Blood work

Let me briefly explain what this blood work stuff means. I usually end up getting my blood drawn almost every week to see how I am coping with the chemo. There is no definitive test that I have done to show if my cancer is stable, progressing or in remission. What the tests show are how all my organs are generally functioning and how my blood counts, specifically, white, red, platelets etc, are performing. So if my white count is low I'm more susceptible to infections and hence the Neupogen shots. Each abnormal bit of blood work may be an indication of something wrong with a specific organ and just aids the doctors in diagnosing different problems. Again, there is nothing specific that would say, oops, kidney cancer.

Oh yea. My blood work today was fine. I had a really nice chat with Mary about how I have been feeling the past few weeks.

Carpe Diem.

Weekend update

Friday late afternoon, Diana, me, Mike and Kevin drove to Rob's college to pick her up and go for dinner in Bethesda. As I mentioned before, we went to P.F. Chang (sorry Pat) to celebrate Mike's birthday. It was a great dinner as we all have our specialty dishes that we love. Ordering was really funny because as we sat down we didn't even give the wait staff a chance to say "hi my name is......". We just say "hi, we are ready to order". It was great to see Rob again but the drive and the traffic were a bit of a pain in the arse! All in all, a really nice evening.

Saturday lunch time we watched Man U beat Fulham 4-0 in the FA cup playoffs. Shit, we are paying well. Sorry to bore you all with this incessant soccer (football) talk. I guess you have to be a fan.

Saturday evening we were supposed to go for dinner with some of our good Baltimore friends. I had been feeling quite decent for the last couple of days but for some reason I really started to feel like crap Saturday evening. I have no idea what to attribute this to. It's general aches and pains and fatigue. A real malaise.

Sunday I wasn't feeling that much better. So on Monday morning we will be making a few phone calls to our Doctors. We may also be going to see another thoracic surgeon who specializes in lung cancer to get an updated second opinion.

Ordinarily I really dislike TV reality shows. But there is one show I watch every Sunday evening called Extreme Makeover Home Edition. The basic premise of the show is ABC and Sears combined with a whole bunch of really generous companies and people helping those that really need help. Specifically building them new homes. I watch this because when I think my whole world is going down the toilet these stories really lift me and show me that there are many others out there that are also suffering but just in different ways. It also shows me what good there is in this world. What more could you ask for.

Carpe Diem.

Phil's visit

Picture is from August 2008 Today is somewhat of a mixed emotion day. Allow me to explain. It's Russ's birthday today (yippee) and it's also the 1 year anniversary of me being diagnosed with lung cancer (oh shit!). So where are we after one pretty long tough year. Well, still here for one thing. I wish I could say that all is great but I know that we still have a good fight on our hands.

Gerry, Carolina, Ilan & Russ - London March 5th, 2009.

Now onto Phil's visit. As Always, the visits are way too brief but they are really uplifting for me. We talk about all sorts of things and plan all sorts of things. Of course, we always have to get approval from our older sibling for some of the nuttier things we plan. Suffice to say, a lot involves travel. I was actually able to treat Phil to lunch today which is a feat in itself. She always finds some way to justify paying for our lunches or meals but today I won. All $20 worth of it. It was the company that was worth a million.

Carpe Diem

Meeting with Dr. Kumar

Picture is from January 2009.

Today we met with Dr. Kumar. She is the oncologist who has taken over for Dr. Erlich in the interim. I say in the interim because as soon as Dr. Erlich has established himself in another practice we will more than likely be moving there. The meeting went fine. We asked all our questions and confirmed the treatment plan for the near future. My next chemo treatment will be Monday March 16th. Hopefully, if I am doing and feeling well, I will get all three drugs again. So far this week I have been feeling ok. Better than before! My next scan will be at the beginning of April.

Now onto the really important event of the day. Dr. Chef Mike's birthday. Yes, our little snot goblin turned 18 today. We went out for a quick bite to eat tonight but the real dinner celebration will be this coming Friday evening. Diana, me, Mike and Kevin (Mike's best friend) will pick up Rob from school and go to P.F. Changs in Bethesda. Yummee.

Oh yea. Man U beat Newcastle 2-1 today. Still 7 points clear in the table. We are number 1.

Carpe Diem.

