20.1.11

And Up And Down And Up Again


Today is January 19 and oh what a difference a couple of days make.  I drove today to Muncie solo.  I have a better understanding than ever of my digestive difficulties.  Without this pain I require minimal medication for pain, taking only one or two of the oxy fives a day.  My spirits are lifted.  I feel really good and I just wish I felt good.  It is weird that in my mind I am fine and happy and ignoring all reality just like always yet when I move about the animal reminds me of it’s presence.  The lymphedema is persistent and requires daily attention, another constant reminder.  I am tiring easily but seem to be getting stronger with each day that I do not have the stomach cramping issues.  Yes I am even eating a fiber bar in the night when I feel the beginnings of an ache and now can do it without feeling uneasy.   In the past two days I have slept horizontal in bed for up to two hours.  Oh what a joy it is to be able to lay down, although I cannot lay on my back I can assume a prenatal, and drift off to sleep in the warmth of a bed. 
January 20 and the abdominal aches kept me up in the night and persist this morning.  Even with the apparent effectiveness of the laxative regimen I am suffering so I have much more to learn about what the animal is about now.  I am resolved to aggressively go after it and determined to gain a control over it.  By midday I am in pretty good shape.  Gas issues have passed and base line pain is manageable, but it does make walking difficult and a little slow.  I travelled today and shoveled some snow.  The temp is going down to single digits tonight.  Vanessa fixed an excellent dinner of chicken breast vegetables and a tater smashed to smithereens.  I had a gab and pain pill for desert.  I am once again in pretty good condition after my bout last night.  My meeting today gave me some serious homework to be done by Tuesday latest and delivered to the client.  

Spiralling Down


Days have passed since I visited here.  Yesterday started a new week and was a good day all around.  I have pain now that is constant across my lower midriff and gastronomic pain that comes with eating and digestion, the latter finally coming under control with large daily doses of laxative.  I have continued to lay off the morphine taking instead 2 or 3 5mg oxycodone, which seems to be doing the job to the extent it needs to get done.        
I am very weary, for it has been well over a year now since I have slept more than a couple of hours straight without getting up to hit the lou.  I am definitely not in any shape to drive and rely on Vanessa to cart me about on my business needs and this is the seventeenth of January. 

14.1.11

The Sick House

I remember as a child a ‘sick house’ in the neighborhood. ‘Don’t go into her house’ Mom admonished.  ‘Why not’ came my protest.  Sometimes she had her Grandson over, always marginally entertaining.  His parents were ‘golfers’.  But it wasn’t the Grandson, it was the cookies that always seemed warm and over sized, and usually served on her back step with some milk under the shade of the catalpa tree.   Raisin cookies without the raisins, for I had tasted a raisin cookie once.  If Mom knew I would be locked down for life, or at least until third grade.  So I would go and knock on the back door and ask for Roger, sometimes knowing he wasn’t there.  I was always invited into the kitchen and she always carried on a lively conversation getting me to talk more than I should have.  I could make her laugh and I liked her laugh.  Then out the door because ‘kids don’t eat in the house.’  Seemed ideal to me at the time.  Mom would ask where I had been,  ‘playing with Roger’.  ‘You didn’t go in the house did you?’  ‘No’ came my lie.  ‘Good, I do not want you in that house.’  ‘Why not?’  I would always ask and one day she turned, her face darkened and in her quiet voice she said ‘she has ringworm’.
I cannot imagine being ostracized for a common fungal infection.  Mom’s fear was rooted in her lack of knowledge, yet she preferred retaining her ignorance and fear over having a good relationship with a neighbor.  The poor woman must have had it once but Mom went firmly believing it was a life long calamity of the most contagious kind.  In my neighborhood I am the sick one in the sick house.  I can only imagine what impression some of my neighbors have.  I wonder how many of my Mom’s live about who fear the animal as mysterious and contagious.
I have learned to measure what I tell people, preferring to give them a card directing them to this journal rather than verbalizing my condition.  Without knowing their frame of reference I have no idea if I am generating interest, fear, compassion or boredom when answering questions about the animal and me.  It is best just to tell folks I am getting along just fine.  My closest friends and associates and of course any one who reads my journal know more than they care to I am sure.
I have decided to forgo pain medication as a regimen, deciding to take it on an as required basis only.  Once again this week I was plagued with the terrible pain of constipation.  After two days of laxatives washing down laxatives I resorted to the nuclear option yesterday at 3AM.  By early afternoon I was at last functional, with the knee numbing cramps gone.  I made it through the night without pain meds and skipped them this morning.  I hope the chemo has improved me enough that urinary pain is at least bearable.  The next couple of days should tell the tale for the time being.  Tragically I have found constipation to be a common thread among cancer patients.  Based on my Google experience I see there is plenty known about it but apparently little to do about it.  With all the research there are no available pain meds that will not also impact digestion.  If it were mine to do I would certainly want some effort put into finding a working alternative for pain relief that in and of itself does not create pain.      

