A Simple Message of Support

School is starting, so I'm starting to see a lot of cars that have messages painted on them. "Seniors Rule" or "Class of 2000-whatever rules," that kind of thing. We didn't do that when I was in high school. We'd throw eggs at each other's cars, and I remember one ill-fated experiment involving jelly donuts, but that was about it. Years later, a friend got married so we wrote the usual things on his car, but we used shaving cream. It sort of ate through the paint. You could still read "Just Married" years later, long after I think the marriage ended.

I was up at the hospital the other day, and the car next to mine in the garage had a message painted in the window, too. It said, "We love you Mom." It definitely looked like a girl's handwriting. Now, it could have just been a nice message from a loving daughter. It could have been an attempt to make up by a daughter who did something really, really bad. But I don't think so.

Whatever the truth may be, I like to think that it was a message of support. Mom's car, after all, was in the hospital garage. I'm assuming that Mom was up there for treatment, and the message was a way for the daughter to let her know she cared. At least I hope that's what it was.

In the end, the truth doesn't really matter. I'll never know the story behind it. But it made me smile. And that was enough.

7:08 AM ET | 08-31-2007 | permalink

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Leaving a Record of Lessons Learned

I was looking through a magazine this afternoon. Actually, I was stalling, because I couldn't think of anything to write for today, and I was sort of hoping for inspiration. Then I saw a picture of an American soldier from World War II. He was probably in his early 20s. It's funny, in pictures from a generation or two ago, people always seem to look older than they really were. I wonder if that's true for us, too. Maybe we just don't see it.

If he's still alive, if he survived the war and came home, he'd probably be in his 80s now. As time marches on, veterans of World War II are dying. It won't be too much longer before they are all gone, and their voices lost. We'll know about the war from the books and films and all, but we'll have lost contact with the people who lived it.

Vietnam veterans are in their 50s and 60s. How can that be? They were all so young when they left, yet that war is ancient history to today's teenagers. There are oral history projects whose goal is to preserve the stories told in the voices of the men and women who lived them.

That got me thinking about all of us. We have all learned so much, lived so much, and yet there's really no way to pass on a lot of that knowledge. And no real way to pass on the stories we tell each other. I have the great fortune of having this blog, but I just wonder if there isn't something else we should be doing. Granted, you can be told about cancer, just as you can be told about war. But unless you live it, it won't mean much. There is knowledge, hard-earned knowledge, that each of us now possess.

Maybe we should think about some sort of oral history project. Or maybe we should just leave something behind for those close to us: letters, a diary, tapes or even videos. Just something to say, "I was here. I lived through this. And this is what I learned." I guess what I'm really talking about is some way to tell those who will follow in our footsteps, "You're not alone."

7:13 AM ET | 08-30-2007 | permalink

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Haunted by a Phantom Future

The following essay is from the NPR My Cancer weekly podcast:

People who have lost a limb say that sometimes they can still feel it. They feel phantom pain from an arm or a leg that's no longer there. Clearly the brain, or at least some part of it, didn't get the message.

As a cancer patient, I've lost little bits of my body. Some pieces have been cut out, some burned, frozen, radiated, or poisoned with drugs. We hope most of the tissue that was killed was tumor cells.

And I have a form of phantom pain, too. I have a phantom future. I've always been a fan of tortured metaphors, but let me explain. The day before I was diagnosed almost two years ago, my future was wide open. Okay, I was getting older, a little too old to start a whole new career. I have a mortgage and obligations, so I couldn't just grab a backpack and head out on the road. But you know what I mean. There was still plenty of life out there to be lived. I had options.

A day later, all that changed. My future was cut off. I had serious cancer. In those first few weeks, I was told I had six months left, then 12, then 20. None of those prognoses really matter, except to scare the heck out of you. But they had one thing in common. They curtailed my life. My death, whenever it came, was most likely going to be much sooner than I expected. The unlimited horizon I considered my future? That was gone.

It's funny. I still think it's all out there. I think about jobs and career paths, things I want to do, things I have to get done. I plan ahead. And then, of course, I'm reminded of the reality of my life. My death from cancer doesn't appear imminent. But I know I won't be able to do some of the things I want to. For one thing, my body has been pretty beat up. I'm just not physically up to it.

When I find myself thinking two, or three, or even more years ahead, am I being silly? Feeling the phantom pain of a future that's no longer there?

I don't think so. The alternative would seem to be just giving up. Telling yourself you have no future, so why even bother to dream? That really is the road to an early death.

On the other hand, I need to be honest with myself. Cancer has stolen at least some of my future. Of course, a lot of people didn't expect me to live this long. Who knows how much time I really have left? I'd hate to find myself two or three years down the road with no plan for the future at all.

