I am terrible with anniversaries.

I missed blogging my one year endoscopy anniversary, when I was first informed I had a suspicious tumor in my stomach (May 17, by the way). I also missed the anniversary when the endoscopy doctor confirmed, while I was waiting for a flight back home in the Denver airport, that I had stomach cancer (the name of this blog: 23/5 or said another way, May 23).

Today is another one year anniversary. I felt I needed to provide an update.

One year ago I started chemotherapy. And I started this blog.

Doctors placed my chemo port the day prior. Then, on June 12, 2019, at 9:00 am, the nurses at Walter Reed’s Murtha Cancer Center accessed my new port and started filling my body with FLOT chemo drugs.

Since no one bought me paper for any of my multiple one year anniversaries, I decided to keep myself busy:

I rented a sod cutter from HomeDepot and cut out a bunch of dead patches of grass. Now I just need to lay the 30 pieces of sod I bought.

What a difference a year makes, though.

Shortly after my first chemo session, I immediately began feeling the effects and had little to no energy. I would go on walks and really struggle. I ended up spending the next 180 days mostly in bed, isolated from my family and friends.

Never would I have imagined a year ago that I would have spent all day under the sun, cutting and laying sod.

Nor did I think a year ago that my chemo and surgical recovery would have prepared me for COVID-19 like it has. My type-A personality would never have allowed me to quietly sit at home and wait out the stay-at-home order…#thankscancer! But I did my part for our nation:

I self-isolated [ok, I did it because my doctor’s ordered it] and needed to socially distance [because my wife didn’t want me to get close to anyone] due to my compromised immune system. I binge watched a bunch of shows because I couldn’t do much else. It was impossible to be my normal go-go-go self – always working, doing, moving. In the end, I was put into a corner for my health. But as we know:

I’m happy to say that I am a cancer fighter and survivor. I look forward to saying I’ll be a COVID-19 stay-at-home survivor, too.

I am now doing all I can to have the time of my life:

Until the next post…which hopefully won’t be another five months.

So it has been a little while since I have posted an update.

My only excuse is that I am living my new life. I am playing with my kids. Going with my wife to her favorite stores (who knew there were so many HomeGoods in and around Northern Virginia). And, I am back to work, and have been for about a month now.

I started slowly at first by just working 5-6 hours a couple times a week. After a couple of weeks, I worked up to my current full duty day (8-9 hours), 5 days a week.

To get to this point, the biggest hurdle I had to overcome (besides recovering from my tumor/stomach removal, chemo, and gallbladder surgery) was feeding myself.

Over the course of two weeks in mid-January, I weened off of my TPN regime under the guidance of my oncological nutritionist. During that time, I alternated days of TPN and eating on my own.

Though the eating was tough, I regularly met my 2,000 calories a day goal…its amazing how many calories mayonnaise and Ranch dressing add to what you eat, but I don’t recommend them on your cereal.

At the end of the two weeks, I knew I was ready to pull my PICC line. So, on 28 January 2020, my surgical oncologist performed the following:

All 43 centimeters (or 17 inches) of spaghetti tubing came out without issues.

For four months, I survived on the 1900 calories a day the TPN provided. I would not have made it through chemotherapy or the cholecystectomy (aka gallbladder removal surgery) I endured without the white liquid gold that flowed through my veins for 14 hours a day, seven days a week.

Two times a day, my wife had to flush my PICC line to prevent a blood clot from forming and blocking the TPN flow. She was amazing and never allowed the line to get blocked up.

In stark contrast, my line seemed to get blocked during every hospital stay…it was very annoying getting the line unblocked. I think that speaks volumes to my wife’s dedication and support to me, every day, two times a day for four months. A little bit (or a whole lot) of love goes a long way in caring for someone.

That leads to today.

I am eating on my own. Just like a big boy.

Unfortunately, I don’t get to eat big boy food.

No steak, hamburgers (with or without cheese), french fries, BBQ, chili (with or without carne), wings, or even salad (only to be used as garnish or on top of burgers). Or really anything tasty. But there are a few exceptions.

