Thursday, August 31, 2006

An Unwanted Journey: Day 0282 - Chillin'

Cancer has its blessings. One such blessing is the realization that territoriality is stupid. When we are healthy and immortal, we protect our turf. We get defensive and irritated when someone apparently has the nerve to offer us advice or, worse yet, threatens to invade our area of responsibility.

Today, my Community Care Access Centre nurse and I were speaking about lessons learned during cancer treatment. I mentioned how many things which would have raised the hairs on my neck a year ago, no longer have an impact. These days, it takes a concerted effort to insult me or to make me think that my territory has been invaded. That's a good thing, I think.

One of the virtues championed by Christianity is humility. But the chances of finding a Christian with true humility is next to nill. Still, whatever the chances of finding a humble person or of cultivating your own brand of humility, it seems to me that getting a diagnosis of cancer might just do the trick. Somehow knowing that your life is threatened by cells with a type A personality makes it easier to chill.

Wednesday, August 30, 2006

An Unwanted Journey: Day 0281 - Simply Music

Music is a gift. I don't mean listening to music, although many would agree that doing so is indeed a gift. I mean making music.

I am no great musician, but one of the casualties of my battle with cancer has been my playing fingerstyle guitar. Part of why I couldn't play was simply physical. I didn't have the energy or I couldn't stand the weight of the guitar across my shoulders or the pressure across my abdomen. Part was psychological. Playing the guitar or making music in general was part of leisure, something which seemed truly extravagant when dealing with life and death issues.

Tonight, I picked up the guitar again and picked a few tunes, mostly John Denver selections and transcriptions from Fingerstyle Guitar magazine. I am so rusty that it seems like someone else used to play the guitar, not me. But after a few minutes, I found myself at least recognizing the tunes and the body memory of my fingers beginning to acknowledge familiarity with the technique.

For me, it was beautiful. For others, I don't know. But the sound touched me deeply, despite whatever failures I have as a musician.

Making music may be therapeutic. It can also be incredibly frustrating, but usually that happens when I begin to imagine what other people would think of my playing, about what other musicians might do with the material, about what really good fingerstyle guitarists could do with the piece of music in front of me. When I forget thinking and simply make music, the exercise most definitely is therapeutic.

But that's not why I do it. I do it simply. I do it for itself. I do it because it begs doing. So, why haven't I been making music? Because sometimes I can be stupid and self-conscious. In the future, I will attempt to forget myself and let it happen.

Tuesday, August 29, 2006

An Unwanted Journey: Day 0280 - Pathology and Therapy

"Atoms don't get cancer; animals do." - Ken Wilber, Sex, Ecology, Spirituality: The Spirit of Evolution, p.103.

One of the truisms of evolution is that increasing complexity, especially biological complexity, means that more things can go wrong. We know this intuitively, although we rarely articulate it in terms of evolutionary development.

Postmodern humanity, for example, is fraught with neuroses and occasionally psychoses that would be rare, if not outright impossible, among our ancestors and primate cousins. That's the price we pay for living in an ever more complex sociocultural environment with its myriad symbols and concepts and opportunities for mental differentiation and dissociation. I mean, how many chimpanzees do you know who need cognitive therapy from Dr. Phil?

Cancer, as we all know, is a pathology. It's the result of biological processes gone haywire, of cells and organs which have fallen prey to unbridled growth and failure to differentiate along normal biological patterns. In my individual case, the cells of the sigmoid colon and rectum, instead of growing, dividing, and dying normally, somehow lost the normal constraints which harness growth. The cells of the gastrointestinal tract grew, but did not differentiate, according to normal patterns of the GI tract.

For each cancer, medical science tries to devise a variety of therapies, a way of dealing with things that have gone wrong. Therapy is intended to set things aright. With cancer, especially colorectal cancer, we have therapies like radiation, chemotherapy, and surgery, all of which seem blunt, almost brutal, in their implications. So it is no exaggeration to think of therapeutic measures in military terms.

Radiation blasts cancer cells to prevent growth. Chemotherapy interrupts cellular processes at the DNA level to prevent unbridled growth, although in doing so healthy, natural cells also get targeted - collateral damage, if you like. Surgery is perhaps the most obvious of all. Find the tumour and route it out. It's like ethnic cleansing.