I guess I'll just keep planning and dreaming. People who have those phantom pains say they feel like the real thing. So my phantom future might as well feel real to me too.

7:00 AM ET | 08-29-2007 | permalink

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Learning to Laugh About Cancer

I heard my first cancer joke the other day. I assumed that cancer jokes must exist, but I had just never heard one. It's not the easiest subject to joke about, of course. I know that when I joke about it, it can make people uncomfortable. But I do think it's important to be able to laugh about it all. I mean, funny things do happen. And of course there's the old cliche, I laugh so I don't cry.

So here it is:

When a cancer patient dies, why do they nail the coffin shut?

So the doctors can't do just one more round of chemo.

OK, so it's not really all that funny, although there's certainly a ring of truth to it. But I am still encouraged that someone even tried to come up with a cancer joke. I wouldn't recommend telling it at a party, for instance. But who knows, it might get big laughs in the chemo room.

Cancer takes so much from our lives. I think it's important to keep it from stealing our laughter. And for all the people who don't have cancer, and who get uncomfortable if we joke about it, it's OK. It's just a disease. We need to be able to laugh about it, and we need you to laugh with us. Not the uncomfortable nervous laugh, but real laughter, the kind that makes you feel better. We'll all be better off.

So have you heard this one? Two tumors walk into a bar... OK, that may be in questionable taste, but I've just always wanted to say that.

7:23 AM ET | 08-28-2007 | permalink

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The Posse that Keeps Coming

"Who are those guys?" That's a line from the movie Butch Cassidy and the Sundance Kid. Butch and Sundance are talking about the posse that is on their trail, and no matter what they do, that posse just keeps coming. It's a mixture of frustration, anger, but also wonder. Why do they keep coming?

That's sort of the way I feel about my cancer. We cut out my first tumor six years ago today, actually. I figured that was it. The cancer tried to take me and it lost. I moved on to other things and never really gave the cancer much thought after that. But it didn't give up. In fact, it was gaining on me.

Five years later, I looked behind me and it was right there. So I've tried every trick I know. Actually every trick my doctors know. Brain surgery? That took care of one of the tumors, and it hasn't come back there. Chemo? Well, that worked for a while, slowed the cancer down, but ultimately it broke through the drugs.

We tried new tricks. Radio Frequency Ablation. My doctor stabbed the tumors in my lung -- stabbed me, too, in the process -- and burned them. That seemed to work pretty well. Except that the tumors took a different route. If they couldn't attack my lungs, they attacked my spine. They just keep coming. I look at them on the scans, see the white spots, and think, "Who are those guys? Why are they so determined to get me?"

Fine, we hit them with radiation. That slowed them down, but only briefly. It's a little like Butch and Sundance jumping onto one horse to confuse the posse. It may work, but only for a little while. But I wasn't done, my doctors injected hot cement, literally, into my vertebrae, burning the tumors and sealing them off. That should do it, right?

Nope. Little ones seem to be forming in my other lung. Who ARE those guys? Doesn't the cancer ever get tired? Doesn't it get the message that maybe I'm just too much trouble? I'd like to say to it, "Look, you gave it your best shot, made my life miserable for a while, let's just end this. Walk away and we'll call it even." But somehow I think that the cancer just isn't open to reason.

In one of the movie's greatest scenes, Butch and Sundance jump off a mountain to finally get away from the posse. That's not really an option for me, unfortunately. We still have some tricks left. But it does get tiring. Every time I look behind me, the cancer is still there, and getting closer each time. Who are those guys?

6:42 AM ET | 08-27-2007 | permalink

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The Best Defense Is a Good Offense

I had a brain scan yesterday. It was clean. I actually got the word from my doctor barely an hour after the scan, so no agonizing wait. A decent day, I guess. When I went down to the MRI department, one of the nurses recognized me from before. "He's an old hand here," she said. "We like it when you come to visit." I was thinking about that later. It must be strange for the staff at the hospital. At some point, some patients will stop showing up, for obvious reasons. But they'll never know what happened to them. The patients just stop coming. It was nice that the nurse said that, and I realized that each time I show up, it's another way of saying I'm still here.

So what's next? Well, I still have three small tumors on my spine. We have to figure out what to do about them. I guess the standard treatment would be to wait for a while, see if they grow, and when they get to be big enough to cause problems, find a way to deal with them. I'd just as soon not wait. My feeling, my entirely non-medical opinion, is that I'd be better off attacking them when they're still small. So this will probably mean some form of radiation. But we'll do some more scans in a month or so and see what's happening.