Pizza seems to be OK for some odd reason. But the pie has to be plain old cheese pizza…no pepperoni, sausage, onions, bell peppers, or mushrooms – an by the way, pineapple is never allowed on pizza!

I am slowly learning what I can eat. It still consists of lots of rice and potatoes (mashed, not fried or roasted), for now.

Scrambled or hard boiled eggs are OK, but bacon or breakfast sausage are no-no’s.

A little bit of pasta, but without any crazy sauces…except for my wife’s other worldly Ragu…not the nasty store-bought brand, rather the homemade variety! Delizioso!

High fiber fruits and vegetables are out of my diet for now. Without a stomach to breakdown them down, I have to stick to a select set of cooked veggies and skinless fruit.

And, don’t get me started on sugar products. Refined sugar is a gut buster…literally.

But, everyday I am getting stronger. Everyday I am learning what foods I can (and can’t) eat. Everyday I am going back to the gym. Everyday I am doing things with my wife and kids – especially playing a lot of Mario on the Nintendo Switch…lots of Mario.

It’s all good!

I am alive and living my new life…and I am excited to see where it takes me.

While I explore my new “normal”, I’ll just try to avoid blue shells:

I am out of the hospital and a little lighter in the abdomen without a gallbladder.

Shortly after my last blog post, late on Christmas evening, the surgeon who took over for the emergency room doctor visited my hospital room to convey that he and his colleagues, after more discussion, are 99% sure that I need my gallbladder removed.

In the time from when I completed all my various tests in the EF, was admitted to the hospital, and finally settled in my room, a small team of surgeon’s reviewed all my previous CT scans and determined I have had an enlarged gallbladder for some months now. They speculate that I had so much else going on that my body just ignored the symptoms of the inflected organ with developing / developed stones. (At some point in the not-too-distant past, I had a pea-sized stone, but passed it)

Now that most of my primary cancer and post-gastrectomy issues resolved, my body woke up to the issue with my gallbladder.

Therefore, no more medical testing was required. The remedy: remove the gallbladder forthwith!

The plan was a straight-forward 60-90 min laparoscopic cholecystectomy. The surgeon’s would start with a small incision near my belly button and then make three small incisions along my rib cage on the right upper quadrant of my abdomen. They would cut out the gallbladder and ensure the bile duct from my liver was clear so it could take over the missing organ’s functions.

But, when has anything been straight-forward with my care and treatment as of late?

After a 4-hour procedure, the surgeons removed the gallbladder, but in a more traditional slice-you-open approach as I had so much scar tissue from my gastrectomy, the laparoscopic approach was not successful.

So, now I am home with another abdominal scar and only pain from the healing cut to bother me. (I am waiting for an issue with my appendix so the doc’s can complete the abdominal Bermuda Triangle they start with the first two surgeries)

Luckily it was only a 2 and a half day stay in the hospital. Just in time for me to get home before my mother-in-law jumped on a plane back to Italy. She has been helping us for the last six months while I went through treatment. It was such a blessing to have her help as my wife and I went back and forth from the hospital literally hundreds of times over the past 180+ days.

No more body drama! Now is the time for me to physically recover, and my family to return to a stable living pattern.

Now that 2019 is closing, I don’t want any more hospital stays. No more nights filled with stabbing pain. No more infusions of toxic miracles to beat back my cancer. Only healing and good times ahead.

2020 is going to be a great year! I can just feel it…

“[…], mend a quarrel. Seek out a forgotten friend. Dismiss suspicion and replace it with trust. Write a letter. Give a soft answer. Encourage youth. Manifest your loyalty in word and deed. Keep a promise. Forgo a grudge. Forgive an enemy. Apologize. Try to understand. Examine your demands on others. Think first of someone else. Be kind. Be gentle. Laugh a little more. Express your gratitude. Welcome a stranger. Gladden the heart of a child. Take pleasure in the beauty and wonder of the earth. Speak your love and then speak it again.”

Howard W. Hunter

Beautiful words I try to live by.

I would like to say I am sending this Christmas message as I am snuggled under a blanket in my home with my family around me.

