Treatment: I’m Leaking

I hadn’t cried yet over this cancer mess. The fact is, I hadn’t felt the need to. Yet.

I’ve envisioned crying great tears of joy sometime in June when the docs announce that I’m cancer-free. I see my self falling to my knees, heaving sobs, thrusting my fists in the air, the king of the world, having triumphed over this damned olive pit.

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I had a girlfriend once who would say, whenever she cried, “I’m leaking.”

She also would swear she could never cry. Every time she would say, “I’m leaking,” she’d add, “I don’t know what’s wrong with me. I never do this.”

She did it a lot.

It would seem I should be doing it a lot these days. But so far, no. Shouldn’t I?

I have.

This morning. At the radiation center.

A couple, maybe 65, even 70, came in and after checking in with the receptionist, took seats in the waiting room. The husband had the clipboard in his hand. He peered at the questionnaire on it, lifting his chin to focus through his bifocals. The wife shifted in her seat, as if she’d sat on a chair full of ants.

A nurse came out to introduce herself. “Are you family?” she asked. The woman nodded. “The wife?”

“Yes.”

It seemed the woman was afraid even to talk, that talking would wake her from the nightmare and remind her that this was no dream at all, that she was really here.

The nurse asked the couple to follow her. She led them to the room The Loved One and I were taken to the first day we were here. The room where they tell you all about radiation and chemotherapy. The room where they show you the video of the smiling guy lying back on the table underneath the business end of the radiation gun. It’s all pleasant in the video. Everybody smiles. “There may be side effects,” the voiceover guy says.

Yeah. There may be.

The couple disappeared into the room. The nurse closed the door.

I began leaking. Tears rolled down my cheek.

I cried for them. And for me.

 

Treatment: Looking For Normal

I’m going to try to write a regular post here. I’ve had two radiation treatments and one chemotherapy blast. I got yesterday and today off and it’s back to the machines tomorrow. Other than two sudden onrushes of dizziness and nausea — sending me scurrying for my bottle of super-duper anti-nausea dope — I’ve been living normally.

It feels as though my mouth is getting dry and thick. I can’t tell at this early date if it’s a real side effect or my imagination. Either way, I’ve knocked off alcohol-based mouthwash and I’m drinking water like a man fresh off a stroll in the Gobi. The Loved One is flitting around every few minutes, reminding me to keep hydrated. I’m lucky to have her around.

So, in lieu of a third dizziness/nausea wave, here I go with something I’ve wanted to put up here for a couple of weeks. Behold Big Mike’s Must-Read Nonfiction Books for Every Home Library™. [BTW: Pay no attention to all the ™ marks I’ve been using of late — they’re just another in my series of silly affectations. I like to have a weird brand of Fun™, in case you haven’t noticed.]

Anyway, herewith in no particular order are the books every smart citizen should have read, plans to read, or keeps in her/his library to give visitors the impression s/he is enlightened:

In Cold Blood: A True Account of a Multiple Murder and Its Consequences, by Truman Capote, 1966 — A landmark in what would become known as “the new journalism,” Capote wrote the scariest goddamned account of the random murder of a farm family in Nowheresville, Kansas back in the ’50s. The subsequent 1967 Richard Brooks movie starring Robert Blake as Perry Smith also was top-notch.

The Canon: A Whirligig Tour of the Beautiful Basics of Science, by Natalie Angier, 2007 — The New York Times science writer visits experts in the major scientific fields of inquiry — genetics, cosmology, biology physics, chemistry, and many more — for insights into what humanity knows as of the dawn of the 21st Century about…, well, everything. She writes in a poetic, almost flowery manner that takes the edge off what could have been an arid tome.

The Demon-Haunted World: Science as a Candle in the Dark, by Carl Sagan, 1995 — The frequent Johnny Carson guest (who, BTW, never actually uttered the phrase “billions and billions”) searches for the reasons people believe malarkey. If you’ve been paying attention to this year’s presidential beauty pageant, you know folks eat up malarkey as readily as as they down McDonald’s french fries. Sagan actually connects credulity in ESP, speaking with the dead, homeopathy, etc. with our growing inability to discern real from bunk in the political sphere.

The Whole Shebang: A State of the Universe(s) Report, by Timothy Ferris, 1997 — No, not the Timothy “Tim” Ferris who writes all those toss-away self-help books, this TF writes science books. Shebang is written for the scientifically unschooled (me, for instance) and updates us on the what we know about that big dark, sometimes glittery thing we occasionally see in the Midwest at night. He explains arcana like curved space and multi-universes so that even I can grasp them.

Freakonomics: A Rogue Economist Explores the Hidden Side of Everything, by Steven D. Levitt & Stephen J. Dubner, 2005 — Levitt’s the rogue economist, Dubner his writing guru. This book made a lot of people itchy by proposing that US crime statistics went down in the ’90s as a direct result of the Roe vs. Wade decision and that municipal election cycles produce spikes in police hiring. You know the old saw, Lies, damned lies and…, but this statistical carnival ride is a hoot — and fairly informative.

