Colorectal Surgeon Song

The Atheist's Christmas

I only remember a few holidays: Christmas, Independence Day, Cinco de Mayo, and New Year's Day.  It's because they fall on the same date each year.  Holidays that are pegged to a lunar calendar, a non-Gregorian calendar, or on the xth day of whatever month just sneak up on me.  So a belated Happy Divali, Happy Chanukah, Happy Kwanzaa, and Eid Mubarak to you - or a be-earlied one.  As I wrote, I don't know when those arrive.

This year's winter break may be a little different because I'm getting ready for surgery.  And by "getting ready," I mean that I have some pre-op appointments, so I can't just sit on the couch and watch football (either kind).  The folks at the hospital want me to have some pretty standard tests done including blood typing.  I could have told them over the phone that I'm AB+,but they still need to stick me as part of their standard operating procedures.  AB+, as you recall from middle school biology, is the 2nd most rare blood type (AB- is the rarest), but folks like me can receive transfusions from all blood types.  Of course, I hope I don't need a transfusion, but this is a good opportunity to remind people that they can help be heroes by donating blood and registering to be bone marrow or organ donors (see links on right).

Getting back to the title.  Despite my lack of belief, we do "celebrate" Christmas - but in the commercial sense. Hey, we're doing it for the economy. It gets a bit busier than usual this time of year, though.  In addition to the Xmas, both our sons' birthdays are in December. So we're doing more than our share to keep Toys-R-Us and Target in business.  We don't start Xmas shopping until December 23, because we're just finishing birthday shopping.  You ask, "Why not do both at once?"  Well, procrastination just doesn't work that way.

The day after Christmas also has a very special meaning in our house.  It's the day when all the presents have been open for 24 hours and the two most traditional phrases are "I'm bored" and "Daddy, fix this."

The entire I-270 family wishes you a joyful holiday, however you celebrate it.

The Waiting Is The Hardest Part

I really don't have much more to say about my status between now and January.  I'm pretty much hanging around, waiting for surgery - and you know what Tom Petty says about waiting (if you don't read the title).

Did you know that I went to the same high school as Tom Petty and a bunch of the original Heartbreakers?  Not at the same time, of course, just the same place.  They didn't name the auditorium or gym after him.  But they could have called it the "Tom Petty Junior Parking Lot" because that where the potheads hung out and maybe where he got the inspiration for "Last Dance With Many Jane."
 
Anyway, I wasn't listening to Tom Petty on the radio,but I did hear this story on NPR about a cancer survivor who's humorously dealing with her multiple cancers by creating T-shirts embroidered with various aphorisms.  Some of my favorites:

• Of course they're fake.  The real ones tried to kill me.
• I lost my colon.  But I'm still full of crap.
• Did I take my meds?  When is my appointment?  Do I have meds?

The third one refers to Chemobrain, the impairment of cognitive function that may occur during chemotherapy and last for years afterward.  This phenomenon has been known for years and recent neurological studies of breast cancer patients bear this out.  We cancer patients tend to forget things, not follow instructions, and have difficulty with some tasks that were easy for us. 

I asked the nurses whether I could use chemobrain to explain my forgetfulness before chemotherapy.  They said...  oh, I forget what they said exactly.  Now where did I put all my oncologist's bills?

Places for your stash?

This weekend, Mrs. 270 and I took the kids to Seven Springs for snow tubing and skiing, well, ski lessons because none of us know how to ski.  It was opening weekend, and the place was pretty empty on Friday, so we had the snow tubing lanes almost all to ourselves.  Overall, the boys had fun.  I 'm not sure what they enjoyed more, the snow tubing or the endless supply of cereal and fruit at the breakfast buffet.  One could get the impression that we don't feed them at home.

We had a couple of crashes on the snow tubing slope and a few falls in the beginners' ski area.  Mrs. 270 suffered the worst damage with a dislocated thumb.  Thanks to the tumor, I had a few leftover Percocet in my bag, so she didn't have to wait for the emergency room doc to write a prescription.  One fortunate thing about being at a rural Pennsylvania ski resort on opening weekend is that the emergency room in nearby Somerset wasn't crowded.  Heck, this ER was, at best, one-twentieth the size of the Shady Grove ER but there were only one or two patients ahead of her.  She left the ER with her entire forearm in a splint.  It was quite upsetting for her.  Not the pain or the awkwardness of wearing the splint, but the fact that the color of the Ace bandage didn't go with any of her outfits.

Back to the snow part. When we arrived at Seven Springs, Mrs. 270 and I realized that our outerwear would not keep us sufficiently warm and dry (the kids were properly attired).  So we headed to the ski shop.  This isn't usually a good idea because only the desperate buy stuff at the resort shops.  I tried on some skier pants, but ended up buying a pair of snowboarder pants (on sale of course).  In addition to being baggier than the skier pants, the snowboarder pants have lots of pockets, while the skier pants have none.  Even snowboarder gloves have zippered compartments.  "What," I wondered "do snowboarders carry with them on the slopes that skiers don't?"  Then I remembered Ross Rebagliati, the Canadian snowboarder who tested positive for marijuana at the 1998 Winter Olympics.  He won his event and gave a new meaning to the term "Pot of Gold."

