Christmas time is here...

...and my present is a week off from chemo. Well, it isn't really a present that was given to me. I'm taking a little time off from chemo and from work over the Christmas holiday to visit friends and family. It's been a hectic week trying to get everything done - last minute shopping, end of year projects at work, end of year bookkeeping for taxes (ugh). I'll be ready to kick back and relax a little, catch up on reading, catch up on long overdue correspondence (including Christmas cards which will end up arriving after the holiday - sorry about that), and SLEEP. The sleep part sounds pretty good right now.

I had to include the Christmas PET scan this week.

And I offer no explanation for the last picture other than some holiday silliness. I hope that you all have a Merry Christmas.

Happy Holidays

Thanks to my good buddy Angela for stopping by after her radiation treatment on Thursday to bring decorations for my IV tree - garlands and candy canes hung with my meds all day - a cancer Christmas tree. And I do mean all day - it was a long one. My chemo port was clogged, so we had take some extra time with the "rattlesnake venom" treatment to clear the clog in the catheter - all in all, about a 9-hour stay. But as bad as that sounds, it really isn't. I have lots of friends there and we drag our IV trees around the treatment center and visit each other all day - a kind of cancer block party. I don't know if this is something that happens on days when I'm not there, but I'm glad they let us get away with it. We learn a lot from each other and generally create a pretty good vibe in a place that might not ordinarily have one. As bad as cancer is, one of the gifts it brings is being with these people - the patients, nurses and doctors - they're all just the best.

This week by the numbers - marker up slightly at 7.2. I should try to see if I can animate a stock ticker on the side to display the tumor marker numbers. I used to keep a spreadsheet with a running graphical display, but lost track of it - buried in a distant subdirectory.

I am running a belated Hanukkah picture - last Wednesday was the last day, but I thought I'd include it as this week's postscript:

The menorah is a little hard to make out in the image. Sorry about that.

I know you...but who are you again...?

How many times have you had that awkward moment - you meet someone that you haven't seen for some time, and for some reason, you just can't remember their name. For cancer patients undergoing chemotherapy, this happens more than we'd like to admit. It used to sort of a patient's joke about having "chemobrain" as a way to explain a little forgetfulness, but studies done in the past few years have documented effects of chemotherapy on the frontal cortex of the brain. There isn't a lot of data on this - the few studies out there have been done with breast cancer patients - they tend to live longer and hence are a better study population than patients with other forms of cancer. It's not clear which part of the overall regimen is responsible for the interference with the frontal cortex - it could be any of a number of things that have managed to cross the blood/brain interface. It could be the cytotoxic chemo drugs that kill actively growing cells; it could be the steroids or other meds given to minimize the side effects; it could be from a combination of these and other drugs administered. For women, it may also be an interaction between hormone changes with menopause interacting with the drugs as well. For patients with extreme fatigue, it may be confounded with altered sleeping patterns. Whatever the precise reason(s), it can mean problems with learning new tasks, performing multiple tasks simultaneously and short term memory loss. The good news is that there is at least one study that indicates that this condition may be reversible to some exent when treatment is completed. I hope they're right.

I'm sure that chemo has probably affected me to some extent. I find myself struggling sometimes at work and in social situations to come up with names of people that I don't interact with on a regular basis or sometimes with people I've recently been introduced to. I probably owe an apology or two out there when I've failed to make proper introductions, but I just drew a blank with your first name, or last name or both. If you give me a minute, you might be able to imagine my short-circuited brain trying to feverishly reconstruct our relationship in the convoluted manner that helps me figure it out:

• I worked with you or someone in your work group on a certain project that triggers a series of relationships that associate you with perhaps as many as three or four people before I figure it out again. I know you from church because your child was in a Sunday school class that my daughter helps out in or that my wife had you volunteer to be a Sunday school teacher, so I try to associate you through a relative.
• You used to ride on my vanpool, so I sneak a peak an old email or ridership report (I still do the bookkeeping on my vanpool, so I have records that go back for a long time).
• Old saved email works great for tracing old threads of conversations that help remember your name.
• I should send a Christmas card to the folks at Google - they've saved my butt a few times.
• I write down lot more things in my desk journal at work.
• I try to put reminders on my schedule to make sure I don't forget things.
• I make checklists.
• I try to keep my brain working constantly - I may not be physically as able I used to be, I can't afford to lose the brain too because I won't get by on my good looks (you've already heard my whine about the various attractive rashes from the Erbitux).