Rather, I am sending these well wishes from my hospital bed at Walter Reed Medical Center in Bethesda, MD…Merry Christmas to me 😞

For the last week or so, I thought I was beset with the flu, since it touched everyone else in my family. I was vomiting, diarrhea, no appetite, fever, fatigued, etc. But I also had weird abdominal pain on my right side right around the ribs.

After a couple of days, all the symptoms cleared except for the fatigue and abdominal pain. The pain wasn’t as strong, so I figured it was just going to take a little more time. The fatigue remained.

Today, I had no appetite for our Christmas breakfast feast of Mickey Mouse waffles, eggs, bacon, and hash browns. The same held true as lunch approached.

In the place of hunger were violent dry heaves.

I told my wife something wasn’t right and we should go to the hospital. I should note, in fairness to my beautiful bride, that she has been wanting me to go to the hospital for a week. I finally relented.

After 8 hours in the emergency room, a chest and abdominal x-ray, ultrasound of my liver, gallbladder, and pancreas, and, finally, an abdominal CT scan, the doctor’s aren’t 100% sure what is going on as I don’t fit any textbook diagnosis for serious liver conditions, choledocholithiasis (gallbladder issues), or pancreatitis.

The ultrasound and CT scan show I have a gallstone, but it is not a concerning one.

However, the CT scan did also show my gallbladder to be enlarged and presenting thickening of the walls. I’ll have to do one more test in the morning to determine if it is the gallbladder…the remedy: remove it.

On a positive note, the issue does not appear to be cancer or gastrectomy related, as all of my other hospital visits revolved around these issues. Yeah, me!

However, it is another hospital stay. Another set-back to full recovery. A little while longer before I will be “me” again.

More to follow. Until then, reread the quote that started this blog post and strive to be a better person this Holiday Season and into the New Year!

First reports are often wrong.

A mentor shared that with me a number of years ago to teach me not to go crazy or overboard with the first pieces of information flowing in during a crisis or stressful situation.

This past weekend once again reminded me that I need to slow my roll.

After arriving in the Walter Reed emergency room Saturday afternoon, the first reports started flooding in from the ER doctor and the attending surgical resident.

My CT scan and subsequent x-rays showed that one of my stents migrated from my esophagus to my upper small intestines. There was likely still a leak from my initial gastrectomy with infection build-up between my liver and spleen.

It was recommended that would undergo a procedure the next day to reposition the migrated stent, add a third stent, and place a drainage tube in my abdomen to remove the fluid buildup that could lead to sepsis if not cleared out.

Not a positive prognosis, with implications of a couple-week hospital stay.

I was devastated at this news.

Why? Why so many set-backs? I just made it through chemo. I was doing everything the doctors asked of me.

Then the call went out to family and friends alike to pray and fast for me. Two of my best friends came and administered a Priesthood blessing of comfort and healing.

In the blessing, I was reminded to stay strong, not to lose faith, trust in my doctors, and that I would be healed and made whole.

Sunday afternoon came and the decision to conduct the procedure was delayed until Monday so the lead Gastro-intestinal doctor could be consulted, along with my primary oncological surgeon. Seemed like a fair decision.

Well-wishes flooded both mine and my wife’s phone and email. We knew lots of prayers and fasting focused on our family.

Then, everything changed Sunday evening.

My oncological surgeon visited my room. He turned the proposed game plan on its head and kicked it out.

His assessment: yes, a stent had migrated, but both stents should just be removed…permanently. There is (and was) no leakage on-going. The “fluid” that the previous medical team was looking at was non-existent. In removing my stomach, the anatomy of my digestive track has changed and would be hard for someone not intimately familiar with my case to interpret CT scans or x-rays properly. In the end, he believed the stents did their job and protected the perforation in my esophagus to heal. The pain I was experiencing was simply the jagged edges of the stent scraping their way down my small intestines as the muscle were just doing their job trying to move stuff down the line.

Hope was immediately restored!

With his words I was reminded of my mentor’s caution. And I also knew that the prayers and fasting on my behalf made this all possible.

Monday came and I underwent the GI procedure.