Breaking News - Updates Later!

My friend complains that I don't update this blog often enough.  Umm, did I write "complain?"  That's no way to talk about someone who just bought me lunch to fatten me up before surgery.  I meant that she made the polite suggestion that I provide more timely information to those extremely concerned about my health.

I got nothin'.

It's pretty much eating and exercising until surgery in January. After that I'll have lots of stuff to write about.

Lunch was really good though.  If you go to P.F. Chang's, try their Banana Spring Rolls - slices of banana wrapped in pastry and fried, then served with coconut-pineapple ice cream.

Grazie amica!

Training for surgery

I never played soccer at at high level.  I was on my high school's junior varsity team.  An ugly foot injury prevented me from spending my senior season on the varsity bench.  Of course, I didn't play at all in college or in grad school because (a) neither school had a soccer team and (b) what did you not understand about my lack of talent?  Only when I moved to MoCo, did I start playing again in a weekly pick-up match, with many foreign post-docs (and a gangly domestic one).  So I quickly developed a three-fold strategy:

1. pass to the Frenchman,
2. pass to the Spaniard (sorry, not you. The other Spaniard),
3) pass to the Brazilian

Early in my pick-up soccer career, I picked up a bad ankle injury.  Later on, I picked up a bad knee.  So nowadays, if I run for more than 1 minute, I have to wrap my knee and ankle and take ibuprofen.

But the doctors want me to get in better shape before surgery.  The surgeon says I should focus on cardio exercises and the oncologist says I should do some weight training to build muscle mass.  It's a good thing I didn't ask the gasteroenterologist and the radiation oncologist too, or I'd have to add pilates and jazzercise to the regimen. So now I'm resuming my pre-cancer exercise routine - OK, truthfully, I slacked off months before the diagnosis. 

Instead of actually running, I use an elliptical. It's not one of the fancy ones with many electronic controls and readouts.  It's a pretty simple one that displays the wrong speed and the wrong distance. That doesn't really matter, my goal is to get up to 20 minutes in the "green zone" of the display.  The yellow zone means I'm moving too slowly and the red zone means my ego thinks I'm a lot younger than my body is.  The lack of any lateral motion saves my ankle.  In addition to the joint-sparing, no impact workout, I can use the elliptical in any weather and, when I get tired, I don't have to worry about how far from home I am.  I also have a knock-off of the Total Gym - you know, that resistance machine advertised by Chuck Norris and Christie Brinkley.  I bought the knock-off because I'm cheap and because it's reasonable for a limited amount of upper and lower body exercise, but I'm not going to get buff with this.

So, If I keep to a rigorous schedule, I'll be in decent shape for surgery.  After surgery, of course, I'll lose weight and stamina again and have to start all over again.  If all goes well though, I will be in game form when the World Cup starts in June.  With the current injuries to our crucial players, the US will need a good bench warmer.  I hope the gangly guy gets in shape too.  We may need him on set pieces.

Thank you. Gracias. Grazie. Merci. תודה

Thanks for the moral support, the practical support, the comments, the e-mails, the phone calls.

Thanks for letting me talk about this in a way that's (I hope) interesting and entertaining.

Happy Thanksgiving everyone.

Cuts Like a Knife (or Light Saber)

I had another meeting with the surgeon to consider surgery dates.  This time, the appointment was at his Chevy Chase office, not in Washington. By the way, Chevy Chase is not named after the comedian.  It gets its name from a 14th century battle between the English and the Scots over deer-hunting.  Usually they fight over soccer and rugby.

Even though I finished the therapy at the end of September, the tumor continues to shrink.  A small part of it seems to be detaching from the lumen of the colon, which probably means that the cells in that area are dying.  A little longer wait before surgery may allow the tumor to shrink more and save some of the surrounding tissue.  On the other hand, too long would increase the chance that those tumor cells that were "missed" by or resisted by the therapy will continue to grow.  The medical literature isn't really clear on the best time to have the surgery once chemo/radiation is over.  Some of the reports from the 1990's claim that it's 6-8 weeks.  Reports from this century claim that waiting up to 12 weeks is OK.

The standard practice in Europe, however, is to wait at least 12 weeks.  Maybe that's how long it takes to get into the hospital in their communist health care systems.  Over here (where capitalism roolz!), the highest bidder gets the premium time slot. So it helps for them to think you're associated with Chevy Chase (median household income of $160K).

Anyway, the plan is to have the surgery in early January.  The surgeon thinks that's not waiting too long.  The advantage is that I'll be able to spend the holidays on my feet and without Percocet.  Also, when the boys are back in school in January, I'll be able to recover at home without having to play Count Dooku in light saber duel against Obi-Wan Kenobi and Anakin Skywalker.