Military images and concepts seem so appropriate for the state of the art in cancer therapy. We battle cancer.

It's because of evolutionary progress that cancer exists. And it is because of further evolutionary progress that therapies exist. Both pathology and therapy are part of the legacy of evolution. On this planet - 3rd rock from the sun - both are part of the price we pay for evolution.

Monday, August 28, 2006

An Unwanted Journey: Day 0279 - Chemo Crapola

A rollercoaster? You bet. Last week's good news and happy thoughts disappeared this weekend with the renewal of side effects from my 5th chemotherapy cycle.

All Saturday was spent either in bed or on the couch/recliner. The fatigue was such that I felt like I really wasn't part of the family at all, merely somebody taking up space. All the while I was thinking about how good it would be to be in Barrie with my brothers and sister celebrating my Dad's 75th birthday. But that would have been an unmitigated disaster for me.

Sunday was worse. Not just the fatigue, but the onset of painful and extremely frequent bowel movements which left me barely able to walk from the bed to the throne and back again. To say that chemo is a pain in the ass is an understatement!

Today, Monday morning, things are a little bit better. I can actually sit on the couch, connect remotely to the servers at work, read/write email, and do some planning and work on various tasks that an IT manager has to do regularly. This is where I truly appreciate the miracle of modern technology. I can reboot a server, check our off-site anti-spam email software service to relieve individual users of checking their uncertain spam messages (almost all of them are real spam and bulk messages), review printer problems, and otherwise pretend that I am on-site at work.

The CCAC nurse also came by this morning to change the dressing for my PICC line and to flush the line. I made sure she understood just how crappy (literally) my weekend was and commisserated with her about the uncertainties of chemotherapy. As I near the end of my treatment, the benefits of chemo seem distant while the side effects seem quite immediate and omnipresent.

But, by Christmas, this will be a vague memory. Even by November, when my colleagues and I go to Las Vegas for a user group meeting, I should be feeling reasonably good. My wife has made the point that I should not take gradually improving health as a license to get involved in any volunteer work. I should, she says, stick to work and my health until such time as I have secured a higher standard of fitness.

She's right, of course. This too shall pass (I really don't like that metaphor these days!).

Friday, August 25, 2006

An Unwanted Journey: Day 0276 - Happy Birthday, Dad!

I remember the occasion as if it were yesterday. We were invited to my brother's home to celebrate my father's 60th birthday. We were all there and having a good time when Dad invited some of us siblings to the front porch to tell us something.

"I have some bad news. I've got cancer. It's in the bladder and I will be beginning treatment soon."

We were all hit hard with the news. Dad's mother and father had both died of cancer, although nobody had yet been diagnosed with bladder cancer, or worse still, died of the disease. Dad's younger brother had also died of cancer at age 53. We were all afraid of any cancer diagnosis.

But Dad received his treatment, painful at times, no doubt. And he has gone in every year for consultations and tests to make sure there is no recurrence. And, thank God, there hasn't been any bad news in 15 years.

Today, my father celebrates his 75th birthday. I called him last night to talk about his success in the battle against bladder cancer. Since he doesn't need many material things these days, I decided to make a donation to the Childhood Cancer Fund on his behalf so that those whose family life is disrupted with a diagnosis of cancer for a child will receive a home kit that the whole family can use to discuss the treatment and understand what to expect.

Since Dad has had cancer and his eldest son has had cancer, it somehow seemed an appropriate birthday gift.

"Congratulations, Dad! We celebrate another birthday today with far better news than what we heard 15 years ago. I hope someday to hear my sons congratulating me on reaching my 75th birthday...only 22 years away now. "

Thursday, August 24, 2006

An Unwanted Journey: Day 0275 - Muskoka Traditions

Every year, for the past 11 years, we have gone to a cottage on an island in Lake Muskoka to visit with my sister- and brother-in-law, the godparents of our two teenage boys. This year, I didn't think we would be able to keep the tradition alive simply because of the treatments I am receiving for colorectal cancer. But events and situations conspired to make it all possible. My only job was to drive the family to the cottage and back again to our home. As it turns out, that is something that is one of the most comfortable things I can do these days.

