Archive for March, 2010

What’s next: chopped liver

March 30, 2010

ecovery Tuesday is here. Woohoo!  Last week’s chemo was uneventful. I am not saying I was not sick from the side-effects but it was just uneventful. No surprises which is the way I wanted coming to this week. My sights are focused towards next week when I meet Dr. A, the liver specialist. My oncologist, Dr. M, is giving me some time-off from chemo. Double woohoo! Dr. A takes over for the moment.

In preparation for the meeting, I started running again, cue in the Rocky music.  I started Sunday by running 2.3 miles@11:28 pace, then yesterday I attended a cross-training class, and today was spinning class or cycling. In between, I did some yoga.  That’s for the physical activity part intended to recover fast. There is also the medical preparation activity, which goes like this;

  • March 31 – chest CT scan requested by Dr. A. This is to rule-out any metastasis (mets) to the lungs. If the cancer has mets to my lungs I will not longer be a candidate for liver surgery.
  • Same date – liver CT scan also requested by Dr. A. This will provide a detailed study of my liver and the locations of the tumors. It will help Dr. A and his team to determine if partially a resection of the right lobe is feasible or total removal of the right lobe to remove the cancer. If the right lobe is removed, the left lobe would take over and grow. It means no drinking or too much drinking. Oh…oh.
  • April 1 – PET scan requested by Dr. M. This will determine if I am responding to chemo and that there are no new tumors. They would compare this my previous PET scan in November 2009 with this new one.
  • April 5 – I meet with Dr. A with all the results of my scan and the ‘verdict’ will be read. Chop that liver! Let’s do it! I just wanted to get this cancer out of me, I want to heal, and be normal again. If I need to give up my liver (and drinking), just take it! Er…just one please.

That’s the plan.  With all this scans, I would be glowing in the dark (from radiation) and blow away the geiger counter. In the meantime, I need to get strong and exercise to remove as much chemo toxins in my body prior to surgery.

My friend/colleague, Art, called today and said I sounded good. Must be due to all the exercises I have been doing. He is working in Portsmouth, UK and he wished that I was there working with him.  Art and I have fun working together and traveling around the world.  In due time, Art, in due time. There are many things I wish I am able to do but I can’t anymore or have been limited. I see others taking for granted what they have, not knowing it can be taken away.  Do take care. Carpe Diem.


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I got buffed.

March 24, 2010

came home from the hospital a bit depressed. Like always, I had a 5 hours chemo session at the hospital and now I am hooked up again to my portable chemo pump for two days. This sucks. How can this be I asked? Last Sunday, I completed an 8K race with my family and felt a sense of normalcy. Now, I am sick as a dog; nauseated, feverish, and just without energy. How can this be?

I thought about the people who gave up on their treatments because of the brutal burden that goes with wanting to live.  But I should be use to this since this is my sixth cycle. I think the more I get stronger prior to my treatments, the more I get confident, and then only to succumb to chemo again.  It brings you to your knees.  How dare you? I thought.

My wife was disturbed again seeing me is such state and pleaded with me to be strong. She teased me with food (ice cream, pizza, cheese, strawberries, and crackers) and I responded like a dog. How can you not respond to food. My habit was to watch the Food Network channel when I am on chemo so her teasing worked. Then, I surprise came in the mail.

I got “buffed”. I received a package from Vicki, aka Skye_Trekker, who lives in Isle of Skye, Scotland, containing a Buff headgear and hand-made soaps from the Isle for my wife and I. This is so cool!  It lifted my spirits and I have been wearing the headgear to bed.  It keeps the sweat off the pillows when I have chills.  Thanks, Vicki, you are such an angel.  Your timing was perfect.  Depressed?  All you need is Buff!


Got buff!

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Cancer-free for a day

March 22, 2010

Yesterday, my family and I ran the Chicago 8K Shamrock Shuffle (dubbed as the world’s largest 8K race) along with 36,000 runners. It was a cold start (31F) again, but compared to last year there was no 3” inches of snow on the ground. But who cares if there was. When you have cancer everyday is a beautiful day. Everyday is a gift.

As I stood there shoulder-to-shoulder with the multitude of runners, I could not help but think that for a moment in the cold, surrounded by my family, I am cancer-free. I was cancer-free for a day and I was racing again. I was dressed like a runner, wearing my Garmin, got D-tag timing sensor on my shoes, and have my bib number C 13145.

I was assigned in the first wave, or seeded, in C corral (I had a good finish last year, see my post ‘2009 Shamrock Shuffle’) but I decided I decided to move to the second wave start in the open corral to be with my family. It is the first-time for my family to run so I want to be with them. Besides, I am not even chasing personal records this time. I wanted to share the experience of a mass start similar to that of a major marathon. Your adrenaline is flowing, you forget it is cold, you hear the noise of the crowd in front as they cheer the start of the race.  Then the cheers reverberate like an echo, moving towards the back. It hits you and you cheer as well.

