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Archive for February, 2010

I am ok


I am ok
February 27, 2010

Last night was one of the worst night I ever had. I think it is the cumulative effect of chemo on my body. The vomits, chills, and cough were in full attack. My sister who was visiting from Canada and my wife did their best to comfort me and clean up after me. God bless them.

I am still here. I am ok. I will be back.

Cheers.

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Meeting Dr. A, the liver transplant specialist

February 23, 2010

Good morning transplant center. Can I help you?” the the lady on the other line said.

Hi, I would like to setup an appointment with Dr. A, please.” I replied.

Ok. Do you have a donor?” asked the sweet lady.

Hmm…not sure how to answer that one.  That was my introduction to the world of transplantation surgery when I first called for an appointment.  I was stepping into a new world.  It brought back memories of my introduction to the cancer world.

March 2008

So are you comfortable with your cancer?” Dr. M, my oncologist, asked me at the hospital.

It was the first time I met Dr. M, and off the bat he used the ‘C’ word on me.  He did not know that I was not aware that the tumor in my colon was cancerous. The doctors from Brazil did not tell me (all with good intentions) and biopsy result were in Portuguese.  But since then he and I are buddies now.

Present

I am sorry.  A donor?  I was referred to Dr. A by my oncologist, Dr. M, for an opinion on resectability of my liver.  I have liver cancer.” I answered.

Toto.  I’ve a feeling we’re not in Kansas anymore – Dorothy from Wizard of Oz.

Welcome to the world of transplantation surgery.  Transplant world and cancer world; they are two different worlds.  You can tell by the words they use.  I remember words like ‘death sentence’ and ‘chemotherapy’ were used on me in one sentence me back then.  Now, I am being asked if I have a donor or maybe if I am the donor.  It just peaked my curious in meeting Dr. A.

After we sorted out my problem and I got myself an appointment Monday, Feb. 22, they asked me to get all scan records and their results including any doctor’s note.  I am all set to go down the yellow brick road.

Cheers

PS:  Will have to complete the second part later, I have to go to chemo treatment now.  Let see if the Wicked Witch show ups.

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Life is good.

February 21, 2010

Life is good runner

That is what it says on my t-shirt.  I wish it was the image of the runner but this one is an image of a golfer pumping fist as the ball goes in ala Tiger Woods, but this is not about Tiger Woods (he’s go issues!).

It is about small or simple victories and enjoying life.  That is how the two brothers, Bert and John Jacobs, started Life is Good, by selling t-shirts in the back of their van in the streets of Boston and along the East Coast.  One t-shirt at a time.

So this morning, God winked (thanks for the book ChrisL) at me and told me to wear my Life is Good tees to church.  I did.  It also made me think of the small victories I had in preparation for next week’s chemo treatment.  Let’s see;

  • Run/walk total for the week: 3 miles
  • Longest run on bike: 5 miles (in a cold 32F weather)
  • Calories consumed: a lot

The result was good.  I managed to gain back some of the weight I loss, but not the hair. 😮  My wife can see the difference in me during the week.  I rebounded faster and I was more determined to remove the toxins in my body by running, walking, biking, and doing yoga.   It was not easy at first.  I sometimes struggled just to my target one mile, or pedal against the cold wind biting my exposed skin, or hold the yoga pose without the nausea surge.  But I got through it and I am ready.

I am not going to say I am looking forward to my next chemo treatment but I feel I am more prepared; mentally and physically.

I remember my first chemo treatment—when I was first diagnosed with colon cancer—more than two years ago.  I was told that systemic chemo treatments are going to be more of a mental challenge than a physical challenge.  It is about keeping your spirit.  It was true then and it is still true now.  It is about not letting cancer take away your spirit.  Similarly, in life it is about not letting any setbacks or challenges take away your goals or dreams.  I was reminded of that today.

It was all about life is good back then, it is good today, and will still be good tomorrow.

Cheers.

