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Archive for May, 2010


Dude, where’s my gallbladder?

May 30, 2010

(Note: The title of the post is a play on the 2000 movie, Dude, where’s my car?)

Monday, May 24, at Dr. O’s office (primary doctor).

on, did you know they took out your gallbladder?” My wife said as she was reading the liver surgeon’s post operative results.

“No. I was asleep remember?” I jokingly replied.

“They took out your gallbladder it says here and they even performed a biopsy of it.”

“They must have a special that day: take one (liver) and get one free (gallbladder).  I was robbed.  They should have sculpted my abs instead, since summer is almost here. ” I continued to joke.

But deep inside, I thought, what does a gallbladder do, anyway? I feel fine, so far. I knew they found some gallstones in my PET scan but it has not yet given me problems. My sister had her gallbladder taken out due to gallstones problems which cannot be dissolved by medication and was painful.  She had a laparoscophic surgery to have it removed and she is doing fine. I guess that is one less thing I have to worry about.  I just have to avoid eating fats from now on.  Got bacon?

(Note: Gallbladder stores bile as produced by the liver and releases it when needed.  Bile helps in breaking down fats.)

Present.

Since that office visit I have been recovering well from my last chemo (May 18). I am able to eat well again, go to the gym for yoga, and run. Yes, run…er, maybe  jog. In my first run coming off surgery, a month ago, I did two miles at a slow pace. I felt some dull pain in my abdomen but it was nothing. It was my knees who were complaining. I felt so good out running again I just ignored all aches and pains.

It was a beautiful day for a run. I felt normal again. I know I still have more chemo ahead of me but I have come to accept that as part of my life. I have chemo week, and then recovery week. There are good days and bad days. The key is to make the most of what is given no matter what day it is—Carpe Diem.

For the week, I have completed about six miles of running. I am still a long way to go to train for the marathon but I will get there. If all my chemo sessions—which first started in January–were a marathon, I would be now at mile marker 15.  I have 11 more miles to go or five more chemo cycles. Whew! And I had to stop for liver resection in between. Oh boy.

No time to celebrate now but I am totally grateful for all my blessings.  I have come this far because of your support and prayers.  However, I still could not get over my missing gallbladder 😮

Dude, where’s my gallbladder?

Cheers.

PS: June 1, Tuesday, I will have chemo again.  Back in the hole.

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Nobody likes pain

May 23, 2010

“re you ready, Bo?” Edith, my oncology nurse, asked me when I saw her the morning of the start of my second course of chemo.

“Ah…” My answer betrayed me.

Ok, I am there at 7:00 am for the start of my chemo but if I had a choice, I would rather be somewhere else. Who wants to have more pain when I have been living with it for more than six-months. I tell myself I need to embrace the pain but sometimes, I too get tired. Nobody likes pain.

Elite runners train to accept pain, want it, and use it to defeat their competitors. Training for pain is totally different from an unwelcomed pain from surgery or chemo. Lately, I have been feeling every little one of them, including a necessary blood draw or an injection to increase my immunity. I have been short-tempered and irritated, even to those I love. I am tired of the nausea, the chills, the sweats, the injections, the pills, the constipation, and the pain of it all.  Make it stop, please!

However, I should be grateful now that my first cycle is done, and recovery week is coming up. I use to look forward to recovery week because I can eat but the energy escapes me now. It did not help that when I weigh myself and saw I lost another 3 pounds. A hard fact staring at me. That is not due to the liver I lost. I casually, mentioned this to the wife, and it opened up a breakfast “conversation”.

I use to see you recover faster and have more energy before your liver surgery. Now you don’t have it. What’s wrong?. You need to fight it, hon. You are lucky your body is still strong to take all the punishment but you need to get back. We need you. Don’t lose your spirit, babes.” She opened up.

That was a hit on the head. I tell you my wife is small but she packs a punch. I need to pay attention. I have five more cycles of chemo ahead of me and I need to get back. I have been steadily giving ground to this cancer, a pound here, a liver there, what’s next.