They all help, along with a healthy dose of fear that I'll drop the ball on something or someone important. I hope that people will understand - I don't want to use it as a blanket excuse for not pulling my share of work and responsibility, but sometimes it takes me just a little longer. Thanks for your patience.

Planning

Sorry I'm a little behind in posting this week - I needed to recharge and catch up on some sleep this weekend. This is pretty typical after a treatment session, and the sequence goes something like this: Get treatment on Thursday (an all-day undertaking), come home a little groggy (mostly from the pre-med drugs intended to alleviate nausea), eat dinner, get ready for bed (lots of steps here - more on that another time). Sleep for about an hour, and then remain awake until about 5:30 or so - the steroids (decadron) I get for preventing nausea tend to make my mind race about randomly but not particularly in a useful manner. I'm finally so exhausted that I fall asleep for a few hours on Friday morning before waking and going in to work. Why bother going in to work at all, you ask? Because that's what I do - I may not feel great, but I actually do get some satisfaction in getting work done, and the decadron does provide enough of a lift to let you physically and mentally do some amazing things. I repaired my roof last year after a windstorm blew a lot of shingles off on a treatment Thursday - something I might not have had the endurance to do without the decadron. I can usually sleep on Friday night - I'm pretty exhausted from lack of sleep, but sometimes the decadron keeps me awake on Friday night as well, and I'm so tired by Saturday morning that I crash and may sleep until I have to go back to the treatment center to get Silent Bob disconnected. The picture above shows me napping, with Silent Bob in the little black case. I may fall asleep again after leaving the treatment center and nap some more on Saturday and into Sunday. I may get a few things done on Sunday, but may also take a nap again. Eventually, I may snap out of the hibernation, but it may take a few days.

I've been taking a little time over the past day and a half to take in a retirement planning seminar at work, with the final session all day tomorrow. For any of you who have this sort of thing available from your employer, I highly recommend it. It's better to take some time to plan ahead well before retirement than to wait until the last minute. It's been a little strange for me to hear that the average life expectancy now may well be up into the age of the high 80's and early 90's, and that you may need to plan on having enough money saved up to support your lifestyle for another 40 or 50 years as a retiree. But I'm probably in a little different place in life than the rest of the class. While none of us can forecast the future and know how long we have to live, I have a pretty good idea what will do me in, and that there's a very good chance that I won't live to be an old man. Living to age 80 or 90 is probably not going happen. This doesn't make trying to plan your future financial resources any easier though. I need to make sure that my health care needs are covered - they're not likely to go away anytime soon, and they won't be cheap. I need to make sure that my loved ones have enough to survive and prosper after I'm gone. It may sound morbid, but there's the basic fact that treatment is buying me time. If I'm fortunate, it will buy time measured in years. But what if....? What if I'm really lucky and beat the odds for long term survival? What if I really do get into that elite club and survive longer than 5 years (statistically that's only 6-10% of us when the clinical trials were done a few years ago)? How do I plan for something that is kind of statistical long shot? There's a chance I may be able to participate in a new clinical trial in a few months - what if it works really well? Of course, that would be wonderful, but how can you plan with so many unknown variables? Well, the fact is that even for healthy people, the future is still unknown, so I really shouldn't fret. It's going to be challenging to fine-tune a long term financial plan, but at least I feel like I've learned a few things and will be better prepared. And I still like to think that statistical long shots are a good thing to hope for.

For the record books, last Thursday's marker numbers went down again - last measured at 8.6 and now down to 6.2.














Snow in my backyard on Saturday morning