Day #23 for Patient #23

••• today's entry continues here below •••

.. for the amount of time that you spend together. And they know (intimately) this very vulnerable part of you. (And they are there to help.)

[ <begin mini-sidebar about weekly shrink sessions>

I am not going to get off-topic here .. but, on the subject of establishing meaningful intimacy with people while you are in one of the (if not thee) most challenging and needy times of your life ..

.. in multiple ways ..

.. remind me tell you about my weekly shrink sessions. We were talkin' 'bout some shit. I was even surprised at myself, at times.

When you have a good listener .. they can help to draw stuff out of you .. stuff that you didnt even know was in there. When you have a good, sympathetic, and even an empathetic listener.

My voice was barely audible at a whisper and hurt like hell for days afterwards .. but I went away. [ Every Thursday from 2:00 to 3:00. ]

Those records will probably be subpoena'ed some day. She assured me that she would "fight tooth-n-nail" .. to keep from releasing them ..

.. but said that she would "document lightly .. because UCSD *is* a public institution. If I were in private practice, I would feel more comfortable documenting more."

So much for the doctor-patient confidentiality protections.

Anyway, I got diverted there for a few paragraphs. But it was worth it. So let's return to interesting conversations with the radiation doctor's nurse.

And when I find myself in a mui feisty mood I will return here to discuss my weekly shrink sessions .. at the Moores Cancer center.

Where pretty-much everything is on the table. Where you can go anywhere you like and it wont seem the least bit strange. Because in your pocket you have the bus ticket labeled » Cancer Patient ..

.. which gives you access to existential lands and to the Twilight Zone .. all at the same time.

Juicy -juice topics.

We even held one of our meetings in the meditation room there on the first floor. That was nice. Big, comfy couches. "Sit wherever you like."

Update - I just returned to this section about my weekly shrink sessions and read over what I had written .. and the voice is my head said » "Dude, that's good writing."

Then the voice said » "If you lift out that section on your meetings with your shrink and transfer it to its own entry .. that would be some entry."

And there I would have to agree.

» A Lonely 99-Minute Window Into Eternity

Getting even more off-topic .. and speaking of writing about privileged and intimate topics .. remind me to tell you about the thoughts I had lying there, alone, behind the huge, bank-vault door ..

.. with a crew of 3 or 4 people watching me on 3 different cameras .. watching me get massive doses of radiation to the mouth and my neck and my throat.

Some interesting thoughts come to you under those circumstances. Right there, in those 3 minutes .. while your face is basically locked onto the platform upon which you are lying.

You know exactly when the actual radiation begins because a rather annoying buzzing alarm-type noise begins .. and continues the entire three minutes until it is done.

Thirty seconds later, the gigantic-fat door opens and the cavalry comes thru to unbolt your face from the platform and they grab hold of your arm and pull you up ..

.. which is nice, cuz later in treatment, it becomes difficult to lift yourself

And when they put you on the bed, they lift it pretty high .. so that the radiation head can go all the way around you. So you are levitated up there. If you fell off, that would hurt, sure.

But the thoughts that come during those essential minutes of cancer treatment (.. and also during the 60 minutes during which the chemo is dripping into your vein) .. these are some very honest thoughts.

I had 33 shots of radiation. Each shot lasted 3 mins. [Tho it takes them 20 minutes to set you up, to align your malignant ass just so .. because they are meticulous about that.) Anyway, that makes » 99 minutes of radiation .. spread over 7 weeks.

When 99 minutes become an eternity. A title, perhaps.

<end sidebar about weekly shrink sessions and thoughts while lying alone on the radiation platform> ]

Back to the radiation nurse ...

And I remember her saying » "The hardest thing you'll ever do."

It struck me when she said it.

But how would she know? She herself has never had cancer, nor been treated for it.

She must have heard such things from other patients, I am guessing.

And such a statement I can certainly understand.

I will not speculate whether it is the #1 hardest thing ever .. because plenty of things seem pretty hard, seem pretty miserable, seem like such ordeals, while you are going thru them, no?

Things that try the souls of men. And test their limits.

But certainly this thing, this cancer thing .. and especially the effects of its brutal treatment regimen .. is ONE OF the hardest. One of. (Historically speaking.) No doubt there, bro.

So .. one of the least appreciated things about cancer, it would seem, is that the oncologist, in order to kill the incurable .. must nearly kill you (the patient) .. or, at least, make it feel like they are trying.

