Fantasy football!

This will be the last post in some time concerning our beloved Rodent Passion and Monkey Knife Fight. Alas, the fantasy football season came, for all intents and purposes, to an end this past weekend. Monkey Knife Fight, after what was a strong regular season, fell prey to some weak wide receiver play, in addition to the sudden disappearance of Antonio Gates, to fall 125 - 82 at the hands of the Eighteen Grands. The team will be completely dismantled in favor of a newer, stronger, more robust team next year. Likely one with a new name, as is our tradition in the Great Pigskin Experiment.

And where do the passions of the Rodents lie as of today? We find ourselves, despite the sadness of a season of losing, full of hope for the future. Injuries to Deion Branch and Anquan Boldin, which cost us many a victory, seem to have healed. With Roy Williams rounding out a strong regular starting 3 at wide receiver, the venerable Isaac Bruce in reserve, and the prospect of long-time Arizona back-up Bryant Johnson likely securing a starting position elsewhere, wide receiver should again be a position of strength -- though depth should never be taken for granted, a hard lesson learned this past season.

With the late-season trade of WR Andre Johnson for RB Clinton Portis, we find ourselves with a strong "keeper" foursome at RB of Portis and Justin Fargas (assuming he retains the starting position in Oakland) along with the promising Laurence Maroney and DeAngelo Williams. To be added in the draft, as mentioned in previous posts: the electric Darren McFadden from Arkansas. RB should be a position of strength, from which we may hope to deal to improve ourselves elsewhere during the course of next season.

A difficult season for Philip Rivers will hopefully be just a bump in the road on his development into one of the top QBs in the league. Meanwhile, David Garrard proved himself to be a consistent and reliable QB -- solid if unspectacular. Some depth may be needed, but the Rodents should be solid at this position next season.

After some years of struggling to find strong play at the TE position, Rodent Passion feels confident that we at last have 2 to depend upon in Green Bay's Donald Lee and Denver's Tony Scheffler. And at kicker...well, they're kickers. Stefen Gostkowski and Neil Rackers are young and on potent offenses, both worthy of keeping around for some time.

The Rodents and the Monkeys thank you all for your concern and support through the course of another rough and tumble year of fantasy football. See you again in August!

Back to work!

After some late morning debating -- do I or do I not head back in today? -- I sucked it up and re-entered the work-force today. Over the coming weeks, I am allowed to work 2 or 3 days per week, up to 4 hours per day...so much as I can handle, really. Though in practice, this will amount to one full day of work per week, as I will be at the mercy of him from whom I can secure a ride, I should also be able to work in limited doses from home, developing control software for a device we've been constructing over the months since I've been here.

I can say that, though at the moment I am fairly fogged in the head from exhaustion, I am glad that I made the call to return to work. It's been nice to have a full day's distraction from the usual concerns of chemo and cancer. I have to believe that any boost in my mental health can only be a positive when it comes to my physical health as well.

Speaking of...we are now nearly 1 week removed from my second cycle of the carboplatin/taxol combo. And I can say, given the usual caveats about the crudeness of the "measurements", that it certainly appears the treatment continues to work. I have a tumor in my right lung, towards the bottom, which is noticeably smaller to the touch. Further, I have not had to use my "bolus" button to increase my pain medication so frequently today as I had the previous several days.

Next treatment is scheduled for January 2...this may be pushed back a day or three, depending on just how and when I get back to Knoxville after spending Christmas in Chicago with the family. I'll certainly try to get back on time to stay on schedule...but we'll have to see.

Update, 12/14/2007

Yesterday marked the second cycle on the taxol/carboplatin regimen. As much as I hate the week of a treatment, I was very much excited to be allowed to go ahead this week, after last week's delay due to low platelet count. My platelets had risen into the "normal" range (not simply into the "treatable" range)...let's hope they stay that way. In addition to receiving chemo, I got a couple of units of blood, as once again we found my red-cell count to be low. I have no good answer as to why my red-cell counts are so consistently low, other than to appeal to the beating my marrow has taken over the past year plus in treatments of all kinds. If I slip just a bit in my iron and vitamin supplements, it seems my counts can get away from me. Just gotta stay on top of all these things, I guess.

One reason I was especially eager to get back into treatment is that I could feel, seemingly, the tumors beginning to once again get away from me as well. I don't know how accurate this "feeling" is, but I felt my pain increase slightly, and overall my body simply ached more as the past week went along. At the end of the day, it's always best to stay on top of the treatment cycle, so much as possible.

A Happy Advent Season to you all!

Fantasy football!

As one season comes to its merciful end, another season begins anew! After falling this past weekend 89 - 55 to Corporeal Punishment in the first round of the losers bracket of the Rock 'n' Roll Fantasy Football League, Rodent Passion faces Popeye's Nephews in the Toilet Bowl to determine who provides tasty beverages at next season's opening draft party. Rodent Passion must at this point be considered the "favorite" to lose...and given my taste in beer, it looks like I'll have an expensive day in August facing me.

Meanwhile, Monkey Knife Fight got back on track after a brief losing spell, winning 150 - 105 over Space Family Robinson in Great Pigskin Experiment action. Next weekend, we're all 0 - 0, entering the play-offs! MKF faces the Eighteen Grands in opening week action, and should be considered the favorites to advance to the next round.

A preliminary thought on hope

I was hoping to start today with some reflections on Benedict XVI's encyclical On Christian Hope. I have finished reading it through once, and figure to begin re-reading soon, offering thoughts and room for discussion as we go. But before we get started there, I wanted to share a funny thought from Charles Peguy's The Portal of the Mystery of Hope (thanks, John), an extended free-verse theological poem:

And you say: This little Hope has tricked me again.
I never should've trusted her. It's the twentieth time that she's tricked me.
(Earthly) wisdom is not her strong point.
I will never believe her again. (You will believe her again, you will always believe her).
I'll never get taken in again. -- Fools that you are.

Peguy presents Hope as a little girl, the younger sister to the mature and serene Faith and Charity. Hope is impetuous, running backwards and forwards and in circles, getting us to chase her all over, running seemingly the same paths again and again. Paths that appear, at least to us, always (or often) to end in human/earthly disappointment. I know that I have felt this way about hope often of late. I find myself second guessing my decisions -- why did I go to Germany? Why did I come to Knoxville? If I'd given any consideration to what was prudent, I'd have stayed near my friends and family in Chicago or in Washington, DC, so that, in times such as these, where I'm feeling a bit scared and unsure of my future, I could have their support and comfort. But each decision made was the hopeful decision -- I wanted to believe I was cured of my cancer when I went to Germany. I wanted to believe we had a few years of fighting before we might have to worry about running out of treatment options, making Knoxville a good move rather than staying in DC with a temporary position. But in each case, I find myself struggling...more alone than I'd like to be (though thankfully, never fully alone). I find myself making the same promises, to never believe that "little Hope" again...though I know, if given the opportunity, I would. It's who I am. I want to hope...to believe for the best. One day, I am convinced, the true Hope will prove worthwhile...the eternal Hope that Benedict XVI writes about in his encyclical. But until then, I will be disappointed, as often as not, in moves in the here and now, which can never satisfy as we long to be satisfied.

"It's smaller, I'm sorry to say..."

"You're 'sorry to say'?" I thinks to myself.

"You were right, and I was wrong."

We had what was both an encouraging and discouraging moment this morning with my local oncologist. He found himself admitting to being disappointed that the tumor on my right side, by what was admittedly a very crude measurement, appeared to be smaller. Obviously an encouraging moment, as our hope remains that a return to the Carboplatin/Taxol combo will control my cancer outside of the liver, allowing us to treat the liver by other means. But what do we make of his open disappointment in being wrong? He'd resisted this return, only reluctantly going back to it on my insistence. When his ego allows him to verbalize such disappointment while our mutual goal should be my improved health, what am I to do? In the end, I choose to make little of it. He has a necessary part to play in my ongoing treatment, though for important decisions, I will lean more on Dr. Mulcahy at Northwestern. I am glad that I have come to know enough about my body and what has worked and what has not, so that I could insist on a treatment over my doctor's "better judgment". I worry for those who either do not pay enough attention to their care, trusting their doctors to be driven by the well-being of the patient, or for those who may know well enough, but fear to speak up in opposition to one with the word "doctor" before their name. The lesson remains for all -- as a patient, you have more responsibility for your health than your doctor. It's a difficult burden to bear when sick, when all you want to do is to put yourself completely into the hands of an expert who will make all the right decisions in order to make you well. Unfortunately, our doctors are human, with limitations in knowledge and/or in character, limitations that we must be ready to overcome as well as we are able.