But sometimes all it takes is a card from a colleague, NancyP from Canada to give you a helping nudge.

The smallest things can change our lives –

one hand reaching out to another…

one prayer whispered in faith…

one moment that shines with His presence.

Thinking of you,

believing wth you,

praying for you –

and wanting you to know

how much I care.

I need to pay attention.  It is all about the small things and what you have.  I need to get back to be among those who care and love me.  I am still here.

Cheers.

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The verdict and consequence

May 16, 2010

ell, the verdict is in. I start chemo again this Tuesday, May 18, or 28-days after my liver surgery. I had a feeling that this was coming when I saw my oncologist (Dr. M) last Monday, May 10 for a checkup.  Dr. M is a good guy and really wants me to beat this cancer. During my visit, he checked my incision wound, which was healing well, except in two places where I am still ‘leaking’.

We need to complete your chemo treatment. You need to do six more cycles of chemotherapy.  Let’s start it next week, May 18, which is almost a month after your surgery. We will go with the same regiment of FOLFIRI (a combination of three chemo drug), but we will leave out your fourth drug, Avastin, for next week.” He suggested.

(Note: Avastin prevents blood vessels, which supplies cancer cells, from forming which my harm the growth of my liver or cause a rupture. Nice!)

Ok” I replied.

After the six-cycles, I want to put you on chemo maintenance.”

He let it hang for a moment, as if looking for my reaction, then added.

There are two schools of thought regarding chemo maintenance. Those who believe chemo maintenance is a way to keep the cancer cells from activating again and those who believe against the practice. There are no current studies to backup either protocol but there are leading scholars in oncology arguing for both. In the end, it will be between you and I, and what is best for you.” He counseled.

Ok. Let me get this right in my mind. Either I wait for my cancer to metastisize again to another organ like my lungs, and maybe give up another lobe, or I have chemo maintenance every two weeks for the rest of my life. Hmm….

I am sure there a people out there who would argue about this. In my professional life, I have been trained to look at business risks, and give my opinion and assessment. I am sensitive to probabilities, impact, and likelihood but this one is over the top. How can I be objective in assessing my own life? Do I risk not celebrating another birthday or see my kids grow? Do I miss out being a grandfather?

Oh, Antonio (Shakespheare’s Merchant of Venice), what have we gotten ourselves into? Shylock (my cancer cells), may ask for more than a pound of my liver. Ha! What sayst thou?

No more! I shall drink the cup of chemo maintenance and thy will be done!

Chemo maintenance is not too bad.  We have other patients who comes in for their chemo maintenance.  The important thing is it should not interfere with your quality of life. Instead of receiving three or four chemo drugs, like you current regiment, this time we limit it to two. You do not carry a pump home and this can be done around your work schedule. We can even arrange for a chemo holiday if you go vacation.” Dr. M assures me.

The consequence.

I will cross that bridge when I get there. Right now, my mind is on Tuesday, May 18. I got to make sure I have enough nausea pills, stool softners, ice chips, pain meds, and a clean vomit bucket.  Who knows which chemo demon will come and visit me this time.

However, I could not help think of the other consequence of chemo maintenance. Specifically, I signed up to run the 2010 Chicago Marathon for the American Cancer Society (ACS). I signed up not knowing if I will be able to train for it after six-cycles of chemo and now with chemo maintenance thrown in to make my life exciting. Oh, you lucky Kenyans! It is useless for me to win the marathon because my blood will be so tainted I would be disqualified when I win it. It is not if I win it, but when I win that race. Ha! Darn, it means winning Boston or NYC is out of the equation as well.

I just read the blog of my friend VickiM (aka Skye_Trekker) from UK. Due to scheduling problems, Vicki was not able to start the Etape Caledonia bike race, an 81-mile bike race in Victoria Park, Aberfeldy, Scotland. Now, she has a DNS (did not start) attached to her resume. Don’t fret, Vicki, who knows I may get a DNS for the Chicago marathon also. I would not mind getting a DNS or a DNF (did not finish) attached to my name but not a DNT (did not try). I refuse that one.

