Day 30, 2nd day of FOLFIRINOX

Woof. This one was a doozy.

Highlights:

1. I have experienced the peripheral neuropathy caused by one of the chemo drugs. Platinum-based ones are known for it. Essentially, cold things feel a bit painful, so I have to watch what I drink and eat or else it might feel like I'm gripping ice shards or swallowing them.
2. I've a bit more stomach upset than before, but have loads of drugs and other drugs to counteract those drugs' side effects.
3. One of the drugs is called 5FU, as in "I will fuck you up cancer, 5 times over because I'm better than you". In case you're wondering, here is an interactive pathway map that should take you about the same amount of time to understand as it would to fully acquire all achievements in Skyrim.
4. Wearing the pump all the time is weird. Having the IV in my chest port is even weirder. Only click on that if you are not afraid of looking at an IV needle hooked into my chest port.
5. I wore my shirt today on a walk today and it felt good.
6. I'm drinking insane amounts of water to keep my body flushed.
7. I'm still drinking all my crazy smoothies designed to boost platelet and white blood cell counts, rebuild good cytoplasmic structures, reduce/eliminate inflammatory substances, and taste a bit like what I would think cud might taste after it's been regurgitated up from the third stomach chamber. Ok, I kid. It's more like the first chamber.
8. Me and my boys watched the end of Tron: Legacy, and every time the pump would peristaltically squirt some 5FuckYou into my IV, my youngest would turn his head at the sound. I'd ideally like to get all this behind me, so I don't have to explain too much of the intricacies of pancreatic cancer to my kids.  

Regardless of how crappy I am feeling I rest assured that Toomie and any of its progeny are feeling worse. Soak it up, you little bastards. Enjoy your crumbling empire.

Day 29, First day of FOLFIRINOX

I'm waiting out this morning before going in for the new juice. Took the bandage off my port install site, and boy does it look weird. It's part subcutaneous alien tissue, part third nipple, part nascent Evil Ash.

I also picked up some cream the doctor prescribed, and it's supposed to make the injection site above the port numb. After they get the needle in, all I need to do is sit there and get some cancer poison transmitted. I'm envisioning it as this huge inescapable cloud of utter destruction to any and all cancer cells floating around in me, and they have nothing to do but sit there and submit to cytocide. Enjoy you little bastards.

Yesterday we had dinner over at my SIL and BILs, and my aunt delivered the tshirts, which are awesome. They are very purple and regal. The logo, care of my BIL, turned out rather nice I think.

A few days before some friends brought over some dinner AND some wicked wristbands! They are Hulk green, of course, and have a very articulate and thoughtful statement laser engraved on the surface.

We are geared up and ready to go. I'm a little anxious, and ready to get the show on the road. This might be the start of a rough 2 months or so, and the endgame I'm working for is worth it.

Day 28, post 1st cycle chemo treatment PET scan news

We got the PET scan results back, and they are positive: the tumor shrank 2mm on one side and 7mm on another. I'm keeping an even keel and being cautiously optimistic, and I am also thrilled to hear this news because the smaller it gets, the less risk there is during surgery. Additionally, there were no other metastases, which means that the cancer (as far as the PET scan is concerned) is still confined within Toomie's dumb ass. The tricky thing is that pancreatic cancer usually ends up spreading, and the PET scan can only pick up bits and pieces of suspect tissue that are of a certain size, so there is the possibility that there are microscopic colonies trying to set up camp elsewhere. Rather than let the terrorists win, we're going to unleash the Shock and Awe campaign to proactively nuke the hillsides and strike first and strike hard.

All this news just barely preceded my youngest son's 3rd birthday, which was lovely gift for us to share.

Tomorrow I go in for the new regiment. I am of the thought that since it's usually used for Stage 4 treatment, and designed for aggressive cases, I will employ it to further shrink the tumor as well as conducting preemptive strikes on all hidden cancerous encampments. I think when the chemo drugs start coursing through my system, and they come across any instances of Toomie's brethren, they will round the bend of whatever circulatory tissue in which they are navigating, find the dumb cancer discussing stupid videogame henchmen topics, and gaze upon it with joy and determination before settling in on some cancer cell decimation. If the chemo drugs had an expression at this moment of discovery, then it might look like this.

Day 26, Lizard King

Went on a walk with the wife, BIL, and SIL this morning. Found a little buddy. BIL took him home to put in a garden terrarium.