“Woohoo! Let’s go! Let’s go! Let’s break some world records!” I shouted. My kids cowered in embarrassment, trying to disown me. Kenya in the house!

The crowd was so huge it took us about 31 minutes to cross the starting line. By the time I get to the starting line, the winner (a Kenyan at 23:29 minutes) of the race should have crossed the finish line. Crossing the starting line, I saw the two boys bolt ahead. Rookies! I stay back. My wife and two girls were just up ahead trying to keep a steady pace. I catch up with Nat at mile marker 1, then Abby at mile marker 2, but where’s the wife?

I get to mile marker 3, still no wife. I increased my pace. I see the last water station up ahead.  It is “Kenyan-time!”  Ah…eeh…yah!.  I am a “Kenyan” powered with chemo juice.  Kawabanga! I grab the two water cups , crimp their tops, and downed it without stopping. Let’s go, Kenyan Bo! After passing mile marker 4, and nearing the finish line.  I see her. ‘Darr she blows.  Puff…puff…puff, her struggled breath sounded, then pausing to a stop.  I moved beside her and patted her familiar butt.

Let’s cross the finish line together.” I said.

Let’s do it.  It renewed her energy.  With one last effort and in full view of the finish line, we picked up our stride.  We can do this.  We can fight this cancer.  I was not going to be alone this time.  Holding hands, we raised it, and together we crossed the finish line.

Life is good.  Tomorrow, Tuesday, I start my sixth chemo cycle.  Life is still good.


PS:  All the family finished.  We all had a great time.  I was thankful for the moment.  Next time I will break the record. 😉

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Tai Chi anyone?

March 19, 2010

Recently I attended a Tai Chi Chuan class at my health club. I have never attended one so I was curious.  Tai Chi is mostly associated with martial arts but there are healthy benefit to it.  Martial arts or not, in my interest to get rid of my cancer I am willing to try anything; let me correct that, short of drinking any ‘snake oil’ concoctions that is. Besides, I would like to know what my friend MichaelS from UK (aka emmteeyess) experiences when he does Tai Chi. He is an enthusiast I must say.  This one is for you, Michael.

So I got yoga, running, and now Tai Chi.

“Slow is more.” Lin the instructor would always say.

Lin is a soft-spoken lady who has a elegant way of moving.  Ok, slow is more.  Hmm…this sound like my slow running, I am beginning to like this.

“The way to bring about your chi is to move in a slow fluid motion.”

She moves as she was as if she was underwater and all of us follow her as she teaches the basic movements. The class was a gaggle of middle-aged people which is very appropriate since they, or rather we all move slow. Nobody can argue we move slow. Where are the hot chicks? Oh, wrong class.

“Slow is more.” Ok..ok, I am slowing.

In fluid motion, I imagine holding the imaginary ball in my hand moving it, twisting, and concentrating on my movements.  Breath.  I am moving so slow, I feel like Neo (from the move The Matrix) dodging all the bullets.  Zing…Zing…Zing.  I digress, again.

She lifts her leg, puts it forward to walk in slow motion. Feel the movement of the feet as it pushes off and swing it forward. And I mimic the motion and in doing so I was sensitized to all the things my leg does as it perform a simple walk.  From there, I sense the other parts of my body; my hands, arms, chest, etc., moving in harmony caused by the slow movement.  Amazing.

She explains about the Tan t’ien which in Taoist term referring to a center of energy located approximately two inches below the navel. You might say the Tan t’ien is the host of your chi energy and you must nurture it as you move to bring about inner energy.

Energy. That’s I need to fuel my spirit. I look for it and take what is given. In running, that’s carbo loading in preparation of the race. I can only do so much to fight this cancer so I am harvesting all the energy I can get.  I run, do yoga, now Tai chi.  Next week is chemo week again.  You know what that means.  I will be there again, this time with Tai Chi in my arsenal.

Ok, let me get this again…”Slow is more.”


PS: Went to my primary doctor who prescribed me more anti-biotics for my sinus problem. She also gave me a referral to an EENT doctor just to be sure.  Just what I needed, more doctors.

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Recovery Tuesday is here.

March 16, 2010

should be happy that recovery Tuesday is here; however, I am feeling a bit under-the-weather. My sinus problems has been bothering me and does not seems to go away. When you can’t smell the food it is hard to find the appetite to eat. I will be seeing my primary doctor, Dr. O, this Thursday to ask her opinion.

Last week’s chemo treatment was relatively uneventful. There was the usual nausea and chills but it was mild compared to the previous one.  Why?  Maybe it was the running I did the previous week to prepare for the coming chemo week.  I felt much stronger too and was focused in my yoga class.  So I tried the same approach this week in preparation for next week’s chemo. I ran 3.11 miles Sunday at 12:31 average pace, nursing my runny nose all the way. I felt good after. Monday came and I wanted to run but did not have the energy.