Tie A [insert color here] Ribbon

Have you noticed that every disease and condition has an awareness ribbon. I think it started with HIV/AIDS activists wearing a red one. Then Susie G came up with the pink ribbon for breast cancer. Those are the most recognizable and you see them on everywhere. Inspired by the quick recognition of those two ribbons and the "Support Our Troops" yellow ribbon, every advocacy group had to have a ribbon, from the obscure (congenital diaphragmatic hernia - a cloud patterned ribbon) to the paradoxical (targeted individuals - indigo). Ummm... if you don't want to be targeted, don't wear a freakin' indigo ribbon. When all the ribbon colors were used up, the cause mongers moved on to bracelets. Full disclosure, I wear a yellow LiveStrong bracelet... I mean wristband, men wear wristbands not bracelets... You can get these in all colors and for all causes too, like a green one to support democracy in Iran or you can simply order a set with your own cause stamped into the silicone.

As noted by Timothy Noah in his Slate article, the proliferation of ribbon and wristband campaigns has diluted their impact to the point where they have become mere fashion statements. Some of the ribbon colors even have several meanings. Orange, for example, stands for Leukemia And Lymphoma awareness, Energy awareness in Nigeria, ADHD awareness, and six more causes. Oddly enough, it does not stand for "Protestants Marching Through A Catholic Neighborhood In Belfast" awareness. The oddest one of the orange ribbon causes is Self-Injury awareness. What do these people do, carefully pin on a ribbon and look in the mirror?

The LiveStrong wristbands encompass awareness of all forms of cancer. But the raison d'etre of an advocacy group is to stand out from the pack in order to attract attention and money. So each form of cancer has to have it's own color. Colon cancer awareness is blue. I'm quite puzzled by that, as it should be brown.

Anyway this got me thinking about other colors and patterns and what they could mean.

• Checkered: NASCAR disease awareness. Help stop hundreds of thousands of southerners from watching cars turn left then crash.
• Peach: Beat Florida awareness. Worn by University of Georgia fans until they win another game. Buy a few of these, Dawgs. You'll wear them out waiting.
  
• Plaid: Catholic Girls Start Much Too Late awareness. Nuff said.
• Paisley: Formerly The Artist Formerly Known As Prince And Now Again Known As Prince awareness. Please help this man make up his mind.
  
• Polka Dot: Chicken Dance awareness. Stop the gratuitous use of this song at every wedding, office party, and neighborhood block party.
• Suede: Let the National Zoo Lions Eat The Stupid Deer That Jump Into Their Enclosure awareness.
• Leather: Real Meat Is Tastier Than Tofu awareness. Soy burgers? Puh-leeze!
• Leather with studs: Punk Rock awareness. Like they need more attention.
  
• Black and Red: DC United Needs Another MLS Cup awareness, aka the Fifth Star campaign.
• Anthracite: Stop US Soccer from Wearing Ugly-Ass Colors awareness. Whatever happened to red, white, or blue?

Did I forget any?.

Copa Mundial-Coup du Mond-World Cup

Sometimes I forget that this is a soccer blog too. Because readers of this blog come from all over the world, here's my take on how our countries did in qualifying for the World Cup 2010 in South Africa.

• El Salvador - Lo siento amiga.
  
• England - Qualified easily, but will still lose to Germany in the tournament.
  
• Israel - Had resounding win over Luxtensteinbourg or something, but failed to earn even a playoff spot, falling behind Greece and Latvia. Seriously, Latvia?
  
• Ireland - Earned a playoff position. No Roy Keane means no distracting drama. In a playoff with France. How do you say "au revoir" in Gaelic?
  
• Italy - The Azurri are headed to South Africa and will need to atone for their Confederations Cup disaster.By the way, I'm still looking for the blue on Italy's flag. If you find it, let me know.
• Scotland - Too bad you didn't qualify. It always fun to see the Tartan Army at the World Cup finals. Come to think of it, they have a habit of cheering for another small country so that they can attend the World Cup, drink, and sing obscene songs about the English.
• Spain - Also qualified easily, upholding their tradition of waiting until the knock-out rounds of the tournament to disappoint todo el pais.
• Trinidad and Tobago - Have another Carib. Rough times after a tremendous effort in 2006, but thank you for keeping Mexico in second place..
  
• United States - Yes, we qualified and finished in first place, but will can we really be happy with that? Honestly? Raise your hand if you dreading the draw.
  

I've got to admit it's getting better

As mi amigo madrileño told me, "The problem with giving people updates is that they expect to get them all the time." So, as you've noticed, I've been inattentive to my updating. And with the excusable position that not much has happened.

My chemo/radiation ended on October 2. For about two weeks after that, I was at a very low energy level and needed to get i.v. fluids several times for dehydration. As I wrote in a previous blog entry, I just watched military discovery and military history channels.

Aside to local soccer fans: surprisingly, Vercingetorix was not featured on any episode of "Barbarians." However, I did see quite a few on the various invasions of Great Britain by the Saxons, Vikings, and... ummm... West Indians, thereby proving that the History Channel is just as anglophilic as Fox Soccer Channel.

There are a few good things to report. My appetite is returning. Which is good as I had dropped 10 lbs. on the adenocarcinoma diet plan. My energy is slowly returning and my blood pressure seems to be climbing back to normal after weeks of being in double digits (for both systolic and diastolic).