And I have several very small nodules in one lung. They're new. It's possible they're harmless. But that's unlikely. They really are too small right now to do anything about. I could have chemo, that would be the normal thing to do, but I'd like to keep trying other procedures. If I went for the next round of chemo, there's maybe a 50 percent chance of success. "Success" in this case being defined as about another four months or so. Four months of being really sick. If I did nothing, the chances are that I would live longer than that. So I'm still committed, with the support of my doctors, to continuing to attack the tumors in whatever way we can, except for chemo. After all, we've been able to kill a number of them, something that the chemo has not, and most likely wouldn't be able to do.

In the meantime, I know that my brain is clean. That's enough for today.

7:20 AM ET | 08-24-2007 | permalink

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Portraits of Lives Destroyed

There was a heartbreaking article in The New York Times yesterday. There's an exhibit in New York of photos of young soldiers who have been seriously wounded in the wars in Iraq and Afghanistan. One of the pictures in particular brought me to tears. It's a wedding photo. A young bride, holding her flowers, and her new husband, in his Marine dress uniform. He had been caught in a burning vehicle and was terribly disfigured, losing virtually his entire face. I can't imagine the pain that he and she feel, or the courage they have. What must it be like for him to walk down the street, seeing the stares of strangers? What must it be like for her, knowing that he is the man she loves, but seeing the face of a stranger? What will it be like for them in 20 years, when memories of the war have faded?

We have all been struck at random by a disease. Luck of the draw. But these kids, and actually not all of them are kids, are being hurt and disfigured and damaged because we sent them into harm's way. I know it's easy for those who oppose the war to say, "We didn't send them there." But like it or not, agree with the war or not, they are over there in our names. Walk down the street anywhere in this country and it's clear that this nation is not at war. Our military is at war. For the rest of us, life goes on. But for the thousands who have been so damaged by war, their lives have been forever changed.

I have seen war up close. It's a meat grinder, taking some of the best this nation has and churning out broken bodies and lives. I should know better, but sometimes I need a reminder too. I look at those pictures and know that the pain I feel, the pain I complain about, is nothing. I look at all the pictures, the photos of those who have fallen, the pictures of grief-stricken families at graveside, that wedding picture, and I know that I have it easy.

7:05 AM ET | 08-23-2007 | permalink

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Even with Cancer, Life Marches On

This has just been one of those days. Nothing major. The garage door broke. With the cars inside, of course. And lifting it probably wasn't smart, since I just had a spinal procedure. If my doctors are reading this, I was careful. Honest. We had some heavy rain and it's clear the roof needs to be replaced. My computer had to be wiped clean after I got a virus, and I still don't think I have it working right.

I was tempted to write about the computer virus, using it as an analogy and all, but that just seemed too easy. All I can say is that I hope moderately bad things happen to the people who created it. Not seriously bad things, just annoying bad things. Everything that happened has been relatively minor. But taken as a whole, today's been a pain.

I think sometimes that we ought to get a pass on stuff like this. I don't mean to whine, but sometimes real life added on to the cancer can be a heavy load. It seems to me that life should be one way or the other. You can deal with all the regular stuff that goes wrong day to day, or you can have cancer. If you have cancer, your appliances and house and car should all know that, and they shouldn't break. It only seems fair.

Of course, if that were the case, we'd have to spend all our time on the cancer. And who wants to do that? It's not that I actually have to do anything about my cancer each day. I don't. But it is on my mind most of every day, and that can wear you down.

Cancer or not, life does go on. Things break and have to be replaced. Repairmen will come some time in that 10-hour window they give you. We can deal with anything that is thrown at us. I really do wonder, though, how the garage door knew that breaking down today would be such a pain. Think it did it on purpose?

7:03 AM ET | 08-22-2007 | permalink

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Support in a Strange Land

I was struck by something when I read all your posts yesterday. First off, of course, I am extremely grateful for the good wishes. Over the days that we spend together, there is a constant string of support for each other. Good thoughts to try to calm the nerves and fears before a procedure. Advice from those who have gone through it before, whatever "it" may be. Condolences when there is a loss. Most of all, just understanding.

It was almost eactly six years ago when I was first diagnosed. At the time, I knew nothing about cancer. I'm not sure that I knew anyone who had it, although I must have. But in the beginning, cancer was something that happened to other people. Everything about the disease was new, everything was scary. I was truly a stranger in a strange land.

Now, of course, things are different. I'm not talking about the superficial things. I know more about cancer, of course. I know more medical terms. I know the side-effects of certain drugs. I know how long I will feel the effects of a procedure. But something much more important has happened, too. I've changed. I think we all have.

