Thursday, October 22, 2009

Nine More Years?

Today, I heard the results of yesterday's Bone Marrow Biospies, which found no tumors in the base of my spine! The Biopsies were still sent to a lab to be studied more closely, and the doctors expect that there will still be some tumor in the bones, since the bones are always the last to heal. My PET Scan from Monday also came back, and while the results weren't groundbreaking, there is still clear and substantial progress being made. The same was found to be the case with today's bone scan.

All of these tests and pre-test procedures are tedious, but it's really nice to know that all of the hard work and suffering is paying off. Though I've been told that the high rate of recovery I've witnessed so far will likely taper off towards a slower pace, my only hope is that the treatment continues to be effective, so I can get the disease into remission and head back down to NCI (National Cancer Institute) in Bethesda, MD for the vaccines.

Immediately before chemo started, I was lucky enough to take part in a vaccine trial for a variety of very rare tumors. It consisted of a number (six, to be exact) of Bone Marrow Biopsy samples to isolate the tumor, followed by a day of collecting my blood and platelets in order to create a personalized vaccine of my own, for my own particular illness. Though the trip to Bethesda was painful and postponed the beginning of chemo, the hope was that by administering the vaccine to me in the end, once the tumor is in remission, then my body will have a better chance at preventing the tumor from returning. Apparently, the second vaccine trial run was fairly effective and with new and improved research and procedures, the hope is that this trial will be even more successful than the last.

The logistics seem to add up, which is great. But we all know that numbers and statistics don't always hold true in the real world. When talking to my friend, who was really excited over the news of the past few days, he told me that "all I have to do is focus on the big picture; the light at the end of the tunnel."

He is exactly right. If I could focus all of my energy and attention on that day so many months from now when I hope to hear those magic words that I can go back to living my life, it would all be so much easier for me. Unfortuntately, that just isn't possible. I still have to feel the nausea slowly creeping in as I sit here in my chemo bed. I have to deal with the next two weeks of illness, which make the routine things in the day ever more difficult, lonely, and frustrating. I have to continue living in a body and a mind that I don't fully recognize, continuing to wonder when I might once again feel like myself.

My dad and I came to the consensus together the other day that at this point in time, it would be hard to see my life being any worse. The limitations on my daily opportunities combined with the constantly overwhelming sickness make it seem obvious that my life is a troubled one. Although it sounds awful, it really made me feel better to hear someone else agree with me that my life was just about as bad as it could get.

I joined Planet Cancer, which is an online social networking site for young adults with cancer. I didn't expect to meet a ton of people, but I want to get my blog out there to as many people as possible and maybe even to connect with some people with whom I share my struggle.

The other night, around 12:30am, a girl sent me a message on the site's instant messaging system. Having been previously unaware of such function's existence, the instant message caught me by surprise.

She told me her name, and I reciprocated with mine. She asked where I was from, I answered and she answered back. To make a long story short, I was shocked that this girl, who happened to be fourteen years old, was meeting people on this site at 12:30am on a Tuesday, or a Wednesday depending on how you look at it. I would like to believe that even if things are bad, like even as bad as cancer, that 12:30am is still pretty late for a fourteen year-old girl on a weeknight.

More disturbing to me still was this child's revelation that she has been battling cancer since the age of 5. That makes nine years. Nine years makes my four months seem trivial and easy, though a simple length of time cannot begin to explain this experience, nor can one use time as a means of beginning to understand it.

My experience has been undoubtedly different from hers. How? I can't be sure, though hearing her say "nine years" made me feel deeply for her and put my own six-or-so more remaining months in a much different perspective. It also made me wish so strongly that I will be done with this thing after whatever chemo, radiation, vaccines, etc. they say need to be done are done.

Nine years? It's a scary thought. But I've always said I would take this one day at a time. And today, on a daily basis, my life is a colossal struggle. At least I can find solace in the fact that my tests came back nicely, so the treatment is working. I'm dedicated to being in remission and on with my life way sooner than nine years from diagnosis.

Tuesday, October 20, 2009

Doing the Best I Can

One of my mom's friends recently asked me about the source of my motivation and strength. In the context of the conversation we were having, it was inherently a compliment to my recent perseverence, but I think my response was somewhat underwhelming.