Finally, I had a follow-up appointment with the surgeon. He thinks the tumor shrank by about 50%. That's consistent with the absence of pain in the area since the fifth week of therapy. The radiation oncologist thinks it may have shrunk more than that, as it's hard to differentiate the tumor from dead tissue with that kind of exam. But the only way to tell is to inspect it upon surgery.

Here [He] Comes Again

OK. This is the first blog entry in about 3 weeks. If you're expecting a lot of news, then you'll be disappointed. In the last three weeks, the effects of chemo and radiation have really caught up to me. In addition to radiation burns, I've had low blood pressure and needed to get i.v fluids because I haven't been my usual, perky self. Also missing are my appetite and ambition to do much other than watch WWII documentaries on the Military Channel and Military History (I can tell you a lot about the P51 Mustang and the B17 Flying Fortress).

I did finish the chemo/radiation therapy last week. That was a huge relief because the end of radiation means that the tissue damage won't get any worse. Now I'm healing for a few weeks until my tissues are again damaged by surgery. Then more healing.

Then more chemo.

Then more healing.


When I'm in remission and have recaptured my energy, I want to start a rec league soccer team of radiation therapy survivors called "Nuclear Boots." And yes, the goalkeeper will wear drip-dry gloves.

Just Throwing This Out (Up?) There

I'll get back to the naming poll in a short while. In the meantime, week 4 is over. It went pretty well except for the radiation burns (dermatitis) that are really starting to chafe. The other side effects are increasing too. A pretty common one is dehydration - I wake up with cotton-mouth and my blood pressure has been low. The nurses asked if i want i.v. fluids to re-hydrate, but I've passed so far, opting to drink more, or "push the fluids." The problem with that is that the fluids push back.

Another side effect is nausea. I've been taking pre-emptive anti-emetics for this and so far, so good. They've prescribed three lines of anti-emetics.

"Take Kytril. If you still have nausea and vomiting, use Prochlorper. And if that doesn't work, use Lorazepam. If that doesn't work, we'll give you a new prescription.

The fourth line anti-emetic, Emend, is the one that actually works, but they don't prescribe that initially because it's too expensive (according to my infectious disease physician friend). Unfortunately, they don't prescribe Marinol. But that would be the best thing for cancer patients who are losing weight because one of the side effects is the munchies.

One of my friends, a mother of three, said about the side effects, "It sounds a lot like pregnancy." So, I have diarrhea, nausea, and exhaustion in common with pregnant women, and the radiation burns maybe feels like having an episiotomy. But the main difference is that I don't get a shower.

"I have a tumor."
"Oh wow. Where are you registered?"
"Tumors R Us, Bye Bye Cancer, and Target."

Name That Tumor

Tumor, tumor bo burley
Banana fana fo firley
Fe fi fo firley
Tumor!

So, obviously, we need a naming contest. Submit your entries in the comments section. So far, we have:

• Mr. Tumor - Joe Doc, a conservative idea, from the right wing.
  
• Amani (Tumor) - BaRRD, impressive that she knew him as Toomor is one of the few NFL players not in trouble with the law.
  

Please do not use the tumor's location in your entry, because some will think that you're referring to me. The winner will be selected in true soccer fashion by a process that's too complicated to explain.

The Tumor Speaks

I-270 stupidly forgot to log out of the blog, so I'm taking over to set a few things straight.

Look. They've been trying to kill me with poison and radiation for three weeks now. And all of you are cheering for them. What did I ever do to any of you? Nothing. Not a damned thing. You just don't like me. I know why you don't. I don't fit your profile of someone you want to associate with. You don't respect me because I wasn't born into an elite, big-name family like Hodgkins or Wilms. And I didn't go to the fancy cancer schools like Sloan-Kettering or Dana Farber and become a brain tumor or something.

No. I come from the streets - worse than the streets, the sewer. I'm just trying to get out of here. You think it's nice where I am? Hell no. All day I have to sit here while all sorts of... stuff slides over me. And the smell? I can't begin to describe it. Not to mention that sometimes it gets drafty in here - if you know what I mean. Hey! What the.. jeow8yu4jsdgfgdfdsf..................




OK. I got the computer back. Sorry for the rude interruption. Week three is in the books. A few side effects. The worst are the radiation burns on, well, down there. The hints of nausea are, so far, controllable with the anti-emetics. I have three of those, with on option for a fourth, but that's another blog in the making. The bottom line is that I'm still healthy enough to write stupid stuff on the internet.

A Tale of Two Cities (And Their Clubs)

Week two is over. It was pretty much like week one. The low point came Wednesday night watching DC United play miserably in losing the US Open Cup. I didn't make it to the final like I did last year, so DC's record in finals that I attend is still 2-0.

A group of us went to the 1997 MLS Cup final, including my friend from Madrid (no, he didn't fly over for the game, he lived here at the time). Nevertheless, he doesn't completely follow the DC United references in this blog. So I've made a list of similarities between DC United and Real Madrid to make this blog more relevant to him.:

Each team:

• Plays in it's nation's capital (let's start with an easy one)
  
• Has players with Spanish names (another easy one).
• Has fans with Spanish names (Oh hush. You knew it was coming).
• Paid too much for its star Brazilian.
  