The weekend was fabulous. Our relatives are marvellous hosts and wonderful godparents to our children. This year's highlight (every year seems to have at least one standout memory) was watching my youngest son learn to water ski. It was also a lot of fun for me to listen to the family play euchre while I tried to get some rest (the only downside to the weekend was the sleepless nights and frequent bowel movements, probably a side-effect of the antibiotics I was on for the low-grade infection I suffered when my blood counts were so low). Listening to the laughter and grand standing, posturing, and nonsense was exactly what I needed.

And then there was the food and drink. My nurses at CCAC gave me the go-ahead to break my fast on beer, wine and maybe a mixed drink or two over the weekend. Apart from one beer that I had a couple of weeks prior, I have not imbibed at all since the beginning of the year, so it was a real treat to have some beer, wine and a couple rum and coke. Not to mention blue-berry pancakes, bacon, wonderful salads, selections from the Picard peanut gift pack we brought along, jelly beans, and so on. Oh yeah, my brother-in-law's BBQ treasures were fantastic too!

Probably the best healing aspect of the weekend, though, was having a chance to participate and listen in on conversations that would otherwise be unlikely. Phone calls just don't allow the time required or provide the relaxed atmosphere for talking at leisure about what's happening in our lives. The give and take of long conversations with people who truly make a difference in your life is a gift beyond measure.

Wednesday, August 23, 2006

An Unwanted Journey: Day 0274 - Chemo and Blood Counts

I'm sitting in the chemo suite at the Grand River Regional Cancer Centre having had my blood drawn already and waiting to see if my blood counts are acceptable for my 5th chemo treatment.

This waiting period (sometimes referred to as a chemo holiday) is a good news / bad news scenario. The good news is that I'm not experiencing side effects directly related to chemotherapy. The bad news is that I've been very susceptible to infection and I have had to take 10 days of antibiotic treatment for a fever from a generalized infection which the doctors were unable to locate.

As I write, the nurse has just come by with the blood counts from this morning's blood draw. The results were fantastic! I can't believe how quickly the improvement occurred. In just 2 weeks of delay for me to recuperate, my absolute neutrophil count jumped from .9 to 6.3, the highest it's been all year! Similarly for white blood counts and platelet counts. Even hemoglobin counts are up somewhat.

So on we go with treatment number five.

Maybe I'm a sucker for statistics, but the counts relayed to me this morning have made my day. I haven't felt much better, but I guess that's just another indication of how critical these scientific measures are in the treatment protocol. Over the past couple weeks, I've had very disruptive sleep patterns, far too frequent bowel movements, and substantial fatigue. But however I might have felt physically, it's clear that the delay did wonders for my recuperative powers. Probably the antibiotics had some effect as well.

In any case, I feel ready to tackle chemotherapy again and get this phase over with.

I've figured out how to make these long sessions easier to endure as well. I've tried watching DVD movies, listening to my iPod, using my Pocket PC, and chatting with the volunteers. Suffice to say that 5-7 hours in the chemo suite requires multiple tactics. Today, I am working with my notebook computer while waiting and getting my infusions. This means I can respond to email from my place of employment, check backups and configurations on the servers, process and organize my calendar and task lists, plan departmental strategies - generally get things done that would be difficult, if not impossible, while onsite at work where I am far too available for IT-related interruptions!

So, it appears that today is a very good day. As one of the volunteers, herself a lung cancer survivor, and I commisserated, any day above ground is a good day.

Let's raise a glass to health!

Thursday, August 17, 2006

An Unwanted Journey: Day 0268 - Cancer Currency

I drive a Toyota Camry, and of course that means that I notice almost every Camry that I see on streets and highways. I am battling rectal cancer, and of course that means that I notice almost every news story with a cancer connection, no matter how tenuous.

This week was no exception. Toronto is hosting the biennial AIDS conference with about 24,000 people attending. Apart from big-name celebrities like Bill Clinton, Bill Gates, Steven Lewis, and Richard Gere dominating the conference coverage, there has been surprisingly little news broadcast about new discoveries. One aspect of the fight against AIDS/HIV that was unknown to me was the estimated casualties world wide - 11,000 are estimated to die daily from AIDS/HIV.