I told her that I don't really have any special source of guiding inspiration. I just tell myself that if I can continue to be, continue to exist, simple as that, then days will continue to pass, one by one, until this whole thing is over. Eventually, it will be over, one way or another, and again there's no use in stressing over the unknown outcome because I'd rather concern myself with the things I can control. And, since there's not much I actually do control anymore, I'd rather not concern myself with much of anything. It's just easier, and I'll take some easy in the midst of so much being hard.

Though she seemed to appreciate my honesty, I wonder what my mom's friend's true reaction was to what I had said. She is a more spiritual person than I, to be sure, and it's no secret that I've been feeling frustrated and rather void of enthusiasm.

It seems that so often while growing up, you're taught to "do your best," or to "try your hardest," and that if you do, somehow things will turn out alright. You may not always win, and things can't always go your way, but you're lead to believe that if you put in enough effort, good things will happen.

But then, there's always the unpredictable. A bad call from a referee can ruin a great game, or a vindictive judge can offer a low score to a great routine, a critic can rip great work, and there's always a chance of rain on the day of a parade. While we can try to prepare ourselves for the unpredictable, it usually forces a deviation from our original plans.

I've asked myself if I have continued to do my best and to try my hardest in the face of my most trying and unpredictable obstacle. The truth is that I really don't know. Every day is a struggle, and for that reason I know I'm trying, but it's hard to tell to what degree my effort reaches.

"Trying your hardest" sounds so noble and deserving of merit, or of positive reinforcement. But in my situation, isn't it okay to just do enough to get by? If I somehow try harder, will it make me less nauseous sooner after chemo? Probably not. That sort of thing is out of my control, but its uncertainty is disincentive for me to give my maximum effort on a daily basis because I know my effort will not be rewarded.

Taking a more far-sighted approach helps, since each day that I try to improve and get stronger may pay dividends in the end results of the treatment and in my recovery. But the chemo is still the treatment and dictates my improvement, and while taking care of myself and being safe constitutes doing my own part, it seems boring and effortless.

Sitting here on the couch, convincing myself to accept the inevitable chemo that looms like a dark cloud over tomorrow doesn't take a whole lot of effort. I don't know what I could really do to try harder at sitting here on the couch. Maybe I'll put my feet up. If I could drink, I'd make a cocktail.

I could try harder to wait patiently, since I spend so much time waiting for procedures to be done. Maybe I've been too concerned with how long it takes to finish them, rather than with their results. Maybe that's because I don't want to concern myself with the results in case they don't come out as well as I want them to, so I preoccupy myself with logistics.

Yesterday was my second PET Scan. The first one, still in the days of I.V. pain meds, was one of the worst experiences of my life, as I was taken off the meds for six hours before the PET Scan administrator had me hold and suspend my arms above my head while lying on my back for 45 minutes. And, though I begged for mercy, she had no way of knowing that I had tumors in my ribs, back and shoulders which were making it torturous for me to hold my arms up. Of course, she could have just listened to me when I told her how much pain I was in, but she had her own agenda.

The doctors later told me that holding my arms over my head was by no means necessary for a successful PET Scan.

I was lucky that my mother happened to show up for the last fifteen minutes of the first scan, because she held my arms in place as I squirmed and writhed in pain inside that plastic tube. Otherwise, I would have had to start all over.

At least yesterday's scan didn't end with me shaking uncontrollably in a pool of my own sweat, letting out an exasperated wail as my arms dropped; a scream that still haunts my mom and sister to the point that they refuse to talk about it. No, yesterday's scan took only an hour longer than expected, with only three failed attempts at putting in an I.V., and finally a successful one that sent blood streaming down my arm.

I departed with my left arm the size of a pillow because of the reaction I had to whatever injection I was given during the scan. And, though I'm quite sure I made my discomfort known to her at the time, the nurse, realizing her mistake after the damage had been done, immediately blamed me for not telling her to stop.

In all honesty, I was relieved to be out of there with nowhere near the headache of the first experience. As far as effort goes, it did take considerable effort on my part to keep from reprimanding the nurse for her idiocy, especially after she had blamed me for her mistake. In hindsight, I commend my silence.