» What's it Like?

If she happens to come over and talk to me again .. I dont think I can stop myself from asking her .. what it's like to work for/with her doctor. (One of my doctors .. I seem to have so many.)

I mean, she probably spends more waking hours with him than his wife. He is very smart. Impressive.

I've always enjoyed working with (and even for) highly competent people. He seems like he is always a step or two ahead of you. (In a good way.)

Some of the other people I have talked to (more than one) .. have indicated that they're afraid of him, or maybe just intimidated by him. As tho he were a demanding task master.

And there is so much riding on his work .. that you want it as good as it can get .. in order to coax from the odds the very best outcome possible. Feel me?

Perhaps the terms afraid and intimidated are exaggerations. But you catch my drift, and I cannot be more clear without quoting them directly .. so you see exactly what I'm talking about. I am thinking of 3 examples .. two girls and one guy. Which gave me that impression.

If it were just one .. you could more easily dismiss it as an anomaly.

I was originally going to discuss this stuff in the entry labeled » Killing the Incurable .. but never quite got around to it. (Blame it on the chemo.)

Well .. maybe I can discuss one of those conversations. But not now. Maybe later. If I remember.

But it had to do with my suggestion that they move up the clinical trials by a week or (even better) two.

That is .. if you want your patients to actually complete the trial. (All four weeks. Once per week.)

Because these trials knock your dick in the dirt quite viciously .. for an hour or two.

The clinical trials girl told me that .. while, radiation and chemo are synchronized in the treatment, because the chemo compliments the radiation (.. as a 'radio-sensitizer') .. there is no such linkage with the trial.

And by week 4 of the radiation/chemo, your ass is already sucking major wind and it is difficult to weather the bio-hazard storm that the clinical trial brings.

You could also conduct the trial a month or two after the radiation/chemo treatment ends .. but nobody is gonna wanna go back after they are done .. unless they have no other option.

Anyway, that was the back-story for the context of my telling exchange. the details of which I may share later. The "I said," and "she said" parts.

» My Radiation Doctor

But I do not want to leave you with the wrong impression. Even if he intimidates others, like I said, he does not intimidate me, no. (Tho I do feel a sense of respect. Sure.)

During the week where my voice went bad .. it was during that week where I was telling both him and his nurse how much I appreciated the clinical trials girl ..

.. cuz she was kicking so much ass on my behalf. (Especially when I had I-V anxiety.) And everybody else had left the room already, at the end of the examination. And I told him that I appreciated him, too.

I was feeling appreciative regarding his skill set at that time because my tumor had shrunk so much so quickly. That was VERY encouraging to me. Something I can see with my own eyes. Feel with my own fingers.

My point is » I was feeling genuinely appreciative for him .. so that 'genuine-ness' probably carried across in what little voice I had left at the time.

And he was walking out the door and he stopped, paused, and then turned and came back in and said » "Thank-you for saying that. Because, a lot of the time, that's not what we hear."

And I conceded that, from a patient's perspective, I could certainly understand how that might be the case ..

.. seeing how radiation is what he does to people. And radiation burns you. (You the patient, not you the doctor.)

I mean, they are using monster doses .. at least, compared to the occupational exposure limits [10 CFR ] we were exposed to in either the military or in the commercial nuclear industry.

If I may try my hand at channeling the good doctor .. I might imagine him saying something like this » "Dude, I want to tell some of these cry babies » 'I'm the only thing standing between you and the grave .. so try to show a little appreciation. The radiation suks, I'll give you that. But the effects of the radiation go away. Cancer doesnt go away. That's what makes it so deadly'."

The fact that both he and I have 'radiation' as the focus of our professions .. that is an interesting parallel similarity, no? [ The 'Rad' in Radified comes from radiation. ]

I mean, in light of the fact that it is basically his job to save my life .. from the very shit that killed both my mother and my grandfather. And he seems to be doing an excellent job, so far.

Anyway, maybe now you can see why I wanted to discuss this type of theme in an entry titled » Killing the Incurable (The Cancer Killers) ..

.. because this is what I was feeling grateful for .. and the other .. where my goal posts looked like they were about to be moved back ..

.. I was not feeling so grateful about that. No, sir.

So there was a nice play of contrast in the themes. Or, of course, it could just be the chemo fucking with my mind so that I am thinking crazy shit and think it sounds normal .. ya know?

What was I just talking about?