The Prince, by Niccolo Machiavelli, 1532 — Through the centuries the term Machiavellian has become a slur but old Nicky was a brilliant political scientist and student of psychology. The following diverse actors can be described as Machiavellian: FDR, Henry Kissinger, Richard Nixon, Jimmy Carter, JFK, LBJ, Hillary Clinton, Mayor Richard J. Daley, and Jesse Jackson. If you haven’t read this, you don’t get politics.

Common Sense, by Thomas Paine, January 10, 1776 — The kick in the ass many citizens of the 13 American Colonies needed to start blasting away at their British overlords. For more than 200 years it was the biggest-selling American book ever printed. Simple, concise, and a bit religious in its themes, CS nonetheless was a revolutionary manifesto to equal any before or since.

The Autobiography of Malcolm X, by Malcolm X & Alex Haley, 1965 — A riveting account of the life of a man who actually led three — or even more — lives. He grew from a street hood, a convict, a minster, a Black nationalist, a human rights activist, and, finally, a consensus-seeker. A brilliant man who otherwise could have bee the President of the United States, only he was born the wrong color, and too soon. Naturally, he was assassinated.

Maus I: A Survivor’s Tale & Maus II: And Here My Troubles Began, by Art Spiegelman, published in Raw magaine, 1980-1991, the second volume in 1991 — If you want a kid to learn about the Holocaust and what it created in its survivors, you’ll find no better tool than this. And Maus is by no means a kids book. The first graphic novel ever to win the Pulitzer Prize, it’s the story of Speigelman’s old man and his times in pre-World War II Poland, in Hitler’s concentration camps, and in his psychologically troubled post ordeal life in America. Speigelman draws the Jews as mice, the Nazis as cats, and the Polish authorities as pigs. If you’re not drained of tears by the time you’re finished reading this, you ain’t human.

A Brief History of Time: From the Big Bang to Black Holes, by Stephen Hawking, 1988 — This became one of those bestsellers, like Thomas Picketty’s Capital, that everybody bought and no one read. That’s a shame since Hawking’s our contemporary Einstein, here to explain to us that time, really, is nothing at all but a human construct. The universe goes about its business while we fritter away our time trying to capture it with a stopwatch.

In the Garden of Beasts: Love, Terror, and an American Family in Hitler’s Berlin, by Erik Larson, 2011 — William Dodd was the last American ambassador to Nazi Germany. He and his family witnessed first-hand and up-close what the Nazi thing was all about. The book will disabuse you of the notion that simply assassinating Hitler would have turned the tide of Nazi history. It wouldn’t have. Naziism carried such a cachet that Dodd’s own daughter fell in love with a Gestapo leader. History’s a lot more complicated than the stuff you learned in elementary school.

The Liberation Trilogy, 3 volumes: An Army at Dawn, 2002; The Day of Battle, 2007; & The Guns at Last Light, 2013, by Rick Atkinson — A thorough and meticulous account of the War in Europe, 1939-1945. WWII was humanity’s ugliest, most evil endeavor, snuffing out the lives of upward of 60 million people around the globe. Yet Atkinson reminds us of all the little things that go into throwing a war, the number of staplers that had to be shipped to Normandy on D-Day, the petty squabbles between diva generals on all sides, the calculations of how many citizens this or that bombing mission would incinerate. We all know the end of this tale but I re-read the penultimate chapter often just for the frisson of imagining the German generals surrendering, unconditionally, at last. Atkinson carefully describes the tears running down the cheeks of Wermacht Commander Alfred Jodl at the signing table.

The Double-Helix: A Personal Account of the Discovery of the Structure of DNA, by James D. Watson, 1968 — DNA makes us human, pigs pigs, and the ebola virus what it is. Watson and his partners Francis Crick and Maurice Wilkins. And — oh yeah! — Rosalind Franklin who, by dint of possessing a vagina, was cheated out of honors, fame, fortune, and dignity, found this little fact out back in the 1950s. A must read for the scientific detectives’ tale and to glean how miserably women were treated by scientists back than ( and even today).

The Power Broker: Robert Moses and the Fall of New York, by Robert Caro, 1974 — Moses remade New York City after his own imagination, moving entire neighborhoods, paving over riverfronts, constructing towering monuments to commerce and international affairs, and even unintentionally (or not) segregating its neighborhoods. How could one unelected man have so much power? Read and see.

The Naked Ape: A Zoologist’s Study of the Human Animal, by Desmond Morris, 1967 — What’s the difference between you, me, and a chimpanzee? Not much, acc’d’g to Morris. Nor between us and any number of other mammals, vertebrates, invertebrates, and earthworms. Morris has interesting hypotheses on why women have prominent breasts and like to wear lipstick. A fun read, although at times outlandish, but largely spot-on as most of its assertions have stood the test of time.

