Reconnecting

Returning to work last week gave me a feeling of reconnection. I didn't express myself as enthusiastically as the dancers on the wall of the SF Ballet building, but there was an inner joy... just being alive!

I only commute to the office two days a week during my first month back. Nurses thought I was rushing things to return so quickly, but my doctor allowed me to give it a try. I made it through my regular shifts, but was extremely tired at the end of the day. Normally, I read on the bus when not enjoying the beautiful views over the

Golden Gate Bridge and through Marin and Sonoma Counties. This week, my tongue and eyes burned and I was too tired to even bother with my Ipod. Thankfully, Viola chauffered me home from the bus stop. The telecommuting days are much easier, more relaxed, and without the commute. It felt great returning to work--getting out in the world again and feeling productive.

I tried a short walk on my first day back. The California Supreme Courthouse is just a block from my office. It was surrounded by wild crowds reacting to the same sex marriage ruling. How sad and disappointing to deny fellow citizens the right to

marry! On my second commute day, I made it to one my favorite places-- the main San Francisco Library. It surprised me how much that short walk tired me.

Below you can witness my ambition surpassing my ability. Our daughter and grandson, Susanne and Bryce, were actually the ones who moved most of that dirt while I spread it around new raised beds in the garden. The beds are up and the vegetables and herbs are now growing. Another year and another garden. A garden is wonderful statement about life. Always a joy, this year it is something more.

Healing

Here's a question to test your knowledge of trivia: What area of the body tans most rapidly?  Why, of course... it's the axilla, also known as the arm pit.  Now, you're probably wondering the point of this anatomical quiz. Well, after a couple weeks of radiation treatments, I became concerned about a dark brown color in my left axilla.  (Doesn't axilla sound more pleasant and sophisticated than arm pit?)   I worried about the radiation was causing an unusual skin reaction-- perhaps skin cancer.  My radiologist explained the axilla's inhanced ability to tan.  I simply had well-tanned a well tanned area of skin from the radiation.  That later became open sores when it went from a great tan to radiation burns.  Enough said!

Today, my oncologist said I am doing great.  He expects the PET scan in two months to show the cancer gone.  I will see the radiologist on Friday for a follow-up on the reactions to the radiation treatments.  I tire easily, especially in the afternoons. The skin over the radiation treatment area is improving, but still red with some scabs.  It doesn't hurt as much and most of the open sores are gone.  What a relief!  The axilla was probably the worst forcing me to keep my arm away from my side in a basic hokey-pokey position.

I caught a cold last week; most likely from attending our usual Mother's Day Brunch at the Glen Ellen Fire Department.  Normally, I hate summer colds, although they tend to be less severe than the winter versions.  This time, the cold didn't seem that bad.  Having just gone throught chemo and radiation, a cold seemed like such a minor irritation.  Ah, relativity.

Yesterday, I sat outside our local Juice Shack and drank a pineapple smoothie.  I watched people passing by and thought about how different my experience has been the last four months.  The world kept turning, but for me it was as if I had stopped and gotten off for a while.  It is nice to re-entering a more normal experience.  I am ready to get my garden planted and take on the Sonoma trails again.

Blossoming Out

Beauty may only be skin-deep, but radiation cuts to the bone.  My left upper torso is far from beautiful with blotchy redness and small scabs from radiation burns.  The flesh feels like it just came out of a toaster oven--and it is cooked medium-well.

I was told that the worst side effects of radiation would follow the last treatmennt.  An oncology staff member called it "blossoming out."  I like it when my flowers blossom, but this is not fun.  It is painful, and I am incredibly fatigued.  It seemed like such a cheerful day when I rang the bell after my last radiation treatment.  Actually, it was a cheerful day, but there's been a predictable increase in my symptoms following that treatment.

Several times a day, I put aloe vera gel followed by a vaseline-type product called Aquaphor.  It's suppose to help the skin, and it probably does, but the burn effects are still obvious and uncomfortable.  The skin stings with raw patches where the skin has come off, especially in my arm pit.  I try to keep my arm out and away from my body.  I sleep on my right side to avoid putting pressure on the sensitive left side.  I imagine the muscles, lungs, throat tissue, capillaries, etcetera, would all look inflammed if they were visible.

