Sunday, May 18, 2008

Very Lucky

Dave’s Great Adventure, Book Three
Chapter 3, Verse 2
May 18, 2008
Very Lucky

I met a gentleman in Houston last week, by a chance encounter, and it made me wonder why things turn out the way they do. He and I are about the same age, I’d guess, and we’ve seen a lot in our six decades of life, but things have turned out very differently for us. What is it that determines the paths our lives take?

He and I were both born some sixty years ago, or so, and were held by mothers who cried tears of joy and kissed us and loved us. Hopefully he had family around to celebrate his birth, as I did. But sixty years later, in the south side of Houston, he appeared totally unloved and abandoned.

I first noticed him as Kathy and I sat in a Taco Cabana restaurant across the street from our hotel. We were just having a light meal when he came in. I didn’t pay a lot of attention, but I noticed that a wheelchair-bound man was moving around near the service areas and at some of the tables. I thought at first perhaps he was a handicapped employee, as he seemed to be checking out each of the areas. It was only when I saw him reach into the paper napkin dispenser, remove a three-inch stack and stuff it into the space between his legs and the side of the borrowed wheelchair (supplies for later?) that I realized he was probably homeless. He moved about from empty tables to the condiments area to the rack with the plastic utensils and elsewhere. Shortly thereafter he came over to the section where we were. As he passed us I saw that he had taken someone’s used paper cup and filled it with pico de gallo from the condiments bar and was eating it for dinner with a plastic spoon.

He headed towards the door. On the back of the wheelchair it said “Peds, Guest Services.” It must have come from one of the local children's hospitals, but we were at least a mile from the closest of the facilities with many busy streets between them and the Taco Cabana. I looked at Kathy and said, “Oh my gosh, did you see that? The poor guy’s eating a cup of pico!”

We were born at about the same time, but sixty years later I am extremely fortunate to be able to say that I have more than I need of just about everything. I have a loving wife and supportive family all around me, a circle of amazingly wonderful friends, and more material goods than I need or deserve. The only thing I could possibly ask for would be for my disease to be taken from me, but we’re working on that. Yet the gentleman had none of these things, as he sat in the Taco Cabana, crippled, destitute and homeless. Why the difference? Is it simply an accident of birth place or circumstances? Different work ethics or work opportunities? Or just bad luck on his part and good luck on my part? I can’t know how he came to be sitting in that borrowed wheelchair eating pilfered pico de gallo on that Tuesday evening in May.

He saw me as I approached him and asked me, “Would you open the door?” But I asked him, “Would you like something to eat?” He was initially embarrassed, as he seemed to think I worked there and had caught him stealing food and was asking for him to order something. He looked up with weary eyes and said, “No, I don’t have no money.” “No,” I said, “are you hungry, I’ll buy you something to eat.” He allowed that he’d like a couple of tacos. So I went to order some food for him, and when the cashier asked, “For here or to go?” I told her it was for the homeless gentleman by the door. She looked over, was sympathetic, and added more food to my order at no extra cost. I took him his drink and food and he went to a table and ate. I returned to Kathy and wondered why I was so lucky and he was so unfortunate.

The trip to Houston this week went well. We arrived there safely, but tired. We didn’t get to the NASA museum as it would have been a full day visit and I wasn’t feeling up to it, but the nearby Museum of FineArts Houston (that’s the way it’s written) was having a special exhibit of several hundred recently excavated artifacts from Pompeii and Herculaneum. Many of you know that I love Roman history and have been to Pompeii a couple of times, but I’m always interested in seeing more, so we decided to visit the museum, selecting that over the held-over “Lucy,” early-man, exhibit at the Museum of Natural History just up the street. We’ll probably see that exhibit next time if it’s still in town. The Pompeii exhibit was just excellent and I recommend it to any of you who might happen to be passing through Houston anytime soon.

The visit with my docs and nurses went extremely well. They are all very pleased with my progress. Dr. Keating said, “You’re making me look good.” All my labs are normal, including my white count, which was up to 3,300. That’s in the low end of the normal range of white cells, which amazes me, because in 2002 when I was first doing the FCR protocol my white counts just got progressively lower and lower until we stopped when they got down to 1,100. The even better news is that of the 3,300 white cells, most of them are “good” cells, the neutrophils and monocytes, with still only a small number of potentially malignant lymphocytes. Dr. Keating cleared me to start the second half of the protocol, which we’ll begin tomorrow morning.