All this attention to AIDS has left me wondering about the battle against cancer. Worldwide annual cancer deaths are estimated to be 7 million, which means over 19,000 cancer-related deaths daily. I am unaware of any cancer-related conferences on the scale of the AIDS conference in Toronto, but I suppose the lack of one huge conference is compensated by the number of cancer conferences. There are, for example, two conferences related to gastrointestinal and colorectal cancers in the next three months alone (Current Trends in GI Malignancies and 5th International Colorectal Cancer Congress).

From the macro to the micro. One news item surfacing Wednesday was the arrest of a suspect in the tabloid-sensationalized JonBenet Ramsey murder of 1996. Less than an hour ago, there were further revelations indicating that the murder was in fact a suicide. What touched me, though, was the realization that JonBenet's mother, Patsy, died of recurrent ovarian cancer on June 24th of this year. Obviously, recurrent cancer is a fear of mine as well. But that is not why the story intrigues me.

Much as I fear cancer, there are situations far worse, one of which is the death of one's child. My own parents have experienced such a tragedy not once but twice. I cannot imagine how I would deal with the death of one of my children, but I know that it would eclipse, by far, anything I have undergone in battling cancer.

Linking current events and cancer is just another aspect of my worldview these days. I don't necessarily recommend it to anyone. But, as my sister-in-law would say, "that's just the way it is."

Monday, August 14, 2006

An Unwanted Journey: Day 0265 - KD Paine's Manifesto

One of the cancer survivors whose blog I regularly read is K. D. Paine. In July, I mentioned how I was introduced (virtually) to Katie Paine by Shel Israel, co-author of Naked Conversations. Today, her entry is The Paine Manifesto.

She has listed 18 assertions about how to survive cancer and I concur with everything she says, although I was not fortunate enough to know the two women whose lives inspired Katie to compose her manifesto.

I wonder, though, if Katie would mind if I took the work she has already done, acknowledged the original inspiration, and yet offered some advice on redacting the manifesto? My goal is to make the advice more generic and perhaps easier to summarize.

Here's my first attempt:

  1. Stay alive. Do whatever you need to do to keep breathing. Nothing else matters.
  2. Maintain your friendships. After ensuring you are alive, caring for others is your highest priority. Doing so will extend your life expectancy by over 10 years.
  3. Be true to your own values. Caring for others doesn't mean surrendering your deepest values. In fact, true friends know what matters most to you and, even if they don't always agree with you, appreciate those values. Don't ever try to be everything to everybody. Choose wisely!
  4. Be productive. Although battling cancer can sometimes drain you of physical and emotional energy, claim the good days and make a difference by doing what you do best.
  5. Be receptive. Sometimes you simply can't do what you would like to do. That's OK. Let others serve you. That's part of the reciprocity of life. In fact, if you want to feel closer to someone, don't do something for them, ask them to do something for you. It works!
  6. Apply the "cancer card". If you don't want to do something because you are sick with cancer or the side effects of treatment, then maybe you shouldn't bother with it when you are well. The "cancer card" is a useful litmus test for everybody.
  7. Find your model. Each of us knows someone whose life and death is a model. Find the one or two who matter most and whose life and/or death most resonate with you. Then live your life and die your death the same way.
  8. Be clear. It's worth the effort to articulate your priorities and values and to communicate them clearly. In sickness and in health, clarity matters.
  9. Be tolerant. People will say and do stupid things. Discern their intent and accept that people make mistakes. But don't tolerate inaction. If someone doesn't show up at all, they probably don't really care.
  10. Things happen for a reason. Whether you understand the reason doesn't matter nearly as much as accepting what has happened in your life and believing that meaning can be derived from it all. Each of us has the choice to invest meaning into everything that happens to us. Again, choose wisely!

Katie, I hope this doesn't feel like a complete rewrite. My intent is to leverage what you have already done and make it my own. Bon chance!

Sunday, August 13, 2006

An Unwanted Journey: Day 0264 - Silly Socks

"Treasure your friends; cherish each day; be useful."
I just finished my weekend marathon of watching the extended edition of The Lord of the Rings. It's a truism to say that the movie (and the book, of course) reinforces the importance of friendship, of the beauty of ordinary life (the Shire), and of being personally productive.
Yet this week's experiences have reinforced for me, quite apart from movie themes, just how significant to our health is that trinity.