As said, though, very preliminary results from this return to carbo/taxol look good. My pain is modestly reduced, and the near-surface tumors appear (by the 'aforementioned crude measurement) smaller. We remain hopeful that our current course may yet lead us to stable disease soon. I was initially to begin my second treatment cycle today, but a measurement of my platelets showed them low, so we postpone till next week.

I am hopeful that I may begin working again soon. I am feeling better mentally as I can reduce my pain killers. I don't know that I have strength to put in a full week at the lab, but I am talking to my colleagues about perhaps working some from home on computer control of some of our apparatus, while perhaps putting in a day or two during the week on-site. Perhaps in time, that "day or two" can be extended.

Fantasy football!

Sadness among squirrels everywhere, as Rodent Passion, after a blistering 4 - 0 start, ends an injury plagued season at 5 - 7 and out of the play-offs. The final game, a 97 - 84 loss to Man Boobs, featured a strong run game, with both starters and three back-ups producing double digit efforts, but the wide receiver corps that carried us early failed to produce a touchdown. There is optimism in the land of the ground hog, as RP will be receiving the first pick in our rookie/free-agent draft next year (welcome to the team, Darren McFadden!), and the running back depth might be used to re-load at WR. Hope, even in the seemingly trivial such as fantasy football, is a good thing.

In Great Pigskin Experiment action, Monkey Knife Fight found themselves on the losing end for a third straight week, after a 149 - 67 shellacking at the hands of the SlopChoppy Express. A better mood prevails here, however, as the play-offs remain attainable. In spite of our 6 - 7 record, a win next week against the hapless Space Family Robinson puts us in the play-offs. Go Monkeys!

Spe Salvi

On Christian Hope. That's the title of the new encyclical by Pope Benedict XVI, the full text of which can be found here. The title strikes me as incredibly relevant to what I am going through right now, leaving me really excited about reading through it. I'm hoping to do so over the coming weeks, perhaps offering some thoughts along the way. I'd really love it if others out there would also be interested in reading along, perhaps commenting on my comments (in the comments section of this blog). It prints out at some 28 pages of text and sources, making it short enough to read through, then go back and pick it apart. Thoughts? Who's in? We'll say first post to come next weekend (December 8 or 9).

There are doctors, and then...

...and then there are doctors who also are scientists. At the current time, I am thankful to have such a one as this on my team right now in Dr. Mulcahy. The difference, as I see it, is that the scientist is much more willing to think outside the "standard book of treatments", to try things that maybe haven't been tried before if there's a chance they might work to either improve the quality or quantity of my life.

So, mom and I went downtown today to visit with Dr. Mulcahy, and to discuss what options are available given the state of things. The first bit of news, I suppose, is that we will not change our current track. I have had the one treatment of carboplatin/taxol, and have seen some very priliminary "results" in the slight reduction of my pain and softening of my near-surface tumors. If a later CT scan (to be scheduled for sometime after my next treatment) shows that this chemotherapy continues to work everywhere outside the liver, we will go ahead and consider options such as the Theraspheres (discussed in previous posts) for treatment inside the liver.

The second bit of news is that, as Dr. Mulcahy says, there are always other chemo options. It simply depends on how far off the beaten track one is willing to go. The thing is, there's not much of a "beaten track" where appendix cancer is concerned, it being so very rare. But there are several drugs that we might consider trying, should the carboplatin/taxol combo begin to fail us. And perhaps, these drugs might work in the liver...though for the moment, we will probably try and continue the current track, as something that appears more likely to produce results.

What's more, Dr. Mulcahy has good things to say about the program at Vanderbilt, just 3 hours from my home in Knoxville. They have a very active program in clinical trials, which may be an option in the very near future. One interesting thing she had to say is that there may be ways to get on a trial targeted for another cancer, if I can make some sort of "humanitarian use" case. This is to say, if there are colon cancer trials out there that we think promising for my appendix cancer, we might be able to write the producer of the drug, and see if they might approve of its one-time use on something other than colon cancer. To get to that stage, though, I have to get myself into the system at Vanderbilt, a process I expect to begin next week.

Fantasy football!

Another rough week for our beloved fantasy football programs. Rodent Passion finds themselves, after a promising 4 - 0 start, on the verge of being eliminated from the play-offs...the longest of long shots, facing our league's most formidable line-up (the powerful Man Boobs) while in a 4-way tie for the final play-off spot (behind in every conceivable tie-breaker). This after a difficult loss to Lucky 1, 92 - 83, that could have been a victory with a few reasonable line-up alterations. Ah, but that's the trick. We must live with the decisions we make, and to second guess is a road to ruin. So while facing elimination, we look forward to next season's opening draft, and the possibility that Arkansas' electric tail-back Darren McFadden could be the new work-horse for a resurgent Rodent Passion.

Monkey Knife Fight also found themselves on the losing end, this time by a 151 - 119 decision to a resurgent Distorted View. Optimism reigns in the land of the angry monkeys, however, as we remain in strong play-off position, with a very good chance at coming home in the money this year.

It's not perfect, but it's good

Happy Thanksgiving, and greetings from the family homestead outside Chicago. Coming home is a wonderful thing, especially after the last month plus of being home alone not working. I'm feeling renewed -- in part from finally feeling some benefits from the radiation and chemo, in part from being among family and friends. One cannot underestimate the power of friendship for boosting the spirits and increasing one's joy for life.

I am reminded of that book on heaven I'd been reading, and some of the discussion/comments from before. Whatever else heaven is like, it is to be that place where every desire is satisfied, every pain quenched. Home is as near an approximation as I have in this life, and to have such an approximation leaves me feeling especially thankful today. I am convinced that our greatest desires are relational, that we are made to know and be known, to love and be loved. It is here where I am most known and loved, where I in turn know and love, more than anywhere else on earth. While anticipating heaven (perhaps soon, but not yet!) it is nice to know I have such a retreat.

A quick update, while I have your attention: I am feeling good, like I mentioned. I'd mentioned in a previous post that I was finally feeling some relief from my pain, thanks to the radiation treatment. Ten days after my first round of chemo, I can say (with some confidence, if not full confidence) that it is working again to reduce my pain still more. In what is now a pleasant surprise that should not be a surprise, I find that one week after resuming this chemo I feel better than I did before receiving the treatment in the first place. It always comes as a surprise, because of course the chemo leaves me feeling especially bad for a good seven days, before the side effects quite suddenly subside, leaving me, as I say, even better than I'd been before starting.

I see Dr. Mulcahy on Wednesday, and it will be nice to be armed with some preliminary, if qualitative, "results" from having resumed chemo. As I've mentioned, I hope to speak with her about, among other things, the so-called Theraspheres treatment. Researching the Theraspheres this morning, I stumbled upon a little video here. Presents a nice summary of what the treatment is like, better than I could put into words, or than you might get from reading their web page. The emphasis in the video (and on the web page) seems to be on cancers originating in the liver, but I have been told that the treatment also works on metastatic disease from other places. They also mention that up to 25% of folks receiving the treatment experience a significant tumor response. The odds may not be that great, but I think I'm due for a break. Here's to hope -- for this life, and the next.

Prayer of the day

May all transitory things, O Lord,
be worthless to me
and may all things eternal
be ever cherished by me.

May any joy without You
be burdensome for me
and may I not desire anything else
besides You.

Continuing the prayer of St. Thomas Aquinas, For Ordering a Life Wisely, last installment here.

A modest update, 11/20/2007

There's not a lot to say in this week's update. We did finish our radiation treatments, the last one coming on Monday. I suppose there is this to say: in the end, there were some modest signs that the radiation had a positive effect on my tumors. I have significantly increased motion in my left leg/hip, and there does seem to be slight improvement in my pain in the lower back. However, the pain in my side has been increasing as we have not treated it, and my overall pain level remains around the same.

I began chemo last Thursday, with the carboplatin/taxol combo. The effects are as I remember them -- I feel a bit queezy for several days following the treatment, and a bit tired, but am pulling out of that now. In the past, I have felt near-immediate (within a couple weeks) positive effect on my pain levels and tumors near the surface. Still nothing to report, but I will post as soon as I notice anything.

One curious thing with this most recent treatment...a reminder that the insurance company is hardly my friend. I ended up receiving my treatment at the hospital rather than at the oncology clinic. This because, for reasons beyond me, the insurance company was unwilling to pay the rates for the drugs available to the oncology clinic, while they had no problem paying the rates at the hospital. Part of the reason for this is that this combo (in spite of its success in treating my cancer) is not listed on the insurance company's list of "approved" regimens. I had brief concerns that they were going to refuse the treatment altogether, but thankfully this did not happen. I fear the day that the insurance company does refuse me treatment...my cancer being fairly rare, and the list of "approved" treatments likely small, slowly varying, with little room for modification on behalf of my doctors...it seems a reasonable fear. And yet, there's nothing to be done about it, so while I will be aware of the possibility, I will not let it bring me down.