Before all this happened, I doubt I could have reached out to someone I didn't know and told them I understood what they were going through, and meant it. I don't think I would have known enough to read notes from other patients, and truly understand what they were saying. We all talk about how cancer teaches us things. I think that's right. But it's not all. It's not just the disease that teaches. Most of what I've learned, I've learned from all of you.

7:13 AM ET | 08-21-2007 | permalink

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A Frightening and All-Too-Familiar Routine

The following essay is from the NPR My Cancer weekly podcast:

I took a day off last Friday. I didn't really mean to. It's just that I got a little busy. It started the way these days always start. With something else. But the pain was bad enough that it meant a dash to the emergency room.

We were in the all-too-familiar routine. An IV put into an arm. A saline drip. Of course, tests. On a scan, where no one expected it, where no one had looked before, there was something. Then the doctor said one of the worst things a doctor can say. "We've found a mass." How could that be? How could no one have seen it? Of course, we all know what "mass" means. No one needs to say it. It may be nothing, it may be benign. But that only happens to other people. And this one is big.

Then came the fear. You know your world is going to change. Actually, it already has. You've crossed a line and there's no going back. Life will never be the same.

Of course the answers came too slowly. We waited for the next test. We waited for the results. And we started to make the phone calls. You all know them. The calls to let loved ones know something bad, something very bad, may be happening.

But something strange happened instead. Things didn't follow the usual path. More specific scans seemed to indicate the mass is most likely just a cyst. Most likely not cancer. A very big cyst, but still just a cyst. They always say, "As big as a grapefruit." This time, it was true. They won't know for sure until they remove it, but that's the way it looks.

That's how the day ended. More visits ahead, more tests, certainly surgery. But this time it may not be the Beast.

And this time, it wasn't me. I wasn't the one in the hospital bed. I was the one standing next to the bed, who couldn't do anything but worry about someone close to me. I was the one who would gladly have changed places. But that's not how it works either. There's a long, difficult road ahead, but it won't be the same road that I'm on. And for that I'm grateful.

7:00 AM ET | 08-20-2007 | permalink

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Leroy's Off Today

Leroy is taking the day off -- nothing to do with his cancer. He'll be back with his blog next week.

7:00 AM ET | 08-17-2007 | permalink

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Unless You're an Action Hero, Healing Takes Time

I grew up on TV, mostly Westerns and old series like Combat and The Man From U.N.C.L.E. I guess the producers of those shows realized that the stars couldn't go through all sorts of danger without ever getting a scratch. So every now and then, the hero would get shot, usually in the arm. Over a season or two, their poor arms might take a couple of bullets. But each time, by the following week, they were healed up and back on the job.

I was thinking about that again a week or so ago when I saw the new Bourne movie. First off, I loved it. Great action sequences, very little plot, terrific camera work, car crashes -- the perfect summer movie. But Matt Damon as Bourne gives out, and takes, some ferocious beatings. SPOILER ALERT: I mean, he kills a guy with a book! And yet for all of the great bodily harm done to him, he limps a little, bleeds a little, but otherwise seems to bounce back from fights that no body could survive.

Healing in real life, after all, takes a while. It's now been a week since my procedures, and I'm still something of a mess. I can feel my body fixing itself, but it's still sore and stiff. If I were Bourne, I'd have to tell the bad guys that I would need to lie low for another week or so to heal up, and then we could go at it again. Our bodies can do amazing things. Undo terrible damage and survive terrible injury. With the help of modern medicine of course. But it takes time, and it's certainly not easy.

It is easy to get impatient though. The healing process can be exhausting, you can't wait to be better, to be your old self, or something approaching that. But regardless of what we want, our bodies work on their own schedules. Sometimes I wish that life could be more like the movies. Except that some movies have gotten more realistic, sometimes too much so. There's a scene in the movie Platoon, where one character has been badly wounded and is yelling, and another character grabs him and says, "Take the pain!" No, I don't want to be in that scene. I was thinking more along the lines of an old TV show where I could say, "Ah, it's just a flesh wound."

7:13 AM ET | 08-16-2007 | permalink

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'Sell By' Dates Aren't Set in Stone

I was explaining my recent procedures to a friend of mine the other day, and she said, "So you're going to live?" I think I mumbled something like, "Yeah, at least for a while longer." Her question caught me totally off guard. I guess it shouldn't have. But I just hadn't been thinking about last week's procedures in that way, that they would decide life or death for me. I just thought of them as another part of the process. I'd have them, recover, and then deal with the next round. One step forward, two steps back, three steps forward, it gets confusing after a while.