Working: People Talk About What They Do All Day and How They Feel About What They Do, by Studs Terkel, 1974 — Terkel was America’s preeminent recordist of the average person’s feelings, hopes, and dreams. Here he speaks with everyone form a cop, a switchboard operator, a supermarket bagger, a welder and even football coach George Allen and actor Rip Torn. This is reality, not that flotsam you get on “reality TV.”

Gödel, Escher, Bach: An Eternal Golden Braid, by Douglas Hofstadter, 1979 — Prose poetry on mathematics, symmetry, intelligence, and knowledge (not the same things, BTW). It gives me great joy to be able to live in a town wherein I can see Hofstadter pedaling his bicycle on the way to teach class on any given day.

Why We Can’t Wait, by Martin Luther King, Jr., 1964 — An expansion of King’s Letter from Birmingham Jail, the civil rights martyr teaches us about history, racism, civil disobedience, and fascism. And to a large extent, Blacks are still waiting.

Ball Four, by Jim Bouton, 1970 — Bouton was an outspoken, opinionated, iconoclast baseball pitcher. He was an outcast on the old, stuffy New York Yankees dynasty and a hanger-on on a couple of expansion teams not many years later. He chronicled his 1969 season, revealing what a major league clubhouse was really like. The book shattered all the stereotypes of valiant, superhero pro athletes and showed them as merely human. It was as revolutionary as any political book. I’ve loved it from the first time I picked it up at the age of 14.

Hiroshima, by John Hershey, 1946 — Simple eyewitness accounts of survivors of the Hiroshima nuclear blast on August 6, 1945. Their common perception? None of them heard the sound of the explosion. You’ll need a strong stomach and a stronger heart to get through this.

The Paranoid Style in American Politics, by Richard Hofstadter, 1964 — You think all this Tea Party, anti-immigrant, racist garbage all stared with reprobates like Ted Cruz, Michelle Bachmann, and Donald Trump? Think again. Politicians and demagogues have been selling fear and hatred here for our entire history. R. Hofstadter (not related, as far as I know, to Douglas) lays out the particulars in chilling fashion.

Understanding Media: The Extensions of Man, by Marshall McLuhan, 1964 — Notice how many groundbreaking books came out in 1964? Here’s another. McLuhan was the first to show us how we touched each other in a society ruled by the electromagnetic spectrum. His message was the technologies themselves shaped us more than the messages they carried.

On the Origin of Species (By Means of Natural Selection), by Charles Darwin, 1859 — Every critter, every plant alive, every fungus, every slime mold, can trace its ancestry to a common, microscopic bit of what we call “life” some three and a half billion years ago. Mutation and adaptation helped all those forms carry on. That’s what Darwin was trying to tell us. Still, some people don’t believe it.

The Diary of a Young Girl, by Anne Frank, first Netherlands publication, 1947; first US & UK publication, 1952 — The firsthand account of an adolescent girl’s effort to hide from the anti-semites who wanted to kill her. Her flower was nipped in the bud. Evil resides alongside hope and love in the human heart.

Silent Spring, by Rachel Carson, 1962 — Hey, there’s a whole world out there that just might get trashed if we continue to use its resources promiscuously and dump our detritus back out. Carson alerted us to this a half century ago yet, like Darwin, she has many, many disbelievers.

Relativity: The Special and General Theory, by Albert Einstein, the special relativity paper was published in 1905, the general in 1916; the American translation in 1920 — Einstein one day looked at a clock tower and imagined what it’d be like to travel as fast as the light rays carrying the image of the clock’s face. Thus began his famous thought experiment that led to his conclusion that time is not set in stone, but a malleable, traversable conceit. His papers are surprisingly accessible to layfolk, but don’t think they’re all that easy to read. It’s still a challenge to grasp all this and the old line is, if you think you’ve got it, you probably don’t.

Hmm. I’m starting to feel a bit dizzy. Better take a shortcut and just list the remaining choices.

The Second Sex, by Simone de Beauvoir, 1949

The Art of War (Master Sun’s Rules of Warfare), by Sun Tzu, 5th Century BCE

Principia Mathematica (Philosophae Naturalis Principia Mathematica), by Isaac Newton, July 5, 1687

The History of the Decline and Fall of the Roman Empire (six volumes), by Edward Gibbon, 1176-1789

Dialogues Concerning the Two Chief Systems (Dialogo sopra i due massimi sistema del mondo), by Galileo Galilei Linceo, 1638

The Civil War: A Narrative, three volumes, by Shelby Foote, vol. 1 1958, vol.2 1963; vol. 3 1974)

A Vindication of the Rights of Woman: with Strictures on Political and Moral Subjects, by Mary Wollstonecraft, 1792