Fantasy football!

Ugh. What a rotten week for football. I think it's time to call it a season for my Bears, 30 - 23 losers to the Seattle Seahawks this past weekend. What the heck happened to this team? Just a few months ago, I was praising them as a well constructed juggernaught, with questions at QB and RB alone. Now the questions go up and down the line-up, into the coaching staff and front office. The hope now is that they get a high enough draft pick to get one of the top 3 QBs coming out next year (Woodson from Kentucky, Ryan from Boston College, Brohm from Louisville), take a RB to move Benson's butt out of the way (or at least complement him as did Thomas Jones), and then completely re-vamp the OL. And hope the defense comes back healthy and with a better attitude next year.

Both of our beloved fantasy teams suffered losses this week as well, Rodent Passion falling 100 - 61 to Corporeal Punishment, Monkey Knife Fight 152 - 112 to the Sunrise Stingers. It hurts too much to talk about it. Here's hoping some lovin' from the family (along with some turkey and stuffin' and cranberry sauce and such) improves my mood next week.

Congrats Laura and Jeff!

Good friends Laura and Jeff head down to Guatemala to get their newly adopted son, David Carlos. Laura is also several months pregnant with another boy -- twin boys the hard way! Congratulations on both counts to Laura and Jeff. God's blessings on you both, and on the little guys!

Another modest update, 11/13/2007

I spoke today with Dr. Grapski, my local medical oncologist. I'm starting chemo on Thursday -- back to the carboplatin/taxol combo that I'd been pushing for. Seems Dr. Grapski is not so worried about conflicts between this chemo regimen and the radiation, so we'll go ahead and finish off the radiation through Monday, too. As far as I'm concerned, that's fine -- it does seem the radiation is finally doing something, so the more we can throw at these guys, the better. Depending on how things go, perhaps we go ahead and zap the side tumor with radiation when I get back to town after Thanksgiving. That'll be something to talk to Dr. Meyer (the local radiation oncologist) about tomorrow.

So why the sudden agreement to do chemo and radiation at the same time? Well, he was thinking of putting me on a different chemo regimen. It was a little aggravating...though I should cut him a little slack...but he was going to suggest I start irinotecan/erbitux. Which I took from last August through April. Cutting him some slack, at no point did I take that here, so I can understand if he'd overlooked it. For all of my moves, I have to stay on top of these things, and can't count on my doctor to be as much on top of them as I am. The problem with irinotecan/erbitux with radiation is that both can induce big diarrhea issues, and he didn't want to double up on that possibility (especially given the problems with dehydration I'd had before). It's less an issue with the carbo/taxol.

I'm relieved. As always, when we get started on something new (or start something again), it's a time of excitement and optimism. Here's hoping that the combo of chemo and radiation beat back the tumors and my pain, and open the door for treating the liver by itself, by other means.

Prayer of the day

May I not rejoice in anything
unless it leads me to You;
may I not be saddened by anything
unless it turns me from You.

May I desire to please no one,
nor fear to displease anyone,
but You.

Continuing yet again the prayer of St. Thomas Aquinas, For Ordering a Life Wisely, from here.

Fantasy football!

We come to the end of another glorious week of NFL football -- God's favorite sport -- with Monkey Knife Fight continuing to ride what is now a 5-game winning streak, victorious this week over the St. Pete Pinheads 103 - 76. MKF now sits comfortably at 6 - 4, in second place in the Autobots division of The Great Pigskin Experiment, with a match-up against the first place Sunrise Stingers looming. With byes now complete, we will see what our full-strength squad is made of.

You'll notice that at the start of the year, I would begin my updates with the tails of triumph of Rodent Passion. This was for two reasons: first, I have a greater emotional investment in RP, they being my "dynasty" team, the players on which I keep from year-to-year. Second, RP started quite strong, and I find I like talking about my successes before talking about the failures. I would never have figured myself for such a person -- I've usually been a "eat my veggies first" kind of guy...as a kid, I would eat around the icing on a piece of birthday cake, enjoying several bites of NOTHING BUT ICING at the end. Tasty. I've been a delayed-gratification guy by nature. And yet, I ramble about my fantasy football success before my struggles...why is this? I haven't noticed the same pattern in my health updates...I'll have to take a look and see...

All of which stands as prologue to RP's performance this week. Which is actually still in question -- as I write, RP stands with a modest 66 - 60 lead over The Headhunters, who still have Bobby Engram to play for the Seattle Seahawks in tonight's match-up versus San Francisco. If Engram is kept to fewer than 60 yards and no TDs (a 50/50 or worse proposition), RP rights the ship in time for the full recovery of its players and the end of the dreaded bye-weeks -- just in time to make a late run for the play-offs. Last weekend, we consummated a trade of Andre Johnson for Clinton Portis with Corporeal Punishment, which should strengthen our running attack though leaving us vulnerable at WR, should Roy Williams, Anquan Boldin, or Deion Branch suffer yet another slump or late injury.

Edit (post-MNF game): Bobby Engram was held to 53 yards, meaning RP defeats The Headhunters by a final of 66 - 65. Woo hoo!

I am confident that in MKF I have one of the top three teams in The Great Pigskin Experiment, and have a strong chance of finishing in the money. In RP, I have a team that could finish in the "toilet bowl", struggling to avoid the responsibility to provide tasty beverages for next season's draft party, as easily as it could finish in the money. The fun begins now!

A modest update, 11/12/2007

There's not a great deal to say today, but as promised last week, I'll give a quick run-down on how I'm feeling, and what we're considering. As of today, I've finished 15 radiation treatments on my left hip and tail-bone. And near as I can tell, there is little changed -- for better or worse -- on these tumors. I still feel no real side effects (that's good!) but no real decrease in my pain (that's bad). There are some indications that maybe, just maybe, we're seeing something happen with the tumor at my tail-bone...but the signs are difficult to read, and still more difficult to try and describe here.

I'm planning on tomorrow chatting up Dr. Grapksi, the local medical oncologist, about resuming chemo -- going back to the carboplatin/taxol combo that I like so much. In addition to my experience with this treatment -- that it seemed to keep the pain under control, while softening up or shrinking the near-surface tumors I can feel beneath my skin -- the timing is good. That is, it's a one-every-three-week cycle, so I can make a trip home for Thanksgiving and my consult with Dr. Mulcahy at Northwestern without interrupting the normal treatment cycle.

Next update will come soon, I suppose, with word as to whether or not I'll be starting chemo sooner rather than later.

Veteran's Day

I wasn't planning any reflections on Veteran's Day...not that anyone would expect one from me, someone who has never served in the military, and has few friends who have. I guess I am inspired out of the blue, recalling having read just over a year ago the anti-war classic All's Quiet on the Western Front. The work is an intense account of one soldier's experience on the front lines during WWI, on the losing side. The author details the relentless brutality of war, as one is changed through the experience, to endure, endure, endure...against all odds, with little that might be called "hope". The life of the soldier during that war consisted entirely of fighting and surviving. Moments of quiet were celebrated, and transition to chaos was as natural as the rising of the new sun.

I found myself, in reading the book, relating in many ways to the soldier. Both of our experiences are terribly lonely -- just as one who has not struggled with cancer cannot understand my struggles, nor can I (or anyone else) understand the struggles of those facing the horrors of war. The discovery of perseverance -- the ability to endure such horrors, which, had we been presented them prior to our experiences, we surely would have rejected the notion that we could so endure.

Many endure terrible suffering, but the intensity of the suffering of war or cancer...the relentlessness of our opponent...goes beyond what is considered "normal" suffering. It cannot help but change us...but in what ways? Does it make us better human beings? I believe (and have mentioned this elsewhere) that we can choose to answer in the affirmative.

To all those who have endured the horrors of war, I salute you. My prayers are with you, and I thank you for yours.

On further reflection

It is patience that governs our response to the "times of adversity" mentioned below in our continued reflection on the prayer of St. Thomas Aquinas, For Ordering a Life Wisely. As St. Thomas quotes St. Augustine in his Summa Theolgica, "a man's patience it is whereby he bears evil with an equal mind, lest he abandon with an unequal mind the goods whereby he may advance to better things."

I quickly wondered, "what is the virtue that governs our response to the 'times of prosperity'?" I think it is in part governed by the virtue of humility. St. Thomas writes again, "a twofold virtue is necessary with regard to the difficult good: one to temper and strengthen the mind, lest it tend to high things immoderately; and this belongs to the virtue of humility." I'm not sure that this is quite it, though...and want to consider this more.

Still, it is clear that there is danger in either prosperity or adversity, and we pray for virtue to be happy in either state. Because as is well known, there are many quite wealthy folks who are unhappy in their excess, and there are many in poverty who demonstrate an uncommon joy. So clearly, happiness is not to be found in either material state, but in the state of our soul.

