an Update....Just Because...

I haven't written anything lately, and I know how antsy I get when the kids don't update their blogs. Makes me feel like I'm out of touch, and people have been so nice that no one should feel that way.

Here goes...

The challenge with my larynx continues. Each morning, a little more resonance returns. I'm intelligible on the phone at present, so that's a relief at work. It has been a month, now, and two weeks since the procedure that was supposed to bring me back to the land of the vocal. I continue to improve, thankfully, and do what I can to communicate. It is a very interesting view on how much I actually talk in "real life" and how I tend to manage conversations, either with stories or questions.

On the chemotherapy side, I'm at the end of a month's "holiday." I have some work travel this week, and then head back to the Opium Den for a new cocktail on Monday, 4/7. It should really just be a two-day effort with day one in the Den and infusing, and day two recuperating. It may turn out that I feel fine on day two, and need to recuperate on day three...but the pump over a 48 hour period is now history. The plan is to do six of this type of session, take a CT in the middle somewhere and after six, and get a grip on what the new cocktail is doing to the lesions. Then, we make plans based on those results when we have them.

Oddly enough, for a planner like me, I've learned to live with the "making plans based on the future results" pretty well. I know that doing anything else, like planning before the results are in, is a waste.

Had a delightful weekend with Family and Friends in Lompoc this week. It was the Third Annual Braves Alumni Golf Classic, the Fubarians have had a team in each of the three. I have no idea how anyone improved on our -8 tally, in the scramble. The wind was its lovely Lompoc self, 30 mph with higher gusts. There were still teams that scored better, but I think some creative accounting may have been involved. The band of brothers that attended could not have been more supportive or fun, and then we fit in all the family for the weekend, too. Carrie and Steve run a great "family B&B," we can't wait for them to add the entertainment center upstairs.

As I end, I always think there ought to be something profound to say. People ask if I view life differently, and the answer is "not terribly." I'd already gotten pretty good at just loving every event in life, and people know I get teary for no reason at all. I still love every minute, and can cry just by passing a picture of Carrie Ellen and me as little children. Saying goodbye to people, whether parents, my kids, or golf buddies---has never been easy, and isn't now. They are all so nice, I just bask in their goodness. None of it is profound, poetic, or life-changing....we'll just have to leave it at that!

Chemotherapy "Holiday"!!

I'm still recovering from Monday's throat injection, and though I can make vocal tones I'm not fully "fixed" yet. He said it would take a couple of days to "break itself in" and shape the correct muscle to my throat, now that it is full of collagen. I'm closer to an obscene phone caller, now...rather than just an old geezer wheezing away.

The big news is that the chemotherapy regimen I was on is over for now. Didn't do this week's session, which would have been number ten. I get what amounts to a monthlong vacation! Then, we are replacing two drugs with one...with different expectations. That would generally be great news, but this change is a result of two things....

One, we aren't making the progress we should on the liver stuff. We need to see better CT results.

Two, my oncologist is afraid that the "pump drug" called Five FU might be the origin of the nerve/larynx issue...not really a virus after all. (No one can really tell since they don't biopsy nerves very often.) If the Five FU is the culprit, we can't chance having it do further neurological damage.

Rather than run that risk, and in order to make better progress on the liver tumors, we're making a change. The new deal will be to have something called "Erbitux" infused once a week...for an hour. (You remember Erbitux…from ImClone…it sent Martha Steward to jail…) I should be able to work that day, and maybe only miss the next...no more entire weeks away from the office. Every third visit, I'd have the Iranotecan that I'm getting now. Both can be infused together, so my time in the opium den will decrease dramatically...and I am DONE wearing that pump around for three days. No more cords, showers with duct tape on the window, sleeping with the little jerk. I may experience some level of pimply rash, though supposedly not as challenging as the first go 'round with the experimental drug.

Just when I figured I had the schedule by the tail...enduring chemotherapy weeks for the first round of the NCAA's and then not another one until the Masters...I’m now back in the office. And I'll be a regular working stiff for the next couple of months. We don't know the length of the next regimen, it will depend on response...but at least we know I'm not growing new ones. THAT, of course, is a good thing.

Can you hear me NOW?

