Friday, January 16, 2009

"Yes You Can, Sir" Cream

"Step right up! Everyone's a winner, bargains galore!" **
Available now - and not necessarily for a limited time - is a product that, when applied conscientiously, can truly change your life.

This unique remedy can:
v Make each day uniquely precious and glorious
v Incite you to tell those you most treasure how much you love them
v Help repair your frayed relationship w/God
v Re-establish the primary importance of our relationships above all other pursuits (wealth/material items, status, prideful achievements, etc.)
v Intensify the compassion in your heart for those suffering
v Eliminate (suddenly) petty arguments w/significant others
v Inspire thinking outside of most typical boxes

Finally - amazingly, it can be applied liberally to re-align perspectives towards a nation's ills as well.

Its' benefits come to many under duress, but the positive effects are obtainable at any time, by choice at a reduced cost.
It operates on a mechanism similar to vaccines – a small does of a malady rallies the restorative reaction in our bodies and minds.
If you could experience the profound positives of this "product" without any life-threatening side effects, would you?


I jest, of course. Kinda. Thankfully, or sadly – it is often the challenges that come to us that most effectively realign our priorities. Meanwhile, there are many self-evident truths that we know in our hearts, and yet manage to ignore in our daily lives. These truths are those listed above – a recognition of what is really important in our lives. The threat or reality of significant loss in one's life forces these truths to the forefront – to a place so in your face that they can't be discounted.

If only we could remember that which we know without having a traumatic reminder.
In the very moment that mortality (yours or that of a loved one) re-presents itself to you, all of the truths that we'd rather avoid come rushing back. And…although painful, it is not an altogether bad thing. In fact, as I have reacquainted myself with these difficult and beautiful truths, vivid colors have returned to the palette of my life. Suddenly, a vibrancy that I hadn't realized that I'd been missing returned.

** see Tom Waites' excellent & hilarious song, "Small Change"


And just a few follow-up notes….

I had my first dose of chemo last Thursday (1/15). It went very well. The actual delivery of the drug took about 30 minutes and the entire time in the doctor's office (from initial blood work, hook-up, etc.) was less than 1.5 hours. Fatigue was the main side effect both yesterday and today. It has been less than 36 hours since I received my first treatment, but so far so good. I pray that my body will continue to respond as well.

I neglected to explicitly mention "my angels" – as I call all of you praying for my good health and recovery – when I spoke of the three-pronged partnership of God, medicine and me/Jacquelyn in my last entry. To be honest, it was much less an oversight than an attitude. You see, I count you all under the "God" category - sent by God to offer us love and support, the embodiment of compassion and caring. In the same way, you are with me every moment of the day. Thanks.

And lastly, I want to clarify a misconception (pun intended) that has come up recently. Jacquelyn is not pregnant. I am not sure exactly what either of us has written along the way to indicate that she is but a couple of folks have asked the question. We are extremely content with our two. What more could we want?

Stay warm all.

Wednesday, January 7, 2009

Going on the Offensive

Greetings all! It's a New Year!
[2008 was tough. I won't say bad, but certainly challenging.]
For me, the turn of the page means shifting from December's focus on healing from my Whipple procedure to the underlying cause of all of this medical proceduring – my pancreatic cancer. Now that the presenting tumor has been removed, my attention turns to how to keep it away.
Today was my second of two appointments with medical oncologists – the doctors who will suggest and lead my adjuvant therapy (treatment given after the primary treatment to increase the chances of a cure). Going into this phase, I thought that they might suggest that I receive no further treatment – neither chemo nor radiation therapy. I had very mixed emotions about this. On the one hand, it could imply a confidence on their part that the evil tumor had been so thoroughly removed that I was clean. On the darker side, it could reflect the absence of effective treatments for pancreatic cancer. Thankfully, neither doc suggested that I do nothing.
They agreed that a combination of chemotherapy, followed by radiation, followed by more chemo was the way for me to go. This is consistent with what the Clinical Practice Guidelines in Oncology recommend. They differed only on how long the initial chemo before radiation ought to be. The very latest thinking suggests that more chemo early on might be more effective. The treatment will take about 6 months in total.
I will start two cycles of chemo with a drug called gemcitabine next week. Each cycle consists of three doses given once per week followed by one off week. After that (in two months), I will have 6 weeks of radiation therapy - daily treatment on weekdays. I will have a week or two of recovery time before undergoing the last two cycles of gemcitabine chemotherapy.
I ought to be able to work throughout this entire period – except maybe for the occasional day here or there. The gemcitabine is generally well-tolerated. I've been told to expect some fatigue, nausea, flu-like symptoms the evening of the treatment, and lowered blood counts. The radiation seems to be the more troublesome of the two. The effects are cumulative with about 5-10 lbs of weight loss, greater fatigue and upper abdominal soreness expected.
I am, of course, totally up for all of this – being prepared to do all that I can to live a long time. There's a three-part partnership at play here – (i) me and Jacquelyn, (ii) the medical professionals and (iii) God. I've been working with the others to the best of my abilities so far. Deferring and challenging as appropriate. Taking action gives me a sense of control. It's time to kick some cancer ass, baby.
Unbelievably – it's been nearly three months since all of this madness started. In the larger scheme of things, I trust that it is only the beginning.
Thanks for staying with me.