Prayer of the day

Grant unto me, O Lord my God,
that I may not falter in times
of prosperity or adversity,
so that I may not be exalted in the former,
nor dejected in the latter.

Our third installment of the prayer of St. Thomas Aquinas, For Ordering a Life Wisely, continued from here. When the circumstances of our lives are such that things go well, we are tempted to presume that we are either deserving or in control. Likewise, when circumstances are such that things go poorly, we are tempted to despair, to lose hope of ever knowing good again. In this case, we may give up trying at all. Both views are a mistake. I discovered early in my struggle with cancer -- when so many things I once presumed to be part of my life abandoned me (my health, my good relationships, the surety of my career path) -- that there is so much beyond my control. This is not to say that we can do nothing to keep such things in good order...just that our efforts alone cannot keep them so. We recall the "Serenity Prayer" of Reinhold Niebuhr:

God grant me the serenity
to accept the things I cannot change;
courage to change the things I can;
and wisdom to know the difference.

The well ordered person struggles to grow in this wisdom.

What I'm reading

For the longest time, my reading list has consisted primarily of classic literature (Dostoevsky, etc.), classics in Catholic or Christian thought (St. Catherine of Sienna, St. Terese of Lisieux, etc.), or classics in Philosophy (Plato, Thomas Aquinas). Contemporary stuff, or anything "light", rarely made my list. I wanted to lighten up a bit, so I asked my brother to lend me a stack of his books from the Star Wars collection -- stories of characters from the movies (or not) within the Star Wars Universe, but not necessarily directly connected to any of the movies.

I've really been enjoying them -- and am finding I can make them as "heavy" as I want, which is fun. Understanding where the authors take the Philosophy behind the Force, for example, has been neat. From the books I've read, it's not so much a battle of "good vs. evil" as it is a battle of two sides of a "pragmatic" coin. Now, I can't say as I'm all that familiar with contemporary "pragmatic" philosophy, but I imagine it might be represented in a popularized way here. Those who follow the Dark Side, for example, are driven by selfish power -- one is happy the more power one possesses and the more control one wields over others. Happiness here might be the wrong word, since one who follows the Dark Side must always look over his shoulder for another who might take away his power. Those who follow the Light Side believe that happiness is found when others also are made happy -- if I live the virtuous life and encourage others to do the same, then all are happy, myself above all. I use my power for the good of others, for "selfish" gain in-so-far as the good of others is also my own. Neither side is driven by an absolute idea of "good" or "evil", but by their pragmatic understanding of what will make them happy.

I've lately wondered about how such a philosophy of ethics would be developed -- groundless except by the collective life experiences of myself and others. I suppose it's out there...perhaps some day I'll find it and read it. One I'm ready to be "heavy" again.

Fantasy football!

As the saying goes, he who lives by Addai will also die by Addai. And so it goes with my Fantasy Football teams this past weekend. The Monkey Knife Fight absolutely mauled the Eighteen Grands in Great Pigskin Experiment action, by a final score of 140 - 91, lead by Indianapolis Colts running back Joseph Addai, who ran for 112 yards, caught passes for 114 yards, and had a touchdown by both means. Though the Colts lost, the glory of Fantasy Football should allow Addai to rejoice that he led any number of fake teams to victory yesterday. MKF sits at 5 - 4, a modest record, but one that puts us in position to make a strong play-of run, which is all we ask.

Like, for instance, Coveropolis, who, in Rock 'n' Roll Fantasy Football League action, defeated a reeling Rodent Passion by a final score of 125 - 36. That, my friends, is ugly. In R'n'R regular scoring, Addai himself accounted for 34 of the 125 points accrued by the Covoropolians -- nearly enough to defeat Rodent Passion by himself. RP sits at 4 -5, also a modest record. But one that tells the story of 2 teams -- the one that started 4 - 0, the other that has continued at 0 - 5. Our season of promise is quickly sinking into a season of disaster, unless our guys return healthy and strong relatively quickly.

A modest update, 11/5/2007

It occurs to me that my last update may have sounded a bit worried. And I must admit that I find myself worried far more often these days than I have for much of my ordeal. With some reason, I suppose.

That said, it is in no wise necessary that we be so very concerned. At least, not because of the pain. The tumors that cause my pain are, at the end of the day, mostly nuisances. I don't believe them to be deadly, really, though they make life tough on the day to day. It remains the case that the tumors in my liver are of greatest concern, and these are the ones on which future treatments will primarily focus (as they have been the driving motivation for changing treatments through the summer). The good news (such as it is) is that my liver tumors remain of modest size (relatively speaking -- they are small in comparison to my abdominal tumors, and, more importantly, small in volume compared to the size of my liver). It is also true that they are treatable with modern techniques (with theraspheres, for example). So I will carry my pain so long as it is necessary, not getting worked up about it, looking forward to attacking the bad boys in the liver as soon as we are allowed.

Prayer of the day

Grant that I may know
what you require me to do.

Bestow upon me
the power to accomplish your will,
as is necessary and fitting
for the salvation of my soul.

This is the next stanza of the prayer of St. Thomas Aquinas For Ordering a Life Wisely, began here a few days ago. To ask of God what he requires of me has often been difficult. It seems I can be sure of what he requires of everyone, not just me -- that I pursue the life of goodness and virtue, striving to love as he gives example (in the giving of his life). I suppose these days, my particular task is easier to determine than it ever may have been -- that I carry my cancer well, that I allow my pain and suffering to change me, make me more understanding of the suffering of all, more giving with what I have (knowing that of what I have, I can claim no real "ownership" or "right" to it -- health, wealth, worldly happiness being so very fleeting). I trust that my salvation is being worked out primarily in how I handle myself through my cancer -- and not just how I handle my troubles, but how I respond to the troubles of others as I carry my own (God, grant that I never become so obsessed with my own struggles that I fail to see the troubles of my neighbor!).

St. Thomas gives us the key to carrying our responsibilities well -- which is that we ask strength from Him Who requires these things of us. He provides the opportunity for good, the strength to do it, and then rewards the doing. All good comes from Him, though we are invited to participate in His work.

Update, 11/3/2007

I didn't really expect to provide an update any time soon. At least, not till I had something bigger to share. However, I was prodded for an update by a friend, and it occurs to me that even in the absence of big news, the regular update on how I'm feeling would probably be welcomed by many. So, here's what I shared with my friend:

I'm still not able to get back to work, as I'm still in a lot of pain -- it hasn't eased yet with the radiation. This was to be expected. At least, they told me it would be at least 2 weeks before I'd feel anything. We're just at the 2 week mark...so hopefully, soon.

Finances and benefits are in good shape. I'm on short-term disability through work -- it's not a federal program, but part of my work benefits package. It's pretty nice -- I'm paid at my full salary for 5 weeks if needed, at 80% for another 5 weeks, then at 60% for 10. If I can manage to fit in another 2 weeks of work in there, I actually earn another week for each of the 1st 2 stages, another 4 for the 3rd stage -- the full benefit kicks in when you've worked at the lab for 6 months...I'd been there 5.5 before taking off.

I really can't say just when I'll be back to work, though I hope it's soon after Thanksgiving. It really depends on what we decide to do next in my treatment, which will be determined when I see Dr. Mulcahy at Northwestern, scheduled now for the Wednesday after Thanksgiving.

It's tough. While we're treating just the 2 tumors that are the likely sources of pain in my leg and tail-bone, I can almost feel the tumors growing elsewhere in my abdomen...in my side, and in my front along the vertical incision from my surgeries. I hate waiting to treat those, but there's no real choice -- though perhaps one of them (the one on my right side) could be added to those we currently treat with radiation. I'll be bringing that up with my radiation oncologist this week.

Thanks to all for your continued concern. I'll try and keep a weekly update on how I'm doing/feeling -- it's probably good for me to keep up running reflections, and I appreciate the concern so many of you hold for me.

Prayer of the day

O merciful God, grant that I may
desire ardently,
search prudently,
recognize truly,
and bring to perfect completion
whatever is pleasing to You
for the praise and glory of Your name.

Put my life in good order, O my God.

This is the opening stanza of the prayer of St. Thomas Aquinas, For Ordering a Life Wisely, which Thomas is said to have recited daily before the image of Christ. As often as I can remember to do so, I do the same. Over the coming days (or weeks, depending on how often I get to it), I will provide the rest of the prayer, bit-by-bit. Often, the brief stanzas make enough of a stand-alone prayer...if but a whisper of a prayer, still a noble aspiration. Some time ago, as I entered the Catholic Church, a good friend -- with whom I have, regrettably, lost touch (God's blessing be upon you, wherever you are, Toyin) -- gifted me The Aquinas Prayer Book, containing many prayers, from which I have learned how to pray for the best things. Perhaps my good readers will be as blessed as I have been by this one.