Upon waking, I was immediately aware that I was pain free. A stark departure from my last GI procedure when I ended up in cardiac arrest due to the excruciating pain caused by the newly placed stents.

The second thing of which I was made aware is that my perforation was completely healed.

Hallelujah! A Christmas Miracle!

Everything my heart desired came to pass. All those prayers and fasts help deliver what I really wanted. The stents removed and my perforation closed.

On Tuesday, a nasty Swallow study confirmed my esophagus was completely healed.

Wednesday morning I was released from the hospital.

This cancer journey has tried me and my family more than I ever thought I could be tested. Irrespective of the pain and suffering, I have tried to remain positive and upbeat. It has not always been easy. But how could I not be positive knowing I have so many people rooting for me to succeed and heal?

Again, I am eternally grateful for the support my family and I have received from so many friends and family.

This has been a team effort!

I still have some healing to do…chemo keeps reminding me that it is still flowing through my veins.

Regardless, I am on the path to a complete recovery.

I know this to be true because I ate pizza today and it was wonderful!

It all started with hiccups.

For the better part of the last month, a sharp cramping pain has dominated my life…actually, more specifically, my diaphragm muscle just under my rib cage on the left side of my abdomen.

The pain quickly escalated to a persistent, sharp stabbing sensation that erupted into torture anytime I took too deep a breath, uncontrolled cough, full-bellied yawn, or ,you guessed it, simple hiccups.

I quickly met with my surgical team; but they dismissed the issue as straightforward spasms to be treated with muscle relaxers…which initially helped.

However, while devouring my Turkey-day “sampler plate”, my abdomen felt like it rebelled against me.

The stomach pain (my daughter says I can’t say stomach or tummy pain anymore because I don’t have one…I’ll have to improvise an alternative descriptor) eventually became overwhelming enough that I had my wife take me to the emergency room at Walter Reed Bethesda.

Shortly after arriving at the ER and a morphine shot or two later, the pain was relatively under control. Just as quickly, I endured a CT scan and a couple of x-rays that revealed I was eating more than turkey on Thanksgiving day!

Needless to say, my stents have “migrated”. Taken a vacation. Gone on strike. Malfunctioned. No worky no mo’.

So, starting on Monday – when the medical A Team arrives – we will work with the doctors to determine the best way forward.

I am so grateful for the immediate outpouring of love, prayers, fasts, and support as me and my family deal with this latest setback.

In fact, within hours of getting to the hospital, two of my best friends drove all the way into DC just give me a Priesthood Blessing of healing and recovery. So much love; so much support!

Also, many friends and family fasted on my behalf to give me, my family, and the doctors added strength and guidance to do the right thing for my health moving forward.

My heart is full from all the love and appreciation poured out towards me today.

I am especially appreciative for one of my daughter’s best friends, who during Church today, stood up in front of her congregation (a couple hundred people) and shared her testimony of Jesus Christ and the power of the fast…and that she was fasting for me!

I was overwhelmed with emotion to know that this beautiful, eight-year-old little angle did all that for me. I am moved to tears of joy every time I think of her sweet action. This memory remains imprinted onto my soul and I will be eternally grateful to her and her parents.

Though unplanned and unwanted, this latest hospital stay will not stop me. I know I have the support of so many to see me through to a full and healthy recovery.

Today marks my final day of active cancer treatment from my oncology team.

I completed the second phase, 4th cycle of chemotherapy (8 cycles in all). Just over 4 months of chemo in all. Throw in 2 months for my tumor removal and gastrectomy, I completed 6 months of treatment today. Very emotional!

We Did It!

But to continue my marathon analogy from my last blog post, I feel like I just past the 26 mile marker on the treatment race course. But I still have that cursed .2 miles to go!

For those lacking in-depth marathon histrionics, the marathon course distance was not always measured at 26.2 miles (42 kilometers).

The marathon, for centuries, was 25 miles long (40 kilometers) as that was the distance between the city of Marathon and Athens. It wasn’t until the 20th century return of the marathon to the Olympics that the distance was set at 26.2 miles in the 1908 London Games for the oh-so-technical reasons to accommodate the British Royal Family’s desire to watch the race start from a garden window and the finish from the Game’s Royal Box. To meet the Queen Alexandra’s requests the course was extended not just a mile from 25 to 26 miles (41.6 kilometers), but 26 miles and 385 yards…26.2 miles (42.1 kilometers). The 1921 Olympic Games formalized the new distance and since it has remained the official marathon running course length.

