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Banquet of life: It is free.
August 15, 2015

At mass, the priest told the story of an immigrant family on a ship bound for the US.  The father and his family kept to themselves in their cabin with their food and belongings.  Until the son ventured outside and found himself in a banquet of food, eating to his heart’s content.  The father found the son and was worried how he was suppose to pay for all the food his son ate, and the possibility of jail sentence.  The son saw the worried look of his father, and said:

Father, it is free.  It is part of our passage.

Life has many things to offer and it is free for us to enjoy.  Everyday we wake up is a gift, as many have said.

That gift was recently enhanced by the news that my CT scan last August 7 was good and I can remain in my current clinical trial.  I know I should have written much earlier as some of my friends have already sent messages asking for news.  I am sorry but I was busy in a banquet.

Stable was in the medical impression.  It means my current clinical trial is containing the tumor growths in my lungs and liver.

Unfortunately, my white blood cell (WBC) count took a hit, and I was not allowed to started my third cycle last August 10th, Monday.  A low WBC makes me susceptible to infection and further treatment would make it worse.  My doctors delayed my next cycle for a week to August 17.

So I have been busy eating any thing that will increase my WBC.  I can almost hear my mother prescribing the latest herbal diet she heard of to increase white blood counts.  Stop it, Mom.

There are drugs out there that can boost your WBC, like Neulasta, which is injected under the skin.  It is painful, expensive, but it works.  However, I am in a clinical trial program and cannot take it.  Instead, I am eating my way like a rabbit: kale, spinach, broccoli, hemp., etc.  More kale, spinach, organics, etc.  You know what I mean.  I am also keeping active by walking and yoga.

Living with cancer, and restricted by the clinical trial rules, is not exactly easy but I am not complaining.  Right now, this drug has given reprieved in the growth of my tumors and gave me another week of chemo holiday.  However, I am not naive to say I am cured only that I am still here.  I know how this works.  It is a matter of time that my cancer will adapt and I myself would have to adapt as well.

In the meantime there is the banquet of life to partake of, and it is free.  Come and enjoy it with me…in appreciative moderation.

Cheers.

P.S. My doctors warned me that they might have to reduce the dosage of my treatment to help maintain my WBC.  Huh?  This is like winning fight by a draw resulting from a stable scan but next time they tie one hand to your back because your WBC is low.  WTF.  Later in the week they double-checked the counts and said, there was no need to reduce my dosage.  I was .02 above the limit.  Whew.  I am glad .02 is not the alcohol-limit test otherwise I would have been in jail for drunk driving.

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Tidying things up.

May 30, 2015

I am on a mission to tidy up things and complete unfinished business.  I am inspired by the book The Life Changing Magic of Tidying up by Marie Kondo of Japan.  If you have ever been to Japan, the Japanese are the most tidiest, if not most efficient, people I know.  I love Japan, especially sumo.

One noticeable thing about Japan is their small living condition.  A living room used during the day functions as a bedroom at night.  Tatami beds are put away after use and the area is tidy again.  I remember a Japanese colleague visiting the US for work was blown away by the Marriott Residence Inn rooms we were given.

“Bo-san (gramatically incorrect in Japanese).  They gave me a big room.  My apartment is just the size of the kitchen” he said when we saw each other for breakfast.  I thought it was funny.  I was true but it was tidy.

So I find it ironic to read something on tidiness coming from a Japanese when Americans tend to have bigger houses therefore prone to clutter.  To me the book was useful in further simplifying my life, a.k.a cleaning up my stuff so the wife will not have to deal with it when the time comes.

This is a difficult topic around the house and I am not one who shy away from discussing it.  I am hopeful of finding a cure for my cancer at the same time I am realistic.  I pray every morning for another day given, then I turn around and write instructions on how to settle things.  That’s life living with cancer.  We live in two worlds: the hopeful one and the real one.  The real one is difficult to accept because I still, at times, ask “why”.  I cannot fully understand this disease and yet it has taught me many things.

I am sure many have learned many things from me.  I receive many encouragement and prayers which boost my spirits.  I am grateful for them.  Lately, I have been consulting doctors again regarding the recurrence of cancer to my liver, aside from the existing ones in my lungs.  Each time I see a new doctor I have to relate my medical history.  I started compiling all my medical records in a binder now I have a box filled with all my charts, bands, blood tests, scans, images, contacts, etc.  Doctors get impress once they see my collection.  They are tagged and highlighted.  Then I tell them about my blog.