Fantasy football!

Rodent Passion now finds itself 4 - 4, with a four-week losing streak in tow, thanks to yet another defeat (this time at the hands of Ethos, 90 - 60) of a line-up dominated by rookies and castaways. The good news is that our long, injury-riddled, tunnel looks to be coming to its merciful end, as Laurence Maroney, Deion Branch, Anquan Boldin, and Andre Johnson return from their respective injuries. With the surprising rise of Denver tight end Tony Scheffler, RP has a chance to regain its early season dominance just in time for the play-offs.

Meanwhile, Monkey Knife Fight has ripped off three consecutive convincing victories, most recently by the score of 146 - 62 over the Lazerphiles. As has been the case all year with MKF, we got balanced scoring all around, though we are pleased with another surprise in the play of New England WR Wes Welker, taking the lead in what was already expected to be a strong WR corps.

Use me

I had wanted to look up all sorts of references on this, to encourage myself and my readers who share my faith. Perhaps I may yet, but I wanted to put this out there sooner rather than later, and at the moment, I don't know that I have the energy to do the kind of formal study that I'd really have in mind.

What I am offering is this: please, friends, let me pray for you. Our Lord's was a life of suffering, and he applied this suffering to our spiritual benefit. Those of us who follow him and are called to suffer are invited to participate in his suffering, and I am convinced that God may empower my earthly suffering to my spiritual gain and the spiritual gain of those for whom I pray.

I know that people are hesitant to burden me with their troubles, figuring that I may just have troubles enough of my own. Yet as I have become aware that people really do want to help me -- and I have to be humble and let them, for both our goods, fighting every instinct in my body that suggests I can do it myself -- I hope people will let me help them. I trust that my prayers, at this time, as I suffer and share my sufferings with Our Lord, sharing also in his, may just carry a weight beyond what they may at other times and places. Please, let me pray for you.

A content Sebastian

I'd never observed this behavior before, in any cat I've known. But Sebastian seems to enjoy kneading, where he'll press alternately with his paws on whatever soft surface is nearby -- usually either my lap or a small blanket. Actually, I've successfully convinced him to use the blanket rather than my lap, seeing as he's still got his claws, and his kneading of my leg was getting rather painful. It is apparently a sign that he's pretty happy with how things are. He certainly purrs quite loudly as he does it.

I've often thought I have a way with God's stupid creatures -- animals, babies, certain women (wait, did I say that out loud?). Yeah, we've become buds. I like having the little guy around. :)

Radiation update, 10/26/2007

I have now completed 4 of my scheduled 20 radiation treatments. So far, I'm feeling nothing at all -- good or bad. No reduction in my pain, but no evidence of side effects, either. They say I shouldn't expect much by way of pain reduction until I've completed at least 2 weeks of treatments, so I suppose patience, as it often is, is the word of the day.

In the meantime, I have not been back to work in the last two weeks. My pains reached a point where the prescribed medications were leaving me in a poor state for driving, much less for performing my work at any reasonable level. The good news here is that the benefits package at the lab is excellent, and I can claim a "short term disability" that will allow me to continue getting paid for a decent while. I can hope to return to work before this benefit is exhausted.

While I don't know exactly what comes next after the radiation, I am making some moves to help in the determination. We have pretty much exhausted the expertise available here in Knoxville, so I have set up an appointment for a consultation with my oncologist at Northwestern, Dr. Mulcahy. I will see her on the Monday after Thanksgiving (11/26/2007). My hope at that time is to convince her that (1) perhaps we can use the carboplatin/taxol combo one more time to control my cancer outside the liver while (2) using Theraspheres to treat my tumors in the liver. Unless she's got better ideas. It certainly seemed that this treatment was working everywhere outside the liver through the summer -- we changed only as we saw the liver tumors growing.

I suppose there's no demand for updates till I notice something -- here's hoping as soon as next week. All the best to all till then...

Quote of the day

There is cause for rejoicing here. You may for a time have to suffer the distress of many trials; but this is so that your faith, which is more precious than the passing splendor of fire-tried gold, may by its genuineness lead to praise, glory, and honor when Jesus Christ appears. Although you have never seen him, you love him, and without seeing you now believe in him, and rejoice with inexpressible joy touched with glory because you are achieving faith's goal, your salvation.

I Peter 1:6-9. The reading from tonight's Evening Prayer.

Fantasy football!

While sick, I couldn't find it in me to provide my weekly Fantasy Football update. With all apologies for those who waited impatiently last week, I will provide a mid-weekend update on the fortunes of both my beloved teams, Monkey Knife Fight and Rodent Passion.

Of course, those who read the comments will know that Rodent Passion fell to the hapless Popeye's Nephews (thanks, Steve) last week, while producing the lowest scoring output in our league's 3.5 year history, largely due to bye weeks and injuries to many of my top players. As those injuries continued to this week, RP fortunes look no better. Barring a super-human effort tonight by Jacksonville tight end Marcedes Lewis (say, his going for 150 yards and 3 TDs), RP will suffer its 3rd consecutive loss. Still on track for a play-off berth, but our players must get healthy (and stay off the weed) if RP is to recover from this slide.

MKF, meanwhile, is on a little run, thanks largely to the unexpected explosion of the fantasy powerhouse Wes Welker of the New England Patriots. He has produced 30+ points for MKF on consecutive weeks, helping to pull out an unlikely victory one week ago, and putting MKF in position for another this week. Heading into tonight's Monday Night Football game between Indianapolis and Jacksonville, MKF finds itself down 7 to the Brookside Bulldogs, with Indy RB Joseph Addai and Jacksonville TE Marcedes Lewis still to play. The Bulldogs counter with Jacksonville QB David Garrard. A close one that could go either way, I like our chances should Addai come back strong from his recent injury.

In football talk, unrelated to fantasy football, I find it interesting how often the subject of character in adversity arises. Just this morning, listening to Mike and Mike on ESPN radio, I don't recall who, but someone was making the comment that "adversity does not build character, it reveals it". I have seen variations on this theme in many contexts, but like I say, it comes up often in football. What do I think of this? Personally, I think both. I'll snoop through my copy of The Dialogue of St. Catherine of Sienna to get her agreement, but I am convinced that suffering both builds and reveals character. While we are born, I believe, with a certain supply of instinctual virtue (if such can really be said -- perhaps it's better to say we are inclined toward certain good behaviors naturally, while others we develop and choose), trials of all kinds -- whether cancer, or merely suffering through going to school as kids -- build in us wisdom, justice, fortitude, and temperance, if we choose. Later trials reveal the extent to which these virtues have blossomed, while allowing them further feed on which they will be nourished and grow.

I think to suggest that trial merely reveals character denies the very possibility that character may be developed. How else might character be developed except by trial? I suppose there are some, who by the exercise of their wills, grow in wisdom and the other virtues, without ever having to suffer trials. Most, however, have to be forced to grow, the way children are forced to go to school. And this "force" comes by way of the trials placed upon us by life.

Edit (10/24/07) to add the weekend's final scores:
MKF (3-4) 110 over Brookside Bulldogs 108
NP (4-3) 54 loses to KC Masterpiece 85

Update, 10/19/2007

First, my apologies for taking some time getting this one out. I had fully intended to post an update on Tuesday, after seeing Dr. Grapski, but between needing time to wrap my head around the latest news, meeting with a radiation oncologist yesterday (Thursday, October 18), and getting sick (I got knocked loopy starting Sunday evening...feeling near 100% only today), I'm only now getting around to this. Thanks for your patience.

So, from Tuesday we have good news and bad news. The good news is that we have likely located the sources of my pains in my back and left leg. There is a growing tumor near my tail-bone, roughly 7.5 cm in diameter, as well as another tumor (not sure the size) on my left leg, near the hip-joint. Yesterday's visit with the radiation oncologist was to discuss treatment of these. On Monday I return for a "mock" run of my treatment, when they will confirm that they have defined the proper trajectories for the different radiation beams used to attack my tumors -- coming in from multiple angles allows a greater concentration of radiation on the tumor versus healthy tissue. Then on Tuesday I begin for real, returning Monday through Friday for the next four weeks. After this time, continuation will be determined by (1) whether my pain is improved, (2) whether we see any regression of the tumor in a follow-up scan, and (3) the severity of any side-effects.