Chemo Doctors (Medical Oncologists) Are » Blood People

The Chemo doctor said my blood counts should return to normal within 30 days (of today). "Definitely."

Chemo doctors are called Medical Oncologists. They are blood people. Experts in the blood, and especially how the various (30) different chemo's affect it. That is their area of expertise. The blood.

A doctor specializing in blood who is not an oncologist is called a hematologist.

If the cancer does come back (she said) .. it usually comes back within the » first two years. So, if you make it that far, you're over the biggest statistical hump. (We're talking about a matter of life-n-death, no?)

But 5 years is really the goal, the gold standard. If you make it 5 years without the cancer returning, you're golden.

If this type of cancer spreads .. two of the "most likely" places it would spread to .. would be » the lungs and the liver.

This is why they closely follow my liver functions (via blood work) and look at my lungs every chance they get.

Did I mention that the tumor is gone? Probably not as much as I should.

It actually started shrinking from the very first day that I got chemo. I remember getting out of the shower, getting ready for an evening trip down to Moores. (They're open late. 8PM. 9PM.).

And I looked in the mirror and noticed that the swollen lymph node was barely noticeable. So I started calling everybody .. I was so excited. So stoked. So encouraged.

» Appointment for First Post-Treatment Scan

Speaking of going for five years with no recurrence .. the clinical trails girl called today .. with the date of the appointment for my "first post-treatment scan." A CT scan. Middle of next month.

I would normally not get this scan until the 4-month point .. if I had not participated in the clinical trial.

They want the scan done at a very specific time » 15 weeks after the date of the beginning of treatment, which seems weird to me.

So as I count the weeks myself, the CT scan appears to be scheduled to occur at the beginning of week 15 ..

.. from the day that treatment started (on Dec 8).

Then, at 4 months, they give you a PET scan.

I prefer PET scans to CT scans. For the PET scan, they shoot you with some radioactive sugar ..

.. then have you sit & wait for 45 mins until the stuff has worked its way into your tissue.

The PET scan takes a little longer than a CT scan, but the needle is only in your arm for a few secs.

With a CT scan however, they put in an I-V, which you leave in for the duration of the scan (20 mins). And they remotely shoot this dye into the I-V half way thru. Not much fun.

So they will be watching me closely.

The CT scan allows them to 'see' abnormalities in tissue. But the only way to confirm that these abnormalities are indeed malignant would be by a tissue biopsy .. otherwise known as the 'chunks of flesh' biopsy.

The CT scan is about seeing 'structures' growing inside your body .. particularly 'structures' which should not be there .. or maybe structures that have grown abnormally large.

A PET scan on the other hand, is about seeing metabolic activity inside your body.

Cancer likes sugar. Cancer needs sugar. Cancer sucks up sugar.

So they have you fast, starving the cancer of its beloved sugar. Then they shoot you up with some radioactive sugar, which goes to the cancer sites, if you have any.

The PET scanner can then (45 minutes later) SEE this cancer eating the glowing radioactive sugar. Too cool, no? Isnt technology grand?

One of the things that makes cancer so dangerous .. is that is reproduces so rapidly .. that it can quickly overwhelm your body.

And when the sugar is injected, the cancer goes to town in a big way, sucking up the glowing, radioactive sugar, which it doesnt even know that it is radioactive. It only knows that it is sugar.

If cancer were really smart, it wouldnt eat the radioactive sugar. Because then the doctors wouldnt know where to focus their beam of radiation, which kills the cancer, because cancer cells divide so rapidly.

When you get your radiation shots, you can HEAR the cancer cells screaming (like a vampire at the beach at noon), "Make it stop! It burns so bad!"

And it is like the Chemo rubs baby oil all over the cancer-vampire, helping to burn it even better. Chemo can be so sadistic at times.

» Sitting in the Chemo Chair with Iron in Your Arm

You may find it interesting, as I did, that the chemo itself is no problem. Both before and after the actual chemo infusion (1 hour) they give you lots of fluids and anti-nausea meds (drugs). And steroids. Cortical steroids.

They gave me so much fluids, so quickly (to protect the patient's kidneys) that my arm was COLD .. all the way up to the shoulder.

So much so that I brought along a heating pad with me for infusions #2 and 3. And wrapped it around my arm.

But you have iron in your arm for several hours.

To be honest, you actually feel pretty dang good both during the actual infusion and for 2 or 3 days afterwards. I mean, you feel like you are starting to get your shit back. But you aint. It only feels that way because of the drugs.