Back in high school and college, I worked summers in a big commercial bakery for one of the major supermarket chains. I would take my friends into their stores, point at the hamburger buns lined up in their golden glory, and say proudly, "I made all those." As I remember, they were all singularly unimpressed. It was hard work, actually more like manufacturing than cooking, but it paid for college, and that counted. What does this have to do with cancer? I'm getting there.

When some items like sweet rolls or muffins were packaged, the bags were sealed with a little plastic clip. You still see them on baked goods at the store. They were color-coded, telling what day the item had been baked, and had a date stamped on them. That was the "sell by" date, the day after which they were supposed to be removed from the shelves. No one really knew what would happen to them on that day if they were still sitting there. Spontaneous combustion? Dissolving in smoke like a Mission: Impossible tape?

Every once in a while I'd fill in at the warehouse, if the hamburger buns were done for the day. And that's when I learned a shocking secret. OK, not that shocking. If some products didn't make it out fast enough, and their shelf-life expired, we'd simply take off the old clips, run them through the machine again, give them new clips of a different color and extend their life by a couple of weeks. Just by passing them through the clipping machine. Clearly nothing bad happened on the "sell by" date, or apparently even weeks later. I remember doing this to one batch a couple of times. Change the little date counter on the machine and they'd live longer. It was that simple.

So that's closer to the way I look at the procedures I just had. They didn't decide whether I'm going to live or die. They just extended my shelf-life a little bit. Gave me some more time. And I can live with that.

7:05 AM ET | 08-15-2007 | permalink

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Cancer's Crystal Ball

"Insomnia is good for productivity. Personal pain is good for creativity." Now, I know all of us try to keep a positive outlook on all this, but that's just ridiculous. But that's what my horoscope said in the newspaper yesterday morning. Is that some kind of sick joke? As I've said recently, I'm not a morning person. I haven't been getting much sleep, and I'm in pain. So you can imagine what my reaction was when I saw that in the morning paper. And if you guessed "productive and creative," you're wrong.

Actually, sleep deprivation is a very powerful thing. Various groups, the military, for instance, use it for indoctrination. In its extreme form, it's used for interrogation. In normal times, it just makes us cranky. I was out on a story one time and we were up for five or six days straight, at most an hour or so of sleep each night. At that point, that little bit of sleep is worse than nothing. I'll never forget the last night when, totally exhausted, I sat there reading typed words on a page. There was only one problem. There weren't any words on the page, even though I could see them clear as day.

As for pain, it has a way of crowding out everything else. It makes you nervous, because you're never quite sure what movements might bring new agony. It makes you forget whatever you wanted to do, or what you were thinking about, or what you needed to do. It makes you forget yourself. The other day, one woman wrote in, I'm pretty sure it was Liz but I was a little sleep deprived when I read it, to say that, "Cancer is pain." Those three words pretty much say it all.

People who haven't experienced cancer, who haven't come close enough to feel its breath, or to feel its arms tightening around our lives, those people ask sometimes, "What is cancer like?" Well, for all the words I've written, Liz's three words may get at the truth more directly. Cancer is pain.

That person who wrote my horoscope wasn't entirely wrong. Pain can teach us things. Some people don't like it when I anthropomorphize my cancer. Probably the biggest and most unwieldy word I will ever use here, but I wanted to see if I could pull it off. They don't like it when I make my cancer into some sort of living being, with its own desires and goals and feelings. But as I think about it, my cancer, at least in the form it's in now, isn't quite life threatening. Oh, it is in the broader sense, but right now, all that those tumors are doing is causing pain and damage. So when I'm sitting awake in the dark hours, listening to the night, and I feel my muscles and tissue fighting to repair the damage, I think about that hot glue hitting the tumor cells in my spine, the heat burning them to cinders in my lung, the cold needle in my ribs freezing them to death. And I hope that those cancer cells are alive enough to feel pain. And I hope that it hurts like hell.

7:13 AM ET | 08-14-2007 | permalink

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Sometimes You Have to Take a Beating

"Sometimes in life you just have to take a beating." A friend of mine used to say that, and he's right. Sometimes there's just no getting away from it. That's pretty much the way I feel right now. Beaten. Sore. Tired. And that's by way of saying that I feel much much better than I did a day ago. These last couple of days have been really hard. When I think about it, maybe it was a mistake to have so many procedures over the course of just two days. But then I think, why have one, recover, and then have another one and have to recover all over again? Why not just get it over with?

The drugs helped a lot with the pain, but they have their own drawbacks. I stopped taking them for most of Saturday and felt terrible, more from the withdrawal than from the pain. I haven't been sleeping all that well because I've been sleeping in a chair most of the last few nights. When you've been stabbed in the back, side, and chest, you really have no other choice. And while having an afternoon nap on a couch or favorite chair is one of life's pleasures, this was different.