Black Boy, by Richard Wright, 1946

On the Revolutions of the Heavenly Spheres (De Revolutionibus Orbium Coelestium), by Nicolaus Copernicus, 1543

Narrative of the Life of Frederick Douglass, an American Slave, by Frederick Douglass, 1845

The Feynman Lectures on Physics (three volumes), by Richard Feynman with Robert B. Leighton & Matthew Sands, 1964

The Federalist Papers, by Alexander Hamilton, James Madison & John Jay, 77 articles published separately, 1787-1788; collected in two volumes, 1788

The Affluent Society, by John Kenneth Galbraith, 1958

How the Other Half Lives: Studies Among the Tenements of New York, by Jacob Riis, 1890

The Americans, Robert Frank, 1958

The Joy of Cooking, originally by Irma Rombauer, succeeding editions incl. Marion Rombauer Becker & Etahn Becker, orig published in 1931; total of eight editions through 2006

Atomic Theory and the Description of Nature, by Niels Bohr, 1961

Experience and Education, by John Dewey, 1938

The Fire Next Time, by James Baldwin, 1963

Logicomix: An Epic Search for Truth, by Apostolos Doxiadis & Christos Papadimitriou, orig. published in Greece, 2008; in the US, 2009

Angela’s Ashes: A Memoir, by Frank McCourt, 1996

Prejudices, seven volumes of articles published in the Baltimore Sun, by H.L. Mencken, 1919-1927

Our Bodies, Ourselves, by the Boston Women’s Health Book Collective, 1971

The Feminine Mystique, by Betty Friedan, 1963

Persepolis: The Story of a Childhood & Persepolis 2: The Story of a Return, by Marjane Satrapi, vol. 1, 2003; vol. 2, 2004

Genome: The Autobiography of a Species in 23 Chapters, by Matt Ridley, 1999

The Blind Watchmaker: Why Evidence of Evolution Reveals a Universe Without Design, by Richard Dawkins, 1986

The Mismeasure of Man, by Stephen Jay Gould, 1981

Consilience: The Unity of Knowledge, by Edward O Wilson, 1998

King Solomon’s Ring, by Konrad Lorenz, 1952

Liar’s Poker, by Michael Lewis, 1989

Guns, Germs, And Steel: The Fates of Human Societies, by Jared Diamond, 1997 — Why do some societies dominate others? How do empires maintain dominance? Why do they crumble? Diamond answers these and other posers regarding our species’ bizarre predilection for beating the bejesus out of each other with the aid of our compatriots.

That’s it for now. Maybe when I feel a little stronger, I’ll finish up the blurbs on the titles that don’t have them. Don’t hold your breath, though.

Treatment: We Band Of Brothers (& Sisters)

Longer Living Through Chemistry

A woman is sitting about seven feet away from me in a recliner, the twin of the chair I occupy. She’s wearing a wrap around her head, but it’s obvious she has no hair. She has no eyebrows either. She tells the nurse, “See my lipstick? I decided to put some on this morning, just for color. Even if I have no hair I can still try to look good.”

She’s now my sister.

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A hefty fellow, looks like a truck driver, sits in a room on my left. When I came in, he flashed me a wave. “Y’better watch out,” he warns, “these nurses’ll spike your bag.” He laughs. I laugh. He’s now my brother.

I’ve got about a half dozen kin in this room, the IU Health infusion center across 2nd St. from Bloomington Hospital. I’ve never seen any of them before now. We’re all hooked up to IV pumps spritzing chemotherapy drugs slowly, steadily, into our subclavian veins — big, thick vessels that carry rushes of blood, the better to dilute the potent elixirs flowing into them. The subclavian vein is about the width of your little finger, the Mississippi, say, among the body’s rivers. It flows into the superior vena cava (SVC), the “rapids” in the words of one of the nurses here who understood and immediately dove into my watercourse analogy. The SVC would be the body’s Amazon River.

The lot of us here have bags of poisons flowing into us through portacaths, little reservoirs surgically implanted just under our collarbones and connected to our veins by tiny hoses. These poisons are so noxious that the nurse who hooked up my bag of Cisplatin had to don a protective gown and double-glove before she handled the stuff. Cisplatin’s going to kick the hell out of me and, it is hoped, my olive pit, the cancerous tumor in my neck.

War is a dirty business. In the words of Gen. Buck Turgidson in the movie Dr. Strangelove or: How I Learned to Stop Worrying and Love the Bomb, “Mr. President, I’m not saying we wouldn’t get our hair mussed. But I do say no more than ten to twenty million people killed, tops. Depending on the breaks.”

That’s among the darkest and funniest lines from a darkly funny movie but it fits here, in this all-too real-life treatment center. Millions, billions — hell, gazillions — of my cells will be smashed, fried, tortured, and pretzled as a result of the three sessions of Cisplatin infusions I’m scheduled for, the first of which is happening as I type this. In the midst of all this mayhem, the fast-growing cells of my neck mass will be killed — fingers crossed. The end result — oh, let it be so! — should be me being declared cancer-free sometime in June.