• Has an iconic, aging player who plays well just when you think he should retire.
• Has fans who demand that the coach be fired with each loss or draw.
• Has fans who demand that the owner and general manager be replaced after each trophy-less season.
• Has fans who hate David Beckham.
  
• Played a home game at FedEx Field on August 9, 2009.
  
• Boasts of winning the domestic league and the region's Champions League/Cup, although neither has accomplished those feats recently.

Feel free to add more in the comments or just repeatedly type "dos a cero."

Cleanliness Is Next To ... ummm... Never Mind

Week Two:

Went to the chemo bar for my 5-FU refill and had some blood work done. The individual counts are mainly OK. My platelets are good, so I can still clot after all those needle sticks. My white blood cell count is down, not very far down though, and this is expected. However, this means I'm on the way to being immunocompromised, i.e. less able to fight off infection.

We all live and work in places filled with germs. Both our kids are in elementary school, so they'll be bringing home an assortment of corona-, rhino-, adeno- and whatever other viridae cause the common cold. At work (and I don't have to tell you this), any number of people - who should damn well know better - don't wash their hands after using the restroom and make it a point to touch each and every door handle and light switch in the building. There are several of these people on each floor, so they can cover this 10-story building with an economy of effort.

So what steps do you take? Well, a popular infection countermeasure (sounds like a spy story now) is to buy the gel-based hand-sanitizer and neurotically apply it to your hands after any contact with the rest for the world. So I tried to buy a couple of big bottles at Target.

Couldn't find any.

Not a single bottle.

Why not? Because panicked parents, fearing a swine flu pandemic that will give their precious children a fever (keeping them at home and forcing the parents to stay home too), have stripped the store shelves of hand-sanitizer. You can identify the children of these parents because, in a few days, the skin on their hands will be dry and peeling due from repeated use of the alcohol-containing gel. The domino effect will then be evident as these parents return to the stores to buy every bottle of skin moisturizer. So, heed my warning, go buy your Aveeno now.

The take-home lesson is this: Don't get cancer when parents are doing their back-to-school shopping.

Week One

FIrst, thanks to everyone who has called, e-mailed, or posted a comment. Mrs. 270 and I greatly appreciate the emotional support and the funny remarks. Keep them coming.

The first week of therapy is over. Well, the first calendar week.

I only had four radiation treatments instead of five. When I arrived at the treatment center on Thursday, the technologist was sending everyone home because the machine wasn't working. Apparently they forgot the change the batteries in the linear accelerator. You can't get 200 D batteries at the store, not even at CostCo. The total radiation dose is cumulative, so they will tack an extra day of treatment on the end. It's like a snow day. Or, as with Montgomery County schools, a prediction-of-snow day.

I did get my week's worth of chemotherapy. The 5-FU reservoir ran dry on my way to work on Friday morning (down I-270, of course). When the happens, a really piercing alarm sounds. Flashing back to the lab days, I worried that the column would run dry. The nurse had locked the keypad on the pump so I couldn't turn off the alarm. I had to take out the 2 AA batteries. Ever tried to do that while driving, drinking coffee, and updating a blog? I exited the highway and drove to the office, where the nurse disconnected the pump.

Anyway, it's nice (at least for the weekend) not to wear the pump and be wary of the line and the tape that secures it firmly to my chest hair. I had told the boys that I couldn't play rough with them because of the pump. So the first thing I did at home was to play rough them, much to the consternation of Mrs. 270. While I was spinning Son 2 right round (like a record baby), he kept confirming my health by asking "Daddy, you feel better?"

The Really Short Reading List

There was a rumor that I’d grown a tumor, but I killed it with humor.
Sherman Alexie

At a recent Dr.'s appointment, I read Sherman Alexie's short story War Dances in the August 10th, 2009 issue of the New Yorker.

I know what you're thinking, "You're lying. No medical waiting room would have a current copy of any magazine." Well (and I'm an expert on this, having been to many waiting rooms recently), offices are keeping their magazine subscriptions current. That's why health care costs have skyrocketed. Read the Obama plan carefully, it includes subscriptions to pricey (and pretentious, east-coast, intellectual) magazines like Architectural Digest. Under the Republican plan you'd get five-year old copies of Guns and Ammo.

Now, where was I before I interrupted myself? Oh yeah, this short story made me laugh out loud (LOL for you kids). I highly recommend it. It was so funny that I plan to buy his new collection of short stories when it comes out next month.

Hey, I have cancer. I'm not taking a chance on finishing a full length novel.

I Want a New Drug

I was going to title this one "Go Ask Alice," But I just know that two of you (you know who you are) will fixate on the lyric "One pill makes you larger." So I chose the Huey Lewis reference instead.

For those who are interested the details of my therapy, there are three phases to it.

