Sunday, December 28, 2008

The Christmas Whoosh

Tuesday morning we (Angie, Heather and me in one vehicle, Michael and Brooke in another) got off to a late start. We hit some weather along the way and didn't get into town until evening. My sister Karen, younger nephew James, and Karen's friend Jay had a far worse ordeal as Seattle had all but shut down for a couple days to deal with the snow. Instead of leaving Sunday, they couldn't get out of Seattle until Tuesday. But their connecting flight from Denver left before they could meet it, so they didn't make it in until shortly after noon on Christmas Eve. She wasn't happy.

Angie, Brooke, Heather, Michael, and I started the Christmas Eve festivities in Mandan at Darcy and Harley's with some contraband snacking before dinner at Angie's folks' house. After dinner we opened gifts.

Brooke went to her dad's for her continued Christmas Eve gift openings, and we returned to my parents' house. Karen had been busy wrapping the presents she had shipped to Mom's and fully intended to wrap days earlier. And we all but turned right around and unwrapped them.

Santa brought Heather more goodies Christmas morning, but Daddy (yours truly) was sleeping in and didn't catch any pictures. Angie and I went to visit her brother Marv and his girl Jill for an hour or two in the afternoon. And then we tried to get the Sinkula Christmas dinner going. The turkey wasn't cooperating very well, but eventually it all came together. And Daddy got stuffed.

Later that night, after playing a bit of Blockus, Angie found two dogs playing in the snowdrift. They didn't appear to belong to any house in the near vicinity, so I called the number on the tags. It turns out they belonged to my old buddy Troy, who had just shipped overseas in early December. I emailed him, saying, "Small world, huh? Two dogs from Tennessee bump into two Twin Cities residents in Bismarck."

On Friday, I also got a nice surprise in a phone call from my friend Mark's wife Lisa. We chatted briefly, as Angie, Heather, and I were off to meet up with Angie's friend Tanya, her husband, and her four boys at Kroll's. Later I returned to my attempt at being Mom's PC tech support. Eventually I had success getting her B&W copier/printer working again -- but not before spilling toner on the white carpet. I did call Mark later and did a quick catchup of what now turns out to be over a year since we had last met up in Fargo.

Meanwhile, Michael volunteered to join Angie to visit her friend Nicki in Flasher, ND. Meanwhile I continued trying to figure on Mom's printer issues; hours later I threw in the towel and talked with Karen and Mom for a bit. I managed to figure out "the other secret" to Mom's "secret" chocolate (and butterscotch) chip cookie recipe.

The snow picked up Friday evening, but I was dead tired. Angie called to note that they were leaving Flasher about 11. I made it maybe a half hour, but zonked out shortly thereafter. The phone rang a little after midnight, and caller ID showed it was from Angie's cell phone, but she left no message. I tried to wake up enough to call back, but I got no answer. Shaking off some cobwebs I went outside to grab a smoke and watch the falling snow accumulate. I called again about 20 minutes later and still got no answer. So I called some Highway Patrol number and checked the weather radar online. After a couple back-and-forths with the HP guy, Angie called and said that they were just leaving Buck's, where Michael wanted to make a quick stop. I called the HP back with the news, and returned to grogginess.

Saturday we were having family pictures at 10 am, so we had to get everybody up and dressed "early". We managed to get everybody there on time and the sitting went well, but of course it took longer than expected for Mom, Karen, and me to make all our selections. Finishing up just after noon, we stopped at home to grab a quick bite to eat and then get ready to head out to the Elk's.

From 2-4 we were celebrating Mom and Dad's 50th wedding anniversary. I really enjoyed visiting with many of our old neighbors and meeting some of the people Mom has worked with. We thought things turned out very well.

After cleaning up, "us kids" and our kids wandered off to Midway Lanes. We invited friends Dan and Sandy to join us, and we all had a really good time. And then it was time to pack for home.

Thank you, everyone, for a great Christmas. I wouldn't want it any other way.

Monday, December 22, 2008

Beginning of the Christmas Whoosh

Michael, my older nephew, flew in from Seattle in Saturday's cold, snowy weather. He is palling around town, and enjoying the midwest winter, first with some Army buddies in the area. They went to the Vikings-Falcons game yesterday, and he dropped by our house to visit tonight.

We opened the "stays-here" Christmas gifts tonight.

Click for full-size slide show.

Tomorrow we are heading west into the wind and snow that seems to accompany about every other Christmas venture home.

Optimism for Christmas

That last post of mine was rather negative. I suppose that was because I needed to ask a question of Dr. Amatruda and take in the answer. Today I followed up with Dr. Sielaff, and had to ask a few more questions and again take in the answers. The former brought me down, the latter actually perked me up. So I hope that this post makes up for the last and lifts Christmas spirits.