This I will commit. I will be at the starting line of the Chicago Marathon with my brother, Raul, on October 10, 2010 and pray I will finish.  It will be a battle between me and the marathon sweepers (race officials telling runners they will not make it and the course will be closing soon).  And, I will raise money for ACS because they are there for me and for all the other cancer patients.  To us, it is all about the birthdays or other milestones.  Happy birthday! May we all have many more to come.

Cheers.

PS:  If you wish to support me as ACS Charity Runner, please follow either link below.  Thank you for your generosity

My personal page.

Team D’Waddlers’ page.

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Getting well and staying well

May 9, 2010

have been recuperating from my April 20 liver surgery. So far my incision wounds are healing well. There are occasional body fluid leaks which ends up staining my undershirt but nothing to be worried about. I am not keloid, thank goodness, but the scar left the incision is big, about 14-inches. I don’t think I will be going topless to go swimming.  Perhaps I should consider covering it with tatoo.

One thing I have learned recuperating from surgery; getting well is harder than staying well. Although my incision wounds are healing well, it still hurts when I move, walk, or ride in the  car. And when I sneeze, tears would just fall from the pain.  Breathe…just breathe.  It is hard to get a good night sleep too.  Sometimes I feel I rather bear the pain of chemo than the long healing pain from a liver resection. In chemo, I can rebound in a week while in liver surgery, the liver wounds and healing takes its time. I get impatient and short-tempered.

Thank God for this blog. This blog forces me to distract my mind at the same time share my experience with you.  It forces me to be accountable to myself.  It is me in the raw, at times, and I write about it.  I can mask the rawness by taking narcotic pain meds but it is just temporary.  Of course, the consequence of taking too much narcotic meds is the withdrawal symptoms, which I sometimes experience, e.g., chills and sweats.  So I have stopped taking them and would just take two regular extra-strength Tylenol at night.  It helps except when I need to move and shift position.  Ouchie….

I will get there and heal soon.  No running at the moment or heavy lifting.  My next challenge is the six more cycles of chemo treatments my oncologist have lined up for me. Yes, more chemo treatments await me. No, my liver does not have to be fully grown to start chemo. Yes, it sucks. No, I am not looking forward to it. Yes, I will do it.  Tomorrow, Monday, I will be seeing my oncologist for a checkup.  If he sees me waking, he will surely tell me we should start on my treatments again.

This is the challenge of getting well. Stay well, if I were you, it is much easier.

Cheers.

PS: Yesterday was the 50th birthday of my wife. With the help of my daughter, Abby, we made this cake for her. Happy Mother’s Day to all the mothers.

Cake for my wife and daugther

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Right Liver Lobectory (Part 2 of 2) – The fart

May 3, 2010

(Note: This is part 2 of the two-fart series. I apologize for the toilet humor here, I just could not help myself. Oops, sorry)

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i, Mr. Alvarez.  We are going to move you to the regular floor this afternoon. So I have to take away your morphine pump this morning.” Abby said to me after the change of shift with Natalie.

No!!!!!” They are going to take away my toy. Oh man, just when I was just getting acquainted with my new “friend”, they take him away from me.

I had a stable first night after my surgery, so it is time to move me to the regular floor, and give up my “friend”. They don’t waste time in this hospital. They want you up and about quick, which pleases my wife too. She knows the importance of activating the body again for quick recovery.

Have you burped or passed gas recently?” Abby asked.

I have been burping but have not passed gas” I replied.

That’s ok, just let me know when you pass gas.”

“Ok.” Man, they do not leave out anything personal when you are in the hospital.

I also will be taking out some of the IV’s in your arm, including your artery line, and just leave you with one. I will also be taking out your Foley catheter. Later, the doctors will be making their rounds this morning to check on you.”