12.1.11

Feeling Guilty And A Job Well Done

‘I’m having kind of a hard time celebrating other people’.  I had to admit I too felt a tinge.  ‘Well, we have nothing really to celebrate, so I say let’s celebrate somebody else’s good fortune whenever we can.  Personally I think chocolate cake should come with all good news’ came my response.  We lapsed into silence again.  I could tell her mind was racing.  As she watches my struggle become more difficult she faces so many unknowns.  Layered on top of that is the unjust burden of perceived sin.  Personally I think sin overstates a natural reaction.  There is burden enough for all without flailing oneself with loathing because of a natural human reaction.  I want to tell her forget the preacher just this once and allow yourself a moment’s weakness if you may.  ‘It’s just that it’s so unfair’.  No argument there.  I watched the land go by in an endless series of flashed images.  I digest input and ideas a little differently with the pain meds effects. Finally I let the silence endure.  Some things best left not said or responded to. 
 My second chemo treatment was yesterday and came off without a hitch.  We had to wait a couple of hours for my prescriptions.  Narcotic prescriptions cannot be fax documents or called in to the pharmacy.  I officially became a morphine user, one pill every 12 hours. While we waited I grabbed a magazine and headed for the comfort station.  Having not moved in 2 days or so I thought I would just sit and relax and maybe it would happen for me.  I had repeated cramps for the past 12 hours or so that came and passed without gas or any other accompanying action.  Just about the time I reached page 3 of the Saturday Evening Post an upward growl of the stomach caused me to lurch a bit and suddenly I dropped a full release.  The stench filled my stall immediately.  I reached around to pull the lever for a courtesy flush.  There was no lever.  This was a modern wave for flush, water and towel facility.  Personally I am not a fan of hands free.  I frequently cannot find the magic spot that turns on the water, usually wave madly all over the place and only occasionally get a paper towel dispensed.  With a sharp cramp more was delivered.  The smell of death now filled my end of the room.  I heard a whimper come from the next stall.  The door opened and an involuntary groan indicated the problem had reached the far end of the room.  I was confident there was a flush button and struggled madly to find it behind my back.  I heard a thud in the next stall, he may have passed out.  ‘Whew’ came the faint voice at the urinal.  Unable to get up yet I worked to rotate on my seat to where I could eye the water supply.  My bowel was now empty.  Nothing left to deliver.  Yet the stench came on as if I had just started.  Fearing something growing beneath me I moved faster.  A faint whimper came from the next stall.  At last turned I found the button and hit it.  In a moment that which was had passed from view and nasal detection.  Clean up was a snap and as I washed my hands I heard rustling from my neighbor’s stall, indicating he had survived.  I left with a smile, feeling fortunate I did it at the medical center and not at home. 