But that does not change things.  The answer I seek is often not there and the decisions I am force to make does not get easier.  Do I go for a cyberknife procedure to my liver or move on to the next clinical trial?  There is always something to decide…and tidy up.

Growing medical records

Growing medical records

 

Running a 10 miler.

My happy place.  Last May 23, I ran the Soldier Field 10 Miler in 2:22.  I was happy I finished.  Each time I finish a race it gives me confidence that I have somehow put one over my cancer.  I finished with cancer growing in my lungs and now in my liver.  Three more miles and that’s a half marathon.  In fact I started looking for one and may just sign up on a whim.

2015 Soldier Field 10 mile finish.  I got the medal.

2015 Soldier Field 10 mile finish. I got the medal.

Cheers.

P.S.  Going to NY for business next week.  I am on a “wash out” period to remove toxins from the previous trial before starting a new one: my third if ever.

 

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About my chemo maintenance

January 9, 2011

ave you decided?” My friend and yoga buddy, Lisa, asked as we were packing our mats. She was referring to stopping my chemo maintenance as suggested by my oncologist, Dr. M.

 

She was not the only one who had asked me during the week. Friends, family, and colleagues have asked about it. The true answer is: I don’t know. The one-year anniversary of my monthly chemo is in August 2011 and from there I will have to make a decision. I pray that I will have to courage to choose between: to stop and have a full life or continue my maintenance and be tethered.

I will let you know when the time comes, Lisa.”

For now, I try not to think about it. There are miles to be run, races to finish, and many more sun salutations to do.  I remember writing before: that for every mile I run is a victory for life.  That I intend to do.

I have started training this week but my miles are low. I came across this article from Runner’s World magazine, ‘Way of the Renegade‘, which preaches low miles but more speedwork and strength training. The less is more training program is espoused by two brothers Keith and Kevin Hanson. I am intrigue by it and will try to include it in my training plan. During the week I started doing speedwork (run fast for a minute, then recover for two minutes) and strength work (run on an incline multiple times and recover). Then today, I did 4.5 miles are marathon pace (12 min/mile).

It is still too early to tell if it will work. The wife has been busy with work lately that she is unable to run. But we managed to put one in one afternoon. It was a cold afternoon when we set out to our usual running trail, and it was just a wonderful care-free run. Like always we talked and it our way to free our minds from our busy lives. We avoided the topic of my chemo maintainance but I am sure it was weighing in her mind.

Tomorrow, I leave for Vermont for business and at the same time see a good friend who is diagnosed with liver cancer.  I hope she is doing well.  Got to send her “Whole Lotta Love”….hit it!

Cheers.

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Rule number 1


Rule number 1

October 26, 2010

wore my 2010 Chicago marathon half-zip shirt for my chemo maintenance today. It is not only to take pride as a finisher, but it is comfortable too. It is warm, light, and opens widely at the chest for Edith, my oncology nurse, to access my port-a-cath. She gets mad if it is difficult for her to get to it. I learned my lesson.

Yup, it is that day again. Chemo day.  I am totally different on days like this.  The household treads carefully around me: quiet and no cooking (I get nauseated from smell of food cooking).  My mood turns sour as the afternoon progress into evening because the drugs to control the side-effects are wearing off.  I now need to manage them on my own.  Last month was hiccups, tonight will be nausea and chills night.   I had it coming to me, I took my nausea pills late, thinking I am ironman, now I may have to pay the price.

I was ok in the morning and early afternoon, then it was all downhill, even after a short rest. Don’t get me wrong I am still nauseated while writing this post, but I need the distraction. I think I may have a plan to conquering this side-effects, since I will be doing this routine on a monthly basis. I need to make it as part of my marathon training plan or program. I don’t think there is a book out there on how to mix in chemo as part of a marathon training plan, so I will make one as I go.

  1. Don’t forget to drink your nausea pills. If you can’t eat you can’t you lose energy.  If you get weak and lethargic, you lose muscles.
  2. Hydrate.  A page out of running journals, but for me it forces you to pee. The more you pee the faster you get rid of the chemo toxins in your blood.
  3. Eat greens, fruits, and protein-rich plant based food. When you take nausea pills, it makes you constipated. Take fiber rich food to move your vowel and get rid of toxins.