1. Neoadjuvant therapy (chemotherapy plus radiation therapy) for 6 weeks.
   
2. Surgery to remove what's left of the tumor.
3. More chemotherapy for 6 months to kill any residual cancer cells.
   

This is what I'll be on in phase 1:

• Chemotherapy: 5-FU for five days per week given as a continuous infusion. No, this is not the same "F.U." that you yelled at Beckham and Donovan on Saturday, it stands for 5-fluorouracil, which inhibits RNA and DNA synthesis in all cells. Tumor cells divide faster than most other cells and need to make DNA and RNA in copious amounts. The 5-FU will be preferentially taken up by the bad guys and slow their growth. Some of the good guys will die, but they will be replaced. The pump I'm wearing delivers the 5-FU at 1 ml/hour. If you were to drink beer at this rate, you'd finish a 12 oz. bottle in 14 days and 19 hours.
  

• Radiation therapy consists of X-rays beamed directly at my backside. This is also given five days per week. Radiation induces DNA damage. The tumor cells try to repair the damage, but aren't very efficient at doing that (especially poorly differentiated tumor cells like my adenocarcinoma). The goal is to use enough radiation to induce irreparable damage. Cells in the surrounding area suffer collateral damage. However, they say that normal cells recover faster from the radiation damage. Nevertheless, it's the collateral damage that leads to many side effects.

I referred to side effects in an earlier post. Those haven't started yet and may not begin until I'm on therapy for about 2 weeks, but why let the facts get in the way of a good joke (or even a bad one).

Same Thing Day After Day

I know that the Soccernuts among you are wondering why I don't post something new each day, like Steve Goff does. Well, he's paid to write a soccer blog. No-one pays me to have cancer, it's strictly voluntary.

Anyway, I start chemo and radiation therapy today. It will be the same regimen Monday through Friday for several weeks, so I won't write about it each day. Imagine how repetitive that would be:

Monday: Had chemo and radiation. Threw up.
Tuesday: Had chemo and radiation. Threw up.
Wednesday: Had chemo and radiation. Didn't throw up. Had diarrhea instead.

Yeah. It's not the kind of stuff you want to read, nor that I want to write. For those interested in the technical details, I'll soon post the regimen that I'm undergoing. It's pretty standard for colorectal cancer.

Just remember (and this is aimed at you, soccer fans), the bad side effects are to be expected. Don't demand that I fire my oncologist just because I have a few bad days.

We Win (?) Trophies

OK Soccerphiles. You already know that DC United's new motto, in the smack-talk with Seattle, is "We Win Trophies." That gives me an excuse to post the my colleague's observations on youth sports.(besides, I'm coming up short on material, so I have to steal some). Anyway, aforementioned colleague was a HS hockey player. Here's what she has to say about trophies:

What I don’t understand is how come all these kids’ soccer teams get individual trophies for just being in a tournament? My one niece has more trophies at age 13 (and nicer ones) than her mother, father, two aunts and one uncle have combined. (And we played on undefeated varsity field hockey teams that won Sectionals.) [Nowadays] They build their self esteem, give them individual Blue Gatorade bottles, have multiple outfits….

We had the hand-me down uniforms the school had. You tried to pick one that fit.

We all drank water from a single ladle from a single metal container. (Yet no one ever got sick.) On good days, there might be orange slices at half-time for games against our bitter rivals.

Heaven help you if you got hurt and needed tape since supplies in the first aid kit were generally used to hold together cleats or to wrap around a stick.

We knew how to improvise back then. Like fanning out across the field with our sticks going through the grass to look for a teammate’s front tooth that got knocked out (it was found and healed nicely) .

Have the coach go into labor during a crucial game? Not to worry. She already has a stopwatch to time the contractions.

Son 1 starts U8 soccer and Son 2 starts Tee-ball soon. I guess I should go buy a trophy cabinet.

Port of Entry

My Medi-port was installed yesterday. It took about 35 minutes, but don't take my word for it because I was drugged and not wearing a watch. I write "installed," because it's really a high-tech piece of plumbing that allows easy intravenous access for administering chemotherapy (prescription chemotherapy, dude, not recreational).

Funny thing though. When they sewed me up, they didn't actually sew up the incision. They used medical grade superglue. No-one sews anymore, it's a lost art. Ever ask your dry cleaner to sew on a shirt button? They just give you a blank stare. Surgery is headed the same way. Nicely starched collar bone though.

Tattoo You

To make sure that they're nuking my ass in the same spot each time, the radiation therapist has to tattoo reference points on me. Yesssss, I'm getting a tramp stamp!

As a soccer fan, I'm not sure whom I should emulate:

David Beckham

or Natasha Kai
























Too bad Heather Mitts doesn't have any tattoos that are visible when she's in uniform (hey, I'm trying to keep it clean here) . Otherwise I'd post gratuitous photos of her too.

Oh what the hell, it's my damn blog.

My Dinner with Adenocarcinoma

Mrs. 270 wants to set up a meeting with an onco-nutritionist and has already bought several books with names like What You Should Eat When You Have Cancer, Feed a Cold Starve a Tumor (or is it Starve a Cold, Feed a Tumor?), and Healthful Foods for Dummies Like Your Husband.