Oh, yeah, after I had the visit with all my docs and nurses, I had to have the bone marrow biopsy. Once again, it was done extremely well and really didn’t hurt very much at all. The worst part of the procedure, for me, was tensing up and waiting for the sharp jolt of pain which I had experienced in the past, but the jolt never came. And I knew, though I couldn’t see it, that there was a huge needle being prodded deep into my hip bone, and that visual is worrisome because you expect it to hurt, but overall, it didn’t hurt any more than falling down on pavement and skinning your knee. And these procedures are done not by doctors, and not by nurses, but by technicians who are trained in the art of bone marrow biopsy. They are trained exceedingly well. We won’t have the results of the bone marrow biopsy until later this week but with all my labs doing well, I fully expect that the biopsy results will also be relatively normal.

Many of you know that I bought a little sports car last year, after not having one for about fifteen years. I had a sports sedan when we moved to Colorado, but with the snow and gravel on the roads much of the year, I didn’t drive it a lot and finally I traded it in for a 4-Runner, which is much more utilitarian in the wilds of Colorado. So I’ve been without a “fun” car for about fifteen years but didn’t really miss it until recently, because when I was recovering from the chemo-brain, I couldn’t concentrate on traffic enough to drive like one would in a sports car. But late last year I was feeling better and so I bought one. I loved that little car, but it had a standard transmission, as God intended sports cars to have. Problem was, Kathy couldn’t drive it. I found, on our little overnight trip to Nacogdoches last month, that I needed help in driving that I couldn’t get if the car had a standard transmission. If we were to travel much in the sports car, Kathy would have to be able to drive it too. So, this month I traded my little sports car for one with an automatic. At least that was my excuse. The fact that the new one has more creature comforts, a sun roof, all-wheel drive, small back seats (for jackets and maps, and such) plus an extra hundred horsepower also may have figured into my decision. It does go! Fast! Kathy drove it for a while on the way to Houston and I saw the speedometer in the 80s much of the time and into the 90s a couple of times! She hasn’t driven that fast since we got back from Germany years ago.

I’m reading Ayn Rand’s "Atlas Shrugged" these days. That’s amazing on several levels. One, I don’t normally read fiction. Secondly, I don’t know how I got through high school and college with out having been assigned to read it. And mostly, it’s rather amazing that I’m able to comprehend this very long, dense "War and Peace"-length book these days. I borrowed it from our friend Bonnie a couple of months ago and have slowly been working my way through it. Has anyone else out there read this book? I still see it for sale in the local book stores, sixty years or more after it was written. Very interesting premise. I’m just getting to what it’s all about and see a lot of parallels between what Ayn Rand was describing and modern work culture in America.

I think that’s plenty for now. I’m going to close this update and get to bed. I start Round Four in the morning and the first day is always a very long day, usually about eight hours. More later.


"Everything I have in life is more than that which I don't have.” --Unknown
(sent to me by our friend Tom Redd in Colorado)

Sunday, May 11, 2008

Halfway Done

Dave’s Great Adventure, Book Three
Chapter 3, Verse 1
May 11, 2008
Halfway Done.

I’ve been extremely delinquent in getting my updates out. I’ve promised numerous folks over the last couple of weeks that I was going to get a letter out but I just haven’t gotten it done. Laura, of TNT, told me that I didn’t have to write a novel each time I sent out an update, that a short memo would do. Anna, who is traveling back and forth to Houston with husband Larry, for his experimental Avastin treatments, is able to send out complete updates in about six sentences. I should be so economical with my words! But in fact I seem to think that I have to write The Great American Novel with each letter because I have so many thoughts running around in my head. However, I haven’t been able to make myself sit down and organize them of late. I guess the drugs are catching up with me. I’m starting to feel more fatigued on a regular basis, am having more trouble keeping my thoughts together, and am beginning to require a period of rest just about every afternoon, like I did for months before I retired and then for a year or more afterwards. I finally came out of my mental fog of “chemo-brain” in the last year or so, but I think it’s coming back.

I really didn’t expect this because I haven’t had the “fuzzies” this time around, a condition long-time readers will remember me describing after each prior round of drugs. During the mental “fuzzies” I couldn’t read the paper with comprehension, remember much of anything and mostly I would just lie around the house for several days until the symptoms slowly went away. I expected to get the fuzzies again, since I’m getting basically the same FCR (Fludara, Cytoxan, Rituxan) regimen I got several years ago, and then, on top of that cocktail, I’m getting the Avastin too. But since I didn’t get the fuzzies I expected that I’d avoid the chemo-brain this time around too. I think I was fooling myself. I have to wonder if the lack of large doses of steroids with each day’s infusions has something to do with the absence of the fuzzies with this new regimen.

