a one-size-fits-all government-run program entails. Similarly, freeing up pharmaceutical companies from onerous, overbearing government regulations and disincentives, toward the ends of affording them greater means not only to develop drugs but to allow them to bring them to market- to patients- more quickly, as well as providing additional incentives for offering their drugs at discounted prices to patients of modest means. (And an aside, but two things: 1- I've never understood the mindset of some who claim corporations, in whatever industry, make "too much" profit. 2- I've always believed that adults ought to be able to ingest whatever substances they wish, be they medicinal or recreational.) Increased utilization of wellness programs, via public or private coverage, pro-active measures as part of an overall health plan can only help as well. Incentivizing the market across all sectors, from providers to patients and everyone in between, to me seems to be better policy than penalizing this (or any) industry, let alone having government take on a far greater role. We need to be- and can be- far more creative on this entire issue.

I don't claim to be an expert (yet) on this issue, nor to have all the answers. I don't believe those on Beacon Hill or Capitol Hill have all the answers either. But ultimately, while I don't know if I consider it a "right," I certainly believe, now more than ever, that anyone in need of necessary medical care should be able to receive that care, regardless of means. What we need to do is to determine and implement the best, most effective and efficient, means to deliver and ensure that coverage and care.

For further reading:
Fixing the Massachusetts Health Exchange
Yes Mr. President A Free Market Can Fix Health Care
How Much Does Medicaid Improve Well-Being?  (7/8)

6.30.11

I had my ileostomy reversal done last Friday, at which time they also installed a porta-cath device to be used to administer chemo meds once I begin that (likely early/mid August.) Everything apparently went well, and I"m very glad to be rid of the pouch, et al... Now that I'm able to eat, digest, and absorb food more normally again, as well as feel more comfortable and confident getting around, exercising (still only cleared to walk right now, dammit!) etc... sans the pouch I can begin to regain some stamina, strength, and weight.

I want to thank Jim Ford for coming by to see me Saturday- it was great to see you again Big Jim, it had been too long. I wasn't looking at the top of my game (unshaven, scraggly hair, scrawny... come to think of it, 'cept for the scrawny part, that sounds like how I looked most Sunday mornings in college.) One thing among many this experience has brought into focus is how easy it is to let time slip away, to put off seeing or doing X, thinking that there will always be time to see or to do X. It was great to catch up with you Jim, as well as reminisce over memories of that House of Horrors known as 14 Elm St! I also want to thank Jim for his insights, experiences, etc... dealing with cancer diagnoses, treatments, and more; I imagine I'll be picking your brain more throughout this experience. And of course I want to thank my sister for all of her help dealing with everything, re. me and my mom, the last week+ Your help was invaluable, I can't begin to express how much. Thank you, more than you know.

One thing I'm having a little difficulty doing is accepting the many offers and wishes of support, assistance, simply interest, from so many people, trying to straddle that line of not wanting to be a pain in the ass to others while not simply shunning or ignoring those offers and wishes, or how to adequately, and/or graciously, respond to those offers and wishes. At times I do feel unworthy of them, and it has been very humbling to realize there are a lot of good people who truly care, especially given my at times- what?- prickly nature, or assholeness, or something. I have become better in those regards as I've- somewhat- matured, but the interest and support I've already received from so many has truly given me pause to consider how I treat others. If this helps me to become a somewhat more caring, considerate, kind person, that's not a bad thing (tho' I might still rather be a healthy a**hole! Kidding...)

Another thing I'm still having a difficult time wrapping my mind around is the why over all of this. I mentioned previously that I've always believed that for every question there is an answer, for every effect there is a cause. With this I just can't seem to see that answer, identify that cause. I realize at some point it simply becomes little more than an exercise in mental masturbation; whatever the answer, whatever the cause, it is what it is, and I know that I have to accept that, but right now it is still frustrating for me to be unable to pinpoint some answer, some cause.

6.21.11

From the When It Rains It Pours Department...