    My favorite protein-rich plant based food is edemane. I consume a bag a day while working, watching TV, and yes now, while writing. I have built my leg muscle memory for three weeks, I hate losing any of them.

  4. Avoid oily foods. For me, it makes my stomach queasy and bloated.  Plus, oily foods are harder to digest.  Plus, I don’t have any more gallbladder and I do not want to over-work my remaining liver.
  5. Finally, you got to move. Whether just to get more water, more edemane, and more trips to the bathroom. I sit in my medicine ball while watching Food Network. It stimulates my appetite.

There I have my plan. Oh, no. I feel a vomit coming. STOP! I swallowed my vomit back. (sorry, I hope I did not mess up your breakfast, lunch, or dinner by the visual).  Hmm…so that’s how digested protein and fiber taste like.

I got to stop now.

Remember rule number 1, drink the damn nausea pills.

Cheers.

PS:  I dedicated this day for my friend in Vermont stricken with liver cancer.  Remember everyday is a good day.

 

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Early Easter for me: Hallelujah

Apri 2, 2010

NOTE:  You might like to play the video below then go up again and start reading.

y phone rang while I was in the middle of baking brownies and cake. I see the caller id saying it’s Swedish Covenant Hospital, where I have my doctors and chemo treatments.  Hmm….

“Hello.” I answered.

“Bo? This is Dr. B from Swedish.  How are you?

(NOTE: Dr. B. is the head fo the Interventional Radiology Department and the one who performed the chemoembolization to my livers last December 2009).

I have not forgotten you and have always kept you in mind.   I am calling about the result of your PET scan” he continued.

Somehow the world around me seems to slow down. I forget about my baking and just held on to every word he said. I paused and held my breath. I just had my PET scan in preparation for meeting Dr. A, the liver surgeon, and it is suppose to tell any presence of cancer.

“I talked to Dr. M, your oncologist, and Dr. K, your colon surgeon, and I had askedf them if  I can be the one to call you regarding the results of your scans. I carefully reviewed the scans and compared it with the previous one. We can no longer identify the metastases in your liver or in your right axillary lymph node. It’s gone.”

I gripped the phone trying to absorb what he just told me.

“Gone?” I asked.

“Yes. Your cancer is gone. The lesions in your liver are gone or non-detectable.” he said.

A rush of emotions came over me while I still hear him explain the rest of the results. I felt tears falling as I absorb the significance of his words. Gone. Not identifiable. I could not believe it. I have conquered the beast again. I did it.

“Bo, let me add that it may not detectable but it does not mean it will not come back” Dr. B adds.

“I know Dr. B. I have been in this situation before in October 2008 when my PET scan result showed no recurrence of cancer but in came back a year later in November 2009. You, Dr. M, and Dr. K gave me my life back again.  I know it can be taken away again but I am very grateful for your help.  Thank you.” I replied.

He further explained what needs to happen and after we finish I woke up the wife who was sleeping prior to working her night shift.  Dazed from sleep, I told my wife the result of my scan.

“It’s gone, hon.  My cancer is gone.  Dr. B called and it’s gone.” I said.  After making sense of what I was trying to say and absorbing the impact of the news she cried in happiness. Oh my God, she said, it is a miracle. Indeed. We called up my Mom and brother in the Philippines.  We told her the good news, then she wept in great thanks to God. I love you, Mom.

It is not always you are given your life back the second time around. I am a totally different person now. I know everybody has to die sooner or later but in my case, and those who still suffer from this dreaded disease, we know if we stop taking our chemo treatments or taking care of ourselves it will be sooner than the rest. So we savor each day given as a gift.

That’s it. Enjoy the day given. So, I laced up my running shoes, dressed to run, and headed out the door. I want to give thanks to God the way I know, when I am at peace with myself. I want to feel the fresh spring air in my lungs, the wind in my tearful face, and the soreness of my tired knees. Thank you, Lord. I love thee. I am different person thanks to You, and those of you who have prayed and supported me. That’s you, my friends and family.  You have followed my ups and downs, my pain and recovery during treatments, and have given me encouragement when I most needed it.   Thank you very much.