No results back from the PET scan, and it sounds like we'll likely get details before the end of day, so that'll be interesting. We're prepping for our youngest son's birthday. He'll be three. Wow. Can't believe my sons are getting so old. I'm loving the time I get to spend with them these days. In retrospect, I ironically ended up being able to see them more because of having to take break from work to attend to my health. Work for a living, or living to work.

I'm probably going to pop by the cancer institute to get my port dressing changed. I'm eager to get the bandage off for good, although I'm still not used to the little raised bump where the silicone aperture is located. I am looking forward to not getting pricked 5 times to find a vein, which is what happened yesterday when I was getting injected with radioactive glucose as part of the PET scan. The chemo is blasting my veins. Here's what the medical tray looked like after they finally got the IV in. In case you're interested, they used a butterfly needle on a vein on the top of my hand. Good times.

 Super cancer poison on Monday!

Day 25, 2nd PET Scan

I have my port installed.

The procedure went very smoothly. I can't ride my bike until it heals, because of the risk of infection, so that kind of sucks. The doctor said I could ride again in 5 days, so Sunday I should be good to go. One bad thing: it's on my right side, and it is kind of sore, so when I'm a passenger in a car I hold the seat belt out. Minor inconvenience.

My mom and I went to go see "Moonrise Kingdom" yesterday. I like Wes Anderson. Saw Bottle Rocket before Rushmore was even out, and knew that guy would be a film maker to follow. It was good to see Ed Norton and Bruce Willis in roles they don't normally portray. Additionally, one of the many previews starred Bill Murray as FDR in "Hyde Park on Hudson". Could be a solid one, or it could end up suffering from trying to stuff too much into one film. Murray looks like he's going to be good.

Today I'm off to get another PET scan, which is a scan to see if there's been any change in the tumor's growth. The goal, ideally, is to see some shrinkage as well as get a baseline to compare against when I start the FOLFIRINOX. I'll do periodic PET scans during chemo (or chemo breaks) to monitor its shrinkage. Like the Seinfeld episode where George has his nether regions exposed and the horrible truth of cold + male genitals = shrinkage is revealed, I expect Toomie to be receding into oblivion.

See ya! Wouldn't want to have in you in me anymore!

Before the actual scan I get injected with some radioactive glucose. The nurse comes in, and the syringe is surrounded in lead. I try to make the Hulk come out after getting injected, but it hasn't worked yet. Needless to stay that stuff has to circle around for a bit before they do the actual scan, so I'm bringing a couple movies to watch: "Mission to Mars" and "The Thing" (remake). Yes, both cheesy sci-fi films, of which I am a fan.

Note on Skyrim: loads of fun, but jeez did Bethesda do a poopy job on QA-ing for the PS3. So far I've seen hanging loads, poor script execution, items that vanish in the gaming ether, and in one  horrible instance the game froze during reloading from an auto-save. I'd just done major battling, and picked up some cool stuff, closed out some quests, and then out a no where a giant sabre cat did me in. I hadn't done a full save...no big deal I thought...I have the auto-save. Queue tears of deep regret. I now I have to replay that entire sequence. Wait...I get to replay that entire sequence! Sweeeeeet. It's all on how you look at it.

Note on FOLFIRINOX: just confirmed with the treatment center that I start the new regiment on Monday. I'm going to be getting pumped full of cancer poison, and the process there will take about 6 hours (I also get to leave with a pump that cycles more in for the following 48 hours). She told me to dress warm. One of the drugs is supposed to make me feel super susceptible to the cold, so I get to dress freakishly warm during the summer. I'm going to be "that guy" you see walking down the street in triple digit weather. If you were to stop and talk to me I'd probably complain about how chilly it is, and could you please hurry up and open the door to the Peet's, I need a cup of hot coffee.

Day 23, Port Day and it's not barrel or bottle-aged

I couldn't sleep well tonight. I usually don't have problems sleeping. I must be excited to get my port. I'm not much of a pill/drug person, and not fond of the idea of attaching medical devices to my body. As I mentioned earlier, if I knew I was going to be getting a multi-media drive of sorts installed, and could interface via USB 3.0, Thunderbolt, and flash card devices, then I'd be more excited. Unfortunately it's less sexy than that. Although the port sounds like something preferable than getting stuck with needles in my arms for bloodwork and chemo injections.