Then, today, I was told that Friday's MRI showed no tumor in the soft tissue of my shoulder, which was thought to be the primary location of the tumor. That's right. The tumor is gone from my shoulder. It doesn't mean anything yet with regards to the PET Scan, which will show us the rest of my body, but I couldn't have dreamed of a better result from that MRI.

At the beginning, the doctors were saying that the tumor was so strong in my shoulder that I would probably need surgery just to maintain close to a full range of motion there. I don't know if this means that I won't, but at least my shoulder is once again my shoulder. It's not some skin and bones with this foreign entity that came in and took over. At least in my shoulder, I've taken back what's rightly mine.

I don't think there's an easy answer to whether or not I'm trying my hardest. Maybe that lesson doesn't fully apply to me right now, though I've trusted it for as long as I can remember. I've always been passionate about the things that are important to me, and while my recovery is obviously important to me, it's just not feasible to give it my all every moment of every day.

And, while I've spoken to God, or whatever supernatural force it is to whom we speak at night, more often over the past few months than I probably ever have before, I'm still skeptical. When I get a card in the mail that urges me to feel God's uplifting presence, my first response will likely still be to crack a joke about feeling God's presense while my face is buried in his porcelain crotch (you know, while praying to the "Porcelain God"). That's just the way I am.

But I do believe that somehow, someway, when this is all over, I will be a better and happier person for having been through it. Just promise me one thing, that you'll remind me of the fact that I just said that the next time I want to give up and throw it all away.

Friday, October 16, 2009

Karma

It occurred to me this morning that maybe I should have seen all of this coming. I mentioned in my last post that a few months before it started, I went through a pretty difficult break-up. I was still having a rough time with it when the tumor set in. But shortly after the break, in May, was my best friend's birthday. As a celebration, we went down to Atlantic City for a night to have some fun and to take my mind off of my recent loss.

I have a strong belief that your mindset, or karma, or whatever you want to call it, plays a large role in the kind of luck you carry with you when you enter a casino. My game is Blackjack, and I usually play well, but on this particular occasion I could hardly fake a good mood and I lost. My friend won, however, so it wasn't all bad, especially since we were there for his birthday and that's a damn good reason to win, if you ask me.

We split a cheap room at the Showboat, and for at least one night I was able to separate myself from the grief that had been consuming my every day.

The next day had rain in the forecast, and we had decided on spending just a few more hours into the afternoon before getting in the car to return home. For those who don't know, Atlantic City is right on the water, and a long boardwalk densely populated with little novelty shops, restaurants, kiosks and arcades connects a string of casinos that lasts farther than the eye can see. While it was expected to rain, we walked outside after a late breakfast into unpleasantly bright sunlight.

We began to stroll the boardwalk, taking a few minutes here and there to peruse the shops, though we didn't buy anything, and by all accounts we were having a nice time. But, before long, while walking down the center of the wood-paneled boardwalk, two pigeons conventiently pooped right on my chest. My friend and I each saw them flying towards us from down the strip, but it happened so fast, neither of us could really have done anything to avoid it. It was like they had planned it between the two of them, like a little game they play, and I just happened to be the victim of the moment.

You know, one pigeon turns to the other and says, "Alright, Ed, how about that one there in the yellow t-shirt?"

"I've got him in my crosshairs, Pete. Locked and loaded," says the other.

And, before I know it, they're right overhead and it's "bombs away," and "bang," there's poop all over my chest. They had just about the best aim in the world, too, since the poop landed in perfect symmetry on either side of my chest. I guess they may have been aiming for my face and just barely missed, but when I looked down I found bird poop just about two inches above each nipple.

My friend reminded me that it's generally considered good luck to be the recipient of bird poop on a sunny day, or any day for that matter, but to me it just seemed to go along with the recent theme of the world shitting on me. My hypothesis appears to be closer to the truth, considering that about two short months later, I was diagnosed with cancer.

As I said before, I don't always have bad luck at casinos. In fact, I usually do well and win. One time, this same best friend and I were at Niagara Falls with another of my best friends (I have a few), and the three of us were all sitting together at a Blackjack table. My other best friend, who wasn't in the previous story, wasn't very well versed in the intricacies and betting schemes of the game, so I was doing my best to help him along whenever he asked for advice. I was doing well, making decent conversation with the dealer, who appeared to be about our age, and he seemed to agree with the philosophy I was using to teach my friend how to play.