Until then, as Sister Sledge sang back in 1979, “I got all my sisters with me.” Brothers, too.

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I Got All My Machines And Me

Nausea

The word itself is sickening. No, not the literary nausea that bedeviled Jean-Paul Sartre’s Roquentin, whose emesis is caused by excessive navel-gazing. I mean the actual urge to hork.

I don’t know about you but I’d prefer any torture on Earth to that of nausea. Just my luck, nausea is the single most common and…, well, sickening, side effect of chemotherapy. Because of that, the 250 milliliters of Cisplatin that’s being pumped into me is part of a hefty cocktail in which I’m practically swimming.

Before the Cisplatin bag was hooked up, I was given 1000ml of saline solution — producing a signature, overwhelming metallic taste in my mouth — to which had been added in succession two super-duper anti-emetic drugs, Aloxi and Emend, as well as the steroid Decadron, which helps them work. These medications ought to keep me nausea-free for the rest of the day but I’m advised to start taking ondansteron (generic for Zofran) before bed tonight and every eight hours thereafter. And should I sense the merest hint of “breakthrough” nausea, that is, a sensation so powerful that the drugs I’ve taken so far can’t control it, I’ll have to take a prochlorperazine (generic for Compazine) pill in addition to the ondansteron. That stuff I’m told, is so strong it may knock me out. The possibility of nausea may well last up to a week.

Again, I’m being poisoned. Let’s hope the poison is a hell of a lot more powerful than my olive pit.

Once the Cisplatin bag is emptied, I’ll be given another big bag of saline solution so by the time I get out of here, I’ll resemble an overfilled water balloon.

Here’s the weird thing: I’m told the nausea rarely leads to actual horking. Now that’s a bum deal — you get all the agony without any of the catharsis.

Lucky for me, I’ll only have to do chemotherapy twice more, again in three weeks and then two weeks after that. Anti-emetics will be my constant companions.

Give ‘Em A Raise!

My Radiation Therapists are now Pencillistas. They told me this morning when I went in for my second zapping session they’ve started reading my posts. They sounded excited about it but alerted me to a horrible error in yesterday’s post. RTs, they said, earn nothing near $80,000 a year here in Bloomington. “Where’d you get your figures?” one asked. From a number of RT job search sites as well as professional association pages, I said.

“Hrrmph. They tell us our salaries are determined by local cost of living figures. Bloomington’s COL,” she continued, “is low. That’s a laugh!”

A few of her colleagues buzzed about that $80,000 salary. From what I could glean, half that would be a handsome yearly take for a Bloomington-area RT.

As far as I’m concerned, my RTs are worth a million apiece.

Treatment: Day 1

Making It Go Away

Yep, you read today’s headline right. No more of this malignant foolishness. We’re gonna kick those damned cancerous nodes right the hell outta my neck. Starting today.

I went in for my first radiation session this AM. These machines cost a sweet $3 million dollars apiece, minimum, which means the most excruciating pain a cancer patient experiences is when s/he looks at her/his bill.

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But wait, there’s a hell of a lot more expense to running these gadgets. Many, if not most, radiation centers have two or more machines in operation. It’s not just a matter of having U-Haul dump the machine on the center’s loading dock, moving it into place, and plugging it it. Oh, hell no. There’s ancillary hardware, personnel protection, lasers, secondary machinery, staffing…, well, dig these little line items:

  • Treatment rooms must be built broad and tall enough to house the machine and allow patients and personnel ample room to scurry about
  • Each treatment room must be shielded so that stray radiation doesn’t turn everyone working in the place into a human reading lamp
  • Target laser placements must be calculated and positioned at an unforgiving precision level
  • Getting the machine approved by various accrediting authorities
  • More computers than you can count to run the operation
  • Video cameras galore
  • Assigning at least two radiation technologists to every machine for every session, at yearly salaries of upwards of $80,000 apiece (a fully-staffed center with two machines probably would have six or seven RTs.
  • One or two dosimetrists per machine at some $100,000 a year apiece to do the calculations for each patient’s radiation dosage
  • One radiation physicist per machine who is, essentially, the super high-tech mechanic of the shop, making up to $250,000 a year
  • All the oncology nurses, dietitians, office staff, social workers, medical records specialists, etc. at varying and presumably attractive salaries
  • Each machine is sold with a manufacturer’s service contract, typically a million or so dollars a year
  • At least one and usually more radiation oncologists, each making scads of dough

Somebody’s got to pay for all that. Medical insurance pays a certain percentage. The patient is on the hook for the rest. Ah well, it’s only money.