In the meantime, we will put aside chemotherapy, and this gets us to the "bad news" portion of our post. We have officially exhausted all chemotherapy options for the liver -- 4 nodules in the liver have seen an increase in size since my last scan, growing by as much as 1/3. Everywhere else (aside from the 2 causing my pain and the 4 in the liver) it appears my cancer is either stable or gone (though we can't say anything with certainly here), so that much is good. Treatment of liver tumors is notoriously difficult, though two techniques have emerged over the last several years that offer some promise. The first uses tiny beads filled with a radioactive element (going alternatively by the names "theraspheres" or "SIMspheres"), which are injected into the blood-stream on its way to the liver. These beads collect in the tumors and there deposit their energy, largely preserving healthy tissue. The second option goes under the name "gamma-knife" or "laser-knife". From what I gather (I have not yet read as much about this), this employs first a surgical procedure to open direct pathways into the liver, allowing laser- or gamma-radiation to then interact directly with the tumors. Both are minimally invasive, with low side-effects and seemingly high success rates, though with the disadvantage -- as with all radiation treatment -- that they interact only with the targeted tumors, and not with any smaller, unseen, tumor in the liver. If simply due to geography (it's offered at Vanderbilt, just 3 hours away and within my HMO region) my best bet will likely be with SIMspheres. I am still gathering information, and must decide when to pursue this. I can say this will wait till after the coming month or so of "standard' radiation treatment. Just how long we'll wait is still to be determined.

And that's about it, sports fans. While the news of Tuesday, that the Xeloda was not working in the liver, was no surprise, it was still a punch in the gut. It is so every time -- no matter how hard I try to prepare myself. Every reminder from the outside -- from a doctor, from a CT scan -- that my cancer is getting beyond the reach of chemo is a jolt. But we respond the same way every time -- we take the hit, and rise again. Life is worth living, at all stages, and so long as I have life within in me, I will fight for it. Thank you all, as always, for your thoughts, prayers, and all other forms of support.

More on Kreeft

In a recent e-mail sent to a friend, I included the following reflection inspired by reading that book on Heaven, by Peter Kreeft. Seemed worth sharing (after modest editing):

One speculation Kreeft brings out in his book is that in heaven, we will participate -- actually participate -- in the suffering of others on earth. I remember reading that and at first being almost jealous of my suffering -- it's mine, after all. How can anyone else be allowed to learn and grow from them when I was the one forced to suffer through them? And then, of course, with time to reflect, it occurred to me that this would be a good thing. First, for me (always starting selfishly...still starting selfishly...). I have seen or become aware of and become more sympathetic to so much suffering not my own over the past several years. As humans we all share the bond of suffering, though in different ways. I am convinced that this suffering is, ultimately, what shapes us most as human beings. If in heaven I am to be most fully human, it makes sense that I learn from the suffering of others -- I want this for myself. I suspect that if I share in the suffering of another, they do not suddenly become any less the suffering of that other -- I will wear my scars...my battle wounds from cancer...proudly in the next life, as will those who bear "scars" of other sorts, from their unique suffering. Secondly, we all desire to know and be known, love and be loved. If heaven is where we are truly most happy, it is where we will be most fully known, and where we most fully know.

Quote of the day

Ah, yes. Spending time in the valley so you will
appreciate the peak.

Gigi, from the comments to the "Quote of the day" from October 7.

I've been contemplating adding some "meat" to this blog, by way of offering reflections on two themes that mean quite a bit to me these days: the virtuous life, and the nature of suffering. I thought I'd take Gigi's comment to get the ball rolling on both of these ideas.

The question is, "is that it?" I mean, is the point of suffering simply to learn to appreciate the good times? Whether in this life, or in heaven? I may have suggested as much, but I really can't believe that's all there is to it. I remember a homily from shortly after my diagnosis. In it, the priest noted that there are two directions we can go...two choices we can make...in the face of great trial. The first is to let our suffering defeat us, making us bitter and angry, hopeless. Or we can choose to become good through suffering -- to become virtuous, facing it with courage, growing in widsom and our conception of justice, through which we become the better equipped to handle the difficulties of this life (which do not stop with, and are not limited by, cancer -- I have only to watch my friends struggling mightily to raise children to understand this).

And what of heaven? I mean, how many of the virtues remain with us in heaven? Is there still the need for temperance or fortitude? I don't no...but I don't think so. Justice? I think that's taken care of, too. Wisdom? Ahhh...there it is. I think we find a nugget of the wisdom of heaven in being able to appreciate its goodness after the struggles of earth. But I also expect there is more here, too. Just what it is, I'll have to think about some more...

Fantasy football!

I find myself growing a little tired of this segment. Maybe it's 'cause my teams didn't do so hot this week, and 'cause things are looking rough for the future. But perhaps some of you are emotionally invested in the fortunes of Monkey Knife Fight or Rodent Passion? It would be irresponsible of me to deprive you of your much needed "fix". And so...in Great Pigskin Experiment action, MKF found itself in a game it could win...only to have Santonio Holmes become a game-time scratch, leading to an 89 - 84 loss to the St. Pete Pinheads. An underwhelming performance all around. We would be optimistic heading into this weekend's action against the Space Family Robinson -- the league's worst team -- but with 1/2 of our team taking a bye, we've filled our roster with waiver wire scrubs for the week. A well-constructed team is looking like a play-off outsider barring some change in our lucky stars.

Meanwhile, RP put forth it's worst production of the year in losing to Coveropolis, 61 - 42. Our super-powered WR corps is hurting in a big way -- with Anquan Boldin, Andre Johnson, and Deion Branch all nursing injuries, and Roy Williams entering his bye week, the coming week looks tough as well. Your prayers are appreciated.

Quote of the day

Heaven’s greatest wonder is not miracles but
goodness.

From Peter Kreeft, Everything you ever wanted to know about heaven

I’ve been reading the above book – I’m about half-way through by now. On reading the above assertion, my first thought is, “really?” Wouldn’t I much rather be made healthy than good? Perhaps that is one’s first reaction. But on further thought, I think Kreeft is right. At least, when I consider my life before cancer, I can ask myself, “how much happiness did my health and strength bring me?” On a conscious level? I have to say I very much took it for granted. I suppose now, if I were restored to health, I would be all the more thankful for it, and would therefore be more happy – but that would only be after acquiring wisdom through suffering, that health is fleeting. And so the greater good here – the greater wonder – would not then be my restored health. It would be the wisdom to appreciate it. In the same way, I wonder if wisdom shouldn’t make me happier regardless of my sickness or health. At least, if I understand wisdom correctly – isn’t it something like “knowing what will make me happy, and making choices consistently to pursue and obtain it”? – it should put me on the road to happiness.

In this life, what has made me most happy has been the company of family and valued friends. Contemplation and learning come second (just how distant is hard to say – contemplation and learning with friends and family is the top of the top). The wisdom to appreciate this – more than health or wealth or whatever – is a great gift. The great wonder of heaven, as Kreeft is pointing out, is not so much the absence of pain and suffering and things like this. It is the wisdom to appreciate it, and to enjoy the One who makes it all possible. And so my goals remain the same – not necessarily the return of my health (though certainly I would welcome it), but the advent of virtue, particularly wisdom, in my soul.

Not really an update...

...but I wanted to give folks an idea as to when big news might be coming. First, I'm scheduled for a CT scan tomorrow (October 5). I leave late afternoon for a little trip with work (for those worried, the neighbors will be by to care for little Sebastian while I'm gone), returning a week later. I see Dr. Grapski (the oncologist) on Tuesday, October 16. We'll have the results from the CT scan, and will take another look at my ca19-9.

With the CT scan, we're looking for 2 things: first, is there an obvious candidate for the source of the increasing pains I've been experiencing? Pain that began shortly after my move to Munich in the Spring of '05, and could at that time be controlled with ibuprofin, has advanced and spread, lately strongest in my left hip and down that leg. Powerful prescription pain meds are hardly enough to keep the pain under control, and leave me tired and nauseous. Should we find something in the CT scan (looking particularly in the bones, the pelvis especially) we may start radiation treatment on that immediately.

The second thing we're looking for is the overall advance or stability of the disease, to let us know if the Xeloda has been in any way effective. I am not optimistic, given the increase in my need for pain killers, and in the increase in my ca19-9 from last time, but we'll see.

There are two directions that I can see my treatment heading. In the first, we find that Xeloda is not working at all. In this case, we probably go back (for what will be a 3rd time) to the Carboplatin/Taxol combo, that was working so well on my surface tumors and in keeping the pain down, but was failing in the liver. We'd then use radiation on the liver tumors (and possibly also on whatever tumors are causing my pain, though we may wait to see if the chemo is again effective there).

The second direction we take if the Xeloda has been effective in keeping the liver tumors under control. In this case, I stick with the Xeloda, using radiation to deal with the pain-causing tumors in the hip/pelvis. Assuming we find such tumors in the CT scan.

More to come on the 16th...

Sebastian to stay!

While there was no definitive test to confirm that he was responsible for little Sierra's allergic response, there is no denying that the little girl is doing a lot better since the little guy's moving in with me. And so it looks like I've got me a long-term roommate. Which is cool -- he and I have fairly well bonded over the last 2 weeks or so. He's an affectionate little guy, to be sure, and we're getting along great.