You know, if there really is a diet that prevents cancer from forming or growing, then there would only be a need for one book about it. But everyone has to get in on the healthful cookbook scheme. I skimmed through some of these books. They all say the same thing: eat fish and vegetables.

I don't like fish. Really, I'd much rather have a land animal.

You know I'm an atheist, but bear with me on this one: If God wanted you to eat so much fish, he wouldn't have put them all under water. I mean, you can just walk up and kill a cow, but fish? You have to get in a boat, go out on the water (and we humans are not natural swimmers), and wait for hours until something jerks your line. Then you'd better hope it's a good fish and not a three-eyed mercury-laden mutant.

In fact, if you read your Bible carefully, you'll know God did not want people to eat a lot of fish. But then his rebellious son came along and worked a miracle to feed throngs of people with just a couple of fish and some loaves of bread - just to piss off his old man.

Placing Sports in Context.

Athletes and sports fans like to throw around the word "war" gratuitously and irresponsibly. The US-Mexico match may turn into a street fight, but it is not a war.

We have a close family friend (I'll call him Joe because that's his name) who is deployed in the Middle East, where we are at war. Joe has been my bro-in-law's friend and a friend to our family for over 20 years. What Joe is doing is serious and any attempts to draw a parallel between sports contests and actual war is wrong. We wish Joe and his 34th "Red Bull" Infantry Division a successful mission and a safe return. They are the only Red Bulls I'll ever root for.

Post-match update:

Well, that sucked. Giving up a goal in the last 10 minutes was awful. Say what you want about the altitude and the smog, but Donovan and Dempsey were both absent for much of the match. Save for Davies' goal, we gave the ball away each time we entered the final third.

Frequently Asked Questions

So here's where I anticipate your questions and try to answer them.

Q. How old are you?
A. Just turned 43 - days before the diagnosis. I really wanted something else for my birthday and this tumor didn't come with a gift receipt. Oh well.

Q. Isn't that too young to get colorectal cancer?
A. Thank you! That's what I've been telling the docs. But noooooo! Just because they went to medical school and did oncology residencies, they think they know more than I do.

Q. Any family history?
A. Lots of heart disease, but no rectal cancer.

Q. What’s the treatment?
A. Roughly it's 6 weeks of chemo and radiation, 3-4 weeks to recover from the radiation, surgery to remove the tumor, then more chemotherapy to make sure none of the cancerous cells escape.

Q. What's the stage?
A. Stage III (T3N1). It's invaded the tissues and has spread to the local lymph nodes.

Q. What's the survival rate?
A. It's hard to say exactly, because the available data are all in aggregate, not stratified by stage and age. The five-year survival rate (post-diagnosis) is 70%. In other words, colorectal cancer patients have a 7 in 10 chance of being alive five years after the diagnosis.

Q. Is that your survival rate?
A. I’m shooting for 100% (n=1). I'm younger than the vast majority of patients, in Stage III, and have a microsatellite instability (genetic anomaly) in the tumor that suggests a better than average response rate to therapy. Also, I'm confident that I'll be around for a while because I'm supposed to die of heart disease, not cancer.

Q. Did you look into any clinical trials?
A. Yeah, but I'm not eligible for the interventional ones in the local area. Many trials, especially the ones at NIH, are for Stage IV patients who have not responded conventional therapy. The oncologists think that this thing will respond to the standard treatment.

Q. Why did you call the blog "The Local Lanes"?
A. "I-270, Exit 1" is my alias on the soccer blogs. The Local Lanes seemed like a good variation on that theme. Besides, I couldn't have my mother tell her friends that her son's blog is called canceruptheass.com.

Finally, in response to a real question:
No, I will not send Twitter updates from surgery.

Freedom Overspill

Washington Freedom 3 - Sky Blue 1

Washington beat the orange-clad Sky Blue (?!) at the Maryland Soccerplex and earned a playoff spot in the WPS. The whole I-270 family attended. My favorite part of the game was the three goals. The boys' favorite parts were eating hot dogs and rolling down the hill behind the north goal. Mrs. 270's favorite part was sitting on the grass watching them roll.

Met another Soccer Insider regular, Joe Doc. He was surprisingly unarmed, which is rare in his neck of the Virginia woods (just pulling your leg dude). We had a beer and started yelling "Free Bird!" at the guy playing the bagpipes.

Why do the Sky Blue wear an orange uniform? Are they Dutch? Gator fans? From the Protestant part of New Jersey? These are the deep mysteries of soccer.

Match report

Testing, testing. 1-2-3

All tests are over (for now). Sure, I'll still have blood drawn a few million times per week, but the big tests, the scans and probes with the fancy equipment of the multisyllabic nomenclature (which are then distilled to acronyms), are over for now. Let's see, I've had a:

• Colonoscopy
• Computerized tomography (CT) Scan
• Positron emission tomography (PET) Scan, and
  
• Endoscopic Ultrasound (ESUS, I asked them not to tell me the sex of the tumor, I want it to be a surprise).