Rest in Peace Bella

This morning we found out that our good friend Spike's (Mervyn Spiro) mom had passed away. She wasn't far off being 100 years old but sadly the last few years of her life were racked with immense pain and suffering. Her mind and sense of humor stayed with her all most to the very end. I was fortunate enough to be able to visit with her a few months ago in Toronto and while her eye site and hearing were a bit compromised her ability to still be kidded by us and throw it right back was amazing. She will be sadly missed. Her hardships aside, we should all be so lucky to live such a wonderful, long and full life. This longevity fact being especially poignant to me personally. My heart goes out to you and your family Spike. Rest in peace Bella.

Carpe Diem.

Chemo 3 (Round 4)

Chemo day today and a bit of a reprieve. My vitals were all fine, my weight is down a couple of pounds and my blood work looked good. But all that taken into account (including the rough past week) they decided to change this weeks cocktail. I only got the Alimta. No Avastin or Oxiliplatin. So hopefully this will be a relatively good 2 weeks. Time will tell! Even though the blood work was good I will still get my Neupogen shots but this time with a small twist. They will be administered at home by Dr. Mike. Yes, the very same person as Chef Mike. He's the only one willing to do it!!!

Carpe Diem.

Weekend update

It's been a tough few days. I'm not sure I signed up for this.

As Diana mentioned in the previous post, I had my blood work done on Monday and everything looked ok on the report back. The only thing that was suggested to me was to try a supplement called Coenzyme Q 10 (CoQ-10). It's supposed to help with the fatigue. I have been taking it for a couple of days and am not sure I have noticed any improvement in the fatigue. Maybe I'm too tired to notice!

On Friday morning I had a chest xray done to make sure there wasn't a pneumonia developing or there was not more fluid buildup in the pleura even after the talc procedure. Our surgeon, Dr. Skaryak, saw the xray and report and said that what she saw was the post op results of the talc procedure. All else looked as normal as it could look! Yea, I know. It doesn't make me feel a whole lot better.

Saturday morning Al Goldstein (aka Goldfish or Fish) came to visit. We picked him up at the airport and he will stay the night and leave tomorrow. It's been really nice catching up with him about all the goings on at work (UPS). For those that do not know, Al and I are both senior Captains flying for UPS. He is on the MD11 and I am on the B757/767. Albeit not right now for me!!! I've also know Al since I was about 8 years old. He is the only one of my good close friends that knows me both professionally and socially.

Saturday evening Diana, Al, Mike and I went for a really nice dinner at Akbar Palace. Then back to the house for more catching up.

Sunday morning I made Al and myself omelettes and then off to the airport to drop him off. It was a really rejuvenating visit for me. The rest of the morning was spent watching Man U beat Tottenham in the Carling cup final. Yehaa!

"And now for something completely different". This afternoon I was in touch with Dr. Erlich. We had a wonderful conversation and I am sure I do not have to explain to you all how much of a mental and physical lift this was for me. I will elaborate more soon.

Tomorrow is chemo 3!!!

Carpe Diem.

From my perspective

As you can probably infer by Adrian's limited writing this week, it has been a pretty rough ride. Two of the three drugs are very heavy duty (Is there "light duty" chemo?) and both cause bone pain and fatigue. Not a nice combo. He pretty much slept through the first week - awake for only about 8 hrs per day. This was probably a good thing for him, but very difficult for me to watch. His blood work up yesterday (Monday) was perfect - good levels of RBC,WBC, neutrophils etc. He's a pretty tough guy! I would have to say that, except for his cancer, he's in good shape for the shape he's in. Just please keep reading and writing as this gives him a lot of strength in combating the constant onslaught of toxic drugs he must endure. As my favourite oncologist (Dr. Erlich) tried to tell me repeatedly, "This is a chronic condition". OK OK I get it now. Some people have diabetes, others cardiovascular disease, and Ade, well, you know the rest... Anyway, he, and we, are still plugging along and intend to do so for a long time.

Diana.

Carpe Diem.

Weekend update

To sum it up, it's been a really tough couple of days. Unfortunately, there is no relief for chemotherapy fatigue. You can rest all you want but you still feel tired when you get up. For some reason, this round of chemo really seems to knock the crap out of me. But there was some light at the end of the tunnel. Man U beat Blackburn 2-1.

Carpe Diem.

