The title is from an old joke, and appears appropriate for this week's posting. I really had a hard time coming up with a title and had a few others as possibilities: Good news/bad news (because of a fairly humorous exchange between Robert Schimmel and his oncologist in "Cancer on $5 a Day"); The "New Normal"; Not the solution I was expecting....
So, where to begin with this. Let's start with the bone scan. I guess the good news is that the pain in my back is NOT a bone metastasis - nope, not cancer. The bad news is that it looks like I really did hurt my back, although we can't exactly tell when or what was the cause might have been precisely. Some overall mild degenerative in my mid-spine, but a marked abnormality on the end of vertebrae L4, possibly an endplate compression fracture. I'm not really sure what the hell that means, other than it makes my back sore if I stand or walk. Is the result of having that old woman run me over back in July? Did the razor clam incident last month finish it off? Who knows. I'll be contacting my regular physician on Monday to get a referral with someone who can get me a start on fixing it. I'll have her look at a few other things that aren't working quite right - I've got some time to get the body work taken care of here in the next few weeks.
Why do I have time for this? Well, I also had a CT scan done on Wednesday. Nothing special - 
just a normal quarterly scan - maybe it could also shed some light on the back pain as well. Well, it was almost normal, although I did give the technicians, who now recognize me as a "regular" there, something of a scare. On the second full body scan, one of the techs came out in a hurry and asked - "Have you had any other surgical work done on your left side that maybe you forgot to put on the form?". Nope. A check quick revealed that I had forgotten that I had taken off my reading glasses as I had laid down on the table, and left them at my side. See picture at left - glasses are pretty obvious. In the upper left, you can also see the speedy new "Power Port" which the techs accessed to put in the contrast solution. Another minor glitch happened here - since it is a power port, they can put the contrast solution in at a higher rate and pressure than a conventional intravenous infusion...except if there is a small kink in the tubing. After the iodine contrast solution is injected, a saline solution is used to flush the line. A kink in the line caused too much back pressure when the saline was introduced, causing the line to shoot off and cover my shoulder with saline. Ha, ha - radiology slapstick! OK, let's get on with the real pictures. I brought the CD back to the office and looked at the images, as usual. Didn't really see much that looked different - if anything, the critters there could be 1mm bigger, or a 1mm smaller - probably within measurement error from last time...or so I thought.
just a normal quarterly scan - maybe it could also shed some light on the back pain as well. Well, it was almost normal, although I did give the technicians, who now recognize me as a "regular" there, something of a scare. On the second full body scan, one of the techs came out in a hurry and asked - "Have you had any other surgical work done on your left side that maybe you forgot to put on the form?". Nope. A check quick revealed that I had forgotten that I had taken off my reading glasses as I had laid down on the table, and left them at my side. See picture at left - glasses are pretty obvious. In the upper left, you can also see the speedy new "Power Port" which the techs accessed to put in the contrast solution. Another minor glitch happened here - since it is a power port, they can put the contrast solution in at a higher rate and pressure than a conventional intravenous infusion...except if there is a small kink in the tubing. After the iodine contrast solution is injected, a saline solution is used to flush the line. A kink in the line caused too much back pressure when the saline was introduced, causing the line to shoot off and cover my shoulder with saline. Ha, ha - radiology slapstick! OK, let's get on with the real pictures. I brought the CD back to the office and looked at the images, as usual. Didn't really see much that looked different - if anything, the critters there could be 1mm bigger, or a 1mm smaller - probably within measurement error from last time...or so I thought.When I went in on Thursday for treatment, my labwork orders had a note "See Dr. Gold before labs." Either I was going to have to stay after and clean the erasers for irritating the nurses last time, or there was going to be a change in my tests. My serum potassium has been acting a little strange lately, so maybe it had something to do with that. Wrong. Way wrong. Those pictures from Wednesday's portrait sitting at the radiologists showed that I have new liver tumors, and my existing tumors have grown, including the primary tumor in my rectum. Ulp. I guess that explains the jump in the marker numbers. Another set of words went through my mind, and I can assure you that none of them is printable. So - no treatment today - actually no more treatment with these drugs at all. There is no sense in continuing to take drugs that are not killing or slowing down the tumors and only making me miserable. I was afraid that this would happen sooner or later, and I guess that it happened this late in the game is better than having it happen a year ago. This is all just an evolutionary race - we treat the cancer with drugs and hope that we can kill it before it adapts to the drug and tolerates it. When the cancer adapts, you throw another drug at it and start the race over and hope that you get it this time. Basically, we ran out of drugs before the cancer adapted to them.
Are we done then? Nah. I'm getting a few weeks off (at least four) from treatment to enjoy life and get all the drugs out of my system. I will enjoy this time and can't wait to get my body back. We'll be evaluating alternatives, although it's a little unsettling to be doing so, knowing that my critters are still growing and I'm not doing anything to actively fight back.
Since I'm ending my present treatment, this means that Silent Bob has been officially retired. I didn't get to say goodbye to him, but just as well because our relationship really had become kind of a drag - I just dragged him around for a few days every two weeks and all he did was squeak every 90 seconds and then whine like a banshee when he was empty. I had to keep him dry and make sure his line into me wasn't kinked or knotted. It was sort of like having to care for an infant tied around your neck - OK, I didn't have to feed or change him, but he was still kind of a nuisance. I also don't have to go to the hospital, which I'll kind of miss. I like my nurses, and we had a two-week cycle that we all got used to, and I will miss my friends who are receiving treatment. I didn't really get to say goodbye to them on Thursday, but I will get the chance when I go in to get checked up and to get my port flushed out. I will bring them treats.
Relay for Life Update
Wow. Our official kickoff campaign starts on Sunday night, and I'm already over my goal of $2000 (now at $2220), thanks to your generosity. The change in my situation will cause a change in the talk that I'm giving for the kickoff event - I'm not exactly sure what I'm going to say yet, and I may end up winging like I did last time. I'll let you know how it goes. I've only gotten one response to the question in my last post regarding whether I should simply raise the bar a little higher, or keep the original goal and let you continue to contribute and see how far I get over the original goal. The response indicated I should keep the original goal. OK with me - I still want you to continue to contribute to my Relay (click for link to my website) even more than ever. If my present condition doesn't emphasize the need for funding cancer research, I don't know what does. Sure, drug companies pay for research, but they can't cover all the bases - research funding also needs to go to universities and medical centers and other non-profit institutions. I join other friends now who are in clinical trials - this could be our last shot, unless we can participate in other trials if our present trials don't pan out. So please, please keep your contributions coming in. Thank you again for your generosity so far. The Relay is at the end of May, so we have another month to go.
