take a "good" look.
y'ain't seen that word here for awhile, having anything to do at all with my medical fortunes.
all y'all 'n 'em are seeing it today.
I have good news. glad tidings I bear unto all peoples.
I haven't been writing about my cancer stuff. I'm way beHeinz, and have some ketchup to do.
I did my third round of the chemotherapy starting Dec.20th, Monday. unlike the last round, all of the drugs starting basically at the same time. we used zofran instead of eloxi for the anti-emetic, nausea reducing drug, nausea being a more pronounced side effect the second time than the first.
either the timing of the drugs, or the zofran, worked. nausea was not as bad this time. you wouldn't want it, but not that bad.
fatigue seemed cumulatively worse.
the third morning of the infusion, and the second day after it stops, were the hard ones the first two times. Dec.23rd, and Christmas Day.
I got the PICC line, the place the drugs go in, out of my arm Christmas eve day. this time they felt it necessary to use my right arm...so I felt even a little more hamstrung than usual.
Christmas angels sang when it was gone.
as you know well, patient reader, I decided to put off Christmas at 708 Arapahoe til' New Year's, when I would be feeling better.
so Christmas came...it came, it came, it came just the same... and I didn't feel like moving.
presents sat under the tree...no one came over...
Scrooge, when confronted with Ghosts. trying desperately to come up with naturalistic explanations for his experiences, says, you could be nothing more than that piece of sour gruel I had for dinner tonight.
my body felt physically sour. like it had ingested something that head to toe did not agree with it.
of course, the point of chemo is hardly internal agreement. I understand the need for an angry, pointed, gloves-off debate.
my system gets confused about what is poison, what is food. food has been hard, and I ...usually the happiest of men to eat, making anyone who loves cooking for a happy man a happy person...have been skipping meals and pecking.
now, I generally run pretty cool in the world. I'm usually me. I've kind of worked on it, and have some ideas about food and exercise and sleep and attitude that make me, I think, a pretty consistent guy.
in fact, most of the time people think I'm taking some emotional place I'm in out on them...they are usually in some emotional place and looking to put it on me.
but I felt sour on Christmas. dim. and I probably wasn't much fun for anyone around me. the combination of chemo down day and Christmas Interruptus made me, I think, more Ghost Scrooge than "go buy the turkey as big as you" Scrooge.
my expectation that this was the last time I would go through exactly this, that on Monday I would find out what would be happening with this much easier oral chemo, Sorafenib, and that I would feel better and have Christmas as the first act of the New Year in a week...all of that seemed a million miles away.
Dr. Klancar had been out of the office Christmas week, and it had been a feat to get an appointment on Monday at all...turned out to be possibly her first of the morning, 8:30am.
personally, I feel like it's like a teacher giving a test on the first day of school, to ambush someone after a vacation the minute they walk in the door, and expect them to be up to speed.
yes, I was feeling better, less dim, less sour.
but janice found a study conducted by Sloan-Kettering in Manhattan on the effects of Sorafenib (with another chemo) on Neural Sheath Tumors. Stewart Greisman, about whom more later, had contacted a doctor at the CU cancer center who spoke of another drug. Ken Morris, musical cohort and champion of my case, had found some online stuff that didn't speak well of Sorafenib and lung cancer.
and I had questions.
all of which I had emailed to Brenda J., the chemo nurse who seemed to have everything together, who promised to forward it to Dr. Klancar.