The thing I dislike most about running a marathon manifests at the 26 mile marker. I know that as I cross that point, I still have those .2 blasted miles to go.

They are the longest 385 yards to run, every time.

And sometimes (curse you Marine Corps Marathon), the last .2 miles includes the longest and steepest course obstacle or hill – for some sadistic purpose known only to the race organizers.

It’s the last .2 miles that gets me every time.

Again, today I feel like I passed the 26 mile marker. I wish it was the finish line, but sadly it is not. I still have to endure the effects of the FLOT chemotherapy regime for the next 7-10 days…my additional 385 yards to go.

Even then, unfortunately, I am not completely done.

In an additional four-to-six weeks, I’ll go back in for an out-patient procedure to have the two esophageal stents removed that have been covering the esophogus-jejunum perforation I experienced after my surgery…you remember, that little “incident” that left me in the hospital for four weeks. 😩

I have to wait these few additional weeks to ensure my body’s recovered sufficiently from the effects of chemo…which includes thinned blood, sensitive internal tissue, nerve sensitivity, white & red blood cell generation, and personal energy levels (have to keep eating…I am still nearly 30 lbs below my normal body weight).

Regardless of the course I still have to run, today was a great and historic day for me and my family!!! 🎉🎊🎆

I am grateful to all the friends that came and sat with me during my day-long infusion sessions. Not to mention the prayers from family and friends far away…and those that fasted (especially my father-in-law) every session.

So let the bell(s) ring out:

From the beginning of my cancer treatment, I (and many others) often used running a marathon as a descriptive analogy of the time, process, and effort required to make it through to completion of care.

I have run many marathons. Inevitably in a several of my races, I ran directly into the mythical “wall”.

Often hitting between mile 20 and 22, the “wall” manifests as the bodies depleted energy causing the runner to slow their pace, sometimes devolving into walking, and mental thoughts that finishing the last several miles will be impossible.

I’ve had my fair share of “seeing Jesus” moments around mile 20-22 where I questioned whether I could finish. In every case, I pushed through and finished the race. It often required a little extra gel or sugar boost and hydration at the nearest water station. And a motivational text from my wife and kids.

During my phase one of chemo, I was knocked down for the first couple of days, and made a near good recovery after several days and felt pretty strong heading into the next chemo session. Of course, it got a little harder each session, but overall, I can’t say I ever hit the treatment “wall” (I count the 24-hr bug that put me in the hospital as an anomaly and not a physical or mental break down).

As I sit here recovering from chemo infusion phase two, session three, I feel I have hit the treatment “wall”. Effects of the poisons chemo drugs coursing through my veins remains longer and longer, while recovery is harder and harder. And I am questioning more and more, “can I do this?”

The physical recovery is toughest.

Like I stated in my last post, it feels like I got hit with a bat, struck by a bus, and run over by a tank (for good measure).

Mentally it is equally challenging as the pain and suffering seems never ending.

Intellectually I know the treatment is closer and closer each day to being over. But I still have to get through each day.

It is amazing how long 24-hours can feel while fighting through the the chemo treatment.

But like running a marathon, you push through the physical and mental “wall”. You know there are fewer miles to the finish line than when you started. You can do this!

On Tuesday, I complete phase 2, session 4 of chemo. My last session, hopefully, for the rest of my life. Knowing that is what has helped me push through the session three treatment “wall”.

The love and support of so many family and friends is the other aspect of breaking through this treatment wall that is carrying me to the end…even though I feel zapped of strength and energy, I know I’ll make it across the finish line upright and pushing til the end because so many are praying and supporting me.

POST SCRIPT: A little note on hair.

Leading into my phase two, session two chemo infusion, I was certain all my hair would fall out again. Every morning I woke up to my pillow covered in hair shedded throughout the previous night.