Easter is about rebirth, redemption, and salvation. I had an early start for my Easter.  In behalf of my famly, I wish you and your family have a blessed Easter.

Cheers. Mazel tov.

PS:  I am still going to keep my appointment with Dr. A, liver specialist, next week to hear his opinion.  Lastly I leave you with this song from the late Jeff Buckley; Hallelujah.  I was humming this while running.

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At the starting line with Dr. B

December 22, 2009

I did not recognized him when he walked in that Thursday morning, December 17.  Dr. B, my radiologist, was in a surgical outfit.  It was different when I first met him last November 23 in his professional white smock.  (See related post, The long road ahead, November 28)

“Are you ready?” He greeted me.  I was going to be awake through the chemoembolizaiton procedure and I was already all prepped up by his staff, and was cold.  Have you notice how cold these operating facilities are?  They say it is because of the machines they have to keep cool but how about me?

I hear in the background the nurse reading my name, my birthday, telling the doctor why I am in there, and my vital signs.  I look at the clock and it was almost 9:30 am.  My day started at 5:00 am with my normal morning rituals, except for breakfast or any liquids, so I was hungry.

“Yes, I am ready” I replied.  He signals the nurse, who has been steadily infusing me with antibiotics and fluids for an hour now.

“Mr. Alvarez, I am going to give you benedryl to make you feel sleepy and relax.” Said Eunja, one of my nurses.  Whoosh!  I felt a rush go through my head and body.

“Wow.” Eunja heard me and asked “Did you feel that?”

She did not intend to give me give me any discomfort.

“I tried slowing the push but high volume of your IV to your port-a-cath seems to have carried the medicine fast.”

Oh well, I thought.  I could not blame her she means well…all of them.  The port-a-cath I have is inserted into the jugular vein which then goes to the heart, so you feel the medicine surge faster instead of infusions from the arm or peripherals.  The implant device is convenient for cancer patients to avoid being poked regularly during chemo session.  (Note:  Veins deliver the inward flow of blood to the heart versus arteries which deliver outward flow of blood from the heart.)

I felt a pinch in my right groin.  It was the local anesthetic Dr. B administered.  He feels for the femoral artery and marks it.  He makes the incision then slowly threads a wire going to my liver.  No pain there.  He stops and tells me he needs to map his way to the liver.

Map?  Don’t tell me you lost your way?  I should have brought my GPS.

But he has something better.  He puts a catheter over the wire and says:

“I am going to inject a dye contrast to map your artery.  You are going to feel radiating heat.” I felt the warmth radiating in my stomach.  He takes an image and there is our map.  Whew!  Smile liver.

He repeats the process inserting different types of wires, catheters, etc, moving ever so closely to the tumors.  With him in the room was Dr. F, another radiologist, and they discuss the careful approach to my liver.  They need to find the right artery to deliver the chemo then embolize or shutdown the artery to lock the medicine in.  One of the tumor was located at the edge so it took them time to position the wires.  He repeats the procedure until he is close to all three tumors.  Satisfied, he locks in the catherter and ask the pharmacy to mix the special chemo concentrate for me.  Houston, we are locked and loaded.

Dr. B tells me it is this time when his patience is tested because of the wait for the chemo concentrate from the pharmacy.  I guess you got have them fresh, right?  Nothing beats fresh chemo in the morning.  I love the aroma of fresh chemo.

When it arrives, Dr. B and his staff were in a flurry of activity.  He delivers the first chemo concentrate with embolized particles.  Panic breaks out among my cancer cells.  What the f#$%k!  Incoming….. boom!  Another concentrate, another, another, and another. I lost count but Dr. B came out firing on all cylinders.  Die, sucker!  Rat-tat-tat.  Shots fired.  Shotgun, machine gun, AK, cruise missile, kitchen sink… Welcome to Chicago.  Do you feel lucky, punk?  There’s a new sheriff in town.  Get out of town by sundown and don’t let the door hit you on your way out.  Ka-boom!

Cloud settles and I all feel is blouted pain in my abdomen.  As if somebody hit me in the stomach several times.  Raw.  But it is over.  Well done, Dr. B, with your help my journey has begun…again.

Cheers.

My wife, me, and Dr. B "The New Sheriff"

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Another white wrist band bracelet

November 16, 2009

She asked me to extend my left wrist.  My nurse this time is Becky, who was about to put a white wrist band bracelet on me.