This morning I thankfully was provided with a Netflix survey to address this morning. I might do a little consumer market research for them (as an opinion spouter), although per their windows of time to meet with their marketing people they indicated in the survey it would either be the day of the new chemo treatment or the day following. HAHA. Maybe I can show them my port and see if they have any ideas on how to improve or enhance the user interface. I keep coming back to nanobots. Nanobots are the answer. Nano that shit.

Any how, I'm off shortly for the install. I think I keep this thing in me for a while. My first implant! How exciting.

Day 21, start of the first no chemo week

We got back from the Lair yesterday. It was a blast while we were up there. A group of us went out on a pontoon boat on Friday on Pinecrest Lake. I had a chance to take my oldest son and younger cousin kayaking on the lake. It was glorious.

 

My brother in law, G, previously demonstrated the monstrous talent of creating a chalupa using Lair taco paraphernalia.

I cannot post pictures of him eating it. The image would likely scar and traumatize those with weaker constitutions. I was sitting next to him and it was almost too much for the human mind to bear. It was as if the kinetics of the construction exhibited geometry that wasn't meant for this plane of existence. At any moment, I expected chants in the name of Yog-Sothoth to break out, and mindless horrors to break forth from the alpine treeline and into the family friendly dining hall. OK, here's a picture of him eating it.

Today I went on a bike ride with my other two BILs, R and Z, on some choice back roads, which ambiance must've been used as inspiration and incorporated into Bethesda's Fallout 3, as part of the post-apocalyptic wasteland. Make sure you view the expanded view of this picture in order to do it justice.

Later on the return route we saw inspirational messages like this one.

It was quite an adventure.

After getting home and washing up, a couple of other buddies came by and hung out for a while. The fabulous duo also presented me with a copy of Skyrim.

I almost cried tears of joy. Bless you gentlemen. I was able to squeeze in a little gaming before another friend, this one from college, dropped off my two boys. She and her husband had graciously taken them over for a play date. Shortly after, my wife arrived home from running errands and we went over to my SIL/BIL's home for dinner.

At the end of the day I was exhausted. It was such a wonderful way to close out the week, and store up some positive vibes for the coming week. I'm getting a port installed on Tuesday morning. Unfortunately, it's nothing so cool as some real life wetware, and I will not be able to download some martial arts conditioning and be able to tell you that I know Kung Fu.

This thing will make getting blood draws and injections much easier, which will be nice because the following week I'm starting the new regiment consisting of four chemo drugs. It should be quite an adventure.

Today's epiphany arrived as I realized that although I might not be the most religious person, I would like to think that I am fairly conscious of what's right and wrong or good and evil: I believe in the power of people, and the fact that we have a choice to do what's right. We don't always do it, myself included, and when we do it's an act that I would make akin to God-hood. I feel amazingly blessed to have who I have around me right now. I am in complete amazement and feel such humility in the face of the kindness that people are sharing with me. It's an utter game-changer to have this support in my corner. I just wanted to take a moment to openly acknowledge it. Thank you all.

Made It

See the full gallery on Posterous

Made it up to the Lair. It is just like I remember it. Lots of pine trees and happy people. It's hard to get irritated here.

I was feeling kinda beat up on the way up. Not sure if it was the elevation compounded with the chemo, but when I got to the camp I was feeling like someone hit me with a pipe in the face, then in the legs, then in the face, then four times in my special place.

I found G and the kids without a hitch. It was so nice to see my son. He's looking like little big man.

It's beautiful up here. Felt much better the second day. I'm chalking it up to elevation. I'm betting that when I do my blood work I'll have some rich red blood cell counts. Blood dope!

Day 17

My oldest son and I had planned on going to the Lair of the Bear this week. We had planned on it about a year ago before all this nonsense started. He went up without me with his uncle and cousin because I had to do chemo on Monday. It's Wednesday now, and I'm still a little beat, but I'm going up for a couple days. Fuck you cancer. You don't own me, bitch. That reminds me of the Fight Club soundtrack where there's this track containing all these snippets of Tyler Durden sayings. One lyric seems to resonate more now than ever is: you are not your bowel cancer. Not exactly the same diagnosis, but point taken.