I wrote up a one page precis of questions and developments, copied on paper all of the emails, and a study or two, and went in to find out what was next.
she looked rested, comparatively, and was very alert and social. to her great credit, she was more than open to the sheaf of paper I ambushed her with, and offered to make the calls, find the info, come up to speed.
she hadn't seen the emails. she said several times, didn't I talk to you about that? she didn't cover up, wasn't evasive, but it was evident she had not brought her weight to bear on my case.
my last question was...all these options...are there any of them that hold any kind of long term hope?
she said, they are all about months instead of years. there's always hope. I've seen the miracle cases, she said. but it's not in the literature.
lisa broke out in tears. she does that for me. it's only my wrongheaded orneriness that keeps me from it.
she wanted to be mad at Dr. Klancar. we come to her for answers, and she wasn't aware, didn't know, it felt like we are on our own.
when I used to watch the Broncos, when my income from gigs rose when they did well and made for bummer gigs when they sucked, I'd yell at the announcers. "well, that boy is certainly a football player. there is no doubt that he came here today to play some football."
personally, I had never been in doubt.
"you just have to say, they've got to get some points on the board if they want to win this game."
the only reason one might not have to say that is if it were too incredibly trite to even mention.
and the refs. I'd yell at the refs. alternating stripes of black and white...alternately saviors and perpetrators of unfair handicaps, the real reason for a loss.
I wasn't mad at the refs and the announcers...well, give or take Howard Cosell...any more than lisa was mad at Dr. Klancar. it just sometimes felt easier than facing what we are mad about, or hurt about, or dread, directly.
Dr. Klancar called the house at 4pm.
first day back from vacation. slammin' busy appointment load.
still, she had called the doctor that Stewart Greisman's friend had emailed, Dr. Elias, at the CU Breast Cancer Center. spoken with him. she said the drug he was working with, Trabecktedin...new vocabulary word...sounded like a better bet than the Sorafenib.
she did this because of the email from Stewart I had printed out and handed to her.
50% of people on Trabecktedin, said Dr. Lillian Klancar, have tumor stabilization. 88% have higher scores on Jeopardy, and better banter with Alex Trebeck.
she had a number he had given her which was a direct in to him, and said I should call Dr. Elias.
I don't care if someone has a day when they are not up to speed. I use some of those coupons myself sometimes.
she had looked at me and said, I just don't have time to do all this research.
to me, I guess that means...that isn't really the focus of my job.
but on a world's record busy office day, she shoehorned in getting up to speed on my case.
think I'll make her one of the team, not one of the refs. an asset, not an obstacle.
the hard won number turned out to be the main number for University of Colorado Breast Cancer Center. well. that can work too.
I let the menu wash over me, pressed buttons, finally Colleen answered the phone. I got a couple of sentences out and she said, can I put you on hold? I'm finishing up another call.
nobody's nice to these people. I try to be. I said, thank you.
it was ten minutes or so. I thought about calling back. but...what exactly was more important to do than wait for this?
she was very apologetic when she returned. I told her my story.
neither the doc nor his nurse were in today. she would email him and he would call...he's very good about getting back to patients. here's my number...if you don't hear from him by the end of the day, call me.
when Colleen was not totally overloaded, she seemed personal and focused.
two hours later, Dr. Elias called.
he really impressed me.
and I liked him.
he made a joke.
Dr. Klancar had said she knew of him in breast cancer research, and hadn't known that he had taken on sarcomas.
he said, when you come to see me, I'll be in the Breast Cancer Center.
bring a tutu, he said.
I said, I'll try to fit in.
Dr. Elias (also Walt Disney's middle name) seems to be one of the world's most advanced authorities on sarcoma. you go to the world map of research online, type in Sheath Cell Sarcoma, and a few spots on the globe light up. including Denver. because of him.
Dr. Klancar said that he had kind of pooh-poohed Sorafenib. when I asked him about it, he said, oh, you can use it, but we did a study two years ago on Sorafenib and neural sheath cell tumors...it wasn't effective.
that, to me, is not pooh-poohing. pooh-poohing is when you express a vague sense of not preferring something. this is, like, we tried it and it didn't work.
Trabacktedin...retail name, Yondelis... had, said Dr. Elias, a proven track record with this kind of stuff.
wow.
