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.

Stanford Disses Old School Radiation

At Stanford since this morning. We came in for a consultation with a surgeon, and the consensus was in line with what we have been told so far, which is good. The only difference is that the radiation treatment recommended by my initial radiation oncologist was characterized as "old school" by the surgeon here. Daaaaamn. No he didn't. He straight up dissed the rad tech. Apparently there's this other kind of radiation treatment that doesn't have to be administered over a course of multiple weeks: SBRT (stereotactic body radiation therapy). Instead I'd get concentrated doses in 5 days. That would be nice. It also sounds like the odds of pulling a Dr. David Banner would go up. I don't have anything on paper to back this up. It's just a gut feeling.

I'm about to meet with the radiation oncologist today, so will probably be here for a while longer. I might actually get dosed today, which is all good.

My wife and sister-in-law are with me, and are amazing. Couldn't be doing this without these wonderful women. Thank you for all your support, ladies.

Oh, and tumor in my pancreas, yeah you. I'm gonna fuck you up, you little bastard. I'm gonna go Cobra Kai on your ass. Sweep the leg.

Keepin it Local

We just received word that the cancer is localized to my pancreas. That is awesome news. -uck you cancer. I am going to slay your ass.

My First Tattoo

I went to the radiology oncologist today to review the blaster ray regiment, and learned that I'll need to be mapped in order to properly calibrate my positioning so I'm correctly irradiated each time I go in for treatment. This means I'll be getting some tiny tats in certain areas that'll be used as markers. What can I say. I'm down for my 'hood, yo.

This doctor is indicating I'll be undergoing blasts everyday for approx 6-7 weeks in conjunction with chemotherapy, which may or may not go longer. Again, we are also getting second opinions on this stuff. My wife is AMAZING, as she's keeping track of all this stuff and coordinating with medical staff to make sure everyone is talking with each other and getting the paperwork needed to shuffle it into the right hands.

It's all moving along pretty quickly, which is good: I want to get this started ASAP. However, there's a part of me that thinks there should be a better way of localizing and blasting the affected area. We should have nano structures that could encapsulate the mass, shielding the external organs and tissues, while irradiating the enclosed mass. Can someone get on that please?

In the meantime I will be doing the old school method of external exposure to rads, which will be somewhat rad.

I'm interested to get some feedback: my sis and bro in law came up with some clever slogans for tshirts proclaiming support for my success, which I thought was amazingly considerate and loving. Again I feel totally blessed to have such wonderful people around exuding so much positive energy. It's all good. Let me know what you think.

A Chance to Go Hulk

My brother-in-law drew the wonderful and completely inaccurate, yet perverse graphical representation of my pancreatic adenocarcinoma

I was recently diagnosed with pancreatic adenocarcinoma. It's apparently one of the more common kinds of cancer if you're gonna get it in your pancreas. Never being one to go half-assed into anything my cancer is very aggressive. I've resolved to kick its ass, however, and will be going through several rounds of chemotherapy and radiation treatment before having surgery to remove some of my plumbing in the affected area.

Thankfully, this gives me the opportunity to explore the option of finally becoming Hulk, or at least Hulk-like, which would be awesome. I will settle for ridding this trash from my body and getting on with my life.

I'm very blessed to have amazing, supportive, caring, and loving family and friends surrounding me throughout this ordeal, which has made it a lot easier to bear given that this has hard to process and emotionally manage at times. In addition, my employer has been monumentally supportive throughout this ordeal.

Part of the reason for this post is to provide folks with information on my state. I'll try to succinctly recap.

At the beginning of June I went into ER because I was jaundiced. Several scans later they found a cyst-like mass on my pancreas which was pushing on the common bile duct in the area, which was causing the jaundice as well as increasing ammonia in my blood level. I was admitted into the hospital and had two endoscopies: upper and then an ERCP, which involved putting a stent in the blocked duct to correct the symptoms caused by the mass. A week or so later I had another endoscopic procedure: an EUS, which involved running yet another scope into my stomach where they Hunt for Red Octobered my pancreas, found what they were looking for and totally fine-needle aspirated the mass (approx 4.2 cm partially cystic tumor: the tumor is approx 2cm) for a biopsy. The doctor afterward said that the preliminary indications were "abnormal", which they treat as cancer. He referred me to a surgeon, and I had to wait for the appointment. While waiting I met with an oncologist, with whom my sister-in-law used to work, who explained the various scenarios we'd face pending the results of the pathology. She explained what the chemo drugs were and what I could expect. The results came back from the biopsy, and the surgeon confirmed that he'd want to do chemo and radiation to clear up the margins around the mass, stop its growth, as well kill other microscopic cancerous encampments elsewhere in my body. The tumor has veins running through it, and needs to be shrunk before resecting. The surgeon indicated that it's Stage 3 cancer, and has likely been there for about a year and a half. I consider myself lucky that I was jaundiced and went to the ER where the medical staff detected it. Otherwise I could've been walking around for another year and a half, or longer, and then have it be much more serious.

Today I'm getting a PET scan, which involves putting radioactive glucose in my blood, and then doing a scan to check how the various cells in my body metabolize the sugar. Cancerous cells are hungrier (the little bastards), and can be differentiated from normal cells. This scan will tell whether the cancer is localized to my pancreas or if it's spread elsewhere in my body.

Tomorrow I start chemo and radiation.

Tomorrow I will see if I can acquire Hulk-like powers, which would be awesome.

I am getting consultations from Stanford and Johns Hopkins as well, and the surgeon I've seen thus far has performed more pancreatic surgeries to remove these kinds of tumors than any other doctor in the US. My oncologist is world class. All the doctors and medical staff I've seen thus far have pointed out that factors dramatically contributing to my survivability are my age, good health (aside from the little bastard jacking up my pancreas), and my attitude.

More important than anything, my wife has been by my side the entire time and an amazing rock for me, and family and friends are effusive with love and support. I'm eager to get this process rolling and kicking the shit out of this stupid cancer. I'm stronger than it.

I'll include more updates as we move on. If you know me, please feel free to contact me, and I would appreciate you not posting anything on Facebook (your pages or mine) relating to this.

Man bag

He's back. The condom perpetrator in my hood is back. He'd gone dark months ago. In fact, I thought he might've either contracted some more glamorous position, such as "crack vial discarder", but alas he still graces the gutters of my street with his DNA wrapped cleverly in laytex.

Just this week I was fortunate to find a pale sheath laying in the gutter by my house. It had been raining, and there was something of the non-flora variety of usual detritus in the gutter. On closer inspection it was a spent vessel.

Immediately I knew what that meant: he was back. I don't have clear evidence of who "he" is. It's been theorized that he is a neighbor or one of many johns in a clandestine suburban prostitution ring. I'm a member of the former school of thought, as a certain neighbor around the corner has two sons who are of age, and likely engaging in such activity. Why they choose to do it in (I'm guessing) a car in front of their mom's house is something I can't understand, nor the discarding of such personal material in such close proximity.

My strongest, albeit far-fetched, theory is that he is an alien trying to disseminate his seed via the sewage system, as he is somehow related to Cthulhu. Perhaps it's a pre-emptive strike to mutate us all into above sea level R'lyehians.

Regardless, I'll be installing a motion activated night vision wifi cams in several strategic locations in order to catch the ejaculator in the act of disposing of the evidence in such an un-neighborly manner. Maybe I'll also film the elusive owner of the dog, who is allowed to wander up on my lawn to empty his man-sized, Alpo-powered bowels on my lawn. Jeez, that'd be swell.