I'll likely be offline for a couple days. I hope to have lots of good pictures to post when I come back. I have an appointment with my medical oncologist on Friday to review my change in chemo regiment. I think I have a week off before I start the FOLFIRINOX. Haha. Every time I see that term I think of the Metal Gear Solid engineered retrovirus, FOXDIE. Good times. Thanks Hideo.

Day 16

Finished last week of first cycle of chemo. Feeling wiped, but otherwise ok. I'm wearing the Hulk shirt J got me to keep the morale up. Here's that picture I mentioned I'd post. It's intense. I make the "GRRRR!!!" face for the full effect of the kids, and it always gets a good reaction.

Even though I'm not going to be doing radiation anymore I still think it's a valid embodiment of the toxicity of this new regiment I'm doing. The shit just sounds gnarly: FOLFIRINOX. 4 drugs. One pump that continues to push cancer poison in for 46-48 hours. One port in my body. 2 cycles. I'll likely start the week after next.

It's a regiment usually used to treat inoperable cases, and I'm opting for it because the cancer I have has a high rate of going metastatic. Right now it's local to my pancreas, per the PET scan, but that's not to say that it could be elsewhere in smaller nodules, like my liver. The PET scans only pick up relatively large masses. This regiment is geared to annihilate any and all instances of cancer, as well as shrinking the tumor and prepping me for surgery. We're going for complete and total destruction of Toomie and his mutant, fucked up clan. Die you bastard. Hulk SMASH! Sweep the leg!

Speaking of smash, here is a clip from some of the little ones running the gauntlet from a recent gathering.

It reminds me of Death Race 2000, only no David Carradine.

Day 14, 2

Went on a bike ride with J and R and had a blast. We stopped at one point and were talking about chemo, because it just always seems to come up...actually I think I brought it up (selfish bastard), and I was venting about the effects of chemo and the other peripheral drugs they give you on the side to counteract other effects, and then there are other drugs you take to counter the tertiary effects of the other drugs.

Doctor: Hello Mr Ficken, how are feeling today?
Me: Fucking great doc! Are we going to kill this bitch today or what?
Doctor: Er, uh, ahem...wouldn't you just prefer that I tell you how the drugs are going to affect the tumor from a chemical perspective, and then highlight the physiological effects while at the same time not really being able to relate to the experience from a personal level because, God forbid I ever contract that nastiness?
Me: Go for it, doc! I'm all ears!
Doctor: Well I'm prescribing Trykillitol for the chemo therapy. Side effects of this drug may include nausea (you might as well tack that on for every single one I am going to review with you), headaches, neuropathic sensations, rectal bleeding, and forehead growth. Basically, it'll make you feel like you're walking on vomitous pins and needles and you'll look like a cross between Ted Danson and Rihanna, but not as famous or wealthy.
Me: Wow, that sounds shitty!
Doctor: Well, I wouldn't know, but there are some other drugs I'm going to prescribe to you that'll help treat the chemo side effects.
Me: Wow! That sounds great! Now I have something to help manage the side effects!
Doctor: I'm going to give you Vomitex for anti-nausea, Brickassium for anti-nausea, and Tripoutphorin for anti-anxiety. Side effects of Vomitex and Brickassium include turning your bowels to quick setting cement, headaches, sex crimes, fingernail explosions, renal farting, and uncontrollable facial tics.
Me: Wow! That sounds even shittier!
Doctor: As I said, I wouldn't know. This is just what I hear from the pharma reps.
Me: Great! Where do I sign up for this treatment?
Doctor: Well, lucky for you the nurse already started you on the IV while we were talking, so you're on the chemo right now, and the prescription is in your wife's hand.
Me: Wow! I'm like totally unecessary in these transactions! Can you beam the cancer into a cloned goat fetus and simply circumvent all this medical nonsense?
Doctor: Those treatments are all in the beta phase of testing, and are actually just science fiction. I don't know why I played into that bit of nonsense you just spouted.

Good times. You gotta be able to joke about this. At least I do. Probably one of my coping mechanisms, and as I said before I need commit to this in mind, body, and soul.

If anyone is quitting smoking, consider Chantix.