I just spent the better part of today at the hospital... not for me, for my mom. She was admitted after an emergency trip for a DVT, part of which apparently broke off and went to her lung. Much like my recent illness this also came pretty much out of the blue- she had noticed a knot in her leg the other day (apparently that was the clot) but, except for it being sore she didn't have any other symptoms until it got very sore and she also found herself very short of breath (the lung issue.) Compounding this is the fact that my sister-in-law just had a mastectomy a little over a week ago, hence my brother really couldn't/can't come down from Maine, and my sister lives in the Caribbean and won't be able to get into Boston until tomorrow evening, if all flights connect properly. I'll handle it- I have to- but I'm not necessarily at the top of my game myself, and I have surgery I'm looking at later this week as well.

Not looking for sympathy but I'll tell ya- it's days like today where I wish I still drank heavily.

6.16.11

Congrats to the Bruins! What an outstanding playoff run and Finals series, and a convincing win on Vancouver's home ice last night to take the Cup. Tim Thomas was phenomenal throughout, and Vancouver just never seemed to have a response to the Bruins' style of play. To me the only recent local championship that tops this was the Patriots' first Super Bowl victory. Great job, Bruins!

Some good news on my health front; I'm scheduled to have my ileostomy reversed a week from tomorrow (6/24; they will also be installing a port-a-cath device at that time, which will be used to administer chemo drugs once I begin that.) This is good news, in that they had originally said I might have it anywhere from 2-6 months. While I'm fully aware of the larger health issue hanging over me, in terms of sheer annoyance the ileostomy has been a b*tch, and I'll be glad to be shed of it. I'll likely be in the hospital for 3-5 days after the surgery. And as I currently understand the thinking is still that they would like to begin my chemo treatment mid/late July, perhaps early August. We shall see.

One thing that is killing me (perhaps I should rephrase that) is that I haven't been able to work out since, really, the last time was the end of April. This is prime running weather, and to see so many people out there, at all hours of the day, while the most I can do right now is walk, has been tough. I really got into running these last 10 years or so but didn't think I'd miss it as much as I have. It makes me feel lazy, and makes me feel jealous of those who are out there, dammit! And lifting and hitting the gym, too- while I don't need to be able to bench press a Buick I'm shocked at how much muscle mass and all I've lost so quickly. Or even just a good, hard 45 mins on the StairMaster. Again, it makes me feel lazy and makes me feel jealous of those who are able to do so. Running and working out are ways to keep my mind additionally occupied as well as provide a boost emotionally and, of course, keeping me stronger and fit physically, strength and fitness I'll need. Hopefully I'll be cleared to start running again mid-July and lifting perhaps by August (of course I'll then have to work that around, and see how I feel, vis a vis chemo treatments and all.)

6.11.11

This one is probably going to be a bit more introspective and personal, but part of the purpose to this is to write down what you’re going through...the reactions you’re getting from others...the plans you must make/change...the way you see/perceive things through this particular looking glass. So toward that end... I've previously mentioned that the genuine interest, concern, and support I've received from so many has been greatly appreciated. Even more, it has been extremely humbling, to the point that I almost feel unworthy of the well-wishes and support I have received from so many. When I previously wrote that if anyone wants to kick sand in my face, now is the time (there are a lot of people I probably deserve that from!) I was only being partially facetious, particularly about the deserving that part. As I recently remarked to a friend:  I've been humbled by the outreach and support I've received from so many good people, past and present, especially as, and I'm the first to admit it, at times I wasn't always the nicest of people (I know I could be an a**hole at times, due as much to insecurity and immaturity as much as anything- and I have matured- but still not an excuse.)