9.1.11

Keep That Train A Movin'-How I Am Doing Now


The scourge of constipation which I have not suffered since last June has returned. What a pain in the a.. so to speak.  Twice this week I resorted to magnesium citrate, the nuclear option to clear the pipes.  Awful to take but very effective in what is supposed to do.  I hope to find a substitute that will keep things moving.  The pain meds knock down the pain and stop traffic on my inner colon highway.  I have 3 or 4 brands of laxative in house.  I will start on two Senna a day tomorrow.  I know from experience no movement in 48 hours means I have to use the citrate.  If this does not keep things moving then it will be trial and error with other products until I find the right chemistry.
Without any digestive pain or pressure I have abdominal pain on the left side that is constant but manageable.  The lymphedema presents an ongoing challenge in my left leg and mid section.  We have increased the time devoted to massage and seem to be making some progress, although it is in fits and starts.  Now 5 days since the chemo and I seem to have some improvement in urgency and pain related to it.    
Sunday morning and I pushed my pain pill interval out to 6 hours.  By then the pain was serious.  Is it gas?  Is it something else?  The pain that comes in waves is gas I think.  It appears every time I eat anything I will have some consequence at the present time.  I took two pain pills and within 45 minutes the pain that would cause me to misstep was gone and the constant ache had taken the drivers seat.  Inger reports my leg and groin have improved and swelling is diminished.  As she worked her magic you could see the color restored and feel the lymph moving (at least is seems like I can).  Even though it fills back in as soon as she is finished, it seems to fill a little less each time.  The serious burning pain with draining is gone.  It is now a discomfort, not a better rest before you try to walk pain.  My head hair is still there and appears to be darkening.  Strange effects of the chemo it would appear.  This past week my appetite has dropped off significantly.  By necessity when I eat I must eat very slowly to prevent horrendous belly aching.  This started before chemo and seems to be progressing right along although there is no indication I am losing weight yet. 

5.1.11

Tough Girls Tough Guys


Are there signals now?  My imagination soars.  A shadow movement, a person in on the edge, a voice it’s signal lost.  It is easy to fall for imagination so great the desire to carry on.  I am blessed with a very active and intelligent full time Wife who is a constant mental challenge and makes sure I don’t go over the edge.  To keep the focus on me she hides her own condition by discussing her issues with her Daughters instead of me.  I cannot escape the irony that in 36 years of marriage she rarely vented to her Daughters.  My swept silver hair is testimony in part to the same.  In 2010 she diverted and it is a good thing there are two of them.  Sometimes they remind me of the family of androids on the Star Trek episode that had a triangular stone hanging on their chest.  They were all beautiful women save one, a male named Norman.  When Kirk cut loose with his liberal logic the brunettes communed and when they could not answer they called for Norman to coordinate all of the minds of the entire android problem to answering the problem.  Norman relied on a super computer.  So my beautiful Daughters and Wife meet through the miracles of technology so many times a day and week through this long ordeal.  A whole world without Norman now, I am left out of the loop, coordinating and staying strong thank you very much.  Watching closely and caring so deeply.  Women surely are God’s grace incarnate here on Earth with hearts so deep and strong.  This relationship of Mother and Daughters gives me great peace.  After the pain of loss passes the Widow will begin a new life, as it always happens.  For her it will be a new place likely, for she has always been one to move and never look back, but only closer to her Daughters.  Together they will find the happiness of life and move on. 
Working with Nurse M I have a new pain regimen.  I will switch from the oxy to a time release morphine sulphate, 20 milligram, two per day max.  Joe warns it will initially ‘put me in the chair’.  We’ll start next week after the next infusion. Rex has been of great help in demonstrating how a balance can be achieved and one can work productively while in constant pain.  Hell, if he can do it I surely can has been my motto and continues to be.  He is a hell of a lot more active than me always flying, living in motels and spending days on airport tarmacs and in hangers and equipment buildings regardless of the hellish weather.  He always loved the winter.  Back in the day we got some of our best business in the snow.  We once paired up and took his turbo rear drive Thunderbird on a what ever you do don’t stop trip to Logansport and back in January to close a new equipment and system order.  We were the only bidders to show up and got the order.  That is what is called being a tough guy in the old fashion pre e mail, voice mail, smart phone, data base, six sigma days of business now gone for well over a decade.  When it comes to my Brother I will never be as tough as he but always aspire that to be.   