Day 14

New Radiation Treatment

Went on a bike ride yesterday with Z, and he took me through some choice locations. One jewel was juvenile hall. As we cruised by I noticed that someone had "repaired" one of the address signs with masking tape. The street number and name had apparently eroded, and some bright soul decided that it would be better to cut out numbers and letter from a large roll of tape and strategically place them on the sign. If it were a font style, it could be called "Penal Code". Prior to getting to the hall, we passed some huge electrical line towers. I think they could be used to treat cancer patients, so I paused underneath one to let Toomie get dosed. Enjoy, you little mindless turd.

Cycle

I complete the third dose of my first cycle of chemo on Monday. I also need to decide on how to proceed: more chemo and radiation, or different chemo. I'm going to make the decision that makes the most sense to me, because I can't keep changing tack on this. It's driving me nuts. I am the kind of person that prefers to make a decision when given a fork in the road, and then completely emotionally, psychologically, and spiritually commit to it and see it through.

Timehop

I got today's Timehop. It's pretty good. It tells me that I was stuck on Deathproof at the time. If you Tweet or Facebook, you might want to check out Timehop. It's another fun way to waste time with social tools. Once you hook it up to your accounts, it sends you an email everyday telling you what you posted the same day, one year ago. It's a little time capsule. They also just started offering the ability to timehop your texts, if you're into that level of minutia. I also mentioned Thundarr the Barbarian. Perhaps my surgeons will use a sunsword when performing the Whipple on me. That would be awesome.

Speaking of the Whipple, here's a pretty good description of the procedure from surgeon William Hawkins from Washington University. Boy, does this sound like a doozy.

I'm obligated to think that since I'm young and in good shape that I'm going to bounce back fast and get on with my life. It's a little mind-boggling to think that there's the whole chemo (and potentially radiation) track I need to do first to even get to surgery. It's going to be quite an adventure.

Day 12 (Fri the 13th)

Opinions are like...

One of the first oncologists we spoke with said something that's echoing in my mind because of recent events. She said something like "My educated patients the toughest ones to treat because they get second opinions and complicate matters." I'm paraphrasing, but that was the gist. I was a bit surprised because I am almost 100% positive that if that same doctor was diagnosed with something, she would be considering other perspectives and options and wouldn't take the first diagnosis and treatment to come out a colleague's mouth. Right? Right.

Having that as a bookend, we had some third opinions to round out the early part of the week, and one of them introduced a chemo treatment idea that hadn't been mentioned by any other doctors. It's more aggressive (meaning people who take it can get pretty wiped) and toxic, while having greater efficacy on tumor blasting (technical term). It's supposed to shrink tumors better, in addition to aggressively targeting smaller metastatic satellites, which is the nature of the beast with my cancer.

Needless to say, I've got to make some decisions this weekend. I might be flipping things on its head, and I know what's best for me after having all the various opinions mercilessly preached like they are the only answer I'll ever find. Thankfully, Pancan put me in touch with someone who had pancreatic cancer went through the chemo I might go through who actually gave me some firsthand input. It was most valuable. I have a lot to think about.

Maintenance

A close friend spoiled me with a lovely gift. She got me a session with a healer/masseuse, by the name of Celine. In brief, it was downright splendid. I hadn't experienced something like that before. She kicked it off with some cranial-sacral work, which was awesome, then we proceeded to let the organs talk. I provided the dialog of course. Toomie came up, and we discussed ways to make his ass crumble up. The underlying notion of it all was: your life is what your thoughts make it (one of my favorite quotes of Marcus Aurelius). It all comes down to personal intention with how you will respond to stimulus, whether that stimulus is a cattleprod or some crappy little piece of cancer trying to fuck up your whole package. With regard to the cancer, I plan to shove the cattleprod up its ass, and let Toomie suck on the charge. I am imagining Toomie as a foreign body. Attack him and his cousins, my little white blood cells...go SWAT on his ass.

Sweet Sacrifice

I have to avoid sugar. Damn you Toomie. Darn near have to give up anything vice-ish. Screw you. With a chainsaw to the dome. It's Friday the 13th after all.

Day 9

Tired. Jeez. In another dr's office waiting room for final opinion. Stanford tomorrow for an EUS (endoscopy ultrasound with fine needle aspiration) to put gold fronts on Toomie, so they know exactly where to blast him in his stupid eyeless mass of a face when they give me the Dr. Bruce Banner juice. Note: David is the TV Hulk, whereas Bruce is the canonical comic book Hulk. I'm going to alternate between the two.