Then Sunday I woke up to a new world. The pain was manageable. I didn't feel so sick. It's funny, when you're in the midst of something like that, as you all know, you think it's going to go on forever. With chemo, or recovery from surgery or a serious injury, you become convinced in the haze of pain and fatigue that you'll never, ever feel better again. So when you do, even when you get just a glimmer of feeling better again, it's like a miracle. I still don't feel great, but I feel a whole lot better than I did.

My body is pretty swollen, I have some new scars to add to the old ones, and some more procedures to cross off the list. I wonder what I get when I've had them all? But we made some progress. I want to thank you all for your messages and thoughts of support, especially the woman who stopped me at Hopkins while she was waiting for her own treatment. I hope your day went well, too.

I'm going to be moving a little slower for a while. I didn't record this as a podcast for today, I just wasn't up to it. But I will be for the next one.

My friend was right that sometimes you have to take a beating. But every time, you have to get back up.

7:19 AM ET | 08-13-2007 | permalink

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Waiting for the Pain to Pass

There are two ways to look at what I've gone through the last two days. We took care of four tumors. That's good. I had been suffering some serious but mysterious pain over the last few weeks, bad enough that I couldn't sleep much. Well, these two days of procedures have taken care of that pain, so we now know that it was caused by the cancer. That's good. I bought myself some time, all the remaining tumors are very small. So that's the glass half-full part.

The half-empty part? The pain and discomfort at times has been so bad that I can barely think straight. I have pain killers, something I usually avoid, but right now I'm going to follow the instructions to the letter. I know that in a couple of days I'll be better. But getting there won't be easy. I know that so many of you have gone through things like this or worse. I wish healing to us all.

7:08 AM ET | 08-10-2007 | permalink

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Getting Stabbed (and Glued) in the Back

I've tried sitting straight up. Lying down. Lying on my side. And everything in between. I'm just trying to find a position that will somehow lessen the pain. The vertebroplasty, called the "glue thing" from now on, was, well, interesting. I was awake through all of it. I was getting drugs, so I'm sure that I wasn't as wide awake and lucid as I thought. But I was definitely awake. And it's always a little scary to be awake on an operating table.

My doctor, who is one of the pioneers of this procedure, was very good about telling me what he was doing. He had to hammer the needle into the bone, which didn't really hurt, but was a little jarring. When he did inject the cement -- well, that hurt. The pain cut through the drugs.

It's very funny, they left some of the cement out in the operating room. When it cooled and hardened, they figured the cement in my body had done the same. Then I had to lie on my back for more than an hour. Under the circumstances, that was agony. Even the pain pills didn't help much.

One of the things they warn you about is the possibility that they may hit a nerve doing all this. And I think they did, the muscles across my stomach have been killing me. That should wear off in a few days. In the meantime, well, it hurts.

But the doctor did two vertebrae, and was happy with the way it all went. One glimmer of good news: The vertebra we had worried about the most, the one with the biggest tumor, was very strong. He had to work to get the needle into it. He thought that meant that most of the tumor was already dead, killed by the radiation I had a while back. That would be very good news, indeed.

So, the glue thing is done. Today I'll have another RFA on my lung and a cryoablation on my rib. How my body is going to react to all this in the space of two days is unclear. My bet is it won't be happy. And it will communicate that unhappiness. It's all progress, I guess, so I tell myself that it's all worth it. And I know that it is. But having been stabbed in the back yesterday, and being stabbed in the front today, this is another one of those times when you are reminded that cancer sucks.

7:05 AM ET | 08- 9-2007 | permalink

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Where Hope Comes In

Right about now, if you're reading this in the morning, I should be getting shot in the back with a glue gun. That's probably not entirely accurate, at least the glue gun part of it, but it was fun to write. The recovery time is supposed to be three hours or so. Apparently part of that time is to let the glue set. Seriously.

Will I feel any different afterwards? I don't know. I doubt it. Other people who have had back pain, and then had this procedure, say the pain relief is almost instantaneous. But since I haven't been having back pain, will I feel anything at all? My guess is no, but we'll see.

It's funny, when I think back to when all this started, I'd heard of chemo, of course, and radiation. But things like the Gamma Knife, Radio Frequency Ablation? Those all sounded like something off of Star Trek. The cheesy original version. It's easy to hear Scotty yelling, "Captain, we need to reroute the Radio Frequency Ablation!" All these other procedures have been a total surprise.