I've been nearly two weeks without a voice. Helps me understand those who are permanently stricken in such a way, so maybe it is God's way of helping me shut up a little.

I'm learning ALOT about medicine. The voice is another strange twist of science. I visited a voice-doctor, on Monday, someone in the Ear-Nose-Throat specialty who sub-specializes in Throat. Great guy, incredibly kind and knowledgeable. Only because of my friendship with another doc, and doc's wife, did I get in at all...his next opening was two weeks away. People are so kind to me in my "condition" it gives me goosebumps.

Anyway, he snaked a tv camera through my nose and down my throat to take a look. What we learned is that there is a muscle alongside each of one's vocal cords that moves the cord back and forth so that they touch and vibrate when we speak. The vocal cords are like sails in the wind, they don't move themselves back and forth, but when in position they do their job. Somehow, the nerve that feeds this muscle on one side is not working...so that the muscle sits too far from the other side of my larynx, leaving its vocal cord just flapping in the wind when I try to talk, rather than connecting with its partner on the other side and vibrating correctly. Visually, it was pretty fascinating to watch tv.

From there, diagnosis is more difficult. What we expect is that I caught a virus, a relative of whooping cough, somehow in the last two weeks. It shows up by centering in that nerve, which could be "infected" with this virus anywhere along about an 18 inch track, as it leaves the spine, circles around a bit and rises to your vocal cords. (There is medical nomenclature for all this, but I don't remember that stuff.) Anyway, we had another CT scan, to try and figure out where along the pathway it was infected by this virus.

There isn't really anything to do with a neurological virus like that, except wait it out. That's 3-6 months. YIKES...I whispered...

Of course, as modern medicine would have it, there is a procedure to fix my larynx until the nerve recovers. So on Monday morning at 7:30, I had a procedure that was new to me. The doc took a syringe and injected collagen (yes, the same as Anglina's lips and their pout) into the little muscle. That enlarges it back into its appropriate place, helps the "sails" of the vocal cords to touch. He says it is magical. You walk in without a voice and walk out 40 minutes later as if none of this past week ever happened. Well, it wasn’t quite like that for me. I’m still hoarse, though I can make sounds…so I'm going back to see why I'm not "normal" although no one should be surprised by now at that...

It lasts for 3-4 months, at which time either the nerve is healthy again...or I get another injection of collagen. So just call me the celebrity cancer patient....! (And for you Fubarian brothers, "NO" he did not ask if he could inject me anywhere else....!)

...but Nine is 75% of Twelve

We decided today that 12 is the plan for this series. CT results were good...no growth, and we assume they are dying in place. Whether they shrink or not is not as big a deal as I once thought, because it is impossible to tell on a CT whether the lesions are alive, dying, or dead. That would take another PET scan, to see the vigor, or lack thereof.

There is also a test called the "CEA" test, which most people refer to as the "tumor markers." It measures the growth of fast-growing cells, as when a healthy, pregnant woman is helping a new baby grow...and also when someone might be hatching cancer cells. For me, this test is completely lacking in direction, because my CEA numbers have actually been lower than most. Back when we took out the colon chunk, the numbers were really low, thus not helpful. Each time I visit the doctor nothing shows that I should be doing this...Yet we know from the pictures that we need to continue. (I'm learning more science in this journey than I thought about taking in school.) The bottom line on this lesson is that I don't mention, or care about the "tumor markers" because the number provides no guidance in my case.

We talked about and scheduled the last three sessions in this series, and also about additional pathways when that's done. What we'll do is complete session 12 in April, go on what Dr. Chang described as a "chemotherapy holiday" to see whether anything further happens...and then attack with radioactive beads and possible surgical intervention if needed. There is also the possibility of further chemotherapy treatments, but we're hoping to find that the little jerks just pass out from exertion and give the challenge a rest. That phrase, called "remission," is not something I thought about using much, but is one we hope to describe quite often.

I'm fortunate to field phone calls from lost friends, enjoy fabulous meals with others, and share time with those who might be having their own challenges in life...Work has gone well. So when I start whining, and someone near and dear says, "gee, I don't know a lot of firms that would promote someone on disability, you ought to shut up and go with the flow a little more" I learn to shut up...

Much better to indulge in wine...than whine.