Anyway, my lack of communication didn’t mean that there were any serious problems; just that I was tired and/or lazy, and a bit busier than I should have been at times. I haven’t really been ill, haven’t gotten a cold or bronchitis or anything, and even my sinus infection has cleared up. I’ll try to do better with updates in the coming weeks.

The last rounds of drugs went pretty well. The first day was very long again, lasting eight hours because of the four hours it takes just to give the Rituxan, which is then followed by the Fludara and Cytoxan. The next two days went much faster though. But I was getting sick by the end of the second day and felt really pretty bad before we even started the third day’s infusions. I was extremely tired and had a splitting headache and queasy stomach, feeling much like I had a bad migraine. I treated the headache like I have in the past with reasonably good results. The headaches usually decline in severity over about five to seven days after the infusions and the fatigue subsides along with the headaches. I still have all the joint aches and am still slowly shedding my hair, but the fatigue is just a bit worse than before.

My blood counts through the last cycle haven’t been too bad. My nadir, or low point, white blood cell counts weren’t as low as they have been in the past, and my platelets and red cell counts have been holding steady. I haven’t required any Neupogen this cycle, which really surprises me, because I would have expected that my counts would continue to decline with each round of chemotherapy. But in fact my white counts last Monday were the highest they’ve been since the first week of the first round of this new regimen, back in February. Not all that high, really, at 2,500, but my counts haven’t been above 2,000 without the help of Neupogen since we started. And even though my counts are up a bit, the lymphocyte counts remain low, at 200. So the stuff is working, but for reasons I can’t explain, it’s sparing my neutrophils and monocytes, the white cells that take care of bacterial infections.

Since it’s been a lot warmer and the flu season is over, we’ve been getting out a bit more. I haven’t been quite so paranoid about being out among crowds or in restaurants. We’ve made it to church (sitting across the sanctuary from where the families with the small kids usually sit) and have been able to eat out and see the family on a fairly regular basis. We even went to a Roger Waters concert (he being a former member of the band Pink Floyd; I’m sure my mom will now immediately recognize who he is!) in Dallas. The music was great but it was ear-splittingly loud where we were sitting. I was wishing I had brought the ear plugs I had intended to bring but forgot (because of my chemo-brain?). One benefit of the concert for those of us involved with chemotherapy was that there was a lot of medicinal mary jane in the air around us. Wow, I haven’t had any nausea since the concert! But I’m always hungry….

The next couple of weeks will be busy for us. We leave on Tuesday to go to back to Houston again, this time for my “mid-protocol” examination and evaluation, with labs and a bone marrow biopsy. If things are going as expected and they don’t think my side effects are too worrisome, we’ll return to Denton next Thursday afternoon and start Round Four the following Monday. I had the option of doing the chemotherapy in Houston, but decided I didn’t want to have to travel the three hundred miles back to Denton feeling as badly as I did after my last course of drugs. Now that I have more confidence in the local nurses I’d just as soon get the drugs here in Denton and be able to go straight home to rest and recover. We’re going to Houston a day earlier than we have to because we’re going to try to see the nearby NASA museum while we’re there. Whether we actually do or not will depend on how tired I am after we get there. My experience with our little overnight trip last month makes me suspect that I’m going to be more tired than I would like. We’ll see.

And that’s about all for this time. I’ll try to get another short update out after we return from Houston at the end of the week but it may depend on how tired I am and what all we have to do to get ready for the start of the fourth (of the six planned) round of drugs. Wish us luck on our trip to Houston this week.


A baby asked God, “They tell me you are sending me to earth tomorrow, but how am I going to live there, being so small and helpless?
“Your angel will be waiting for you and will take care of you.”
The child further inquired, “But tell me, here in Heaven I don’t have to do anything but sing and smile to be happy.”
God said, “Your angel will sing for you and will also smile for you. And you will feel your angel’s love and be very happy.”
Again the child asked, “And how am I going to understand when people talk to me and I don’t understand the language?”
God said, “Your angel will tell you the most beautiful and sweet words you will ever hear, and with much patience and care, your angel will teach you how to speak.”
“And what am I going to do when I want to talk to you?”
God said, “Your angel will place your hands together and teach you how to pray.”
“Who will protect me?”
God said, “Your angel will defend you even if it means risking its life.”
“But I will be sad because I will not see you anymore.”
God said, “Your angel will always talk to you about Me and will teach you the way back to Me, even though I will always be next to you.”
At this moment there was much peace in Heaven, but voices from Earth could be heard and the child hurriedly asked, “God, if I am to leave now, please tell me my angel’s name.”
“You can simply call her, ‘Mom’.”