With the below-zero temperatures, and my general lack of circulation, I answered Dr. Sielaff's "how are you doing?" with "cold". The post-op wound management stuff for the liver surgery went pretty quick because everything looks dandy. I had to razz him a bit about the strange (to me) new appearance of my navel -- which isn't really noticeable to anyone but me. And then we broke into a pretty quick back-and-forth about things going forward.

I asked about the two spots that were resected, and Dr. Sielaff sketched wider ovals (I was envisioning a reduced-scale version of the wide excision) representing the removal of a larger area than the smallish spots themselves. I verified that I indeed still had a gall bladder. He inquired about the Hoag study -- whether or not I had heard anything from them yet. I shared that I had not, but that Dr. Amatruda had emailed them and cc'd me and we are awaiting an update.

And then my question of the days was about the "seeds". Perhaps it was my natural-born pessimism, or the fact that I like to buck up for worst-case first, but I had begun so envision my liver as a slice of watermelon -- as it pertains to both the size and number of the possible tumors. Dr. Sielaff explained that they were more like sesame seeds. That was good to hear, but I was now imagining a Whopper bun covered with them, so I asked about their number. He said perhaps 4 or more were seen during the laproscopic procedure. Relief and optimism returned and my spirits were lifted.

I did my best to relate the main points of my visit with Dr. Amatruda, mentioning the alphabet-soup experimental chemo stuff, the upcoming CT scan, and the scheduled start for chemotherapy. I asked if this was likely in response to the seeds, to try to kill them off, and I believe that is so. I think the Hoag vaccine, if all goes well, could be down the road a few months or so. And adjuvant therapy may also be on the horizon somewhere if the existing tumors -- too small for a needle biopsy -- are killed off.

All went well today, and I wished the folks at Abbott Northwestern a Merry Christmas. And may everyone reading this have a Merry Christmas as well!

Tuesday, December 16, 2008

The Big Question

Today's visit with Dr. Amatruda was another of the warm and good-spirited talks much like we've had in the past. Our topic may have been less than ordinary, but we have good banter.

Given what I had learned in my grogginess following the partial hepatectomy and thereafter, I tried to cut to the quick a bit. So I asked the question, probably the real question that many folks would like to hear an answer to, and one that I have perhaps danced around a bit in the past: "I'm pretty well hosed, right?" Essentially the answer was to the affirmative. And with that biggie out of the way, we continued on discussing my current situation and the latest treatment plan.

Previously, the treatment planned was moreso toward adjuvant therapy, I believe. That is, things along the interferon and interleukin line. But since more "little seeds" of cancerous tumors were found on the liver, Dr. Amatruda has now suggested the chemotherapy route.

After some of the verbiage you will encounter further down, I tried to dumb things down a bit from the big words. I asked if the version I had been telling was a valid attempt:
The chemo is like roto-rooter, going through the system and killing stuff; the interferon is like a vitamin overdose, trying to get my body to kill the stuff but also having similar side effects.
He preferred to reword it something like this:
Let's say you've got moles ruining your yard. You choose one of two options poison (the chemo) or ferrets (the other). The poison may kill the moles, but it also may kill some of the grass; and after they're gone they may return again. The ferrets might also beat up the lawn a bit, but the may get rid of the moles too -- and potentially keep them gone longer.
But as it pertained to the big question earlier, either treatment is essentially to buy time. Stage IV is apparently not a happy place. Some of the treatments discussed were as follows.
  1. High-dose interleukin-2. This is apparently quite toxic and given in an ICU, but it effects may last longer.
  2. "Standard" chemotherapy with temozolomide. Or other chemotherapy types that may be better tolerated.
  3. Experimental chemotherapy with Taxol and STA-4783. This was the way Dr. Amatruda currently recommended.
But before hopping into #3, I first need to visit with Gretchen* to determine whatever we need to determine. And so we started setting up appointments, but it was a wonderful snowy day and my appointment was already scheduled for late in the day, so I'll need to get those things sorted out later.

But it will probably go something like this:
  • Get a new scan. This time a CT, not a PET/CT, of my abdomen and what-not. Shoot for the week between Christmas and NewYear's.
  • Consult with Gretchen in early January.
  • Consult with Dr. Amatruda about 2 days after Gretchen.
  • Start chemotherapy in mid-January.
  • In the meantime, try to keep up on top of the tissue samples that went to the Hoag study.
And also start seeing a shrink to talk about stuff. Maybe not so much me talking about me, but to also include how to talk to the girls. And family. And friends. So you don't end up hearing about his on some stupid blog or something. D'oh!

