Update # 5: Ready...Set...Go!

     Two appointments last week.
On Monday, a renal scan to check on the functioning of my kidneys. On Friday, a CT scan to map out the position of the "pancreatic mass" for the radiation treatment. I now have several cross-hair targets drawn in Magic Marker on my torso that would make me very nervous if Sarah Palin were in the neighborhood. :-)

     One appointment this week.
The radiation treatment "dry run" is set for Friday, with the actual treatments, both chemo and radiation, to begin on Monday, Aug 29th. The chemo consists of four pills twice daily. The bottle is marked TOXIC, which gives one pause...

The radiation is beamed in from front, back, and both sides so as to cause minimum harm at the entry points. The idea is that the four beams intersect at the "mass" causing it maximum harm. Makes sense to me.

Otherwise all is well. I am enjoying being near family again. I can visit with my 92 year-old mom and play golf with sons Jack and Andrew. Larry and Diane treat me like royalty and the dogs, Marley & Izzy, are always good company. And it's comforting knowing the rest of the family are nearby.

Coming soon: The joys of rad/chemo therapy.

P.S.
Thanks for the reading recommendations. Special thanks to those who sent books.

≈ ≈ ≈  

Update # 4: Rage

                      Do not go gentle into that good night,

                      Old age should burn and rave at close of day;
                       Rage, rage against the dying of the light.

Above is the first stanza of a well-known poem by Dylan Thomas. The complete poem is available here. The poem was a reaction to his father's failing health at the close of life, but the clear intent of the poem is to encourage all of us to grapple with the Grim Reaper whatever the source of the threat.

At present, with no pain and few symptoms, my pc is just a concept–a construct in the minds of doctors, a smudge on the image of my pancreas, a treasonous traitor within. Even when the radiation and chemo treatments begin next week, I expect my initial rage will be against the side effects of the treatment. I will have to remind myself to focus my wrath on the cancer itself. :-)

I have decided to have the preliminary rad/chemo treatment here in Charlotte. There are to be five and a half weeks of rad/chemo followed by a CT scan to evaluate the effects, several weeks of R & R to recover from the treatment and, if all goes well, the Whipple procedure at Duke Cancer Center in Durham. The surgery would be followed by four more months of chemo treatment.

The die is cast. I wait and anticipate.

"This too shall pass" --John, JR, Rocky

P.S.
If you've read any good books lately, I'd love your recommendations. As the nausea and fatigue kick in during the treatment, I expect to spend a lot of time reading.

≈ ≈ ≈

Update # 3: Pancreaticoduodenectomy

[The gist of the first two updates are contained in the previous post to this blog. See below.]

This past Monday, Aug 8th, I traveled to the Duke Clinic in Durham, NC, where I had a CT scan and individual appointments with the three doctors assigned to my case.

[Medical details follow. The squeamish among you are permitted to skip this update altogether. :-]

The good news is that my prognosis falls within the 15% for which the Whipple procedure is an option. Yippee! This means that the cancer has not developed very far, it appears not to have spread to other organs, and the tumor has not wrapped itself around a mass of blood vessels which would make removal difficult or infeasible.

At Duke, the Whipple surgical procedure is preceded by both radiation and chemotherapy for a trinity of reasons: (1) Many patients experience difficulties after the surgery which prevents them from receiving immediate chemotherapy to "clean up" any cancer thereafter. With the Duke protocol, patients get the advantage of the chemotherapy beforehand. (2) If the cancer continues to grow and spread while under attack from the rads and chems, the surgery is unlikely to be successful. (3) If the cancer responds to the therapy by shrinking, it makes the surgeon's job easier and less invasive–and improves the patient's prognosis.

At the moment I'm trying to decide whether to have the four to five weeks of radiation and chemotherapy performed at a clinic here in Charlotte or at Duke, which would mean relocating the fifth wheel to a campground in Durham. The therapy is a Monday through Friday affair, so my weekends would be free to travel or entertain visitors at the campsite.

Fingers and toes crossed for a victory of the rads & chems over the cancer cells. Getting finger cramps already. Where's my banana?

That's it for now. Update # 4 when I know more.

Thanks again for your support. I can feel it through the ethers...

--John, JR, Rocky...

May you always have love to share, health to spare, and friends that care. –Anon?