They give you this anti-nausea pre-infusion that lasts for 3 days. But then it wears off. Most of the actual chemo drug should be out off your bloodstream within 48 hours .. if you can drink a decent amount of water .. to flush it out.

It is work, bro. Let me tell you .. it is work .. both swallowing and putting anything in your stomach. The worst I feel is when I am puking or dry heaving. That really sucks.

But I havent puked for 3 days now. Very encouraging.

It really helps to drink aloe vera juice. At first, I thought the idea unappealing. But when I actually tried it .. ooh, baby .. my throat and stomach both liked it.

My weight is down to 152. If you would have told me pre-treatment that I would get down to 150 .. that would have scared me.

For me, dropping from 180 down to 165 is a lot .. but dropping another 15 pounds down to 150 .. whoa. You have to work at getting the calories into your tummy. It's work.

» The Feeding Tube

Back when the chemo doctor was working me about getting a feeding tube .. I think it was week 4 when my weight started dropping like crazy .. I said to her, "No, no .. I just got these Ensure's and I can drink them. Watch me."

But I was thinking to myself .. that if I ever got down to 150, that would mean I should get the stupid tube sticking out of my stomach. Because that was a weight I would never get down to ..

.. because the treatment only had a few weeks to go. And I could hold out that long. Without the tube.

But I never really thought that I would actually hit 150. So I am surprised. And glad that I am 3 weeks out of treatment. Let the healing begin, brother. And let it begin with me. Any day now. ( I shall be released. )

» Fist Bump

The radiation doctor walked into the room recently .. where I am sitting with the clinical trials girl. And he says (mid-stride), "So, do you still have the feeding tube?"

And I say, "I never got the tube. The idea of tubes sticking out of my body .. not so appealing. Feel me, dog?"

The clinical trials girl was sitting too far away for a high five, but close enough for a fist-bump .. with a smile of satisfaction.

No, I did not say, "Feel me, dawg," .. but I was thinking it.

Most patients who go thru the treatment that I did get a feeding tube. Or so they tell me.

The clinical trials girl is the one who had called me, weeks before, and said, "Dont freak out if the hospital calls you and says that they are ready for you to come and get your feeding tube. I merely submitted the paperwork in case you do need one. Because most patients do. This way there will be no delays."

So that's what the fist-bump was all about. It was a subtle but cool moment, which may be difficult to describe.

She also said that most of the patients who DO get a feeding tube .. wait until 3 or 4 months after treatment .. before they have them removed.

I thought this long. But she said it takes a while to get the swallowing muscles back in shape after so long with no use. Three to four months after. That surprises me.

And then there is the fatigue. Not so difficult to describe. But that is a story for another day.

» David Carr Dies of Lung Cancer at 58

Speaking of cancer .. did you hear that David Carr died of cancer? .. at age 58.

I did not know that a person could die of cancer without even being aware that they had it.

So I have been thinking about that ever since he (so surprisingly) died (.. 6 days ago on Feb 12).

Maybe later I will return to share some comments on both the man and his death ..

.. tho I cant help but wonder » did he know .. that he had cancer?

I heard that some people cannot tolerate the treatment and say, "Fuck it. Just let me die."

I must say, I certainly understand the sentiment. Such a decision would depend on a number of factors, including age and health.

Regarding David Carr dying at 58 .. it may sound trite, but worth noting nonetheless .. that it's not how long you live, but how you live the years you have.

[ Here is another guy, Simpsons creator, Sam Simon, who just died of cancer in his late 50's. ]

» Citizenfour | Edward Snowden | Oscars

I find it somewhat curious ..

.. that David Carr had just finished interviewing Laura Poitras, Glenn Greenwald and Edward Snowden (live via Moscow) that very same day ..

.. about the filming of Citizenfour, which has been nominated for Best Documentary ..

.. and is the odds-on favorite. (Trailer.) Timing is everything, they say.

Rad note » the subject in this entry has drifted far enough to warrant its own separate page. (Blame it on the chemo.)

So I have lifted and transferred to its own page the section that deals with David Carr and the Oscar nomination of Citizenfour, starring Edward Snowden.

At the end of that page you will find a link .. to return you here to this exact spot. See here » David Carr, Citizenfour & an Oscar for Edward Snowden (Laura Poitras & Glenn Greenwald).

» The Community College

Speaking of teaching .. I want to share with you an article written about our community colleges ..