Hopefully, I have stopped "blossoming."  I think I may be a little less fatigued than yesterday, but that may be wishful thinking.  The doctor hopes I will be ready to return to work in about two weeks, so let the healing begin!

Last Radiation Treatment

Here's where I began my daily treatments sessions over the last month:

Passing time...

Radiation beam aligning for treatment.

And now the fun begins...

Remote video observation of the radiation being delivered.

A happy day for staff and patients.

The plaque under the bell reads: 

We join you in joyous celebration of the completion of your treatment session...So ring the bell to say farewell.

Farewell to treatments! The radiation will continue to kill cells in my body for weeks to months.  Next week, my only medical visit will be a blood draw at the lab.  Then two doctors visits, radiologist and oncologist, the following week.

Thanks to Viola for taking the great pictures yesterday and being with me every step of the way.

What a Long, Strange Trip It's Been!

Tomorrow is my last radiation treatment!

I feel like I've been in a small car for seven or eight hours -- and I still have an hour and a half to go. The scenery is no longer interesting. Nobody in the car has anything left to say. I just want to get there and relax...but I'm not there yet. I have to keep driving.

I haven't been posting as frequently and discovered that many of you noticed. I am very tired and obviously, I'm ready to arrive at my destination. While my treatment ends this week, my recovery continues. It will be two and a half months before I can have another PET scan to see if the cancer is gone. It will take that long for the cells damaged by radiation to complete their healing process. The PET scan can't distinguish growing cells, cancerous or not.

It is hard to judge how I feel at this point. I am very tired and my eyes often burn like when I have been over-tired and trying to stay awake. My tongue still hurts,

especially after eating, but I can taste chocolate and I am glad to report it is wonderful. I felt better this past weekend sitting in my easy chair and watching the rain. When the sun is out, I want to garden but don't have the energy to do it for long. I break into a sweat easily when it seems as if I haven't really done much of anything.

The assaults on my body will soon cease and I can begin to heal this battered body. I now practice my guitar for a few minutes a day. Practice will build the calluses on my fingertips again, and time and activity will strenghten my back muscles to garden. In a few weeks, my leg muscles will be ready to take on the hills of San Francisco. Just the other day, I realized that I will ride a bicycle again soon, a thought that sent my spirits soaring.

In the meantime, the moody weather suits me just fine. I have time to think about living again--and I can't wait for it to be effortless.

Another Day, Another Dose

During the initial part of my radiation series, I began to put some normalcy back into my life. I drove a car again, visited the local library, and had lunch at our local Cafe Citti.  Viola and I visited the nearby Quarry Hill Botanical Garden. Walking around forty acres of rare and endangered Asian plants felt great, even if it did wear me out. We sat by some Tibetan prayer flags looking out at our valley and feeling grateful at being alive.

Now, after two weeks of radiation, I am beginning to feel more fatigue.  There is a sunburned feeling on my left upper body that includes both on the skin and deep in the tissues.  The effects of radiation are cumulative and what I am feeling is to be expected.  My radiologist wants me to wait at least two to three weeks after my last dose before returning to work.  Another month of feeling tired, sore, and basically lousy. So far, I am lucky that frequent applications of Aquaphor, a vaseline-like skin lotion, have keptmy skin in pretty good shape- just a blush of color.

This weekend our daughter, Zoe, visited with granddaughter, Teagan.  Now that's a way to cheer up a tired guy.

Hit Me With Your Best Shot...

I have begun radiation therapy.  "Fire Away!" as Pat Benatar sang.

Radiation therapy kills cancer cells and stops them from spreading using high doses of radiation.  My chemotherapy eliminated the tumor, but there may still be some remaining cancer cells.  The radiation will destroy any remaining cancer cells and reduce the chances of the lymphoma returning.