All of this tells the oncologists that my tumor is in Stage III. It has breached the intestinal wall and has invaded the local lymph nodes. This, and the location of the thing, fixes the regimen: pre-operative chemo/radiation therapy, surgery, then more chemo.

I had a pet scan. I named him "Spot." Ha ha ha.

Pray, don't do that.

Don't pray for me. I mean to say, I do appreciate your thinking of me, but please don't say you're praying for me. After all, what are you asking your god for?

Umm. God? Please let his cancer go into remission. You know, the cancer that you gave him in the first place? Yeah, make that go away.

Be honest. If you believe in an omniscient and omnipotent deity, you have to believe that your deity gave me cancer is the first place. And if he knows what he's doing, then why ask him to change things.

I would also appreciate not hearing:

• God works in mysterious ways. This is a b.s. way of saying that bad stuff happens and nobody knows why.
• God is testing you. No, not me. Maybe he's testing the oncologists.
• The Lord will provide. Well, He certainly provided the malignancy.
• Rectal cancer? Holy sh*t. Actually, this one makes me laugh, so go ahead and say it.
  

OK, so are we clear on that? No prayers, no cliches. It won't work. Why not? Because God is punishing me for being an atheist.

I'm ready for my close up now

Today, the colonoscopy revealed colorectal cancer. Here's the back story

A couple of weeks earlier, I thought that I had hemorrhoids. So (at the insistence of Mrs. 270) I tried to see my primary care physician, but he was not available, so I made an appointment with one of his partners. She gave me a digital rectal exam. Now this is important guys. When you are going to have a digital rectal, get a woman physician. Her finger is smaller than a man's.

So she said that she felt something unusual in the "upper aspect." I thought "Ha, ha. you said ass-pect." She referred me to a gastroenterologist, who was not a she. You know you're in trouble when the only box of latex gloves in the examining room is XXL.

After the discomfort of that exam, he scheduled me for a colonoscopy. "Well," I thought, "At least I'll be asleep for that."

If you've never had a colonoscopy, the day before is also difficult as you must stop eating and then take laxatives. You get to the to the studio and they have the nerve to ask "How are you?" I replied, "I'm starving and I have diarrhea." Nevertheless, the nurses were quite upbeat, with one of them urging me to scream when the other put in the i.v. needle as a critique of her technique. I responded with a mild "Eek," which had them in stitches

I didn't take the full course of laxatives and told the nurse that I was behind schedule. She didn't laugh when I said "behind," so I had to tell her it was OK to laugh at that. They wheeled me in to the portrait studio and the anesthesiologist started to put me under. "I'm ready for my close-up now, Mr. DeMille" (Yes, I actually said that).

The scope showed tumors. My GE-ologist sent them off for pathology, but the initial diagnosis was made.

DC United 3 - Colorado Rapids 1

Son 1 and I saw DC United beat the CRapids 3-1. Son 1 was wearing his #99 home replica (with his name, not Jaime's on the back) DC's Brian Namoff opened the scoring with an own goal. Namoff redeemed himself later with a wicked header off a corner kick and inside the near post. So DC scored four unanswered goals?

The match was part of a double-header, with the Freedom playing Red Star Chicago in the early match. We didn't make it to the early match. But, when we walked up to buy tickets, some people who were leaving after the first match gave us their tickets (section 119), so we just bought the cheapest seats available, but settled down in 119, not too far from the field. Nice digs.

Prior to kickoff we met some of the Soccer Insider regulars: BlackandRedRedDevil, OWNTF, VirginiaBlueBlood, and Mrs.VBB. Good folks with good taste in beer, and proof that not all of us on the internet are raving lunatics.

Son 2 has no interest in watching soccer, nevertheless, he likes his #14 away replica (with his name, not Ben's) so we bought him a DC United hat.

We drove back through the city so that Son 1 could catch a glimpse of the Capitol Building, the Washington Monument, and the White House at night.

Prologue (Updated)

So, why write a blog? Well, I have a lot of stuff on my mind. Now I can share it with you (but give it back when you're finished, I really can't afford to lose any more of my mind).

I've thought about having a forum for my opinions on soccer, Eurosnobs, and why I enjoy the game so much. But, there are many soccer blogs available that are written by persons with more knowledge of the game. So mine would just be a place for rants, and there are many rant blogs out there as well. So, in looking for a niche, I really couldn't find one. Until (as you'll read later) I was diagnosed with cancer. Soccer and cancer? There's my niche.

OK, to be honest, Marcia Williams had this niche first. I wish her and the Williams family the best and encourage everyone to consider registering as a bone marrow donor.

Some may think that I'm taking this lightly or sharing too much. To them, I say, get your own damn blog and write seriously and guardedly. I do have limits though, I won't post photos of the colonoscopy or the tattoos on my butt for targeting the radiation therapy - unless, of course, I can make money from it.

Maybe this is therapeutic, maybe I can use cancer as a reason to blather on about why those of you in the United States should all burn your foreign-team jerseys and buy American. Whatever the reason, I'm going to keep writing.

UPDATE: I backdated this entry to put things in perspective. I started this blog in mid-July, after the diagnosis was made.