Two Jackson-Pratt drains

Oh my, the dreaded catheter pull. That’s something I don’t look forward to. She empties the Jackson-Pratt (JP) drain attached to my hip (looks like a hand grenade) and continues busying herself.

Later in the morning, the resident physician came by to check on me, then another another from Dr. A’s team, and finally Dr. A himself. He notices the blood in my urine collector and asked me if I know of a Urologist. He suggested I do a consult after discharge, but for now it is nothing to worry.

Have passed gas?” Dr. A asked.

What’s up with this gas thing? The resident had asked me the same and another doctor, now Dr. A. What the fart?

No” I replied. I was too embarrassed to asked why but Dr. A does not consider it important so I did not bother.  He gave final instruction to Abby regarding my move to the regular floor and he was off to complete his rounds. Now, the dreaded catheter pull. Oh…oh. Seeing the apprehension in me, my wife asked Abby if she could be the one to remove my catheter. Whew!  It helps when you have nurse-wife.

April 21, Wednesday. At the medical/surgical floor, I was given a comfortable room. There were many patients on this floor recuperating from their illnesses. There was lots of activity; somebody periodically checks my vital signs, draws my blood, and drains my “grenade”.  I was continuously being infused with fluids, since the instructions was NPO or nothing by mouth. I do not have my morphine pump but there were instructions to give me a shot if needed.  I was mostly on Toradol, a pain med, which helps me get through the day.

Mr. Alvarez, did you pass gas yet?” The nurse asked.

This continuous fascination with my fart amazes me. I keep on burping but this does not count. Finally, my wife tells me that the anesthetic puts my organs to sleep and they want to make sure all my “pipes” were working, up and down that is.

Not yet” I replied.

You need to start walking outside the hall, so you can pass gas” He adds.  They want me to fumigate the hallway now. I did walk but still no gas.

April 22, Thursday. The team of Dr. A came by do their rounds.  They were happy that I was recovering well and recommended I go home later in the afternoon. I said I have not passed gas yet, but they said it is ok since they were hearing abdominal sound so everything should be getting back to normal…soon.

I can sense my wife was uncomfortable with me being sent home quickly.  Fortunately, Dr. A came by to explain the logic. He believes I can recover faster at home where I am more comfortable.  There are no nurses to bother my rest.  At home, I will be forced to walk or stand or just stay active, instead of convalescing in bed.  Finally, he adds that the hospital is the worst place to recover due to potential exposure to infectious diseases.  As far as not passing gas, it will happen soon enough as long as I stay active, he said.  Hasta la vista, baby.

At home the vigil for my fart continues. Man…oh, man. My mom upon hearing of my passing gas problem, started praying for it to come. I told my yoga-buddy, LindaK, about it too, so she told her prayer circle, and the word was out that we are praying for my fart. I imagine God has received many requests from the faithfuls, but praying for me to pass gas might have raised His eyebrows.

April 24, Saturday, 02:10 am. What’s that? I said to myself. My stomach was rumbling like the sound of Simba, the lion king, growling, stretching, and on the prowl. He is restless and on the move, as if trying to escape his tight cage.  He growls again and I wait patiently.  Shh….  The growls grow louder and louder, and in the thunderous roar of Simhasan (yoga pose), I let out my much awaited fart. Roar!!! Roar!!!

Honey, wake up. I farted” I shook the wife from her sleep.

That’s good. I am happy for you.” Sleepily, we hugged in a sigh of relief. I wish I could add tears were streaming on my cheeks as we hug but that’s corny. But all I can say is, everything is all ok in Fartland. The end.

Cheers.

The incission and the grenade

PS: Last April 26, Monday, I had my JP drain removed.  Dr. A talked to me and told me the results of the biopsy of my liver.  Of the four lesions, three were dead and one had minute presence of cancer.  He said it was good we had it all removed.  Thanks God.

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