Sunday Aug. 7, 2011

When I initiated this blog in December of last year, I did warn readers that I might write about most anything. So far I have posted my own poems and those of others; reviews of books; political rantings; expressions of affection for pets and wildlife; and the progress of my building project in Hereford, AZ.

Well, my life took an unexpected turn a few weeks ago in that I was diagnosed with pancreatic cancer (pc–small letters; I refuse to give the malady the dignity of capital letters :-). Until now I have hesitated posting anything here or on FaceBook. To my surprise many of you responded to the pc news with warm support and asked to be kept in the loop. So, I've decided–for better or for worse–to put it "out there" on this blog.

I made peace with my mortality decades ago; still the pc has posed a real test of my philosophy of life. Unless you're an Islamic suicide bomber, death is almost universally regarded with dread and negative emotion. My defense against death is Hopeful Agnosticism, a lazy religion which is practiced without the need for worship, rituals, tithing, or other obligations. However, I do consider myself a spiritual being, perhaps having a "human experience" as Buddhists believe. Reincarnation, dejà vu over and over again until you get it right, is to me much more palatable than the Heaven or Hell duality.

The pc cloud does have multiple silver linings: the malady will not keep me from growing old (already there!) and I won't have to worry about running out of retirement funds. My "bucket list" includes exotic cruises, a round of golf at Pebble Beach, and perhaps a vacation in Bali. I'm determined to become neither morbid nor maudlin about the pc. I've no cause for regrets: au contraire, I've enjoyed a life filled with travel, adventure, and wonderful people.

[NB: Feel free to skip the next three paragraphs of boring medical stuff.]

So, here's the chronology: In late June I noticed symptoms that WebMD indicated might be hepatitis. Since my primary care physician was out of the country, I went to the Emergency Room at the Sierra Vista Regional Health Center. Blood tests for hepatitis were negative and a preliminary diagnosis indicated a blockage in the bile duct of my gall bladder.

Okay, I could deal with that. I figured they'll remove my gall bladder and that's that. What I didn't understand is that the bile duct is actually a part of the liver and is closely connected with the pancreas. The blockage was caused by a "mass" (read: tumor) in the head of the pancreas pressing against the bile duct. Biopsy of tissue from the mass was found to be malignant. Ultimate diagnosis: little pc (pancreatic cancer). Hmmm...

On July 18th, a doctor at the University (of Arizona) Medical Center (UMC) inTucson installed a stent at the site of the blockage. I have never been in any pain and the stent eventually provided relief from the hepatitis symptoms. My appetite has returned and my energy level increased. I have lost 25 lbs which greatly improves my appearance in a bathing suit.

On receiving the pc diagnosis, I decided without hesitation to return to NC to be near family. My son Jack flew to AZ on July 24th, and we drove my truck and fifth wheel across country, arriving at my brother Larry's home in Waxhaw, NC, on Sunday, July 31st.

Duke University Medical Center has accepted me as a patient and I'll have my first meeting with the doctors there on Monday, August 8th. I will post an update when I return.

Thanks for all your warm wishes, kind thoughts, and prayers.

–John Roquemore Floyd, Jr. (aka JR, aka Rocky)

≈ ≈ ≈

Spiders on the Trail

Once again in North Carolina, I've resumed the walks with my brother's gentle Rottweiler, Marley, which means dealing with spiders whose webs crisscross our wooded trail every few yards. There are of course spiders in Arizona, too, some of them quite daunting --tarantulas, wolf spiders, and the dreaded brown recluse-- but they live in burrows and do not build elaborate webs at eye level across hiking trails.

I have a great deal of respect for spiders, not just for their ability to inflict pain and in rare cases death to humans, but because of the beauty and intricacy of their webs. They are fishers of insects, casting nets in the air. As a child, I watched garden spiders build beautiful orb webs in the windows of our house to catch the bugs attracted by the light on our side of the window. Clever spiders.

Beautiful as a well-constructed web might be, they're a nuisance to hikers and runners. I always carry a small branch with me to clear the way, leaving the spiders all a twitter about the "big one" that got away. As they are critical to the spider's survival, I do not wantonly destroy webs and will take a detour around a web on the trail if I notice it before my branch takes it down.

I suppose if I were a real man, I would walk without the spider branch. But beautiful as they may be, there's still something creepy about a spider's web...

≈ ≈ ≈