PS: Tomorrow, February 22, I have an appointment with a liver transplant specialist for a second opinion and resectability of my tumor.  Never met a transplant specialist before I hope I do not look awe-struck.  Hope is he likes foie gras too.

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Kong Hey Fat Choi meets St. Valentine’s

February 17, 2010

It was the Chinese New Year over the weekend.  The year of the Tiger. (Can you almost hear the song ‘Eye of the Tiger’ by Survivor or picture Rocky3?  Let me remind you with a youtube clip below).

Each Chinese New Year, I like joking my Chinese male friends by greeting them with my crooked Chinese “Kong Hey Fat Choi”.  In fact, I get a kick out of saying it even when it is not even Chinese New Year and when I see them, right JanW and RyanT?  What comes with celebrating Chinese New Year are the traditions and customs that go with it.  I grew up eating ‘tikoy’ or fried sticky rice coated with scrambled egg topped with sugar during Chinese New Year, and I am not even Chinese.

It is the merging of these cultures that makes us.  But how Valentine’s Day and Chinese New Year ended up on the same day is an irony to me.  East meets west and both like the color red.  Similarly, I have been receiving articles, product infos, and other alternative methods of fighting or conquering cancer.  Let see, there is the drink that swears to cure cancer, acupuncture, Asian herbs, testimonies, etc., all telling one can do away with western medicine.  No more chemo?  Wow.  Perhaps my Asian side should listen more to this but when you are dealing with your own life, it casts different perspective.

I could almost imagine the conversation with my wife, my family, and my doctors.  “Honey, it says here I just drink this juice everyday and my cancer will go away.  How about we stop my chemo next week?”  “Hey doc, I have done many chemo cycles already; it keeps coming back, how about I stop and do this herbs.  It say it works!”  I am happy that some can find comfort in the healing qualities of ‘Chinese snake oil.’  It is not for everybody.  My conversations on how to get rid of my cancer are mine.  I value the life given or day given to me because I want to be able to share it with those I love.

Such conversation took part with my oncologist, Dr. M;

“I thought about what Dr. V (GI doctor) suggested on considering liver resection for you.  He suggested we consult Dr. A of Northwestern.  He is a liver transplant specialist, I have referred some patients to him before and is very good.  We ruled out liver resection last year due to the position of your tumor in the liver.  It was close to a major artery therefore it was risky for resectioning.  Thus, we went for chemoembolization.” (See related post ‘At the starting line with Dr. B‘)

“Doc.  I know what we did last year to have come this far.  I have faith in you” I said to assure him of my trust in him.  I love this guy.

As if a plan had formulated in his mind, he continued.  He wants me to complete three more chemo treatments, do a PET scan to see if my liver tumor has shrunk, and then assess for resectability with Dr. A.

“If resectable, we stop your treatment for two weeks for you to gain strength, do the liver resection, and we put you back on chemo to complete the rest of the treatment.  If resection is still not an option, I need to change your chemo regiment and complete the course.”

There’s the eye of the tiger.  Staring back at me.  Kong hey fat choi in english is happy valentines.  Tikoy wrapped in chocolates.

Well, if I follow the Chinese mythodology on this.  Dogs are best friends with Tigers.  Good think I was born in the year of the Dog.

Hit it Rocky.  Punch out those cancer cells out.

Cheers.

PS:  I still do run/walk when I can for one whole mile. 😮

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I am almost out of the hole again.

February 14, 2010

Happy Valentine’s to everybody.

I am almost out of the hole.  I completed my third chemo treatment last Thursday, February 11.  The next day, Friday, we tried something new to get me back on my feet right away.  I normally get a booster shoot (Neulasta) one day after my treatment to help me build my white blood cells.  (Note: chemotherapy kills cancer cell including healthy cells.  When white blood cells go down your body’s immunity weakens making you susceptible to other sickness and infection).