Today, I thought about running but I could not get motivated. I got to get going on my running!

Last January 1, 2010, I wrote about my hopes and plans for the new year. One of them was to run the 8K Shamrock Shuffle with my family. That day is looming close, March 21. I am looking forward to the race but I know it is going to be difficult for me.

“It’s an 8K for crying out loud!” Yeah, try running it with toxic chemo drugs in your blood and a runny sinus.

Last year, I did this in 54:10. It was my first race and I clearly remember that day. (See my previous post, “2009 Shamrock Shuffle – My first Race”). There was 3” of snow and it was cold. I hope the race conditions this weekend will be better.

No matter what, I will be there on the starting line with my family. As for the time, who cares. I will cross that finish line and claim my token moment that I will be cancer-free one day.


PS:  One more chemo cycle and I see to Dr. A (Transplant Specialist) on April 5 about liver surgery to remove the tumors.

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Tuesday people

March 8, 2010

Love each other or die

Once you know how to die; you’ll know how to live

When you’re in bed, your dead

– Morrie Schwartz

hese were only a few of the many aphorism that Morrie shares in the book by Mitch Albom, ‘Tuesdays with Morrie’. There is a movie version of it, released in 1999 with Jack Lemon and Hank Azaria starring in it.

I had watched the movie version long time ago; then lately, I noticed this book among my reading piles. I don’t remember how or who put it there but on a whim I began reading it. God winked. The book was about second chances and rediscovering one’s self. It happened when Mitch revisited his old professor, Morrie Schwartz, who was dying of ALS or Lou Gehrig’s disease. The visits would become regular on Tuesdays and they would talk about the lessons of life.

If you know you are going to die tomorrow, what would you do today? Some people would probably go eat the best steak or go Vegas or do something outrageous. Or maybe you can do something that is really important to you, like love and family. Some problems or material things are no longer important if you know you will die tomorrow.  You cannot bring them to your grave.

Of course, that is not how reality works. Most of us believe, we will not die tomorrow. Therefore, we will attend that important conference calls tomorrow, plan exotic vacations, think of what we can buy with our tax refund e.g. designer purse or shoe, or dream of bigger house or latest car. However, there are times when you get bumped in the head and a reset happens, like cancer or a tragedy. You wake up and see the things differently.  I wish we get bump in the head more often, so we can care more about each other.

Back to Morrie.  I can relate to this book and its messages. There are more important things in life and they involve our family and friends. Tomorrow is Tuesday. Like Morrie, I am a Tuesday person. However, I have two personalities depending on which Tuesday it is. I start chemo treatment every other Tuesday. On chemo Tuesday, I am cranking and irritable.  On recovery Tuesday, I pig out and very thankful for all my blessing.  I guess there must always be a balance in life, otherwise it will not exist.

I am a living example on how I have changed in my priorities. I prefer simpler things and hanging out with my family. My wife had changed too.

“Hon, I have given up shopping just for you to get well” my wife one time told me one time.

“Huh? What about your eBay account? Bags and purses included?  Bolsa de Gucci?” I joked her. I just heard the chorus “Hallelujah” in the background. And she did stopped. I love her dearly.  Instead she run with me and we have more fun now.

You do change when you know you are going to die or the possibility of it. The trick is not to ignore those possibilities and do what is important to you. I will close by an excerpt from the book. I thought Morrie was talking to me and my cancer.


“We’re Tuesday people” he (Morrie) said.

Tuesday people, I (Mitch) repeated. Morrie smiled.

“Mitch, you asked about caring for people I don’t even know. But can I tell you the thing I’m learning most about this disease?”

What’s that?

“The most important thing in life is to learn how to give out love, and to let it come in.”

His voice dropped to a whisper. “Let it come in. We think we don’t deserve love, we think if we let it in we’ll become too soft. But a wise man named Levine said it right. He said, ‘Love is the only rational act.’ “

He repeated it carefully, pausing for effect. “ ‘Love is the only rational act.’ “


Tomorrow is chemo Tuesday.  I will see you tomorrow, Morrie.


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Breaking the barrier

March 6, 2010

y wife and I decided to run after her PT session. We decided to run along the lakefront. It will be my first time to run outside since the October 2009 marathon and being ill. I had one goal. To break one mile barrier that day. I had a hard chemo treatment, so what better way to get back than to run more than a mile in the open.  Woohoo!

So, I dusted off my my Garmin , put on my cold weather gear (leggings, cap, gloves, etc.), and went through the motion as if it was my normal Saturday training run. I even strapped on my fuel belt with no fuel. What’s up with that!

