Slow slide down

~ Dave ~ Leave a comment

So, I am on the edge of chemo nadir: the low point of my blood cell counts and start of many side effects. I can confirm, this is true and is happening to me. Don’t know how much more tired I will become or how much my body will ache.

I feel like I aged 20 years over the past two days. I walk like an old man, with my hip and back joints all out of alignment. But at least I am up and walking. My sweet wife endured a slow stroll around the neighborhood this evening to help me get out of the house.

Being stuck in the house is one of the hardest parts so far. I have never been one to just chill in bed for the day. Always up, always doing something. Now, I am pacing the floors and walking up and down the stairs, just for something to do – there are only so many subreddits to check throughout the day for updates.

My sleep is affected too. I think I’m going to have to chat with the doctor on Monday about insomnia. I can’t sleep at night…very frustrating. On a positive note, I am getting caught up on my binge list from Netflix and Hulu! Go Brooklyn Nine-Nine! Hilarious show and it helps keep my spirits up!

Supposedly, the down days will last for the next 4-5 days. It will be tough, but with the support of my family, I know I’ll pull through…just in time for my second chemo session during the middle of next week. Yeah! Something to look forward to!

And on another positive note, head shaving day is soon upon us! Figured I would get through Father’s Day with a full head of hair before sacrificing my locks to the follicle clipper gods before sending them down the trash.

This is tough, but I will endure!

Pick your poison

~ Dave ~ Leave a comment

Chemotherapy, or chemo for short, is my first big step towards a cure. It is also used for tumor control or palliative purposes. By way reminder, my treatment regime is called perioperative care: chemo-stomach surgery-chemo. It is the most accepted treatment regime for gastric cancer; but that said, no standard of care exists for the treatment of gastric cancer. This is the “best” current approach – and by “best”, I mean it nominally elicits the better results than other care regimes.

But what is chemo exactly? Chemo is the use of any drug to treat any disease, but it is most closely associated with the treatment of cancer. In reality, chemo is the process of introducing poison – masquerading as medicine – into my body to halt the cancer’s growth and prevent metastasis (spreading to other parts of my body). The poison does not discriminate between health cells and cancer cells. This results in a number of side effects including nausea, diarrhea, constipation, hair loss (most susceptible healthy cells to chemo), loss of appetite, fatigue, susceptibility to infections (due to attacks on white blood cells), bleeding (due to attacking red blood cells), mouth sores, and neuropathy. Simple, right?

Not so fast. Each cancer responds to different drugs differently, duh! Oncologists select from ten (currently) separate chemo drugs for gastric cancer. One or more chemo drugs are used based on a number of factors (e.g. age, stage, physical fitness) and generally accepted medical practices.

Winner, winner! Chicken dinner! I hit the demographic and cancer jackpot for a 4 toxin medicinal concoction know as FLOT: Fluorouracil (5FU), Leucovorin (folic acid), Oxaliplatin (Eloxatin), and Docetaxel (Taxotere). But wait, I wrote FLOT and the first letters of all the drugs make FLOD…or if you rearrange them FOLD (not a good letter/tile set for Words with Friends or Scrabble) and no, DOLF is not a real word. Unexplicably, FLOT uses the name brand of docetaxel known at Taxotere; weird considering the other chemo drugs also have name brand alter egos.

On a positive note, I am subject to all the previously explained side effects and more…yeah me! #ChemoCrusader!

Infusion of the chemo drugs into my system occurs every 14 days for 4 cycles at the John P. Murtha Cancer Center at Walter Reed’s National Military Medical Center. Instead of getting an IV each time, I had a port placed. It makes access much easier.

Today: phase 1, day 1, cycle 1. So far, I am battling the verge of mild nausea, tingling lips, tight throat, and ninja chops to the mandibles (when I eat something, especially something crunchy…ouch). The nadir, or lowest point of blood cell counts, happens between days 5-9, with many of the other side effects can happen within hours after. Many of the other side affects begin to taper around days 11-14. But what about the chemo’s affect on my most enviable physical feature?