Had a splendid realization while sitting here next to my father-in-law and wife: love is when your family takes time out of their day to shuffle you to doctor's appointments and answer chemo-radiation phone calls on your behalf all the while getting your back with spoken and silent support. Thanks guys. Love you.

A Fancy Scapel

Just drove past the Bentley and Lamborghini dealership, saw a sweet ride and my first thought and statement was: man...I want that thing to run over my tumor. No joke. That's how I roll. Run that shit over Toomie's face.

Day 8

Just wrapped up second round of chemo for first cycle. Suck on the juice Toomie, you stupid lump of malformed cellular evil.

The IV hurt like a mutha going in. I'm now kicking myself for not getting the port. I'll have to wait on getting it based on my platelet count, which gets blasted during chemo. Hopefully my nurse will see some good numbers and give me the green light in the next few.

I'm about to go to CPMC to have another opinion on the radiation treatment. I'm tired right now, and it'll be good to get another perspective on the treatment. That being said, I don't think we are going to deviate too far from the current plan.

When I'm eventually ready for surgery I understand the recovery period is considerable, so I'm trying to get in super good health/shape in order to bounce back as soon as possible. I'm getting a hydration pack for my bike rides, which will be awesome. I won't have to stop anymore for water breaks.

I'm feeling a little stressed about how to handle all this treatment as a prep for eventual surgery, and manage time out for work, as it sounds like there's going to be another round of chemo squeezed in before the scans to see if I'm ready for surgery. Maybe I'll see how I feel and go to work depending on how I feel.

Right now I'm wiped, but since I just got juiced that makes sense.

We are making final decisions on the tshirts. They are looking purple and very fine.

Speaking of shirts, one of my old school homies got me a very appropriate pre-second round-of chemo gift. Makes me feel like Hulk will smash! I'll post the pic later. I'm doing all this on mobile, and I don't like the way the app (Posterous) doesn't provide any photo editing capabilities.

Day 5

I woke up this morning to the screams and laughter of my sons, nieces, and nephew bounding off the walls. GOOD MORNING!

My brother in law and I went for a bike ride, and we passed an area with grazing animals. I saw one and it was the oddest beast I'd ever seen. Why it had a eucalyptus branch in its hand and positioned so far from the tree I will never know.

The bike rides help keep me sane right now. Thankfully I've not experienced any nausea from the chemo, but after 12pm I start to feel beat down a bit, get minor headaches, and sometimes feel achy like I have the flu. I really can't complain given the fact that I'm housing some majorly toxic material designed to straight up annihilate cancer cells in my body. I am happy to endure given that I know this liquid poison is killing Toomie, that little selfish bastard. In fact, I think he's been making my pancreas the whiner organ in my body.

I've imagined conversations with my pancreas and the other organs, and pancreas is probably on the outs, by no fault of his own. It's got Toomie with which to contend, but the other organs couldn't really give a shit.

Kidneys: Hey Liver, you want to go check out the drainage in the common bile duct?
Liver: Nah, it's not so much fun any more now that Pancreas has Toomie, and the two of them are such attention whores.
Duodenum: Tell me about it...all Pancreas does is whine about how it's going to get chopped up in a Whipple procedure all because of Toomie. Jerk doesn't even mention that it also means I'm going to get the axe as well.
Kidneys: Yeah, that sucks, Duodenum. As least you'll always have the Family Guy reference to you acting up.*
Duodenum: Yeah. Man that show cracks me up! Is there a bad episode?
Liver: I know, right?! How many voices does Seth MacFarlane do?
Kidneys: Seriously! That guy is a genius.
Pancreas: Heeeeyyyyy guys.
Kidneys, Liver, Duodenum: [in bored drone] Hi Pancreas.
Toomie: [cheerily] Hi guys!
All: Fuck you, Toomie.
Pancreas: Sorry for being such a stick in the mud. I'm just feeling so tired these days, plus I have this stent in my duct. If I had an ass, then this stent would be in it.
Toomie: I like sugar, and growing mindlessly in Pancreas because I'm a fucking tool.
All: We know, Toomie.
Kidneys: You suck, Toomie.
Liver: You're such a buzzkill, Toomie. God I can't wait til they take you out. You blow dead rats!
Duodenum: How's that chemo taste, Toomie?
Toomie: It's kinda tangy and makes my cancer hurt, and I'm so lame that I don't care. I eat anything. I'm kinda like those heavyset people who go to Cracker Barrel, and stuff themselves until their asses are able to form a localized singularity causing all the matter and energy in the surrounding area to gravitate and be consumed by the sheer cosmic ass mass in a single dark hole.
Liver: Guess what, Toomie...on the way out during the Whipple procedure...
Pancreas: Aww man....I have to have one of those....
Kidneys: Shut up Pancreas....
Liver: ...on the way out, I'm totally going to stab you in the cancer.
Toomie: You're a liver, you can't even wield a knife!
Liver: Bite me, Toomie! Gall Bladder is going to make one out of its secretions, and I'm going to cut you in your stupid cancerous cancer.