Oh, and you'll be happy to know, Mom, that while St. Sebastian is my reminder to strive for the virtue of fortitude, St. Thomas Aquinas includes patience as a part of fortitude. There's our favorite word again... :)

Fantasy football!

Next verse, same as the first...Monkey Knife Fight continues to battle, consistently scoring well relative to the league, with balanced scoring up and down the line-up, but not well enough to overcome the week's opponent. This time, MKF falls 143 - 121 to the Sunrise Stingers. We grow tired of this nonsense.

Meanwhile, Rodent Passion continues to delight and amaze, staying unbeaten with a solid (if unspectacular) 92 - 61 triumph over Corporeal Punishment. The lesson for this week is the necessity of prudence to organize and discipline the passions, in order to achieve one's goals. Keys to this week's victory again included Deion Branch, acquired via trade before the season as part of a deal in which RP relinquished the rights to Rudi Johnson. Now, good Rudi has been a mainstay in the RP line-up for 2 years. He'd been, perhaps, the single most reliable member of the squad. But in fantasy football, one cannot grow attached to one's players at the expense of improving the team for the near- and long-term. A second key was the late addition to the starting line-up of Sammy Morris, starting for New England in place of the injured Laurence Maroney. In a move demonstrating uncommon fore-sight (for this fantasy footballer, anyway), I'd picked up Mr. Morris a few weeks back, anticipating just such a possibility.

Health update, 9/27/07

Yesterday, I made a brief visit to Dr. Grapski's office to pick up some prescriptions. While there, I had the opportunity to check on my ca19-9 levels, measured a week ago. The news is not good, I'm afraid: after my first cycle of Xeloda, my ca19-9 came in at 307. Three weeks later, after a second cycle, it measured 390. You'll remember that "normal" is at or below 35. Now, this could mean nothing. When I first took the carboplatin/taxol combo, starting in June of 2005, I had a similar spike after the first cycle, going from 240 to 420, before it started a steady decline to "normal". However, that spike was accompanied by a series of other effects suggesting the treatment was working. Primarily, the pain I'd been feeling dropped considerably, as I went from needing the suggested maximum daily dose of ibuprofin, to needing no pain relievers at all. This time, however, I've noticed no change (or if anything, a slight increase) in my pain levels.

We'll go for at least one more cycle before making any decisions on what to do next. I'll get a CT scan after this cycle, then we'll also do more blood tests, to see if my ca19-9 continues to rise. If it is determined that Xeloda is not working, it will be time to get creative. We have reached the end of using chemotherapy alone. We note, for example, that while the carboplain/taxol combo had stopped working in my liver, it was still working everywhere else. It is possible that we could return to that chemotherapy while using radiation on the tumors in my liver. That, anyway, is one option among those that will be considered once the results are in from the CT scan and next blood test. More to come on this by late October...

Fantasy football!

Another week, another tough loss for Monkey Knife Fight, this time 161 - 139 to the EighteenGrands. Now in this league, 130 points is a really good score. Though it should be good enough for a win, MKF has found themselves on the losing end two consecutive weeks with such a score. We now find ourselves at 1 - 2, entering into the dreaded byes. It's early in the season, too early to call any week a "must win"...but this coming week vs. the first place Sunrise Stingers is a must win. With week 6 looming as a likely loss, with half the blade wielding chimps taking the week off, a run of wins is necessary to keep our play-off hopes alive.

Meanwhile, the Rodents are delighted. Seemingly putting it all together, Rodent Passion took league scoring honors for the week with its 130 - 68 victory over Gametime Decision. A strong performance by QB Philip Rivers complimented the continued stellar performance of our mighty receiving corps, which over-came the loss of Andre Johnson through the sensational play of Roy Williams, Anquan Boldin, and Deion Branch. In a daring pre-season move, RP traded perennial fantasy football standout Rudi Johnson for promising young runner DeAngelo Williams and the aforementioned Branch. Key to that deal, at the time, was the hope we have that Williams will develop into a stud in the NFL. In the short term, the play of Mr. Branch has been a key to consecutive wins. An important intra-divisional match-up awaits this weekend with Corporeal Punishment. At the moment, RP finds itself alone in first place in the Beatles Division of the Rock 'n' Roll Fantasy Football League. With Corporeal Punishment alone in the division in second at 2 - 1, a victory would give RP a daunting 2 game advantage, and would make them the clear front-runners for that all-important first-round bye in the play-offs.

Update, 9/25/07

Just a quick word since my transfusion: had that on Saturday, and I was feeling the positive effects almost immediately. "Go juice," as my uncle called it when he was getting 'em (also during chemo).

Z asked about talking with my docs about "rhEPO". Actually, this was the first I'd heard of the term. However, I had been getting a red cell booster (starts with an "a"...can't remember the name of it at the moment) since the Spring. We'd taken me off it for a while, but with the recent happenings, we'll put me back on it.

Before this Spring, I'd never needed any help with my blood levels. I'd never needed a break from treatments, never felt unusually fatigued. Now, I suppose with the cancer moving to my bones, it's that much tougher for my body to reproduce the cells as I need them.

All those years of giving blood...I think I've still given more than I've taken, so I feel good about that. :)

Meet Sebastian

He's my new roommate -- at least for a short while, perhaps permanently, depending on circumstances. Seems my neighbor's new-born little girl, Sierra, has developed a fairly serious allergy to something. Just what, we're not yet sure. But as a precaution, while we're still waiting for the test results, Sebastian is moving in with me. If Sierra's allergies are of something other than cats, he'll head back next door. Otherwise, I'll have a buddy to watch football with. :)

St. Sebastian is an early Christian martyr, about whom very little is known. He is traditionally depicted as a young man bound to a tree, pierced by many arrows. Some time ago, my buddy Dave, moved by the appeal for the virtue of fortitude, gave me a prayer card of St. Sebastian, who is often invoked for healing from physical and spiritual wounds:

O Lord, grant us the spirit of fortitude, so that guided by the example of the martyr St. Sebastian, we may learn to bear witness to the Christian Faith and patiently support the sufferings of life.

God willing, my new roomie can act as a reminder of my need for virtue in general, for fortitude in particular. Trying to paraphrase St. Thomas Aquinas (and I invite the correction of those who understand the great saint better than I), fortitude is that habit of the soul which allows us to overcome the fear of death that disables our reason, leading us to despair of our fate. By the willful application of reason against the passivity of my flesh which leads to fear and despair, I am reminded that by faith I believe in the God Who overcame death, and have hope that He will provide for me at my own.

Health update, September 20, 2007

I met this morning with my oncologist, Dr. Grapski, of the Thomson Cancer Survival Center (link to the right). Blood tests showed I'm in good shape to start cycle three of Xeloda -- took a first dose after leaving his office, and the second just minutes ago. We've begun tracking my tumor marker, ca 19-9, the levels of which have proven to be a solid indicator of the activity and growth of my cancer. My ca 19-9 from 3 weeks ago was at around 300. While this is high (normal is below 35 or so), it doesn't mean much by itself -- when we can compare it to today's number, that's when it'll be significant. We'll see...I don't have a feeling either way. I've had it as high as in the 400s...I've had periods where I've been happily "normal". Right now, we just hope to see it go down.

We set up a CT scan for mid-October, after this present cycle is finished. I'll meet with Dr. Grapski two days later. By then, we'll have our first indications concerning the effectiveness of this treatment.

In the meantime, I'll be getting a blood transfusion this Saturday. My hemoglobin is at 8.8 g/dl -- "normal" is between 13.8 and 17.2 g/dl. A transfusion should push me up to around 11, then hopefully my body takes care of the rest. Why am I so low? I don't really know. I've been low (but not this low) since coming off the irinotecan/erbitux I'd been taking through the spring. I suppose the Xeloda takes out some...maybe the cancer in my bones is doing bad stuff, too. Plus, I was losing some blood due to those digestive/urinary tract infection issues I believe I'd mentioned. In combination, I suppose it's easy enough to believe my red cells would be low. Hopefully, a transfusion helps me out -- gives me more energy, helps the body recover a bit better, stuff like that.

Edit (9/21): I'd confused my hemoglobin with my hematocrit. The first is "the iron containing oxygen-transport metalloprotein in the red blood cells", and is quantified by mass per volume of blood. The second is a "measure of the proportion of blood volume occupied by red blood cells" and is reported as a percent. For men, it is typically between 38% and 52%. My hemoglobin is at 8.8 g/dl. I don't recall the hematocrit...but when I've needed a transfusion in the past, it's been around 24% to 27%.

Fantasy football!