My hair, oh my hair! My soon-to-be-lost lushes locks! That’s right, I’ll most likely lose most, if not all, my hair. #BaldIsSexy

Luckily, that means its only a few weeks before I transform into Captain Picard – we both exude a profound personal charisma, intelligence, and adaptability which expands our fame throughout the known universe and often leads to our being entrusted with great responsibility accordingly. Ok, that explains Picard, not me. But, when I lose my hair, I think a quick silver Sharpie crown will give me instant credibility and foxy stile.

On another positive note, just about the time my hair starts to grow back, I’ll start my phase 2 post-op chemo regime – the same FLOT protocol.

The goal of my chemo is to shrink the tumor and kill any unobserved cancerous cells. In the end, this treatment protocol is a critical element towards my path to a cure. Bring it on!

Coincident or miracle?

~ Dave ~ Leave a comment

Since shortly after my cancer diagnosis, I have run into a number of friends that I have not seen or heard from in a while. Perhaps at any other time in my life, I would have chalked those encounters up to happenstance or accident. However, now I see them as little miracles granted to me to find strength, hope, and encouragement.

I am eternally grateful for my family and friends (some recently rediscovered) to help me along this journey.

The Eve of Tribulation

~ Dave ~ Leave a comment

After weeks of talking about it, tomorrow treatment begins. That isn’t to say that I have already started my path to recovery.

Some may joke and deride the notion of, “thoughts and prayers” as a fruitless means to overcome trials and heartache. That is not true (fake news!). I can tell you that the prayers and positive affirmations and fasting and hope from others have given me strength and already intervened to fight back against my cancer.

Following my initial diagnosis, my medical oncologist and surgical oncologist laid out a treatment plan centered around me having Stage III or possibly Stage IV cancer. Given the size of the tumor in my stomach its location, and results of my initial CT scan showing possible thickening of part of my small intestines, either of those two stages was the most likely scenario.

The doctor’s pressed for an additional endoscopy, with an ultrasound, additional lymph node biopsies, and probe into my small intestines, in order to establish the staging and refine my treatment plan. The initial plan revolved around perioperative chemotherapy, meaning: chemo-stomach surgery-chemo. Since I am relatively young (the average age of stomach cancer diagnosis is 68 years old) and that I am relatively fit (don’t judge me by my last marathon finish time…but I did score 99.8 out of 100 on my last Air Force Physical Fitness Assessment!).

With Stage III or Stage IV as the most likely prognosis, in addition to the more invasive endoscopy to see the inside of my stomach, I was scheduled for a laparoscopy wherein the surgical oncologist would check the outside of my stomach and adjacent organs and lymph nodes for signs of cancer.

I had the more thorough endoscopy a couple days after my first meeting with the medical oncologist. In addition to the preoperative treatment plan, the doctor set me up for genetic testing and chemotherapy orientation to be completed when I had the endoscopy results and we could meet again to discuss what was seen. I was scheduled to do all this back-to-back-to-back.

I endured the extensive blood work for the genetic testing and sat shocked and apprehensive during the chem class. But then came the follow-up visit with the doc.

As my wife and I sat in the doctor’s little office, the first words out of his mouth were, “we [referring to my treatment team of oncologists and GI doctors] are amazed at what your endoscopy revealed! Where we expected greater depth and diffusion of the tumor [given its present size], we just don’t see the cancer there. The cancer has not spread to my small intestines, either. And after going back-and-forth amongst the team, we are diagnosing you at Stage II cancer.” The primary care plan of perioperative treatment was still to be followed, but there was no need for the laparoscopy. I would need to get a chemo port placed in my chest so I can start chemo sooner than anticipated.

Now returning to the matter of “thoughts and prayers.” In the moment the doctor uttered those words, both Patty and I knew that this diagnosis was made possible by the overwhelming out pouring of love, support, encouragement, and “thoughts and prayers” and fasting from family, friends, co-workers, and our church members.

As I write this, I am preparing for my port placement. I start chemo tomorrow. I move forward with gratitude in my heart for all those who support me and offer hope and encouragement on this journey. I know my treatment will not be easy, but I have the “thoughts and prayers” of so many that I know I will not be alone.

How it all began – grab a sandwich, this could take awhile

~ Dave ~ Leave a comment

How? How was it that I got cancer? I really don’t have an answer for for that question.