“What’s your name?  What’s your birthday?” I replied.  “Good.”

Satisfied, she proceeded to attach the bracelet on my left wrist.  She’s got her man now and I can’t escape.  The last time I had one of these bracelets was when I ended up in the emergency room after having an allergic reaction to chemo.  (See my July 23, 2008 posting; White Wrist band Bracelet).  This time around I needed to have an ultrasound liver biopsy.  After giving me the news that my cancer is back and is in my liver, Dr. M arranged for an immediate liver biopsy.  That was last Friday, November 13 or Friday the 13th.

Becky joked me about it too.  Stick to nursing, Becky.

But it was a lucky day for me since I was on a waitlisting for the unscheduled biopsy that day.  A time slot opened for me so Becky and I are now getting to know each other now.  Since it was unscheduled, I did not know who was going to be the doctor performing the biopsy.  I was stripped down to my waist and was cold inspite of the warm blankets she piled on me.  She had managed to access my port-a-cath in my right chest for medication, when a lady entered.

“Where do you want me, dear?” She’s from pathology, Becky explained.  “Over there’s fine” replied Becky.

She was a modest size lady in white gown.  She navigates her rolling lab table with a microscope and several slides to a corner near my bed.  Her role in this cast of thousands was to check the liver sample tissue.  But where is the doctor?  With that thought, he walks in and goes about his business.  He checks the ultrasound gadget, dabs a cream, and puts in my right rib.

Boy,  that cream is cold.  As if reading my mind, he asks “is it cold?” What can I say…duh!  He then proceeds to clean my right lower rib with betadyne and explains the procedure.  He injects local anesthetic where he plans to make entry, then makes a small incision.  So far so good.  I see him holding what looks like a barbeque skewer with a corded handle at the end.  With a serious voice, he said.

“I want you to breathe in deep and hold.  Ok?  Ready.  Go.” My chest expands.

Then holding the skewer-looking probe with his right hand, he plunged it through the incision just below my right rib.  With his left hand he holds the ultrasound gadget to guide him.  What happened to the sedative, I thought.  No pain killers!  I feel the probe puncture in my liver and go deep.  I hear the rising beeping noise of the heart monitor as he tries to reach the tumor to get a sample tissue.  Becky notices I can’t hold my breath any longer.

“Ok, breathe.  When ready take a deep breath again and hold” he said.  The probe is still inside me.

This is counter intuitive, I thought.  You breathe to relieve pain just like when giving birth, right?  But hey, what do I know, I am just a slab of meat being poked.  So when I was ready I took a deep breath and hold.  Then…click.  He removes the probe and hands the sample to the microscope lady.

After a while she says “not good.” What the fart!  Did I just drew a rookie doctor?  I did not have a choice since I was not scheduled but this is ridiculous.

I hear the doctor discuss with Becky about getting a longer probe to reach the tumor.  I was no longer cold.  He returns and says…”we have to do it again.  I want you to breathe in deep again and hold.” I obliged just to get it over with.  I don’t think we are bonding good, doc.  He plunges it again with determined heaviness to get his pound of liver.  I hear the beeping sound of the heart monitors again…beep..beep..beep…I can do this…beep..beep..beep.…then…click.  I breathe.  This better be good or I have to do it myself, this time with morphine.

He hands the sample to microscope lady and I lay there waiting and sweating in a cold room.  Becky tells me I did good.  I was praying the microscope lady would say the magic word because I don’t I can do it one more time without passing out from pain.

“Its good” she says.  Alleluiah!  Praise God! (choir singing in the background)

The doctor tapes me up and checks for any internal bleeding.  The liver if full of arteries and there is a risk of internal bleeding if the biopsy is done wrong.  He tells me I am going to feel sore as if somebody punched me in the stomach.  Well I got punched twice.  He adds that the results of the biopsy will take time and not to expect it until Wednesday, Nov. 18.  In the meantime, I need to stay in the recovery room for four hours in case of fever or bleeding.  He cleans up and signs some paperwork.  But before he leaves, he tells me to call him if there is any problem.  I am sure I will receive his bill for stabbing me twice in the liver.  Maybe I get a discount from not having pain killers.  Oh well…

Becky cleans me up and calls my wife.  Together they take me up to recovery.  Now we wait.

Cheers.

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