*see see 15:26 for duodenum reference

At least, that's what I have so far. We'll have to see how it goes from there.

My oncology nutritionist indicated that I need to watch my sugars, because Toomie likes them. Ass. I'm going to figure out how to creatively enjoy food while at the same time eating to kill Toomie.

[Technical side-note: I know some of you are part of the Google Group I set up that sends out an email whenever I update my blog. It's much more of a thrilling experience to just go directly to the blog, as opposed to reading it in the un-sexy format of the email notification. Just read it at http://jromi.blogspot.com. If you're inclined to subscribe, I've added a service to which you can add your email. Just scroll the bottom and follow the steps.]

Day 4

I'm calling some of these posts by their days, as in "days in chemo cycle" since so much is built around this timeframe. After the first cycle, I get to go to the thuper thecret Dr. David Banner radiation room and blast Toomie with tightly focused kill waves.

Right now I get to experience all the magic that chemotherapy has to offer AND I am coupling the joy of the cancer death cocktails with some additional procedures in preparation for the megablast I'll get after this cycle. Unfortunately, my radiation tats I received won't be used, as the new radiation treatment will first involve another endoscopy during which doctors will embedd 3 gold "seeds" into the tumor. These seeds will be used in conjunction with a combination PET and CT scan to lock in the proverbial phasers into a tight band of death rays upon emission. However, I admit that I  also think of the Predator's fancy weapon triangulation tracking as well. Perhaps it's a blend of both techniques.

I am getting a little stir crazy, but don't really feel all that energetic or inspired to go out running around, so I'm catching up on the glorious back catalog that Netflix has to offer via streaming.

Also, with the stent in my duct, I have to avoid high roughage foods, and so my cherry intake is met with freshly smoothied Bing's. I am starting to see the benefits of having a cherry pitter.

Day 3, the Fourth of July

Oh Day 3. What a day you have been. Chemo. It ain't no joke. Don't get me wrong, it's not the worst thing ever. I'm taking this drug that suppresses the vagus nerve with the effect being that I don't suffer any nausea. On the other hand, there are less than pleasing side effects.

Regardless, I know that stupid tumor has it worse. Glug glug, Toomie (I calls it Toomie now). Drink up all that yummy cancer killing poison! It's the Fourth, and this one will be your last. I've rung the bell, and have enacted my own symbolic Paul Revere warning.

In order to promote a sense of normalcy, I'm still squeezing in bike rides. This morning I rode out with one of my brother in laws, took an easy stroll, got a bite to eat, and stopped by his house on the way back to see the family. My nephew was busy trying out some yoga moves.

Then I rode home, and was greeted by my aunt and uncles, who came over to help us square away some homeowner type tasks (THANK YOU!). A bit later I was able to sneak a photo of some baby birds who've been chirping away like they're expecting a Mutual of Omaha's Wild Kingdom highlight. Momma bird had just come by with some food and hooked them all up, a la Alicia Silverstone style, so they weren't too camera shy.

Later, we took a trip over to a neighborhood court, where some families get together each Fourth, and hang out. I was fortunate enough to help set up the kids donut eating contest donut line.

My youngest son didn't want to follow the "no hands" rule. He cannot be tamed.

Not too shabby of a Fourth. Happy Independence Day America. I will remember this Independence Day not of Bill Pullman as America's President flying fighter planes to attack alien spacecraft, but as a day upon I continued my treatment to make me independent of Toomie...that greedy evil little bastard. For you I have to say "The surgeons are coming! The surgeons are coming!"

Day 2

On Sunday, my sister and brother in law hosted a pre-chemo party that was awesome! My tricky Auntie Party secretly enlisted party-goers with a mission: to text me Ficken-inspired pictures while I was I starting chemo the following day.