The radiation is a very precise procedure. A body cast was made for my head and left upper body.  I lay in the cast to position my body correctly each time and to help me remain still.  My treatment area includes both the site of the tumor as well as the lymph node chain above it.  In the photo you see a red outline done with a permanent marker (my tatoos are so small they are barely visible).  Because my cancer was Stage 1, only this one area receives the radiation dose.

The treatment itself only takes about 20 seconds to the front of my body. 

The machine then rotates 180 degrees and I receive the same dosage to the back my body. Most of the treatment time is spent carefully aligning the radiation beam. In the photo you can see red light beams from the lasers used to make the precise alignment. I will receive radiation five days a week for four weeks.

Side effects of radiation vary with the area treated and vary from individual to another.  In my case, I was told to expect fatigue, hair loss, skin changes similar to a sun burn, and some irritation on the left side of my throat.

So far, radiation is not as bad as chemotherapy.  The treatment area feels a little swollen after therapy and feels like mild sunburn.  I am experiencing fatigue, but able to get out in the yard and enjoy Spring in Kenwood.  The radiation effects tend to become more prominent after a couple weeks.  Keep those positive thoughts coming my way for mild side effects and a quick recovery.

Thank you for letting me, be myself, Again!

I want to thank everyone for helping me along my journey so far.  As Sly and the Family Stone sang, "Thank you, for lettin' me, be myself, again!"  

Your cards, emails, phone calls, flowers, casseroles, pies, cakes, cookies, CDs, books, prayers, chants, and positive vibes have kept me going through tough times.  It seemed that every time I would start to feel depressed, someone would make contact and cheer me up.  I feel very humbled by the many, many acts of love and caring.  Knowing you are surrounded by love is more comforting than I can adequately describe.

Most deserving of my appreciation is Viola.  She is the who held me tight and stayed strong in those scary weeks last January when we awaited the diagnosis of the mysterious lump.  She's kept fresh flowers in our home, helped me bathe and get dressed, covered me with blankets and propped me up with pillows. She has fed me so well that I gained a couple pounds instead of losing weight, both surprising and pleasing the oncology staff.  It is hard to imagine getting through the past couple months without her.

V and I look forward to seeing all our friends and family again.  Happy together, like that day pictured below, celebrating our tenth anniversary last fall-- travelling by train from London to Paris and returning to Monet's garden where were married.

Not that too!

I received some disturbing information at my radiation education session.  I was prepared to hear about the side effects, such as burning of the skin and fatigue.  I learned that I will get some scarring in my lungs and possibly in my throat.  But nothing prepared me for the news that I would lose my chest hair.  "Not that too!", I cried.

There is only so much a man can take and I so I began googling chest hair loss.  Much to my relief, there are solutions for this most embarassing of problems. 

Yes, you probably recognize it, an actual Austin Power's chest hair piece for only $19.95.

An even simpler solution is a shirt I can wear on those hot days of summer when I want a natural look.

Should my deepest fear be realized and my chest hair fails to grow back, there are the Japanese chest hair implant clinics.

My google search even lead me to a mystery that my new specialized knowledge solved.  I know there is no mystery in the article below, it is simply one of the side effects of chest radiation.

It's Getting Better All the Time!

Good news today at the oncology center! My doctor cannot feel any evidence of the tumor.  He will not order a diagnostic scan now since any remaining cancer cells should be eliminated by the radiation treatments.  My lymphocytes are back to normal and I can discontinue the support medications I was taking three times daily.  I can go out in public shaking hands and kissing babies.  I can eat popcorn now without the risk of mouth sores, but it will be hard to enjoy until butter tastes like butter again.

One of the best things about today--I got the PICC line removed! I couldn't look as they pulled the twenty inch catheter out through my biceps muscle.  It is such a relief not worrying about lifting my arm too high or snagging the tubes dangling out of my arm.  If this sounds too graphic, be grateful I haven't posted pictures!

And there was more good news about my arm with the blood clot. It is no longer painful and the doctor will reduce my intake of anti-coagulants from six months to three months.  I also get to reduce my visits to the lab for blood draws from once a week to twice per month.  I asked the doctor if I would be able to do one arm push-ups when the treatment is over.  He said "Sure".  I said that's great because I never could before.