The Electron Pencil

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.

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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.

I Got All My Machines And Me

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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.

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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.

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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.

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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.

That’s Me, BLHOR-2016-508

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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.

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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.

I Wish

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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.

Tho I’m In Sharghe Now, Thee?

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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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Internal Combustion

I want to start this one off by typing The truth of the matter is…. But that’s not true. The truth of the matter is I’m juggling two truths right now.

I may be better off typing The truths of the matter are….

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Maybe that’s why I have such a headache right now as I type this. Or maybe I’m getting sick, which might be bad, real bad, inasmuch as my being sick could well play havoc with all the best laid plans to clobber My Olive Pit™ — the tooth that’s supposed to be pulled tomorrow at nine, the surgery to install my drug port and my feeding tube Tuesday morning, the radiation therapy that’s slated to begin Thursday morning.

We all want to get going on this. My doctors. My friends and family. The Loved One. Me.

Me? Really?

Two truths. Maybe I don’t want to get going on this. Maybe I’m about as afraid as I’ve ever been in my life. Maybe I’d be happier if I could just stay here, indefinitely, in this state of preparing.

That’s all I’ve been doing for a couple of months, preparing. Now the tough part begins. And I’ll be goddamned if I don’t want it to. Maybe I should call Drs. Wu (radiation oncologist) and Allerton (medical oncologist) and ask if maybe — just maybe — we can delay this rigmarole for a few weeks. Months, even.

How about this? Can’t we just wait until I’m 87 years old, frail, my teeth falling out like so many pieces of that sickening sweet Halloween Indian corn, my friends all dead or dying, Steve the Dog long gone, Donald Trump’s now-18-year-long dictatorship finally being chipped away at by a new, younger generation of street revolutionaries?

By that time, I can say to Wu and Allerton, Aw, let’s forget the whole thing. I’m on the way out anyhow.

Of course, My Olive Pit™ by that time may well have grown to the size of…, oh, let’s see…, a baseball. Better, a cantaloupe.

Then again, by that time I’d be long gone. At least that’s what they tell me. Flashback to the exchange between me and the ENT guy who first went looking for cancer in me:

Me: So, is this gonna kill me?

Dr. Pugh: It will if you don’t do anything about it.

Not much room for argument there. It’s hard to argue against the truth. One truth.

Okay, the truth of the matter is I have to do this.

A-a-and, the truth of the matter is I don’t want to do this. Oh, my aching head.

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Preparation Aches

Preparations for the concerted poison and radioactive ray attack on My Olive Pit™ had been moving along at such a glacial pace that I sort of forgot about the “hell” (Dr. Wu’s word) I’m slated to endure.

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BTW: chemotherapy really is a poison attack upon the body. It’s no different than, say, dropping a third American nuclear weapon on Tokyo in the hope of ridding Japan of its ruling militarists toward the end of World War II. Sure, the war-loving madmen who helped push the globe into all-out conflagration would have been fried into the afterlife, but so would have hundreds of thousands of common citizens.

In my case, belligerent fanatics in the form of squamous cell carcinoma are gradually taking over my body’s government. My medical oncologist — one of my two top generals — has decided the best response to this development is to flood me with with Cisplatin, a platinum-based drug. The Cisplatin will attack the cancer cells, instructing their DNA molecules to shut down their reproduction and repair functions. Okay, cool, all those crazy belligerent fanatics will be killed — but the populace, the innocent cells of my body, will suffer as much or even more so.

Some of Cisplatin’s possible side effects include kidney damage, neurotoxicities resulting in hearing and vision loss, anemia, and severe nausea and vomiting. What kind of sadistic general would want to be responsible for such collateral damage? The kind that wants to win a war that otherwise would destroy the homeland. Namely, me.

Add Cisplatin’s effects to those of radiation therapy and many billions of my body’s cells are gonna get the holy shit kicked out of them.

That’s why there’s so much prep work to be done before chemoradiation therapy can begin. My bod must be in as tip-top shape as it can possibly be, a tall order considering the number of years I’ve spent on this planet enduring normal wear and tear in addition to my own abuse and neglect of this not-so-sacred temple.