While I sat in the rather dull room with clinical looking chairs, my wife and sister in law waited for all the specifics to be resolved between the two hospitals (doing a joint venture between John Muir and Stanford) we had all these wonderful texts come through and they were amazing. Thank you all so much. It means more than you could know.

Today was the day after the first week of the first round of chemotherapy, and overall I feel pretty good. There wasn't much of a difference when they started the chemo flow in my IV (I've not opted for installing a port, since they remind me too much of heartplugs, "don't worry Thufir, everyone gets one here"), so I apologize for not having any thrilling experience to convey.

For this week and the following 2 I will have 2 more injections of the chemo drug, and my mental image when I think of the whole process is the tumor mindlessly drinking up the poison, shrinking, falling ill, and dying, so they can eventually cut that fucker out of me.

Below are the pictures I mentioned before. I was particularly biased towards the Hulk one, of course. Thank you all, again!!

Getting the Juice!

At hospital now and finally getting bloodwork done in prep for chemo! Fired up to poison that little bastard and any of its unwanted little cousins. Die you little fuckers! Die!!

Thank you to everyone for your Ficken support photos! They are amazing and are great to see especially while I'm getting started with this process. I feel incredibly blessed to have you all in my corner. We are going to beat this together.

The Deep Breath Before the Plunge

There's been some changes with regards to how I'm going to be undergoing my treatment. Initially I was going to be doing chemo and radiation with the radiation done in conjunction with the chemo. After a consultation at Stanford I'll be working with doctors there and at John Muir following the same chemo regiment (initially formulated by my oncologist prior to any involvement from Stanford), and doing radiation in between chemo cycles. The SBRT treatment will only last 5 days as opposed to doing 5.5 weeks Monday-Friday of the aforementioned "old school" radiation.

The benefit of the new radiation, is that it's highly concentrated, much more accurate, and veritably blasts the tumor in ways that I liken to the wasteland outside of New Chicago portrayed in the seminal 80s series, Buck Rogers in the 25th Century. I will be doing another endoscopic sonogram procedure which will involve implanting 3 gold "seeds" in the tumor. These will be used to map out each plane and closely target the mass in order to localize the dosage. After doing the first round of chemo then the radiation I'll do another round of chemo and we'll see if the tumor is in a position to be resected.

I'm finally starting chemo tomorrow, and I feel a mix of conflicting emotions: hope, anxiety, anger, excitement, loneliness, and love. For those who know me well, you'll know I'm a big fan of science fiction. There's a litany in Frank Herbert's Dune that keeps popping in my head when I start freaking out:

I must not fear.
Fear is the mind-killer.
Fear is the little-death that brings total obliteration.
I will face my fear.
I will permit it to pass over me and through me.
And when it has gone past I will turn the inner eye to see its path.
Where the fear has gone there will be nothing.
Only I will remain.

I also had a good friend make a remark inspired by another exceptional book, The Stars My Destination, where the protagonist, Gully Foyle, vows to exact revenge on the ship, Vorga, that leaves him stranded in a non-functional ship adrift in space. He says, "I kill you, Vorga. I kill you filthy." I like the revenge theme, especially now. I plan on taking revenge on this little tumor, which has so effectively thrown my life into upheaval. As the days and doctor's appointments go by, the realization of the impact of this thing is that it's not just my life: it's my wife's, my children, my family, and my friends. We're not done yet. My wife has as close friend who was diagnosed with Stage 4 breast cancer, went through chemo and and a double mastectomy, and is still going strong, and has been a huge inspiration to me, now more than ever.

Tomorrow I go in and start chemo, and begin this journey. Things of value often require significant effort and sacrifice, and I'm ready for the challenge. For all of you who've sent emails and words of support, we cannot thank you enough, and I apologize if I haven't been able to respond to all of them. This definitely feels like a shared experience and we are going to collectively beat this little bastard into submission. I've always been curious about chemo, and ironically now I'll have firsthand knowledge of it. I'll try to capture the highlights and share them because, hey, who doesn't want to get a visceral, anecdotal recount of a chemo treatment?

Regarding the Ficken Fo' Life shirts: nothing's been locked down yet, but when we do, I'll figure out a way to message it out to people about procuring one. It's definitely going to be purple, so start listening to some 80s Prince and get ready.