That's where hope comes in, too. Last January, when things weren't looking so good for me, when we started to talk about my having to get everything in order, my attitude was, let's try whatever is out there. Who knows what might work? And that's what led us to RFA, vertebralplasty, and cryoablation, and may lead to others that I haven't heard of yet. As I write this, my computer spellchecker is going crazy over some of those terms. So clearly they're new. Of course spellchecker doesn't recognize "blog" either.

I'll let you all know what it was like in tomorrow's blog. In the meantime, bring on the glue.

7:05 AM ET | 08- 8-2007 | permalink

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Adding Insult to Injury

I'm not a morning person. I admit it. Coffee helps a little, but it's still not enough to make me much fun to be around. The hospital called yesterday to say they were moving up my appointment for the vertebroplasty tomorrow from 10 a.m. to a 7a.m. arrival. My first thought was that they're taking a huge risk. Not with the procedure, the doctor has done hundreds of them, but with my mood. I guess I'll be drugged up pretty quickly, so that may help. The worst thing is, I can't have any coffee at all before the procedure. Adding insult to injury.

I've been trying to come up with the right term for the procedure. "Vertebroplasty" is just not that easy to use in a conversation, and "that glue thing" doesn't sound right either. I sort of like "cut and paste," because that's actually pretty accurate. My doctors said that when they were looking at my spine, they noticed that one vertebra, not affected by the cancer, was showing signs of fracture. That's from my age, height and weight, and just wear and tear. So they said they'll fix that one too, while they're in there. And who can turn down that kind of deal?

I really don't know what to expect tomorrow. I thought I'd had just about every possible procedure, but this will be a new one. You're partially awake for it, but the drugs are so good that you don't much care. The first time I had a Radio Frequency Ablation, I was lying on the table and I asked my doctor when he was going to start. He told me they were just finishing up. All this was taking place a couple of inches from my face. Like I said, the drugs are pretty good.

Then Thursday I have another RFA to clean up one spot in my lung, and a Cryoablation to freeze one rib to kill some cancer cells there. So the next two days are going to be pretty tough, I think. It's a lot to put your body through.

I think I would feel much better about all this if it was all I had to worry about. But when we're done, then we need to start figuring out what to do about the other tumors on my spine. I worry about them. I know they're growing, or at least I suspect they are, and I want to see if we can't deal with them sooner rather than later.

But for the next few days, I'll be glued, burned, and frozen. I'll have to make it up to my body somehow.

7:03 AM ET | 08- 7-2007 | permalink

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Now in the Role of Sisyphus: Cancer

The following essay is from the NPR My Cancer weekly podcast:

I'm tired. Physically tired. Mentally tired. Having cancer just wears you out. It wears down your soul. I've lived with it for six years, especially for the last year and a half. I've written about 300 pieces about cancer for NPR. I don't know how many words that would be, but it's a lot. Thousands of miles driving to and from the hospital. Visit after visit, procedure after procedure.

Having cancer is a little like the myth of Sisyphus. Remember Sisyphus? The guy who had to roll the boulder up a hill each day, only to have it roll back down again. So he had to do it all over again the next day. I think Sisyphus at least got to rest at night. When you have cancer, you have to keep rolling that boulder. If you stop, it will roll back down over you.

I did a little reading and it turns out that Sisyphus was a bad guy. He deserved that whole thing with the boulder. He probably should have gotten worse. So I've been wondering -- can I tell someone that I learned my lesson? That I'm sorry for whatever it is I did to cause the cancer?

Of course I can't. Cancer is not punishment. It's an indiscriminate killer. It doesn't care who you are or what you've done. It doesn't care if you're a good person, or bad. Or like most of us, a little of both. It doesn't care if your life is a shambles, or if you've totally gotten your act together. It comes when it wants to. Maybe that's why it seems so cruel.

I would imagine that while Sisyphus was rolling that boulder up the hill each day, he thought about all the bad things he'd done. At least you'd hope he did. I think that most cancer patients think about the bad things the cancer has done.

In fact, maybe I've got this all backwards. Maybe it's the cancer that's Sisyphus. I know, I'm torturing this myth to death. But maybe the cancer is trying to kill me, then every day I get up and it has to start all over again. I hadn't thought of that before. I sort of like the idea.

I hope the cancer is getting tired and frustrated. I hope it's thinking about all the bad things it's done. Cause I'm going to make it work to get me.

7:03 AM ET | 08- 6-2007 | permalink

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The Elephant in the Room

A good friend of mine came to visit yesterday. We were roommates in college and traveled around Europe together when we both dropped out of school. Back then, you really could live well on five dollars a day. We've stayed in touch over the years, but not as much as we should have. He and his family live in Philadelphia, just a couple of hours up the road. But over the years we drifted apart, as can happen with the closest of friends.