It’s been two months since I’ve learned I have cancer. The entire time has been taken up with tests, procedures, dosages of medications, drainings of blood, and various other high-tech voodoos designed to get me into fighting shape. The dental work that’s been done upon me has eaten up the lion’s share of time. Not that my choppers were in particularly bad shape — quite the contrary — but any trifling dental issue, any picayune gum irregularity, must be dealt with now before my mouth’s healing capacity is compromised by radiation therapy.

To that end, Dr. Wu’s office rang me up Monday and asked, essentially, What in the hell is going on? He wants to get going with radiation treatment. Funny he should have called that day because I’d been stewing the entire weekend, wondering why my dentist, Dr. Baker, hadn’t scheduled me for a tooth extraction yet. That’s the last thing I have to get done before the War on Cancer begins. I was about to dial Dr. Baker’s number when Dr. Wu’s office called.

So, I spent the day raising hell with Dr. Baker’s phone person. She told me Baker doesn’t do the yanking, her associate (who happens to be her father) does that work. But that Dr. Baker — ohsweetjesus, this is gonna get confusing — doesn’t have an opening for ten days or so. Maybe more.

Uh uh, sez I. That won’t do. Who else can I go to? Dr. Baker I’s phone person gave me a few numbers. I dialed them and told those phone persons I needed a tooth yanked ASAP otherwise I was in danger of collapsing from a cancer attack. None of them had openings within the next few weeks. So, I dialed Dr. Baker I’s office again and tried to put on a sniffly voice (BTW: I won’t be nominated for an Academy Award this year). Isn’t there anything that can be done? I begged.

The woman must have taken pity on me. She sighed, Okay, we can fit you in as an emergency patient Saturday morning. Success.

I called back Dr. Wu’s crew to spread the good news. His peeps told me, “Good, now you can come in tomorrow to get your mask fitted and your mapping done.” I was to come in the next morning at ten.

Alright, then. I hung up, satisfied that we were moving ahead.

And it hit me. This “hell” Wu’d promised me was about to begin. Tomorrow (Tuesday), as a matter of fact.

I thereupon fell into a deep funk. The day, overcast already, seemed to turn even darker. I could no longer entertain the fantasy that Dr. Wu or Dr. Allerton, my medical oncologist, might call and say, Haha, did we pull a fast one on you! You don’t have cancer. You won’t need any radiation or chemotherapy! Aren’t we pistols?

Honestly, when hellish potentialities loom, you start dreaming crazy dreams.

I’d been poring through the newspapers and all my bookmarked science sites daily, searching in vain for breaking news that a brand new drug had been discovered, one that would make radiation and chemotherapy unnecessary. Pop a single pill and — boom! — down goes the cancer. Or perhaps some machine might be invented by a consortium headed by Elon Musk, Stephen Hawking, and Warren Buffett, a gadget so advanced its operator could press a button for a deliciously quick second and thereupon zap the offending nodes and tumors into nothingness.

Need I clarify? No such scientific advancement is forthcoming.

I’d be going to hell starting Tuesday.

I was so discouraged that I couldn’t even talk about it with The Loved One. I sat smoldering in my recliner, unable even to say hello when she came home that evening. Poor kid. At first she was worried that I’d gotten some horrible news. I roused myself enough to tell her, No, that wasn’t it. Otherwise, I was mute.

My black moods aren’t necessarily fleeting but, having battled clinical depression for years I’ve learned how to pull myself out of a morass, they don’t last much longer than a night. When I got up the next morning, I was able to explain what was happening inside the coconut to The Loved One. She, too, is experiencing a kind of hell.

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Battle Lines

I met a couple of delightful radiation technologists yesterday. Their task was to fit me onto an electronic, moveable platform that’ll shift me in and out of their radiation machine.

Oh, it’s a hell of a task. Precision is paramount. They had to shift my hips and shoulders this way and that, often by millimeters, centering me. The strapped my feet together so I wouldn’t be tempted to cross my legs during the 15 or 20 minutes I’ll spend daily in the machine. They placed pegs in the platform for me to grip tightly, further guarding against herks and jerks. They jammed brackets into the platform, shoving my shoulders down, thereby clearing them of the radiation beams. They placed a form-fitting plastic mold under my neck to hold my big bean steady. All this was done as a laser beam attached to the ceiling shined down on my sternum, giving them a centering point of reference. Then — the pièce de résistance — they created a mesh mask to be fitted to my face.