Anyway, zapping a tumor with one of these machines is called external beam radiation therapy, meaning the radioactive stuff remains outside the body and its powerful rays are focused on the offending masses. (Other radiation therapies entail introducing radioactive material directly into the body; for instance, patients with thyroid cancer have radioactive iodine inserted into them.) The guts of these machines are linear accelerators, complex machines that supercharge the energy output of subatomic ions, causing them to emit X-rays. Other types of accelerators stimulate protons or electrons.

Now, the linear beam aspect of these machines describes their ability to focus the radiation into a direct line so it can be aimed at a tumor. Normally, particle radiation travels 360º outward (think of the sun, radiating in all directions). The idea is to get the most radiation aimed at the tumor and the least diffusing around, doing damage to surrounding tissues.

BTW: Among the most advanced radiation treatments these days is proton therapy. Proton treatment is super-focused and does a lot less collateral damage than, for instance, the machine I lie under today. Bloomington not long ago was home to one of the very few proton radiation centers in the country. In fact, when it opened in 2004, there were only two other such facilities in this holy land. Sweet, huh? Then Indiana University and IU Health officials decided it would be in humanity’s best interests to close the center back in 2014.

Funny thing is, acc’d’g to the National Association for Proton Therapy, there are now 20 centers in operation in the US with some 15 more being planned or under construction. One of the primary reasons the IU center was shuttered was the recent trend of medical insurers to scream bloody murder when presented with the bill for proton therapy and, in many cases, flat-out refusing to cover such treatment.

Makes you feel proud to live in a nation that has the world’s best health care system, no?

Not that I’m ungrateful for my own access to this costly treatment. In so many ways, I’m the luckiest guy imaginable, starting with The Loved One standing beside me (or sitting in the waiting room).

So, today I checked in at the cancer radiation center across Tapp Rd. from World Wide Automotive Service. I flashed my patient ID under the scanner and noticed a sign warning me and others that one of the center’s machines was down for the day, a not-uncommon occurrence in this business. Lucky the center has its million-dollar-a-year service contract. I cooled my heels for a few minutes before one of the Radiation Therapists who did last week’s staging and simulation on me appeared to lead me into the treatment room.

It’s funny, it seems everyone who works in the treatment rooms is bubbly, bright, and quick with a joke. I can think of two reasons who all these people seem so chirpy:

  1. It takes a special person to work with people who may be dying or suffering greatly every day, and
  2. Seeing the daily parade of cancer patients and realizing they don’t have cancer is a constant reminder that they’re the luckiest ducks around

There’s probably an element of truth in both.

The RT’s locked me into my personalized chocks and blocks, my mask, my leg restraints (they don’t want me inadvertently crossing my legs), my shoulder brackets, and other paraphernalia. Then they positioned me just so under the room’s targeting lasers. Honestly, they’d nudge me a millimeter this way and two millimeters that way, the precision is so demanding.

Then they did a CAT scan on me to verify the exact location of my cancerous nodes and did several X-ray images to make sure my neck was in perfect alignment and my jaw was out of the beam’s path. All this took some 20 to 25 minutes. The actual shooting of the linear beam into me lasted a mere five minutes. In the meantime, I had to lie motionless under my mesh mask (my RT told me she’d yell at me over the intercom if I dared to move). All the RTs and their assistants and interns remain in a control area outside the room, natch, otherwise they’d begin to glow all night long.

I tried to while away the minutes by scoping each surface that would appear above my face (various beam shooters, X-ray imagers, scanners, and other doodads were arrayed around my head attached to so many stout arms; the whole contraption throughout the process whirred, hissed, beeped, flashed, and clicked as each module was moved into position). I followed all the action visually — fortunately I was allowed to move my eyes. I concluded that $3 million for this complicated apparatus was prob. a bargain.

And then, I was finished.

More accurately, I’m just beginning.

Malignant: All The Way

Shoot The Moon

Well, babies, I’m in it now. The scalpel jockeys, Drs. Haddad & Ghosh, did their respective things yesterday AM, Haddad hooking up my drug port and Ghosh fitting me with a gastric feeding tube.

There ain’t no turning back.

My first radiation session will be tomorrow at 11am and then every day Monday through Friday at 8:30 through March 18th. My first chemotherapy session will be Friday, right after my second radiation party. Then there’ll be two more of those splashes, dates and times TBA.

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You may ask, what’s the worst thing about getting two surgeries on the same day? The surgeries, it turns out, were a breeze. And, thankfully, both docs closed me up with glue as opposed to catgut (or whatever they use for sutures these days) so I won’t have to worry too much about getting water or soap on my wounds. I gave myself a top-half sponge bath and a bottom-half shower this morning. The whole affair took nearly an hour, mainly because I was hyper-cautious about accidentally yanking out my stomach tube, the very idea of which is giving me the shivers as I type.