Looking back there were a lot of people I treated poorly throughout my life. If you were one of my good friends you were probably spared, but so many other people... Any of you who know me can probably come up with numerous examples of that behavior. I like to think it was less out of malevolence than out of the insecurity and immaturity that I referenced (often fueled by having a drink or ten more than I should have had.) I'm not sure why... Unless I knew you pretty well part of it was- is?- keeping people at arm's length, attempting to appear- at best- cool and indifferent, at worst cold and uncaring, disrespecting or hurting people pro-actively, before they had the chance to disrespect or hurt me, a do it to them before they can do it to you mentality. And with very few exceptions, that was never a reflection upon how people actually treated me, but a reflection of my own incredible insecurity. Too often, I never gave a lot of people a chance period, to like me or to loathe me, instead simply pushing them away through my attitude, my behavior. And while it probably hurt them temporarily, ultimately it likely hurt me even more, denying myself the opportunities to befriend, to support, to care about and in turn be befriended, supported and cared about by so many others.

It's taken me a long time to mature in that way. While not perfect, I had become a better person in that regard, long before any of my health issues arose, tho' at times I still have a difficult time reaching out to people- even people I know well and care very much about- as much as I'd like. I'm still hardly a touchy-feely person. Which, especially now and given the outreach and support I've received from so many, makes me feel somewhat unworthy of that outreach and support. I have and do care about and treat people better than I did when I was younger, and I do like and feel better about myself as a result. But I still can't help but think about the way I treated too many people in my past, knowing there's likely very little way I can make it up to them, and knowing that's the lasting impression they have of me (if they have one at all.) I guess the best I can do is to just try and pay it forward as they say... Maybe that's called maturity.
(See? This is the maudlin kind of stuff I hope to avoid!)

6.06.11

The Bruins need to get it done tonight. What sucks is that they've played pretty well on the road- they could easily have been coming back to Boston with a split or even a 2-0 lead themselves. Just some tough breaks, some late mistakes, but things that can be corrected as opposed to simply being overmatched. Hopefully they'll get back into it tonight.

I've lost a lot of weight. I've been a lot of things in life- average shape, decent shape, bulked up, beer bellied, fat, very fat, and for the last 10 years or so relatively fit and lean. This is the first time in my life I've ever been scrawny. Admittedly I haven't been eating all that well lately (due first to simply feeling ill, now mostly due to ileostomy system issues- don't ask) as well as the fact that I haven't been able to lift in well over a month and I've lost a considerable amount of muscle mass, particularly upper body mass. Tough too is that, due to the ileostomy, I've had to change the way that I eat; slowly, smaller bites, chew very well- in short, eating civilized- whereas before you could put anything down in front of me and I'd wolf it down in 3 minutes. Eating slowly, etc... fills me up sooner, hence I simply don't eat as much as I did before. This morning I weighed 143 lbs, which is the lightest I've been since 8th grade; if anyone wants to kick sand in my face, now is the time (there are a lot of people I probably deserve that from!)  Hopefully I won't lose much more and can begin to put some weight back on. The odd thing is that, truthfully, except for feeling a bit fatigued (due to poor sleep and the aforementioned weight loss) otherwise I feel good, feel fine.

I came across this in Peter King's SI column today:

"I always felt like you really do a better job with less time than more time because when you have less time you focus immediately on what's of the utmost importance. Whereas when you have a lot of time to deliberate as to what to do, a lot of times you kind of get off on little tangents.''- Bill Parcells

For obvious reasons that quote says a few things to me currently. I've always had the mindset that I can put off X for the moment because there will always be time to do X; if nothing else this whole thing has made clear to me that, in fact, there isn't always time. Trite perhaps, but true.

Go B's!

6.03.11

Following the advice of Phi Mu Delta brother Jim Floyd:
You always said you wanted a shot at becoming a writer...well the time to write is right now.

Use some of your time to write down what you’re going through...the reactions you’re getting from others...the plans you must make/change...the way you see/perceive things through this particular looking glass.

If nothing else, it will prove an exercise that gives you focus and perspective.

