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Posts Tagged ‘managing side effects’

Last night Al, Kay and James come over for dinner. Cassie makes flank steak with Asian marinade, fried rice and sesame sauce in the mode of Japanese Village. James has teeth and has matured. He enjoys playing with some pots, spoons and the pile of newspapers. He is intrigued and attracted to Otis. I think that it will not be long before we will be protecting Otis from James, rather than the other way around.

Today is D-Day for the Sphincterotomy. I sleep late, wash in the detailed way they require before surgery and we head out to Victoria General Hospital via Pure Vanilla. I can’t eat anything at this point but Cassie has a latte and a fruit Galette. It’s just pleasant to relax for a half an hour before getting cut.

We arrive at VGH to check in at the front desk. However, they have no record of my surgery!!! It turns out that even though the surgeon’s assistant believed that she had sent the paperwork over, it never arrived and she did not confirm it. So, the surgery is not scheduled. And at this point I have been fasting for 14 hours and both Cassie and I have taken time off work to get this done. ARRRRRRGH! The earliest they can schedule me is June 16th. This is very disappointing to me since I am really psyched up to get this over with. Cassie is incensed by the incompetent waste and the disrespectful use of our time.

The kind VGH booking manager comes over to talk to us and offers that – though there are no guarantees – there is a 50:50 chance that they might be able to fit us in at the end of the shift if the surgeons and operating room staff pick up some time during the day. We decide to wait since I’m all fasted and scrubbed and at this point 50:50 is better odds than I’ve had up until now.

VGH is undergoing renovations so there are no chairs in the admitting area. We find seats in the ER waiting room instead, letting the admitting clerks know where we are. I read a wonderful cruising book that I have read before and am reading again: the highly recommended An Embarrassment of Mangoes”. Cassie entertains herself by watching and making quiet, snide comments to me about the low-life people that are waiting as walk-ins for emergency treatment on a sunny Thursday afternoon.

At 1:30pm the admitting clerk fetches us and it looks like we’re going to git ‘er done. I get admitted and tagged. Then, it’s all a rush since the period between when they have realized there will be time for my procedure and the last slot available is narrow. I change into the humiliating surgery gown and the nurse gives me a prophylactic Zantac to make sure my guts stay quiet. The porter is waiting, tapping her foot while the nurse completes the preoperative work up. Then it’s into the holding area for the OR. My surgeon comes by to see if I have any questions and to give me his verbal instructions for post-op care. Then it’s into the OR. The anesthetist also stops by and we discuss the potential for trouble if I am provided with too much oxygen given the Bleomycin received during chemo last summer.

The surgery is done face down (prone) but they don’t maneuver me into this position until I am under. I notice there are a couple of muscular looking male orderlies scrubbed and gowned in the OR. I’m sure the prospect of flipping the 105kg dead weight that I will become is cause enough to call in some extra help. A surgical intern or student tries to get the IV line into a vein in the back of my left hand. After a minute of poking around in an uncomfortable way the anesthetist (who reminds me a bit of the actor Sam Elliot) grunts “stand aside” to this dude and personally sticks the IV needle into the back of my right hand with one deft shot. Perfect.

A few seconds later I am out. I wake up in the recovery room with the eerie feeling of no time having passed. I have noticed this before with general anesthetics. I wait there for a half hour until the nurses are sure I am stable. Then it’s back to the prep area where Cass meets me and takes me home. I am now sitting on a thick absorbent pad while she has gone to exercise her horse. My time sense is still woefully screwed up by the general anesthetic. It is getting dark out and is just about 9:30 pm but my brain seems to think it’s only about 6pm. Weird. I have no pain but some bleeding. It could be worse. Much worse.

“Whenever times get bad, just remember that it could be worse. After all, you could be a crack whore. Unless you already are a crack whore, of course. I can’t see how it could get worse than that. Meth whore, I suppose. Yes, things could always get worse, you could be a meth whore.”

“It could be worse. A woman could cut off your penis while you’re sleeping and toss it out the window of a moving car. There’s always that.” Fight Club

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<Warning… some disgusting details about Tom’s body are in this post>

Wikis_on_toilet

So, it’s been a long time since I’ve posted anything here but the reason is good. My condition has been stable. I am well. I’m fat and sassy.

However, as a side effect of the horrible constipation of chemotherapy, I severely aggravated a pre-existing anal fissure. Basically, cancer “ripped me a new one”. Today I got news that I am scheduled for surgery to correct this problem. I will undergo an Internal Lateral Sphincterotomy. Basically, I have a jagged tear in my rectal lining (if this is too much information, you should have left this post about four sentences ago). This causes bleeding and pain on a regular basis. What fun!