Friday, January 2, 2009

Preparing for a Lifetime to Avoid its' End

"We felt we were doomed to die and saw how powerless we were to help ourselves; but that was good, for then we put everything into the hands of God, who alone could save us." - 2 Corinthians 1:9
"We know that these troubles produce patience. And patience produces character." – Romans 5:3-4
(Cancer) "You intended to harm me, but God intended it for good." – Genesis 50:20

Preparing for a Lifetime to Avoid its' End

Looking back on this experience, it seems as if I have been inadvertently preparing for this challenge my whole life. Although I would never wish this upon anyone, I feel that I am ready to handle this adversity. I am thankful for these lemons (thus far) and as long as I am allowed to see my babies grow up, this will all be a good thing.

I can see four distinct areas of my personal development that have put me in a unique position of strength to respond well to the pancreatic cancer that has invaded my body.

  • First is my diligent exercise over the past 15 years or so. My motivation has been to offset some of my more detrimental behaviors (vices that I opted to indulge) in the hope that I might still manage to live a longer life. But, as it turns out, that dedication has allowed me to recover more quickly from an illness rather than avoiding the getting sick to begin with. An unintended benefit. Besides that, being a non-runner who now runs marathons has taught me that amazing things are possible if I put my mind to it.

  • Secondly, I convinced Jacquelyn to be my life partner. I chose her because we make an exceptional team. We work so well together that there is, I believe, nothing that we can't do. I could never have imagined the storm that we would have to weather. Now that it has hit, we are not only not running around patching up the roof, but we already have provisions in the basement! If anything, we are thriving in the midst of this adversity.

  • More difficult to identify or express, but probably most important, is the role that my previous spiritual questioning and seeking have had on where I am today. To invoke the title of a rewarding book that I read along the way, I am a believer in "Finding God in the Questions". Wrestling with those uncertainties has made me more comfortable with not having the answers. Similarly, facing a premature death has stripped me of my comfortable reliance on much of what I used to depend on – without leaving me spiritually uprooted. I think that my previous doubts have allowed me to more readily recognize now the tangible sense that God is walking alongside me in my life.

  • The last unintentional preparation for this challenge has been my work with a therapist. Possibly the single most important unintended upshot was my recognizing my right to be happy in life and to ask for what I need from people. That allowed me to reach out to those around me (friends and family) for prayers and support throughout this ordeal. This has made a tremendous difference for me – both in the way I have felt and, I believe, in the outcomes thus far. I doubt that the pre-therapy me would have asked for, and so benefited from, the love and encouragement I have experienced from all of you.

The combination of all of these – the real-time payoff and lessons of physical exertion, an extraordinary partner, God's loving arms, and personal responsibility for my happiness in life – enable a hopeful and positive perspective.

Up until my last birthday, I have always felt like a kid. In facing my mortality, I have, unfortunately, lost a little bit of that innocence. But that loss is not the end of the story. An appreciation of it and all that I can do next is what matters most. I have been presented the choice between being a victim of my circumstances and being a survivor. I choose the latter, without really knowing just what that means. It is the only alternative. To focus only on the pain and loss would mean never realizing my strength. Therein lays the opportunity.

Although I can't know what awaits me yet, I believe that I am ready. I have been strengthened by the trials thus far, and hope that the trend of positive reinforcement continues.

May God bless all of our lives with health and happiness in 2009!