The dealer was a really nice guy, and as I said earlier, I truly believe that good karma at the table leads to favorable results. The only oddity that stood out about this dealer was that his voice was very weak and high-pitched, almost like that of a girl. I presume he had simply undergone some sort of surgery to make it turn out that way, but it wasn't the first time I'd come across that sort of situation and it made no difference to me what his voice sounded like.

My friend, however, the same one from the first story, must not have been as aware as I that an operation, usually performed out of necessity to remedy some dangerous condition, could leave a man's voice sounding that way.

At some point, my other friend, the Blackjack novice, was dealt a tricky hand, and for some reason he didn't agree with my advice for him. We asked the dealer, who echoed my instructions, but still my friend wasn't convinced. In the end, he decided against both of our opinions, and as luck would have it he lost the hand.

"See, you should have listened to her-- HIM!" said my friend from the first story, and though he tried to cover it up, the slip was undeniable.

I tried pretending like I hadn't heard anything at all, and so did the dealer, who sort of put his head down shamefully for a moment before picking the cards back up to deal. And, after a few awkward moments, we were again playing Blackjack.

You could probably have predicted that after making such a comment, my friend's luck turned immediately downhill. In fact, I wouldn't be surprised if he lost every hand from there on out. I, on the other hand, continued the good rapport I had created with the dealer, and my good fortune continued until I finally decided to walk away with a few hundred dollars' earnings in my pocket.

That second story clearly has little to do with my cancer, but I like telling it and it reminds me that things haven't always been so bad.

I've come to the point in my treatment where the doctors have ordered an MRI, a PET Scan, and another Biopsy, which will be my ninth. A Biopsy is when they remove a sample of bone from the base of my spine from which to take a sample of the tumor. Yes, they actually break off a piece of my spine and I assume try not to crack the area around it too much. And bone takes a really long time to heal. And yes, I endured eight of these Bone Marrow Biopsies within the first few weeks of hospital experience, as three different hospitals scrambled to find a diagnosis for what was ailing me. One of them was actually done while I was awake, an experience that pained and shocked me to my very core.

I just returned home a little more than an hour ago from the first of the three tests, a routine MRI. Or, at least, it should have been a simple, routine MRI.

The actual MRI takes only somewhere between fifteen minutes and an hour, depending on the body part being scanned and the extent of the imaging needed. This one took about an hour, which I didn't mind, but what did bother me was the other five hours I spent waiting in the hospital to have it done. Just another example of terrible communication between members of the hospital staff, and again I'm the one who has to suffer.

They had me come in at 9:30am today, only to tell me that they couldn't see me until noon. So, I obeyed the orders they gave me and sat around the clinic until I was told to go down to the MRI facility. The secretary there told me that she was all booked up, and since I had been waiting upstairs in a different place, it was no better than just showing up when I walked into the room. After two and a half more hours of arguing and watching people call one another to accomplish nothing on the phone, and taking elevators back and forth between the first and seventh floors just trying to remedy an inexcusable mistake that they had made, I was told that another MRI facility in the same building would be able to squeeze me in after they were done with their current patient.

I was then escorted upstairs to the other facility, where, wouldn't you know, I walked into a dead empty waiting room. That they hadn't brought me to this other place hours sooner is so far beyond me, I really can't think of anything else to say about it. That the doctors insisted I come to their hospital to use their machines despite the fact that there's a perfectly adequate MRI Imaging place in my own town is also beyond me. But after another long day at the hospital, I'm so fed up with their inability to organize a number line (you know, 1, 2, 3, 4, and so on), I'm ready to give up. If I had the option, I'd rather stand outside, walk underneath standing or propped-up ladders, and tie a bird poop magnet to my head than deal with them anymore. Unfortunately, I don't have that choice to make, and I'm at a loss for how to prepare myself for their lack of know-how with regards to their own jobs.

I want to treat people well. It would be foolish of me to expect that good karma at a casino will lead to good results but good karma at the hospital isn't just as important, or probably more important, considering that the results of the things that happen there really do constitute a life-and-death situation for me. It's damn near impossible, but I think that somehow I'm just going to have to try harder.