My productivity at work was threatened this week as I experienced a variety of unexpected side effects and trouble with my chemotherapy. Dwelling on those issues and problems instead of participating in the exercises of the gratitude project threatened my mental health. But my friends...well, they reminded me why they are a treasure beyond measure.

These friends want to do something to help - some want to visit, some want to drive me to the hospital, some want to simply telephone and tell me they care about my well being, and some don't know what to do.

Here's an idea. Buy me a pair of silly socks. Each time I wear them, I swear that I will be happier, remember the sanctity of each day, and be as productive as I can possibly be. And, isn't it obvious, I'll be thinking of you all day long.

Note: As I prepared in the spring for surgery, one of my books on cancer recommended buying and wearing silly socks and brazen briefs for the enjoyment of the nurses. So we bought a few and I've been wearing them ever since (especially the briefs). They remind me not to take myself too seriously.
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Saturday, August 12, 2006

An Unwanted Journey: Day 0263 - Avelox

The fever didn't last. By Friday morning, my body temperature was normal again, even though I had taken no drugs.

The Community Care Access Centre nurse (from Care Partners) came to change my PICC line dressing as well on Friday morning. I had seen her last on Tuesday, so there was a lot of news to tell her. As she changed the dressing and I turned my head in the other direction (standard procedure with patients who don't want to wear a face mask during the dressing change), she went about her business of tearing out remaining hairs on my forearm and examining the PICC site insertion point.

The inflammation was greatly reduced and the site itself was dry. So it appears that the decision to change dressings was a good one. The nurse even brought along another tape which should be gentler on my skin, even though I bet it still tears out arm hair!

The nurse commented that what I was experiencing with a low absolute neutrophil count, delayed chemotherapy treatment, and blockage of the PICC line were all quite common. That makes me feel so much better. No only am I a "text book" case, it appears I'm a commoner as well! My pride is taking a hit these days.

I had planned on picking up my antibiotic prescription early in the morning so that I could get started on the ten days of Avelox tablets prescribed by the emergency ward attending physician. But when I got them I discovered from the pharmacist and from reading the information sheets the pharmacy now routinely provides with any drug new to a patient, that this kind of medication has a lot of interactions with other medications, including iron pills and multimineral/multivitamin pills, something I routinely take now as part of my treatment regimen.

I discovered that I had to take my avelox tablet either 4 hours before my iron and multivitamin pills or 8 hours after. So, I take one-a-day now at 3:00 pm.

I had been feeling so much better Friday with a normal temperature. But once I took the antibiotic, I started feeling under the weather again. In fact, this afternoon (Saturday), the effect is even more dramatic. I feel dizzy and weak, much more so than before taking the tablet.

And so it goes. The side effects of the medication are certainly manageable, especially in light of what the risks are in getting a bacterial infection. But the bottom line is that I still feel funky...yes, I know that's a very technical medical term! If the side effects get any worse, I'll have to plan ahead to ensure I am at home and don't have to drive anywhere immediately afterwards.

From what I've read online, it would appear that I am getting a treatment designed for patients with community-acquired pneumonia (CAP). Ten days is one of the longer treatment periods for this quinalone type antibiotic. The dose is 400 mg per tablet.
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Friday, August 11, 2006

An Unwanted Journey: Day 0262 - Hot, Hot, Hot

The instructions from the Grand River Regional Cancer Centre are very clear. Patients are to monitor their body temperature at least twice a day. If your temperature reaches 101 degrees, then go immediately to the emergency department of the hospital, tell them you are being treated at the cancer centre, and expect further blood tests and possibly antibiotics.

I have watched my body temperature increase incrementally over the past three days. Last night it hit 101 degrees about 7:00 pm. I waited 5 minutes and took another temperature reading...again 101 degrees. So we packed up and went to the Grand River Hospital's emergency ward.

The waiting room was packed. Even the triage area was packed with people waiting for treatment. But after about 15 minutes, we were taken by a triage nurse and processed. She took my temperature again and it had risen to 101.5 degrees. They registered me immediately and put me in a room to have blood samples taken and to rest until a doctor could see me.