Letters from Zimbabwe

From Dennis:

One of my ZimKids, Brian Dube, woke up Monday morning and walked with his gogo (grandmother) to the local clinic for his tuberculosis pills as he has done every day since his diagnosis a few weeks ago. He seemed a bit stronger the last couple of days. Six weeks ago I took him to the doctor for treatment of ringworm he’d had for 8 of his 10 years. A few weeks later he was getting weaker and weaker and his cough worse and worse. Both his parents died of HIV related Tuberculosis when he was two. We got him tested and it turned out he had both TB and HIV as well.
When I visited him the week before right after I had arrived back from the states he asked for his favorite foods, butternut squash and potatoes. I brought him that and a chicken but couldn’t see him because my back had gone out after the two-day flight from the states and a yawning stretch that snapped something back there. – Old age!
By the following Monday he was feeling a bit better. He was on lots of medicine, ARV’s, TB treatment and ringworm treatment. He weighed about 40 lbs. He told his auntie that he wanted to get his shoes ready for school. She told him the schools were not open - no teachers, no money, no school. But he didn’t believe her. He said he was going to go there to make sure after polishing his shoes.
On Tuesday, he woke up at 3 am in the twin sized bed he shared with his gogo in a room that doubles as a kitchen in his auntie’s three room house. He complained of pain in his stomach. He died an hour later.
I got the call later that morning and went to see them. All the furniture was removed from the living room to make way for the women who came to comfort Brian’s auntie and gogo. The room was filled. His aunt and uncle raised him as their own for eight years and his loss was devastating. I paid my respects and spoke to Lovemore, his uncle about the arrangements.
In a crisis I act, feeling comes later. It will be two more days before I feel any grief. But this time I felt immediate anger and outrage after I looked at the bill from Homage funeral parlor. For an average American it had the equivalent impact of getting a $40,000 bill that had to be paid in full in a couple of days or the body would lie in a refrigerator that would constantly loose power while it rotted. I drove with the bill to a well-connected friend and she called the City Council consumer czar. An hour later he told me to call the funeral parlor and that they were willing to negotiate. After berating me for calling the city officials they agreed to meet the following day, Wednesday at 9 am. In the meantime I had visions of little Brian in a refrigerator filled with bodies stacked on top of one another rotting.
The next day I picked up Lovemore and went to Homage Funeral Parlor. It is located in a large industrial area along with about 7 other funeral parlors scattered amidst rusting vehicles, and dozens of auto repair shops, coffin makers, sort of third world kiosks with women making flower arrangements out of plastic bags in the shape of crosses, bouquets and circles.
Many of the funeral parlors are former auto repair shops so you’ll see old vehicles broken down in the corner of the lot, the garage turned into a chapel. Death is big business in Zimbabwe what with cholera and AIDS. After some talk they agree to cut the bill in half provided we buy the coffin. The money from Brian’s dolls paid for his coffin. I along with money from those who gave me outright donations paid the rest totaling $250 US.
We drove a couple blocks away to the coffin makers, agree on a price and they begin to build it. It’s just quarter inch particleboard held together by small strips of wood with Chinese made handles that you can’t hold. It’s so flimsy that if you don’t hold the bottom the body would fall out.
We drove back to Lovemore’s to get Brian’s clothes and medical records and a blanket and returned to Homage to identify the Brian and arrange for him to be washed and dressed. We waited in the former garage now chapel while they got Brian’s body out of the fridge in the next room. I could hear the creaking of the door as they opened it when the odor of rotting flesh smacked me in the face. I escaped outside with Lovemore. Ten minutes later we had to go into that next room to see this little boy lying on a dirty piece of metal wrapped in a plaid wool blanket.
We still had to get the signature of the doctor who certifies cause of death. He makes the rounds every morning to a dozen funeral homes to sign a form essential to getting the death certificate. For his signature he gets 300 Rand – a fortune for Brian’s family(the equivalent impact of $3000 US for an American). He had come and gone without signing because he needed to see Brian’s medical records. One of the drivers from Homage came along to direct us to his house. Turned out he lived on the opposite side of town 30 kilometers away in a beautiful house built on a knoll in the bush on the western edge of the city. En route the driver told us that the doctor was a Cuban educated cardiac surgeon AND a police officer who now parked 2 new Peugeot cars in his driveway courtesy of government handouts. He also tells us Homage gets 7 to 8 bodies a day - most between 16 and 30 years old. This ‘doctor/police officer’ has to sign the forms for each one at 300 rand a pop and he visits a dozen other parlors. You do the math. He’s making a fortune. After getting to the house, the driver returned with the signed form and tells us the doc is angry that we are there because he does not want the bereaved to know where he lives.