The mask serves a dual purpose. One is for the technologists to draw aiming points on it without permanently marking my ruggedly handsome mug. The other is to hold my head as absolutely steady as humanly possible as the radiation enters my neck.

All the pegs, brackets, sticks, pool cues, garden hoses, and other paraphernalia have been graduated and marked to my specifications and will be pulled out every time I come in for treatment.

The technologists did their work smartly, quickly, and with a fine sense of humor. Now, that’s what I call customer service. As far as I can tell, everybody in the radiation rooms has a top-notch bedside manner. Considering how scared to death all their customers are, that seems a prerequisite asset.

Dig the following slide show featuring two aspects of the mask as well as one shot with it on me as I lie on the table. The thing sticking out of my mouth is a bite stick; that ensures my tongue is kept down during the beaming, sparing it too much unintended fire.

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Young Again

If My Olive Pit™ hadn’t been located right next to my thyroid gland, prompting my docs to immediately check for thyroid cancer, I might not be feeling as chipper and frisky these days.

True story.

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The first thing Dr. Behney, my primary care physician, did was order a big blood panel on me. The phlebotomist, as a result, drew several gallons of the red stuff out of me, causing me to stumble around the streets of this bustling megalopolis for the rest of the day in a stupor, my skin pale, black circles around my eyes, my only utterances grunts — in other words I’d been transformed into a Donald Trump supporter.

Anyway, if you’ve been following this story so far, you know I don’t have thyroid cancer. I do have squamous cell cancer located in ipsilateral lymph nodes around my throat, which I’ve been milking for content for a month now, as any self-respecting blogger would.

The blood test, though, revealed I do suffer from hypothyroidism, apart from my cancer diagnosis. Last week, Behney prescribed a daily dosage of Synthroid, a synthetic hormone to replace the stuff my lazy-assed thyroid hasn’t been producing for what turns out to be many years.

I’ve been taking Synthroid since Friday, a week’s worth of it now. Sometime around late Monday afternoon, I noticed that I was as active and non-exhausted as I had been years ago. See, for a long time I’ve noticed myself feeling utterly spent at least by noon every day. I had to come home daily and collapse in my recliner, sometimes unable even to converse with The Loved One. My legs would feel as though they weighed 150 pounds each. Merely crossing the room to turn the lamp on or off seemed a titanic task. I was cranky and unambitious. Even in my morning shower, I’d feel as though I ought to get out and collapse in my chair. I figured it was all related to my congenitally deformed heart and the resultant Congestive Heart Failure I’ve been diagnosed with since 2003.

The Loved One came home Monday and saw me standing up, a surprise in itself. I was chatty and working on dinner. I looked alive. She marveled at the transformation.

I’ve been similarly energized each day since. I actually feel young again. All, apparently, because I now have enough of the hormone that regulates my body’s energy level and metabolism.

Hell, this never would have happened without my cancer diagnosis. Life is funny, no?

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All Doped Up

I’m gonna need that newfound energy to keep track of all the medications I have to take these days. Here’s the list of my prescribed drugs, several of which actually are keeping me alive, the rest profoundly affecting the quality of my life:

● Furosemide (generic for Lasix)

● Potassium

● Allopurinol

● Enteric Aspirin

● Metoprolol

● Sertraline (generic for Zoloft)

● Atorvastatin

● Doxazosin (generic for Cardura)

● Synthroid

● Vitamin D3

● Clarithromycin (for my dental sessions)

That’s 14 tablets a day (some are multiple pill doses). I also picked up a couple of anti-nausea drugs yesterday; I won’t take them until chemotherapy starts but I’m assured I will, indeed, need them. All that’s in addition to the chemotherapy drug cocktail and all the drugs that’ll be injected into me immediately after each therapy session. Throughout my treatment, my blood’ll be monitored closely to make sure various substance levels remain acceptable. Should those levels drop, I’ll be prescribed the appropriate drugs.

Conceivably by March I could be taking more than 20 different medications a day.

I have to admit I have no qualms whatsoever about contributing to the uber-wealth of certain pharmaceutical company CEOs. Call me a pharma-capitalist running dog if it makes you feel any better.

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