.. which I found very interesting .. titled » The Promise and Failure of Community Colleges.

Which basically says that » "a very large group of young Americans are not prepared, either financially, cognitively or socially, for that kind of education."

Because only ~8% of community college students transfer to a 4-year college ..

.. and only one third will earn a two-year degree within 6 years.

I have spent considerable time at community colleges ..

.. mostly in California, so I feel qualified to comment.

Especially since both the dog and my brother went to Ivy league schools (Columbia & Yale). Both home-town schools.

You may find it interesting that roughly HALF of all students enrolled in college at any given time ..

.. are studying at a community college.

Wow, that's a lot.

Rad note » the subject in this entry has drifted far enough to warrant its own separate page. (Blame it on the chemo.)

At the end of that page you will find a link ..

.. to return you here to this exact spot. A shuttle service you might say. A hyper-linked shuttle. See here » College » Life-Enhancing Classes with the Best Professors.

» New 17-inch Toshiba Laptop with AMD A8 & Radeon R5

But before I get too deeply into that .. I should first mention that I got a new laptop. After 10 years with the old one.

Which I bought when the Bug was a newborn. (He is now 10.)

There was a mix up with the rent and I could see that I would be living out of my car (Porsche in Laguna) for a while ..

.. and FOR THAT I would need a laptop ..

.. which I could then use at either the coffee shop or the library. That was the impetus for the purchase.

(Doncha just love those little side-excursion detours down memory lane?)

Rad note » the subject-drift here with getting a new laptop was severe enough to warrant its own entry .. see here » New 17-inch Toshiba Laptop With AMD A8 & Radeon R5 Gfx.

At the end of that entry, I have included a link to return you here .. to the exact spot from where the text was lifted.

(Search engines like it better when different topics get their own separate page.)

» Adobe Dreamweaver CC & Enabling Maximum Creativity with the Creative Cloud

Update .. my curiosity got the best of me ..

.. so I downloaded and installed a trial copy of the new Dreamweaver (called "CC") ..

.. and took it for a creative spin around the new 64-bit block .. to see what it's like.

Wow. What a piece of software. What a well designed piece of software.

Elegant. Smooth. Rock stable. My first 64-bit Dreamweaver experience. Beautiful. I'm definitely impressed.

Rad note » the subject-drift here with demo'ing Dreamweaver CC was severe enough to warrant its own entry ..

.. see here » Taking Dreamweaver CC for a Creative Spin Around Adobe's 64-bit Block.

At the end of that entry, I will provide a link to return you to the exact spot from which this text has been lifted and moved.

» The Bitterroot Burn of 1910

Speaking of enhanced creativity ..

.. before I forget, you shouldnt miss the new (Feb 3) American Experience (PBS) feature titled » The Big Burn ..

.. based on the 2014 book by Egan .. a truly gifted writer.

He is one of my favorites at the New York Times.

This deals with the great fire of the summer of 1910 in the Bitterroot mountains, which destroyed an area the size of Connecticut, and where 78 firefighters died.

Narrated by Oliver Platt.

The Bitterroots are not far from Coeur d'Alene, which is where the Wow girl grew up. Wallace is a key town mentioned in the video.

Nova did the same thing with (the super-excellent) Einstein's Big Idea (video), also based on a book.

And like Alex Gibney is doing with Lawrence Wright's 2013 non-fiction book about Scientology.

If you are out of the country, you may need to configure a US-based proxy.

Egan also wrote a book on the Dust Bowl titled The Worst Hard Time, which Good Reads ranks #16 .. out of more than one thousand books on American History.

» The Truly Gifted vs the Diligent Student

Speaking of the truly gifted .. I would be lying if I said that I never pondered the idea of the truly gifted vs the (merely?) diligent student.

Certainly, if the truly gifted does not develop their gift, their talent, the diligent student can easily surpass. No?

Over the course of my life, many people have said things to me .. that made me think.

For example, the lady at Zinc cafe in Laguna, who said » "I know a lot of people who work very hard at this." (implying that I made it look easy)

I bet they do. I had actually been working at it rather diligently myself. Certainly a student of the seemingly timeless craft. Tho it did feel like it came easily.

And more such things have I heard along those lines. Thought provoking things. Many more. And often under curious circumstances. And with unusual people.

So, I feel qualified to discuss this topic .. because I have thought about it for a long time. Over decades. And from many different perspectives.

To be continued ...

The end. ■

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