Anyways, I'm still pretty much the same as always at this point, a tribute to boring consistency like no other. And frankly, I'll be doing my best to maintain this -- oh, I'm planning on doing so for quite a while.

*I'll have to try to get more information later on.

Sunday, December 7, 2008

Life Goes On Around Me

After the surgery on Wednesday, I had been feeling able to walk by myself already by about 4:30 -- just a couple hours afterwards. In fact, when they took me to the parking ramp in the wheelchair, they'd wanted Angie to swing the car around to end up right in front of me. But since it would have meant navigating the up-a-level/down-the-exit-side wanderings, I just got out of the chair and walked past the 20-ish cars to catch up with her and make exiting the facility easier. This was the start of me perhaps not taking it as easy as I should have been doing.

Having made it to an upright position for sitting, it was a bit uncomfortable trying to return to a prone position. And since sitting in front of the computer clicking and reading and tapping at the keyboard does not feel like any kind of exertion, I think I'd begun being a upright perhaps more than I should have been for the past couple of days. Come bedtime, finding a comfortable position lying down was a bit difficult. And since I usually sleep on my side, but mostly on my stomach, sleeping only on my back was making my back quite sore. So it was even easier to resume a sitting position.

But as the Vicodins dwindled through yesterday, I tried harder to get comfortable lying down. And this morning I had to have Angie do a morning routine with Heather while I slept in. The result is that the area on my right side that has intermittent twangs of brief, sharp pain has receded a bit. (Or maybe I'm feeling the sore back competing for attention a bit more?)

Anyway, I may be a stubborn old cuss, but when all else fails I'll do what I believe I'm supposed to be doing. Or at least I'm more inclined to lie down a bit more than I have been doing in the past few days.

My Distractions

Angie probably wouldn't care for me discussing her health concerns here, but I'll try to summarize: for a couple of months she has been stressed and her cycle has been way out of whack. The other night she finally sought medical attention and was prescribed the pill to try to set her cycle straight. This seems to be working in its initial start.

It snowed the other day, and at least I knew enough to ask Brooke to shovel the driveway while Angie and her friend were gone to the hospital -- she would have really been after me if I'd done it even though the first round was a fairly light dusting. When Angie finally returned home from the long medical visit, the first thing I heard was, "Who shoveled!?"

I knew better in part because I'd already sneaked out and driven to the drug store to fill her prescription for her. I was still taking the Vicodin, but that dose was wearing off and I'd gotten familiar with the effects in the previous days. And besides -- I needed to get out because once again my fake beer supply was gone.

In the meantime I've been spending a lot of time maintaining some of my online haunts. On Facebook more folks I know have been appearing, and I'm doing what I can to maintain on online presence there. But it's been as my alter ego, High Plains Blogger, where I've been doing many of my wanderings and updates. In particular, I've been rather engaged with Twitter as HPB. I really try to keep these two sides of me a bit separate, but since that's what's been keeping me busy lately, I'll make this brief mention.

Heather picked up a bit of a cold the other day, and we've given her some children's ibuprofen to nip in the bud some minor fevers and orneriness. That appears to be working as well. Brooke went to a movie with her boyfriend last night, and today they and some friends went to Cheap Skate for an afternoon of rollerskating. I've been instructed to ignore the fresh snow and let Brooke shovel again once she returns from skating.

A view from the garage.

Cripes, this post was been filled with a lot of random thoughts. 'Tis the season to be scatterbrained, I guess.

Before I forget, I'd better say an early "Happy Birthday!" to Dad, who will be 79 tomorrow. I hope I had gotten the cards out in the mail earlier this week.

Wednesday, December 3, 2008

Partial Hepatectomy

Today I had my surgery; I just got home a little while ago. I'm a little fuzzy yet, but my story goes something like this.

Everything seemed to go well as far as the planned procedures and what-not. Dr. Sielaff performed the surgical resections of the two locations he had earlier expressed interest in. These tissue samples were then used with the tissue kit for the Hoag study.

Being a laporoscopic procedure, Dr. Sielaff was able to further investigate tissues surrounding the ares of initial interest. Apparently there are more tumors on my liver -- "like little seeds" I believe Dr. Sielaff said. Their size and number meant that these were not treatable today.

So the main goals from today's adventure have been accomplished -- the larger tumor sites have been removed, and the tissue samples are off to Newport Beach for some warmer weather. My surgery was about noon; I seem to remember being awake about 3pm; and I was able to navigate Angie home from Abbott Northwestern's south-of-downtown-Minneapolis location back home. And I seem to be feeling fairly spry at the moment.