It could have been genetic. It could have been environmental. Or it could have been [insert your own theory here or leave a comment with astute speculation].

Regardless, the “how” has become less important as I focus on overcoming the “what”: Stage II Gastric Cancer. However, I do find it cathartic to document the process that got me to this point.

I was born under a full moon in August of 1973…ok, I am not going to go back that far.

For the past couple of years, I have been dealing with stomach pain and discomfort. Patty and I thought I might be gluten- or lactose intolerance. The symptoms were never severe enough, though, to go see a doctor. That all changed this past January.

I had just completed a marathon (I don’t want to talk about my time…it wasn’t my best). In the post celebration activities, I got a spicy chicken waffle sandwich. Within minutes of eating that abomination delectable concoction, I began to experience the worst heartburn of my life. The burning persisted all night and into the next month.

I, like most men, am pretty stubborn. I think it was by my third bottle of Tums and countless doses of Pepto Bismol – chased with an occasional shot of Milk of Magnesia – that I figured I better go see a doctor. It also didn’t help that about the only thing I could eat without getting heart burns was white rice.

The first Dr appointment ended with me getting a prescription to Prilosec – a common antacid medication. And a recommendation to go to Walter Reed or Ft. Belvoir to get tested for something called H. Pylori…a stomach bacteria known to cause, amongst other things, ulcers and reflux pain.

The Prilosec helped a little. I didn’t go get the bacteria test because I would need to be off the meds for a couple of weeks for the test to be effective. But when the intensity of the heart burn returned a few weeks later, I went back to the Dr. This time I was given a stronger antacid medication called Protonic. I asked how long I would need to take the meds. When the Dr told me it my be for the rest of my life, I asked if there was some way to see what was going on in my belly…I didn’t want to have to take antacid pills for the rest of my life. The Dr gave me a referral to get an Endoscopy so a GI specialist could take a look and see what was going on; as a bonus, they could conduct the H. Pylori test while exploring my innards.

Fast forward six weeks or so, I finally got into the Ft. Belvoir hospital. I was hesitant to complete the Endoscopy as the Protonic med was working pretty good. Of course, I didn’t want to have to keep taking it, so it was swallow-the-camera time!

The procedure went well. I was sedated and really don’t remember anything after being wheeled into the room. The next thing I knew, Patty and Ian were in the recovery area and the nurse said I could get dressed when I felt I could get out of the bed.

After I was dressed, we asked the nurse if there was anything else we needed to do. She said, “No,” and that I could leave. We assumed the Dr would have come into the room if there was an issue and would just call with the results in a couple of days.

We had just gotten to our car when my cell phone rang. It was the Dr asking why we left and that she need me to come back to talk. As we sat in her office, the furthest thing from my mind was what came out of her mouth.

“We found something during the Endoscopy. The cancer, I mean, the growth is around an ulcer. We did a biopsy, but it won’t be back for a week. I need to go to the lab for blood work and then go get a CAT scan. If the biopsy comes back as positive, we’ll have to transfer you to Walter Reed for immediate care. If it is negative, we’ll meet to discuss care options.”

The gravity of the situation hit us both, leaving us near speechless and suddenly filled with dread. As we jumped around the hospital from test to test, we had to find someone to take care of Scarlett who was just getting home from school.

By the time we finished all the testing, the hospital day staff was going home. We couldn’t find the Dr anywhere. Luckily, while leaving the GI section, we bumped into her in the hallway.

“What do we do next?” Wait…that is all we could do for now.

A few days later, the Dr called to say the CAT came back clean. No cancer or tumors in any other part of my body. She concluded saying that the biopsy should be back any day now.

I felt so relieved after that call. So did Patty. It was short lived, though.

Work required me to travel to Colorado for a 1-day conference. I left the day I received the news about the CAT scan. Upon my return back home I received a call while at the Denver airport. The Dr reminded me of the post-Endoscopy discussion. Without saying that I have cancer, she simply stated that she has referred my case to Walter Reed and a medical oncologist and surgical oncologist would be calling me soon.

May 23, 2019. The day I became a cancer patient. The day I started to become a survivor. Follow my journey at twentythreefive.