4.1.11

Throw Parts At It

Chemo+1 it’s 4:30AM.  I have a faint burning and urge but not enough to act on.  Last acted 2 am and took 2 tabs then.  2.5 hours between actions represents a record that has not been seen since before the surgery, wow.  Oh, never mind.  With all the time spent in the comfort station my reading speed has increased dramatically along with retention.  Seeing that magazine subscriptions to keep up were going to denude a rain forest and destroy a river to produce and add to a mountain to get rid of I have crossed the line to books.  Who knows, my Sister has a regular magazine stand next to her lou with books, puzzles, pencils and so forth.  At the Christmas brunch I visited the facility 4 times and noted that the word puzzle no doubt she looked forward to finishing was being magically finished.  I always found at least one word and apparently many other visitors did the same.  Before leaving I visited the laundry room, featuring it’s own lou in the corner designed with a corner shape.  Here were the trailering and vacation magazines making up the Man of the House’s main dream.  This facility was made for long term communal meditation of the most moving kind.  I always admired their design of facilities and how it cleverly took advantage of the footprint of a very old house. When you really find a frequent need for it, you become a natural critic I think.  
Got Nurse M squared away on my medication requirements.  I am really sure we are not entirely on the same page but we will get there.  Nurse M works well through e mail.  My messages always include my name and dob, which is how she identifies me.  She has a lot of patients.  Using e mail chains assures a back up to all communication on both ends, although I do not feel the need to back up routine correspondence and updates. 
I tried to express to John last night how hard it was getting.  My oncologist has me on a monthly visit to monitor my condition and progress of the disease.  The scan showed the animal alive and thriving and ‘shadows’ about the left area.  I cannot help but be haunted by my Mom’s passing, from learning that the final assault had began to becoming incapacitated and non communicative was a few very short months.  Hospice was months long, born at first entirely by my Sister and in the end by all of us who could.  Only thing I can say is it is a good thing I do not have a lot to put in order but how do you decide what to put in order?  Oh of course the obvious, finances and final arrangements, but what else?  I know I could go out now and seek forgiveness of all of those I perceive I have wronged in some way.  This could include anyone who was ever in my employ and some very close friends.  If I go there, like an Earl it could be an entirely different story but with characters that probably would prefer to forget.  I won’t go there, but pray forgiveness, for at heart I may have been misguided but my motives were never entirely self serving.  Huh, maybe I should have gone into politics. 
Electing not to push the envelope, he went to drain 2 hours 50 minutes sld (since last drain). 
Got in a good day’s work and stayed on the 4 hour interval for meds.  I continue to struggle with hydration.  The animal works hard to dry me out from the inside it seems.  I now have thermal mugs always ready at my TV chair, office, comfort station and men’s room.  I struggle to reach 48 oz per day and my goal is the magic 64.  Urinary pain increases and is a signal that I am not taking in enough water. 
I had a visit with Pastor Miles on the phone today.  His voice is a comfort to me and I was afraid he had forgotten about me as it had been some time.  Not so of course, but his plate is full with wife, grand kids and a Church to minister.  A miracle in his own right, given only 18 months to live in 1997 and stubbornly holding on he is testimony to what might happen.  I assured him I would never give up, and am getting ready to order a free range chicken for sacrifice at the full moon during the sign of the cancer in the astrological cycle.  I plan to adapt the massage table Inger uses for the event.  I am resourcing the chants and incantations’.  This is only one of the many treatment options I am open to. I have always marveled at the intelligence and desire to live that seems to express itself in every living creature, cancers included.  The clever disguises, the surprise moves and sophisticated survival techniques you think are reserved for us ‘smart ones’ you see demonstrated in insects, under the microscope and indeed in the animal.  Bent on reproduction at any cost to assure survival of it’s kind.  Bent on survival for life’s sake just for the sake of living.  My battle is against in many ways my equal and in some ways superior on the field of survival of host or parasite. 
There are several ways to repair a machine of any kind.  When you know a lot about the machine your way is methodical and follows a ladder logic if not this then this until the problem is determined and appropriate repairs are made.  At the opposite end of this spectrum is when you know very little about the machine and you are under severe time constraints, so you ‘throw parts at it’.  Almost every car owner has experienced a large repair bill for extensive parts because the technician simply did not know enough to get at the problem except to start replacing parts.  So little is known about cancer that the best we can do is find willing candidates and throw parts at it and keep track of what works and doesn’t at present.