Form in hand we drive back to town for the death certificate, which was relatively straightforward – no bribes necessary. On to get the finished coffin, so light I carry it under one arm to the pick-up and drive it to Homage.
I left my house at 8 am. It’s now 1 pm. Back at Lovemore’s the house and front yard are filled with a couple dozen women and three old men. Brian’s 65-year-old grandfather, Mr. Sibanda, had just arrived having ridden his bicycle 70 kilometers from their rural kraal.
After Mr. Sibanda ate we loaded seven women including his auntie and gogo into the back of the pick-up and drove to Homage to get the coffin. The women began to sing hymns in Ndebele and didn’t stop until Brian’s body was resting at their kraal 5 hours later. We had to wait outside while another funeral of a three year old finished - listening to the wailing of it’s mother as she got into their tattered pick-up and loaded their child’s coffin to head for the cemetery; the men had to push the truck to jump-start it to depart.
We walked into the chapel, women on the left, me and Mr. Sibanda on the right and sat on the wooden benches while they opened the door and wheeled the coffin out as the now familiar stench wafted over us. Lovemore stayed behind to drive another load of people direct to the kraal. A prayer, a hymn followed. We carried the coffin to the pick-up, the women piled in around it and we began the 4 hour journey to the kraal: 40 kilometers of tarred road and 30 on a gullied, scarred and often disappearing dirt road deep into the rocky hills through streams and over rocky outcrops driving at a snail’s pace.
As we approached the kraal nestled on the lower slope of a valley with views of thatched round houses beneath gigantic rocks we could hear the singing of the women who gathered from around the area. They lined up behind the truck and followed, many crying, one ululating. The men waited for us quietly at the gate of the kraal. A second pick-up arrived with Lovemore and 10 others aboard from Bulawayo.
After leveling the hump at the gate we drove into the compound and parked. The women followed and gathered in a group. The men carried the coffin into the thatched round house. Women followed singing hymns. His coffin was placed at the side under a hanging blanket. The women took turns sitting with Brian’s body throughout the night until the next morning when he would be buried.
Mr. Sibanda made sure I was ok. Everyone was incredibly warm and gentle. Gogo took me into her house to show me photos of Brian’s mother and father. She told me with Brian gone there is no reminder of their parents. Brian’s father was a trucker. They died in their twenties.
Night was falling. With no electricity anywhere nearby, the stars were dazzling. All the men sat in a circle around a fire drinking calabash. The women cooked and by 8pm had approached each man to pour water over their hands to wash and then presented us with our food. Women would not eat until 10 pm after the men finished and their dishes were washed. I went to sleep in the back of the pickup.
In the middle of the night I woke up to the loud hymnal singing of men and women. No one slept. And by dawn people could hardly speak having sung spirituals throughout the night.
After the men were served breakfast at 5:30am we walked up a slope behind the compound near a field of maize and beneath a large flowering bush, cleared the grave site and began to dig six feet down. One of the elders measured the coffin with lengths of corn leaves tied together to size the grave. 45 minutes later it was finished. We all gathered in the compound, men in one group, women in another. The women sang. The coffin was moved to the center of the roundhouse and the upper part was opened for the viewing of the body. First the women filed in and walked around the coffin. The men followed. As I passed it and glanced at Brian whose lips held the cotton the funeral home neglected to tuck inside I could feel a crack of emotion I had yet to let out.
The men gathered and carried the coffin to the grave. Women followed - but on a different path. Mr. Sibanda and another elder lowered it and gently placed logs on a lip of packed earth over the coffin. Brian’s gogo, sitting on the ground beside the grave, took a plastic bag and retrieved Brian’s school uniform and sweater and began to tear the clothes into pieces removing all buttons and zippers. Mr. Sibanda draped the pieces over the logs. I lost it.
They filled the grave, placed rocks and branches on top, planted a clump of grass, sang, and gave thanks to those who helped. We walked back to the compound past a man who had just killed a goat for lunch, the men on one path, women on another washing our hands in a bucket of water with fragrant leaves. We gathered in the compound to eat. ‘It’s over.’ They said. The mood lifted.
By noon we were on our way home. I woke up the next morning exhausted. But I had to go to see my kids in Brian’s neighborhood so they could write their thank you notes to the people in America who bought their dolls. I was tired and spent and wondered why I was making the effort as I could postpone it easily. As it turned out the 4 hours with them, with Brian’s friends, renewed me.
The next day along with medicine for scabies and allergies I delivered a ton of maize meal, 150 KG butternut, 85 loaves of bread, 150 bunches of carrots, 60 kg of potatoes, onions and tomatoes and 85 chickens courtesy of the people back home who bought my kid’s dolls. They hadn’t seen bread since Christmas. My kids were happy. ‘It’s over,’ I thought. Time to move on.

Carpe Diem.