Along my booster shoot, I was given one liter of vitamin infusion again.  It helped while it lasted but at night I still got the chills, nausea, feverish feeling, non-stop coughing fits, loss of appetite, and lost of hair.  I need to cut my hair really short to hide the patches.  My kids wanted to shave my head but not on Valentine’s weekend.

My wife can see that I sometimes lose my spirit too no matter how I hide it.  They are doing everything they can medically to get me back on my feet and it is up to me to standup and carry on.  With difficulty, I went to my yoga class yesterday (Saturday).  I think they were surprise to see my walk through like a ghost all bundled up and head covered.  My daughter drove me to class; I need to get my spirits up because I was draining it from those close to me.  I am glad I went.  My body needed to stretch and work away the toxins.  My yoga-mates fed my spirits but I struggled with fits of hacking cough.  I hope I did not disturbed them too much but I was glad to see them.

Mom called to greet me happy valentine’s and told me of her plans to arrive in Chicago from the Manila.  I can’t stop her from coming but I know she is getting stressed.  She turns 78 this year.

The plan is to recover this coming week.  I am going for high calorie food, like pizza as Chris said.  Runners know this as an efficient food; compact but loaded with calories and it fits my shrinking appetite.  There might be a big challenge ahead and will tell you later.  For now, I will enjoy the rest of my Valentine’s day.

Cheers.

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Dr. V (Part 2 of 2)

February 8, 2010

Saturday, February 6 at 6:30 am in the hospital.

We were second in the signup list.  Never been here this early on a Saturday.   Everything was quiet.  With me were my wife and daughter, Abby.  This will be my third colonoscopy (first in Rio 2008, then here 2009, and now) and I still could not get use to that nasty prep drink you have to consume.  It tastes like heavy water but with a distinct smell that cannot be masked by flavorings.  I just got to get through this and then I can eat again.  I am hungry.

After registering, we went to day-surgery unit and waited to be called.  We were first in the empty waiting room.

“Mr. Alvarez?  Follow me.” The nurse said and led to a waiting bed inside.  I was the first patient for the day. “Please remove all your clothes and change into this hospital gown and bootie.  Your nurse will be with you after.”

I know this routine already.  It is just like the routine of my weekly runs before.  Put the clothes and shoes in plastic bag.  Leave your valuables.  Use the blanket to keep warm.  Go to washroom.  Then open the curtains for the show to begin.

“Hi, my name is Liz and I will be your nurse.” I notice a distinct accent when she spoke.

Australia.” I said.  “You must be from Australia from you accent.”

England.  From a small town outside of London.” She replied.  In between the medical questions and the form signings, I learned she just moved to Chicago from Boulder, Colorado with her husband and three kids; the youngest are two-year old twins.  I told her my wife is a nurse and her name is Irish.  She is English and my wife is Irish.  Get it?  Parumpum (sounds of cymbals).  I think I need my sedative now.  The I asked:

“What is haggis?  A friend from UK told me about haggis and deep-fried Mars bar.  I could imagine what deep-fried Mars bars are but have no idea about haggis?”

Carefully choosing her words, she replied “It is dish from Northern Scotland made from sheep stomach.  I don’t eat it but there is a vegetarian version of it.”

Sheep stomach, Skye?.  Hmm…  I think I may need a colonoscopy after eating that.

Back to reality, I learned Dr. V was in but had to take care of an emergency patient.  I will be next.  My wife and daughter joined  me while waiting for my turn.  Then she came for me.  Nurse Marlyn wheeled me into surgery.  Here we go.

I don’t remember much while in the scope room.  They told me they are going to do the endoscopy of my stomach first then the colonoscopy.  I remember being fitted with this mouth piece to keep my mouth open and was told I was to be given sedative and Demerol, a fast-acting pain med.  I saw Dr. V checking me and told the nurse to give me more Demerol.  Bam, I was out.

I don’t remember the scope being inserted in my mouth.  In a haze, I was asked to changed position as Dr. V was in the middle of completing the colonoscopy.  I saw the screen showing my colon and some biopsy samples taken.  And I am done.  Was that a date rape?