In any case, there are only two miserable drawbacks to yesterday’s procedures: 1) my chest and abdomen had to be shaved, so if you see me walking down the street scratching at myself like a heroin addict over the next few weeks, you’ll know why; 2) is my tough skin. No, really. IDK why but it’s become increasingly hard for nurses, docs, and phlebotomists to draw blood from me or start an IV. Yesterday, for instance, two nurses tried to start my IV in different places, failing each time. My anesthesiologist had to come in, give me a blast of lidocaine, and start my IV on the inside of my right wrist. It’s the damnedest thing.

Yesterday I was restricted to a liquid diet so The Loved One and I drove through a McDonald’s for chocolate shakes after I’d been booted out of the hospital. Later I had one of those containers of chicken broth, you know, the kind that look like house bricks standing on end. The broth was low sodium so it didn’t taste like anything. I gazed lovingly at the hearth baked bread on the counter. I opened the refrigerator door and mooned over the leftover meatloaf and baked chicken legs. Oh, and there was fresh avocado as well as some chocolate pudding.

I tell you, I have a will of iron, kids.

My peanut butter toast with rhubarb preserves and all-fruit blueberry spread for breakfast this morning could not have been topped by the combined efforts of the world’s five best chefs working together.

A visiting nurse dropped in at 9am today to show me how to clean and use my feeding tube. It’s really no big deal at all. In fact, I gave myself a jolt of water before she left. I’d been afraid it’d be the grossest thing I’d ever do in my life but today I found it to be a snap. I can’t wait to show The Loved One how easy it is tonight.

Interesting thing: the surgery dept. at Bloomington Hospital has an LED display board just like at the airport, only this one shows the progress of patients as opposed to aircraft.

I figure they should add a little lightness to the sign and list the times under the categories ETS (Estimated Time of Slicing) and ETW (Estimated Time of Waking-up). Then again, nah.

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So, stayed tune for tomorrow’s post wherein I’ll tell you what it’s like to be dosed with radioactive rays. My guess is I won’t feel a thing. The more compelling story will come the next day, when I get hooked up to the chemotherapy infuser. Matter of fact, I just may blog it in real time, considering the chemotherapy center has wi-fi.

Great fun ahead. See you next time.

Malignant: Pay Up

A Costly Disease

In case you didn’t know it, cancer costs a lot of money. A lot.

And if indeed you didn’t know this, it may be prima facie evidence you’ve been in a coma for the last seven or eight decades, which also costs a lot of money, I’d imagine.

Anyway, we got a letter the other day from some outfit called Medical Cost Management Corporation. Now neither The Loved One nor I know the first thing about any Medical Cost Management Corp. Which is why the meat of the letter was so hard to swallow. First, the letter thanked us for participating in its Outpatient Care Review Program.

We had no idea we were participating in any such thing.

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Okay, so we read on:

The proposed outpatient care is not medically necessary and appropriate; and therefore, not recommended.

Huh. So, uh, how much of my care? Part of it? All of it? Should I not be getting all so ramped up for chemoradiation therapy? Do I not have cancer (ohdeargodpleaseplease!)?

The letter goes on to say things like my health care is a decision to be made by me and my doctor and this ruling means medical bills won’t be paid (Some? All? Who knows?)

The Loved One looked about ready to have a nervous breakdown when she opened the letter Saturday night. I told her there was nothing we could do about it over the weekend so she should just put the letter down and let me take care of it Monday. It took a ton of persuasion to get her to follow my advice. (Remember, she’s suffering too.)

In my mind, of course, my plan was to ring this Medical Cost Management Corporation first thing Monday morning and demand to know:

  1. Who the fuck they are
  2. Why the fuck they’d sent us this letter at such an emotionally charged time
  3. And what the fuck they’re talking about, specifically

Oh, sweet blindness, I couldn’t wait to drop all those F-bombs on them! I’d envisioned myself the Gen. Curtis LeMay of F-bombing. This’d be especially gratifying if it turned out, as I suspected, that Medical Cost Management Corporation was some kind of scam outfit, trying to scare me into buying some kind of coverage from them. The bastards.

I counted the minutes down to this morning.

First thing I did was google the Corp. The first four listings that popped up were ads. Grrrr! I knew it! I scrolled down to the first non-ad link and clicked it. Lo and behold, what looked like the firm’s official page would not load.

The dirty bastards, I hissed.

So, I rang the company up. A receptionist answered and I told her, sweetly, I’d gotten a letter from her company and I had no idea who they are or what they want. It wouldn’t do for me to open my bomb bay doors over her — what if she was some kind of answering service? Gen. LeMay would have approved of my restraint. Conserve your ordinance for the most valuable target, he’d say.

The receptionist pushed me off to someone she said handled this kind of thing. Which I, naturally, took to mean a salesperson. Again, Grrrr. The person’s voice mail answered and I left another sweet inquiry and my phone number. Oh, I fantasized, am I gonna lay into that no good hyena!