I had to provide a urine sample, then a member of the blood collection team took samples, not from the PICC line but peripherally, meaning directly from a vein in the right arm. Then the emergency ward nurse took more blood samples using the PICC line in order to prepare cultures to study how my blood reacts to various bacteria.

At that point it was on to get chest X-rays again, even though I had already had chest X-rays on Tuesday. I guess this was to make sure my lungs were clear.

Then back again to the emergency room assigned to me to wait for a doctor. Both the nurse and the doctor checked my lungs with stethescopes, but there was nothing noticeably wrong.

After about 3 hours, I was discharged with a prescription for oral antibiotics to be taken for the next 10 days, one each day. If I still have a temperature of 101 degrees or higher after 48 hours, then I should return to the emergency ward.

In the meantime, the blood test results (which didn't show anything unexpected, according to the emergency room doctor) would be forwarded to my medical oncologist who would call me in a day or two to review the blood culture results and possibly prescribe antibiotic or other medications.

For someone who didn't want to visit the hospital for treatment again for a very long time, I have to admit that the visit to the emergency ward was reasonably quick and painless. It was quiet, unlike other times I have been admitted. Being a chemotherapy patient expedites matters, to be sure.

In any case, the high body temperature and possible infection just highlights how careful I will have to be over the next couple of months while still taking chemotherapy (and probably for a couple of months beyond that as well while my blood counts gradually improve).

One other interesting thing occurred while in the triage area. A woman and her husband sat down next to us and she said, "I read your blog everyday." It took a moment for me to realize my photo was on the site and to realize as well that her husband had a PICC line and sleeve on his arm almost identical to mine. She then informed me that her husband has the same form of cancer as I do and was coming to the emergency ward for a fever as well. I was pleased to think that my blog helps other people in my own community, especially people that I would not otherwise meet.
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Wednesday, August 09, 2006

An Unwanted Journey: Day 0260 - Neutrophils, Blockages, and Delays

Yesterday I visited the cancer centre to get a simple blood sample, have it analyzed, and then meet with the medical oncologist, fully anticipating that today I would be getting my fifth chemotherapy treatment. Unfortunately, that's not how it turned out.

The cancer centre nurse was unable to draw blood from the PICC line, even after several attempts. That meant I had to be scheduled for chest X-rays to ensure the PICC line was not looped somehow in my body. In the meantime, we took blood the old-fashioned way.

While waiting for the X-rays to be scheduled, I met with the oncologist who noted that my blood counts were lower than she would like, although not all the counts would be in until later in the day. She commented on how good I looked and how well I seemed to be doing in general.
The chest X-rays showed no problem with the PICC line itself. This was good news. I really didn't like the idea of having the existing line removed and another put it. So that left a blockage of some kind.

Settling back into the recliner, I waited while the PICC line nurse injected an alteplase solution into the line and left it for 30 minutes. We tried again without success. Then she tried a stronger dose of the same drug. We waited almost 150 minutes after which we were finally able to draw blood. She then changed the dressing. I was pleased to see that the irritation around the PICC line insertion point was less angry even though it seemed to me that the area of irritation was larger than before and that there were more pin-prick marks. Nonetheless, I was pleased to finally get out of the centre and go home.

Late in the afternoon, my supportive care coordinator called and left a message with my wife that my neutrophil count was far too low to go ahead today with my chemotherapy. They want to delay my fifth treatment until next week.

Neutrophils are a special kind of white blood cell that targets inflammation. They constitute as much as 70% of all white blood cells and only live for a few days. I have watched the trend downward for my neutrophil count over the entire year. What this means is that no matter how good I might look, appearances are deceptive. My body is highly susceptible right now to infection.

In addition, I have noticed a general increase in fatigue, even during my good days. Today, for instance, I had to sleep several times and still feel very tired.

So, while we are getting closer to the end of chemotherapy, there are still hurdles to get over. I am disappointed in what happened this week, but I can adapt. I can work from home most days, if necessary, and get rest whenever I require it. By December, most of these delays and problems will be a dim memory.
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Monday, August 07, 2006

An Unwanted Journey: Day 0258 - Cancer as Metaphor

There's cancer and then there's cancer.