At the recovery area, I was joined by my wife and daughter.  We waited for Dr. V to give us the results.

“Everything is clear.  No problem with the stomach and colon.  I am not sure what is causing your stomach pain.  Maybe from your chemo treatments.” Dr. V said.  Then he picked it up again on where he left off suggesting a liver resection for my case.  My wife explained we went down this path before in consultation with my surgeon.  This is complicated.

Present:

I feel like I am being pulled from all directions.  It bothered me over the weekend.   Too many issues on the table compared to my previous treatments.  Cancer sucks.  Tomorrow, Tuesday, in the midst of a expected snow storm, I go down the hole again for my third chemo treatment.  Is this snow storm an omen?  My demons await me.  Part of me will be kicking and screaming as I walk alone to meet them.  I will be doing the dance with them again.  I pick the Messiah for the music.  After we are done, my friends and family await me.  Thank God.

Cheers.

PS:  I did a run/walk today.  I completed one whole mile.  Woohoo!

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Dr. V. (Part 1 of 2)

February 7, 2010

Friday 2:00 pm at doctor’s office.

“Hi, I am Dr. John V.  How are you?”

“I am fine, doctor.” I replied

“Have you ever considered liver resection?  Are there just three lesions in your liver?  Have you ever done a PET scan?  Do you mind if we consult your case with a liver transplant specialist in Northwestern Hospital?” (Note: Northwestern is one of the biggest hospital in the area and among the top in the US).

Huh?  These were the staccato of questions when I first met Dr. V. the gastro-intestinal (GI) specialist.  My daughter, Abby, and I had a confused look.  I was there to consult for my erratic stomach problems and we are talking about liver surgery.  I brought the results of the ultra-scan of my liver and CT scan of the abdomen to make it easier for him to diagnose and avoid more tests.  But he just zeroed in on my liver lesions still present.

“You are young.  Healthy.  You should be aggressive to cure your cancer.  Do I have your permission to send it Dr. A at Northwestern?” He continues.

I thought I was being aggressive about my illness.  The one consistent thing about the doctors I meet is that they always look at me as a healthy specimen who just happen to have metastatic cancer.  It makes me wonder why people get so sick before seeing their doctors.  Perhaps we should listen to their bodies more or just simply have a healthy lifestyle.  Am I the exception?  Make time for yourself and go run or walk.  I digress.

But what about my stomach problem?  As if reading my mind, Dr. V said.

“Ok, lie down let me check your abodomen.  Let’s draw some blood.  Loosen your pants and let’s check your prostrate also.”

Whoa!  This guy is really aggressive on our first date.  After my daughter leaves the room, he squirts a healthy swab of gel in his rubber gloved hand and….hello!  Then gives me some tissue to wipe away…’my tears’.  I felt used 😮

“Everything is good.  Let’s schedule you for colonoscopy and endoscopy.  Are you available tomorrow at 7:30 am?”

I thought doctors don’t work on Saturday?”  I said with a smile trying to wiggle my way out of this ‘date’.  This getting serious.  Do I go to the next level of our budding relationship?

Thinking, I am going to miss my Saturday 8:00 am yoga too.  Hmmm…yoga or colonoscopy?

“Ok, Doc.  Let’s do it.” I blurted.  Too late.

Dr. V and I are really getting cozy now.  After getting out of his office I called my wife to tell him of the news.  Honey, I am coming home with a gallon of nasty stuff to drink to clean my colon again!  And oh, by the way, Dr. V is asking us to consider liver surgery again.  Too much information for a day.  I started my day with vitamin infusion and will end it with a flush of my colon.  Oh well.  I should have said no.  Omm….

Cheers.

PS:  Will tell you more about my colonoscopy and endoscopy.  Also, thanks for Harris tweed scarf, Alaistair.  It definitely keeps me toasty warm and is now part of me.

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