If this proves too self-indulgent, I'll lay it on you, Jim! (I'd still rather be the next Robert Parker or Dennis Lehane, but... )

Briefly: a little over a month ago I came down with sudden, and very severe, abdominal pain. At first I assumed it was simply something I ate but after 14 hours or so of non-stop pain I visited the local ER where, upon performing both a CT scan and an ultrasound several lesions were discovered on my liver, and they suggested that I follow up on that via a primary care doc ASAP. At the time I didn't have a primary care as, for the last 10 or so years, I've had no health issues and in fact have probably been in the best shape physically in my life. My sister suggested a clinic in Boston she was familiar with (due to her prior career in medicine) where I did find a PC (he's very good.) In the interim I ended up making two more visits to the local ER that week, due, again, to severe pain (and I usually have a pretty high threshold to/tolerance for pain) as well as a lot of vomiting. The second week found the vomiting pass but not the pain. I'd also lost quite a bit of weight (and for those who haven't seen me in many years, for the last 10 years or so I've weighed about 160 lbs, so I really didn't have all that much I could afford to lose.) While this was happening my PC made several requests to the local hospital to send along the results of their tests which, for whatever reason/s, they did not. Eventually he had me come in again to the clinic in Boston, and from there sent me over to Beth Israel Deaconess Medical Center to, once again, have a CT scan, X-Ray, and some other tests done. A blockage was found in my colon, a very serious one, one which required emergency surgery that evening. I was also told that evening that it likely was cancerous, as likely were the lesions on my liver. Not the best of nights. And apparently this was all serious and, I guess, life-threatening enough that I was given the Last Rites prior to surgery. I can remember eventually being wheeled into what seemed to be a dimly-lit operating room, and really didn't- and don't- remember much after that. Apparently I was on the table for just about five hours (they removed the colon obstruction, biopsied some of my liver, and also had to do an ileostomy on me.)

I remained in BI-Deaconess for ten days, recovering from the surgery itself, getting used to my ileostomy (the current bane of my existence- thankfully it's not permanent, and may be reversed sooner than expected, but it truly sucks) and awaiting the results of the pathology tests on the colon and liver pieces. The care I received was excellent; apart from the ER trips I'd never been in the hospital for anything other than a knee 'scope back in high school. The last time I was overnight in a hospital was when I was born. The work of the nurses was phenomenal; I've never seen anyone work harder than they. And I never realized just how many people were employed by a hospital; from the cleaning staff to the white coats and everyone in-between it's like a small army.

Eventually I received the results of the path report: stage 4 colon cancer, with metastasis to my liver. As my sister was driving me to an appointment with the hemo/oncology team to more fully discuss the results this came on the car radio, and really seems to sum up where I am right now: Allman Brothers Band - Soulshine. Once I'm deemed sufficiently recovered from the surgery itself the recommended course of treatment will be chemo. I have some familiarity with it, as, unfortunately, my sister-in-law is currently undergoing somewhat similar treatment, for breast cancer. It can't be cured, only treated. As currently stands, the median prognosis is a little over two years; obviously some go longer, some shorter.

Suffice to say, this came totally out of the blue. Until the sudden pain I had the beginning of May I felt fine; was running at 5:30am, hitting the gym, cardio, eating pretty cleanly, light-to-at-most-occasionally-moderate drinking, you name it, and had been for the better part of the last 10+ years, and had no other health issues prior to that. I'd had no reason to seek any medical treatment because I believed I was taking good care of myself and I felt fine. Further, at my age a colonoscopy wouldn't even have been recommended for another 4-5 years or so. What's frustrating (actually, what isn't) right now is simply the why. I've always believed that for every question there is an answer, for every effect there is a cause. Yet no one can give me one for this. As my primary care doctor accurately put it: "Basically, you got screwed." Suddenly finding myself so dependent has been and is humbling. The one bright lining to all of this has been the tremendous outpouring of genuine interest and support I've received from so many, be they family, friends, fraternity brothers, medical staff, you name 'em. It's the one way I've felt blessed throughout all of this so far. Thank you all, more than you know.

I'm not really sure where I'll be going with this. I don't want it to simply be a litany of gloom-and-doom; no one wants nor needs that, including me. Hopefully it won't be too self-indulgent. And if it is, blame Jim for starting me on it! Schmegma!