We were talking about my being sick, and I asked him if he would have come to visit if I didn't have cancer. And he gave me an honest answer: No. Before I got sick, we saw each other maybe once or twice a year, occasional emails or calls, but that was really about it. Now there's a little more urgency. And he said it made the visit more poignant.

We have the kind of friendship where you can go months without talking, and then pick up immediately where you left off the last time. But this visit was a little different. I knew it, he knew it. In the back of his mind, as with so many of my friends, there were some tough questions. He didn't know how healthy I was going to be. I always surprise people by looking pretty much the way I always have. And there's always that fear that this visit, or the next one, might be the last.

I felt the same way. Just as my friends worry about me, I value them. And I wonder, too, sometimes, whether there will be another time to be together after this one or the next one. When we get together, that elephant is in the room, making itself feel right at home.

When I stop and think about it, it's a shame that the cancer made us better friends, or at least made us work a little harder to stay friends. We should have been doing that anyway. But there's always a reason not to -- work, other plans, just the normal things that can fill up all your time.

And that can happen even when you have cancer. There are the demands of normal life, along with all the appointments and procedures, and the days when you just don't feel up to doing anything. But I realize now -- actually, I've known it all along -- that that's no excuse. I need to work at it more. I need to be a better friend.

7:03 AM ET | 08- 3-2007 | permalink

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A Match Still Up for Grabs

This was another one of those days when I really couldn't think of anything to write. So I went back to the blog from August 1 of last year. I was hoping for inspiration or something, I was also just curious about what I was writing about a year ago. Well, I picked a hell of a day.

Last August 1 was the day I found out that one chemo drug I'd been taking had failed. The tumors in my lungs had grown. I can read the anger and disappointment I felt that day. The tumors were bigger than when I had begun chemo. That was also the day I found out that the cancer had spread to my spine. It's pretty obvious that I wasn't very happy about that news.

So where am I a year later? Well, the tumors in my lungs, the ones that seemed the primary threat back then, are pretty much gone. We'll finish off the last one next week with one more Radio Frequency Ablation procedure. It's the spinal tumors that have become the biggest problem. A year ago I had two. I had radiation on them, but one came back. I find myself with a total of five right now. We're going to attack one of them with the glue gun treatment next week, but that leaves the others. For the most part, they're still small. But we're going to have to figure out what to do about them pretty soon.

One of the things I wrote about a year ago was my shock at how fast the cancer progressed when I took a short break from the chemo. Well, I've been off chemo for months now, and it's been a while since my last scans, so I'm a little curious, a little apprehensive, about what's going on inside me. I guess I'll find out soon enough.

So what's happened in this past year? Well, I'm still here. That wasn't always a sure thing. But when I read my words of a year ago, I realize that the power of the cancer, the power to cause fear and disrupt my life again -- that hasn't changed. Since I wrote that piece, I've won a few rounds, the cancer has won a couple. The match is still up for grabs. And I guess that's a victory of sorts.

7:13 AM ET | 08- 2-2007 | permalink

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Racing Against Time

Time. That's really what cancer is all about. It's painful, it's sad, it's scary. But I think what we really all fear is that it's stealing our lives, our futures. It's stealing time. Before we were diagnosed, if you asked, we all probably would have said that we had all the time in the world. Time to accomplish things, time to experience things, time to waste on a lazy afternoon. But the diagnosis changes all of that, of course. Then time becomes precious, something to be hoarded, something to be valued.

Time can also become a burden. Sometimes we hear the ticking of the clock and feel pressure to make every moment count. There's no time to waste. Every moment must be used. That's impossible, of course. And I'm not sure it's good for us, either. It's okay to do nothing. To spend an afternoon just listening to music, or reading a book, or just staring out the window. That's all time well spent. Certainly while you're on chemo, there are days where you really can't do anything but sit on the couch and let time pass by. Worrying about it, regretting those lost minutes, doesn't help.

As I wrote yesterday, I've been thinking about time as I reach the 20 month point. And I remembered something a woman wrote in about when this blog first started. She and her husband figured out the number of weeks they would have left together if they both lived to be 90. They put that many marbles in a bowl, and once a week, they take out a marble and put it in the other bowl. They use that as a time to talk about the week just ended, to reflect on what they've done. I thought that was a pretty good idea.

Now, I appreciate all of your offers to send me more beads, but I really don't need them. But I have a suggestion. Take all those beads and put them in a bowl. And then, once a week, or once a day -- well, you can take it from there.

7:00 AM ET | 08- 1-2007 | permalink

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