24 hour IV through a pump, every three weeks. sigh.
will there be down days after, I asked?
he laughed. nausea, fatigue for a week. but, he added, nothing like what you've been going through.
and there is no cumulative toxicity. each one won't be worse than the last. so, I said, there's not a certain number of rounds?
he said, when it works, we've used it for years.
kathy practically jumped when she heard that. somebody somewhere is talking about years, not months.
I have to be "clean" for three weeks before joining the study. probably starting the 23rd of December. it means nothing countering the tumor for a week longer than if I had stayed with the original chemo. but it also means...a chance to get off the mat. three weeks without sour gruel to overcome...sounds pretty damn good to me!
he said, well, we take a scan after two rounds and see how we're doing. if it doesn't work, there's lots of things to try, even first line stuff.
but this is the best for right now.
in three words, he's the guy.
I feel like 30% of a hundred ton weight has been lifted off of my shoulders. I feel like it's Christmas.
50 % stabilization (don't really know for how long)... I feel more than hope...if it were 51%, one could almost call it promise.
but more...he's the guy. and he's here. well, Lowry, if you don't think of that as the Twilight Zone.
I went to see Jim and Salli Ratts last night, kind of a Christmas Elf run.
I guess I go back with him to 1985 or so, did my first recording in his studio in 1986. we've spent a lot of time serving in a lot of different trenches together, and you couldn't stand next to a better guy when the bombs start falling. he's the first guy to ever let me sit at a mixing board, the first guy I ever played at the Little Bear with. three quarters of the musicians I know I met through him. additionally, he's a model for engineer carefulness I will never live up to, a model for taking the high road in sticky interactions I am still learning from, a model for grace under pressure, a model for patience and generosity. no matter how either of us grow, Jim will always be a mentor to me.
I've always heard of Jim's great and good friend Stewart Greisman, who had somehow frittered his life away being head of the Emergency Rooms at Porter and Swedish hospitals at the same time, instead of becoming a musician as any good parent hopes. I'd met Stewart a couple of times...good guy.
Jim had invited Stewart into the studio a few years back to record a guitar and voice basic for a song Stewart wrote - then secretly hired some musicians and filled out the recording and surprised Stewart with a mixed CD of it.
I don't think the surprise wore off. Stewart started planning for a whole CD as a 60th birthday present from him to his friends.
I was brought in on the case.
now anyone in Stewart's position can approach the project in a number of ways, mostly depending on how much they want to grow and stretch versus how much they want to stay in the comfort zone. another determinant would also be, how much musical talent the doctor/ financier/ plumber would bring to the table.
Stewart didn't know it....probably still doesn't...but he was bringing some pretty darn workable songs and ideas in. and a voice with something to offer.
but, more, right from the first, anytime he could stretch, he'd choose to. anytime I completely violated his comfort zone, asked for something different or more, he seemed to flourish. of course, that only made me ask for more.
every time we got together, the project grew, and Stewart grew.
and always he had the deepest appreciation for the process, gratitude for Jim and I, and a child's delight at everything about it.
I looked forward to every session. the project exceeded, I think, anyone's preconceptions. and Stewart by the end of it was more a friend to me than a work buddy.
it was Stewart, you may recall, who cast about when I was first considering neck surgery, and found the guy, Andy Nemechek.
it was he who asked a friend who referred him to Dr. Elias, and first contacted him, literally saving my life a second time
everyone who loves and supports me, faithful put upon readers of this blog, everyone I care about, this day Stewart has brought all of them some relief. I look around, and all of the reflections I see in faces are happier.
what a gift that is.
Stewart, and Jim before him. I was tearful when I got off the phone with Dr. Elias. I'm just now getting a sense of how strapped in I was, how bumpy the ride has been, how far from the everyday was the place I was living in.
good news. good.
and good people.
I used to say I had no friends. lovers, musical bumpercar relationships, no friends. the year Runaway Express played in Telluride that James Taylor closed the bill, I was in the VIP section watching him play "You've Got a Friend"....he looked right at me, and stopped.
I 'bout have to be raped with friendship. but it's happening. resistance is futile.