While I waited for her callback, I dug a little deeper into the mystery. I checked my medical insurance card for my carrier’s number because I wanted them to know some dirty bastards were trying to muscle in on their business.

That’s when I discovered that, acc’d’g to the back of my card, Medical Cost Management Corp. is my insurer’s “Precertifier.” In other words. MCM is the outfit that makes sure the insurance co. isn’t being ripped off.

Oh.

Okay. Good thing I asked the receptionist and the woman I’d been pushed off on so sweetly. Really good thing.

So, I forced myself to read all the incredibly dense and arcane fine print in the letter. It turns out MCM had determined a certain drug that’s to be part of my chemotherapy regimen is “considered experimental and investigational.” Therefore, the company would suggest to my insurer to tell my doctor to take a hike once he submitted his bill for it.

Aw, fer goodness sakes! Is that all it is?

I dashed off a quick email to The Loved One telling her all is well, we’d probably just have to pay for some silly little drug. Who cares?

I closed the email with a little levity. “We’ve got nothing to worry about — unless it costs something like $100,000. Haha!”

Just as my finger was heading in a downward trajectory to hit the send button, a thought occurred to me: Jeez, how much does this damned drug cost?

So I did some more digging.

The drug is called pegfilgrastim, to be injected into my arm via an automatic little machine 24 hours after my chemotherapy infusion. I’d get a spritz of 6 milligrams of the stuff.

Pegfilgrastim is the official chemical name for the brand drug Neulasta. It’s a “recombinant human granulocyte colony-stimulating factor analog of the chemical filgrastim” used in portable infusion attachments. The International Union of Pure and Applied Chemistry specifies its molecular make-up must be N-(3-Hydroxypropyl) Methionylcolony-stimulating Factor (human), 1-Ether with . Alpha.-Methyl-.Omega.-Hydroxypoly(oxyethylene).

Oh my holy god, that’s gotta cost an arm and a leg for the name alone!

I dug further and found the cost of a single unit of the stuff is $9141.88. That single unit, apparently, is more than 6mg because my particular dosage should cost $5485.13.

That’s almost 5500 dollars for three separate shots. Or (sob) $16,500.

Is my life worth that much?

It may indeed be the cost of keeping me alive. Pegfilgrastim (or Neulasta) is designed to stimulate my immune system by kicking my white cell production into super-high gear. See, the platinum-based cancer fighting drug I’ll be guzzling beginning Friday (I just learned I’m on the schedule today) is an extreme immuno-suppressant. By the time I hit chemotherapy session number three, I’ll be vulnerable to every disease known to humans and maybe even a few not known, to boot. I may even fall victim to something only aardvarks normally catch.

I can imagine many, many things I would rather blow 16 grand on. A mint set of 1969 Topps baseball cards, for starters. My own professional pizza oven, too. An orange Harley Fat Boy. Lots of things. But I’ll have to pay it out, most likely, unless MCM changes its mind, to keep myself disease free for the next month and a half.

Man. Cancer sucks.

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I Wish

 

 

Malignant: A Lisping Heavy

I Got The Roscoe, See?

So, old Doc Baker yanked tooth No. 18 out of my skull just about an hour ago.

The sumnabitch was so locked in he had to saw it in half to get it out, piece by piece. Odd, that, since it was the only tooth in my head that showed any mobility at all. The rest of my choppers are set in concrete, fer gosh sakes.

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BTW: ID-ing it as No. 18 doesn’t mean it’s the eighteenth of my teeth to be to be extracted. Dentists have a numbering system and that one, the middle molar in my lower left jaw, just happens to be No. 18.

Anyway, I’ll look and sound like a movie tough guy for the next couple of hours, talking and drinking coffee out of the side of my mouth.

See, this is one thing I was most afraid of. I take great pride in my choppers. I’ve never had a cavity in my life. I brush and rinse and floss to a fault. And now I’ve got this huge chasm in my jaw.

The problem, though, was the prospect of laying there as the doc yanked and grunted, my mouth agape and numb. Hard to believe, but in this day and age dentists have to use pretty much the same techniques their predecessors from, say, the 1880’s did to extract a tooth. It’s basically chisels, pliers, and muscle. The only difference is dentists can administer something a tad more efficacious than a shot of rotgut whiskey for the pain.

Which brings me to my numb jaw, lips, and tongue. It’s just about impossible for me to pronounce my consonants properly, particularly my lingual/dentals. So, basically, I’m articulating like a cross between Edward G. Robinson and Sylvester the Cat.

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Tho I’m In Sharghe Now, Thee?

Hallelujah, I’ve crossed the tooth hurdle. Now all that stands between me and chemotherapy is surgery Tuesday, when my drug port and feeding tube are installed.

In a weird twist, I’m not at all apprehensive about that one.

Meanwhile, I’m going to enjoy this glorious day with The Loved One. She’s my moll.

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