Half a point to Gigi for getting that Monkey Knife Fight is a Simpsons reference. Of course, how hard would that be to guess for anyone that knows me fairly well at all? I've got to admit, though, I was disappointed no one gave me a Tyson v. Secretariat ("They were so drunk" -- Moe) or anything. Perhaps stung by the lack of recognition, MKF could not pull out the nail biter versus the Maroon Tigers, falling 132 - 129. MKF continues to get balanced scoring, however, and remains a legitimate title contender.

In Rock 'n' Roll Fantasy Football League action, Rodent Passion remains undefeated, carried by a super-powered wide receiver core. We put the smack down on KC Masterpiece, 104 - 72, despite another poor showing by Rex Grossman. I've got to admit, I haven't the patience of Lovie Smith for Rex's lackluster efforts. He's taking a seat this weekend.

Health updates

I can't seem to find a good way to archive all the health updates in a convenient place. So I'll make this list of links to all of them, updating it whenever there's a new posting. I'll keep the link to this post on the "links" list on the right.

1. Chronology
2. June 30, 2007
3. July 14, 2007
4. Xeloda (August 8, 2007)
   
5. First cycle down (August 23, 2007)
6. Round two in the books (September 14, 2007)

A better idea, from Z in the comments -- I'll make a permanent list of links on the right, so you don't have to click twice to get to any of the past updates.

Quote of the day

God has created me to do him some definite service; he has committed some work to me which he has not committed to another. I have my mission; I may never know it in this life, but I shall be told it in the next. I have a part in a great work; I am a link in a chain, a bond of connection between persons. He has not created me for naught. I shall do good, I shall do his work; I shall be an angel of peace, a preacher of truth in my own place, while not intending it, if I do but keep his commandments and serve him in my calling.

Therefore I will trust him. Whatever, wherever I am, I can never be thrown away. If I am in sickness, my sickness may serve him; in perplexity, my perplexity may serve him; if I am in sorrow, my sorrow may serve him. My sickness, or perplexity, or sorrow may be necessary causes of some great end, which is quite beyond us. He does nothing in vain; he may prolong my life, he may shorten it; he knows what he is about. He may take away my friends, he may throw me among strangers, he may make me feel desolate, make my spirits sink, hide the future from me -- still he knows what he is about.

John Henry Newman, Meditations and Devotions, III, 1855

Round 2 in the books

As of yesterday, I am through two rounds of Xeloda. I wish I had something more to say about it. No noticeable change in the levels of my pain meds. Still around the same level of side effects -- meaning, virtually no side effects. I'd guess the nausea and fatigue I feel is more a consequence of the pain meds than of the chemo. One disturbing sign -- my vertical scar is getting a bit tight. I've been feeling this coming on over the last several days. There is a noticeable hard spot, right near where my belly-button used to be, which had not been there until recently. I don't want to get ahead of myself on what this might mean...certainly something to discuss with Dr. Grapski when I see him next week.

Fantasy football!

So, the rule goes, nobody except you (meaning me) really cares about your (meaning my) fantasy football team. But this is my blog and I'll do what I want. You don't like it, you can start your own blog and criticize me mercilessly (which is how I gather much of the "blogosphere" works). And even though you don't really care, I'll be posting news on both my fantasy football teams on a weekly basis. Happily, in Great Pigskin Experiment action, Monkey Knife Fight (who can guess the reference first? And be specific...) starts at 1-0, getting balanced scoring across the line-up: Matt Hasselbeck, Travis Henry, Joseph Addai, and Antonio Gates doing the heavy lifting in a 132 - 105 win over the Lazerphiles.

I'm told today by Dan Shanoff that there's no shame in winning your fantasy football game while being the lowest-scoring team in your league to do so. So I can proudly say Rodent Passion completely destroyed the under-manned Popeye's Nephews by a score of 73 - 51. They, too, are 1-0 in the Rock 'n' Roll Fantasy Football League to start the year. (Note: due to different roster sizes and scoring systems, the scores in the Rock 'n' Roll Fantasy Football League will be consistently lower than those for the Great Pigskin Experiment).

Now the name Rodent Passion stems from a Dave Barry article of many years ago, the gist of which I can't recall. There was something about squirrels making sweet, sweet, squirrel love, which he referred to as "rodent passion", which he then remarked would make a great name for a rock band. I don't know about that, but it's been a great name for a modestly successful (1-time Super Bowl runner-up, 2-time play-off participant, in its 3-year existence) fantasy football team.

In contemporary times, we have a rather limited view of "passion", typically confined in our thoughts to purely sexual matters. Classically, however, "the passions" suggest something akin to our emotions, that part of our soul that is moved by events outside of us, "passively" as it were. They are neither good nor evil in themselves, but can lead to either good or evil. The aim of the good man is to train, or tame, the animal within, so that one's passions can aid in the performance of good and noble deeds.

In the past week, the Rodents have been moved to anger and sorrow in various parts because of Chris Brown of the Tennessee Titans. For nearly 3 years, he's been a waste of space on our roster, and one week after we finally wash our hands of him, he produces his best game as a pro. Were I compelled to act purely from my passions, untempered by reason, I might act in a malicious way (either by thought or deed) toward Mr. Brown or the good owner of Popeye's Nephews (shrewd enough to select Mr. Brown in our recent rookie/free agent draft). The inner man, the Dennis who longs to be good, however, takes this opportunity to forgive Mr. Brown, delighting in his resurgence, and congratulate the Nephews for their astute acquisition (even as I totally destroyed them on the field). A good man would never gloat over a fallen opponent. I'm still working on this, people.

Far From Home

Reminiscing again over my time in Munich...

Here's a picture of my band, Far From Home -- Southern Germany's best honky tonk! It was great fun, and the folks in and around the band were among my best friends in Germany. John (the drummer) and I have since moved to the US, but Michelle (vocals, acoustic guitar) and Robert (lead guitar, vocals) have been joined by Wolfgang (bass) and Fritz (drums) and have been doing really well. Mary Beth left the band late last year to pursue a solo career, has put together her own band, and will be touring Holland soon. Look her up if you're there! She's a heck of a song-writer -- you check out her stuff here.

First cycle down...

On Wednesday I took the last dose of my first cycle of Xeloda. I wish I could say something...anything...about if or how much it's working. But the nature of the business is that it takes time. The first obvious sign that things are working would be a decrease in my aches and pains...unfortunately, there's been none of that. No increases though, and since during the weeks leading up to beginning Xeloda my pain had been rising, I suppose we can take this as a modest positive.

I get a week off before seeing Dr. Grapski again next week. We'll probably start looking at my ca19-9 (my tumor markers) with some regularity, but it will take 2 measurements to have any kind of indications as to what's happening there. This will take, from today, 7 weeks, and by then I'll be about due for another CT scan. All of which is to say that the only "news" on the effectiveness of this treatment can come from an improvement in my pain. Here's hoping for the best there...

At the very least, this has to be the easiest chemo I've ever taken. I had some mild nausea over the past week, but it's been easily managed. Nothing even approaching what I've experienced on other regimens. I was told to watch for a reddening or blistering of the hands and feet -- something on the level of 2nd-degree burns at its worst -- which can be a common side effect of the Xeloda. Good news here -- I saw nothing like this. I suppose this is probably something to watch for as the treatment continues, though.

Xeloda

And so it begins. This evening I start my new chemotherapy regimen, with 3 500 mg tablets of Xeloda. I'll take 3 tablets every morning and evening for the next 2 weeks, then I'll get a week off before starting again. Repeat till (1) we know it doesn't work or (2) we're fairly confident that my disease has stabilized. According the link, xeloda "is a prodrug that is enzymatically converted to 5-fluorouacil in the tumor by the tumor-specific enzyme PynPase, where it inhibits DNA synthesis and slows growth of tumor tissue." I've had 5-fluorouacil (5-FU) as part of the very first chemo regimen I took back in the Spring of '04. It's really hard to say how effective it was -- we know that there was no visible growth on my CT scans during that Spring, and that my ca19-9 (the best tumor marker we've got) was at a reasonably low 80 ("normal" is less than 35 or so...right now, my level is somewhere around 250) when I finished. We weren't tracking the ca19-9 during those months of treatment, not knowing till the first Sugarbaker surgery that this was a viable indicator of the level of cancer in my body. The main difference with xeloda is that the poison is activated in the tumor -- the highest concentrations, if I'm understanding things right, will be in the tumors themselves. I can imagine that this might lessen the over-all side effects, though I'll experience to some degree or other the "usual" -- fatigue, nausea, etc.

I'm always a bit anxious at the start of a new regimen. Never quite sure how well it's going to work...hoping that it works well, shrinking tumors and otherwise halting their growth for an extended period...fearing that it won't work at all, leaving me in 3 months with still larger tumors. And big questions about where exactly we might head next.