So, we set off at Montrose harbor where my running club, CARA, usually meets and headed in the familiar pathways. Ah, the familiarity of the surroundings brought back memories. The cold wind, the crunch of my shoe on snow covered paths, and the sounds of my breath.  Through the run I was nursing my intermittent cough and infected sinus.

Cough…cough.  Dripping nose.  Heavy legs.

Lift your knees.  Shuffle…shuffle.  Drip…drip. Crunch…crunch.  Cough…cough.

Where’s my running buddy?

Up ahead.  I checked my Garmin for my pace and it read 16:35.  Man, that is fast walking to some people, no wonder my wife is ahead of me.  She turns around.

“You ok, hon?” she asks.

“Yup.  Just go ahead.” I replied.  Shuffle…shuffle.  Sniff…sniff.  Shuffle…shuffle.  Cough.

She tries to stay with me then slowly runs ahead or I slowed down.  I thought it was funny. I did not mind. I was enjoying myself. Peace, a sense of normalcy, and small victories. In the end, we did 1.96 miles with an average pace of 16:01. It is not exactly breaking the world record but I am happy with it.

This week’s running totals: 7.45 miles

  • March 2 – 1.96 miles @ 16:01 average pace
  • March 3 – 2.42 miles @ 14.32 average pace
  • March 6 – 3.06 miles @ 14.03 average pace

Let's go, babes! You can do it.

I have a sense of achievement this week which gives me confidence going into my next chemo treatment.  Of course, there will be no running involved during chemo week; but  I wonder what new excitement awaits me.  I am getting use to this up and down cycle.  It is all about total acceptance and surrender.  With your help I will get through this.


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Meeting Dr. A, the transplant specialist (Part 2 of 2)

March 2, 2010


(Note: I apologize for the delayed posting of the second part. I had to get rid of the Wicked Witch first.  She managed to find a way to overcome all the vitamin infusion and anti-nausea medicines I was given by the potions she makes.  Times up, W.  Goodbye.  Ease on down…ease on down the road! )


y wife and I were waiting in one of the examination room at the transplantation center. While waiting I could not help see the difference in the environment and its patients. There were patients with clear indication of cirrhosis of the liver whose hope is only for a liver transplant. They have thin bodies and bloated abdomens. Some were healthy but pale in color perhaps from hepatitis. But it is the eyes that tell the story. I see it in the patients at the cancer center and I see it here too.

My thoughts were interrupted when a big scholarly gentlemen walked in with another gentleman in surgery scrubs.

Mr. Alvarez. Hi, I am Dr. A and this is Dr. K who is a Fellow and part of my surgical team.” He shook my hands and it is like touching the hands of God. Warm and confident. They were not big but you know that those hands have performed miracles.

Now I know how St. Thomas (Doubting Thomas), the apostle, felt when Jesus asked him to touch his wounds to believe in Him. Dr. A’s hands do God’s work. Those hands were not for flipping burgers I tell you. If ever those, those hands are going to remove the tumors in my liver.

I have all the results and scans you gave, I think it helps me more if you tell it from the beginning to make sure we are not missing anything” he said in a reassuring tone.

So, I took Dr. A through the history of my cancer from being first diagnosed in Brazil when I had a bloody stool experience in March 2008. The colon surgery and the six months of chemotherapy after that.  They cleared me after that.  I was given a program to follow and monitor for re-occurrence of my cancer.

Who did the colon resectioning?” he asks.

Dr. K at Swedish ” I replied. He was taking meticulous notes.

Then the relapse. I told him I first became suspicious that my cancer was back when the results of my periodic blood work came back with elevated CEA level (tumor count) in August 2009. A second blood work in September 2009 showed an upward trend. I did the Chicago Marathon in October 2009 and went for my PET scan November 10, 2009.

He listened intently and would interrupt me to ask for more details. He was curious as why the liver surgery did come up as a first option when it was detected that my cancer had now metastasized to the liver.

Surgery is the best way to remove the tumor.”, he adds. “We do liver resectioning here as if it is an ordinary procedure. We even perform it on healthy patients who wish to donate their liver to somebody. It is our bread and butter at the transplant center.”




He brought in Katie, nurse practitioner, to coordinate the plans for me. He wanted a liver scan performed.

We have the best machine to do the liver scans here at the hospital” he proudly commented. I like him.

The other scans can be performed in my “home” hospital and they can just get copies of the results. The plan is to complete my six cycles of chemo and assess for resectability.

Do you have any questions?”

Two. How do you resect a liver? How long is the recovery?” I said.

In your case, since the tumors are in the right lobe, we either remove the areas were the tumors are or remove the whole right lobe.” (Gulp!)  “We will make that determination once we have all the scans and did our study.

After surgery you cannot lift anything heavy for three to four weeks. Your hospital stay is about two days, after that we kick you out.” he smiled. Tough love, doc.  I am in good hands.

Next time I will ask him about those pins in the lapel of his white doctor’s coat.


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