"'F*****g Jews... The Jews are responsible for all the wars in the world.' Gibson then asked the deputy? 'Are you a Jew?'" [from TMZ, 28th July]

I understand that alcoholism is a disease. I appreciate that those with the disease may demonstrate characteristics completely out of sync with their day-to-day personality. But I also believe that both the behaviour of alcoholics and what they say when under the influence come from within. They are not imposed upon them. Individuals are responsible for how they behave and for what they say, whether they've been drinking or not.

Anti-semitism is a cancer every bit as dangerous and harmful as the invasive adenocarcinoma that has affected my life. If only we knew how to treat anti-semitism like we treat biological cancer with radiation, chemotherapy, and surgery.

Instead, we tend to cover up, forgive and forget, make excuses, blame the drinking. But what Mel Gibson said and the way he behaved in Los Angeles on the night of July 28th should not be forgotten. What he said is indicative of a tumour of the soul. Untreated, it will grow and metastasize. Unrecognized and denied, it will eventually destroy.
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Wednesday, August 02, 2006

An Unwanted Journey: Day 0253 - Infection

The CCAC nurse came to my home today to change the dressing for the PICC line. Because the redness and swelling at the insertion point had not diminished, but had actually intensified in redness and seemed slightly more elevated, we decided to call the cancer centre and have the infection examined. I was able to get an appointment right away, but had to wait about 90 minutes before the nurses in the chemo suite began their treatment.

The treatment consisted of changing the dressing for the second time, swabbing the area with a variety of liquids whose names I can't now remember, and applying a gauze dressing instead of the tape dressing. What this means for me is that we have to change the dressing every three days instead of seven days. It also means that I can no longer see the insertion point or the condition of the infection. Suits me.

Today after we examined the site at home, I started feeling queazy and fatigued. I suspect some of that was simply worry about what might happen, the worst of which seemed to be removal and replacement of the PICC line. Thank goodness that's not going to happen.
The most likely explanation is that I have developed a sensitivity to the chorhexidine used to clean the area around the insertion point.

I guess this is no big deal, especially in comparison to what others are going through or even in comparison to the side-effects of chemotherapy that I'm experiencing. But it has defined my day to some extent. Cancer treatment certainly is full of surprises and things to occupy the mind. But I'd much rather be doing other things, almost anything else.
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Tuesday, August 01, 2006

An Unwanted Journey: Day 0252 - Comparisons

Even though last week was what I called "a banner week", Saturday, Sunday, and Monday were not. Those are the days, every two weeks, when I can count on side-effects from chemotherapy laying me low. Yesterday (Monday) was a bit of a surprise, though. I felt like I'd been in a train wreck. Bowel movements were frequent and painful, with little time in between to catch my breath and rest.

This morning is better, but we're in the midst of a scorching heat wave in southwestern Ontario. I'm in an air-conditioned environment, so I have a great deal to be thankful for, but others working outside are not so fortunate. With the air conditioning, I am able to both telecommute to work and go on-site for awhile without jeopardizing my health further.
Others are less fortunate.

I've mentioned Leroy Sievers before. Unfortunately, this morning's blog entry, Bad News and Difficult Decisions, recounts his setback from ineffective chemotherapy drugs. Unlike me, Leroy is worse off now than when he started chemo in January. Doctors recommended an eight-week holiday from chemo, but that holiday only allowed the tumours in his lungs to grow larger than what they were when he originally started therapy. In addition, the cancer has now invaded his spine.

Leroy doesn't know what to do, and he's absolutely right in observing that probably no one else knows what to recommend. I know the feeling of receiving bad news. I can empathize with him that no matter how prepared you might think you are, you are never ready to hear news like that.

So, by comparison, the world is my oyster today. My bottom hurts, I have four more treatments and their accompanying side effects to endure, I'm feeling weak and tired...but I have not received any bad news for a long time now, not since I was hospitalized for pulmonary embolii.

Leroy, my thoughts and hopes are with you as you make these difficult decisions about whether to continue with chemotherapy and, if so, which drugs to have administered. Peace be with you.
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