So, to avoid the slow, dirty process of waiting for each follicle to fall and cover my bedding or clothes, my wife took the clippers to my head and I quickly followed with a razor. Bald as a new born baby’s bottom.

To my surprise, within about two days, my hair (and beard) started to grow back.

Now, three weeks later, my hair is still quite short and growing back slower, but it is growing back…while I am receiving chemo. Weird. Who knew that would be the greatest discrepancy between the two phases of chemo. The first striped me bald for the better part of three months. The second slowed growth, but kept it on my head.

Round 2, infusion 2 of chemo is done. It was completed a week ago.

Chemo, this second time around, is much more taxing on my body and health. The exhaustive and pain-riddled state I am left in does not lend itself to wanting to jump on-line and keep this blog updated.

Yet, here I am. I am doing better today than I was yesterday. I’ll feel even better tomorrow. Each day I feel the negative effects of chemo less and less. However, I know that in a week, I get to do this all over again.

But after the next session, I’ll be able to declare I have only 1 chemo infusion left. And shortly after that, I will have no chemotherapy to ravage my body.

Twenty-three days ago the second round of chemo began with me wondering how different it might be from the first round.

Broadly, I have suffered the same side effects to include nausea, diarrhea, painful joints, muscles, and nerves, insomnia, and a general sense of feeling like I was hit by a bus, then run over by a tank, and finished off with a good beating from a baseball bat.

Added into the mix on this sequel to my chemo treatment, I can add vomiting – or at least attempts at throwing up – to the distinguished list of feats and side effects. For the first time I am grateful I don’t have a stomach…because you can’t throw up if there is no repository of liquids and partially digested food to serve as the font. No, I get the effects of full effects of vomiting through dry heaves, but no satisfaction or relief by actually retching.

Around day eighteen of my first chemo session, my hair fell out – another noted side effect. I am 23 day’s in and have only lost a hair follicle here and there. So, will I be lucky this time and keep my hair that has taken these past 3 months to go back? I don’t think so.

As I look around my bed, on my pillows and blankets, and in my general vicinity, everyday there are more and more hair follicles lying about. I give myself another couple of days and I’ll be bald once again.

I know the hair will grow back. Some friends and family have speculated my hair would grow back red. Or curly. Or curly red. No, it will come back more grey and silver than any other color. But I know it will grow back.

Round 2, infusion 3 is just a week away. Never give up, never surrender!

Today, I emerge from latest infusion of chemo in relatively good health and spirits.

Don’t get me wrong. The first ~96 hours were pure torture on my body and I questioned whether I could make it or not. Not only was the chemo poison coursing through my veins, but I have two stents sitting in the middle of my chest, one inside the other in my esophagus to protect the perforation that is still healing, which cause constant pain and discomfort.

The doctor’s provided a “GI cocktail” to help alleviate the pain…Mylanta mixed with lidocaine to numb my digestive track. However, after a week of drinking the disgusting concoction every few hours, the positive effects diminished significantly.

Therefore, this past Saturday, I ended up in the Walter Reed’s after-hour’s pharmacy to pick up more potent pain meds that now do a pretty good job of breaking through the discomfort and provide relief…especially at night, that then allows me to sleep.

Now that I survived the latest chemo session, and thanks to the daily 1900 calorie TPN infusion, my health and weight are holding steady. My energy levels are up, allowing me to get out of the house for a bit each day by either going to a store or locale with my wife or just taking a walk around the neighborhood…especially one that ends with me picking up my kids from their bus stop at the end of the school day.

And go figure, just as I start chemo again, my hair and beard return…just in time to fall out again in the coming days.

Oh, to be folically challenged with winter rapidly approaching!

At least now I know I can have a full beard back within about 60 days of my last chemo infusion. Which means I’ll have a hairy Valentine’s! But it also means I’ll be slick skinned for Movember’s men’s health awareness month. Bummer : (

Compared to my beard, the hair on top of my head is slowly growing back…all bit a little greyer, but more distinguishing. It will probably be a good six months for my Hollywood locks to regain their prior splendor and appearance.

Three more sessions. Six more weeks. I’ve got this.