The surgeon will introduce a conservative, clean cut that should relax this area and allow this tear to heal. This should mean that the pain and bleeding will end. (And there was much rejoicing.) Though it is a short operation – only 15 minutes – I will really need to take it easy for at least two weeks to allow my ass to heal favorably. And then, I will no longer be a pain in the ass.

Surgery is in eight days. Be still my throbbing rectum.

“A little boy was sitting on the side of the road crying after his dog had been hit and seriously injured by a car when a kind old priest came by and asked what had happened. The little boy responded, ‘That car just ran right over my dog’s ass!’ At which the priest replied ‘No, son….we don’t say ass. You mean rectum.’ The little boy turned to the priest and said ‘Rectum?, damn near
killed ’em!'”

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Dear Mom,

You considered having children an important and serious business. You had a degree from the University of Toronto as a nutritionist but you also had good common sense about what was good for people to eat. You often told me that when you were pregnant with me you liked to have a beef-steak with streamed broccoli for breakfast. I ate well as  a child and teenager. There was always lots of good food to eat and you cooked from scratch every night. As a preschooler I remember you getting dinner on the go at about 3pm unless you were cooking something Ukrainian, which had to be started in the morning.

You used to tell me about how both your and my dad’s genetic backgrounds were generally good. People in our family live into their late 70s or middle 80s. Heart disease is virtually unknown. Your father had died of cancer at the relatively young age of 69 but you always rationalized his early death with his occupation; He ran an auto repair shop from 1920 to 1965. You would tell me stories about the fumes and solvents that he used without the proper breathing apparatus and ventilation that is now required. Your implication was that my grandfather had “voided the warranty” on his body by subjecting himself to a carcinogenic environment so it was understandable that he didn’t live his full life.

I’m happy to have survived Hodgkin’s Lymphoma, at least so far. Long may that last. I don’t think that my contracting Hodgkins had much to do with either my genetic background or environmental toxins I might have encountered. I do think it relates to a prolonged period of impaired immunity I experienced due to a serious infection in 2007 which I discuss in detail in “A Child’s History of Lumps”. However, I do believe that all of the crap that had to be done to me to put the Hodgkin’s into remission has “voided my warranty”. I’m like a DVD player that had a sticker on that back that said “No User Serviceable Components Inside. Breaking of this seal Voids Warranty.” My seal is most definitely broken.

The chemicals and radiation treatments that were used to kill the malignancy has left a trail through my organs. The Adriomycin has possible heart effects and the Bleomycin has possible lung effects. The Vinblastine has caused neuralgia which I often feel in my fingers. The radiation treatments have increased my chances of contracting other types of cancers including Non-Hodgkin’s Lymphoma. So, I’m sorry mom but, all bets are off on my possible projected life span.

However, I’m certainly happy to have had all the health, both genetic and environmental, that you gave to me. It was like capital that I had in the bank and needed to spend for a rainy day. It allowed me to withstand the cancer treatments. There are many people who are not healthy enough to do so. The doctor’s can decide that the condition (either genetically or due to deterioration) of your heart and lungs are too poor to withstand the Adriomycin and Bleomycin. My immune system could have dipped much farther than it did, exposing me to an infectious illness that might have killed me. There are a dozen times where my body could have failed me in my struggle. But it didn’t.

Thanks mom.

And sorry about breaking the seal… I had no alternative.

Love always, Tom.

Leona Petrachenko, 1924 – 2001

momandme3

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A few notes from the weekend:

  • I was really tired and a little blue this weekend. I slept more than nine hours on both Friday and Saturday night and had a rest on both Saturday and Sunday afternnoon.
  • We had a very pleasant dinner with Gord and Janet and their friends Glen and Bonnie. Janet made a fantastic prime rib roast and we spent a pleasant hour or two drinking scotch and telling stories after dinner. We didn’t get a chance to bring out the guitars and play which was a shame since both Janet and Bonnie are guitar players. We will try to get to that next time. Otis and Tucker really enjoyed chasing each other around the billiard table.
  • We did trailer the horse both last Thursday and on Sunday. We’ve figured out a method of getting the trailer in the driveway that has worked very well two times in a row. We unload the horse on the road and Cass takes him up to his stall. While she’s doing this I bomb down the road and turn the rig around at the next intersection and come back to the driveway from the other direction. Then I back it in with Cass directing me. From the other direction there is a little more pavement on the side of the driveway and the angle of the drive is slightly more favourable. I still need to make a few backs and forths to get the trailer around but these are done on the asphalt, not while wallowing in the muck at the side of the driveway. So, goodbye demented truck driver… hello truck drivin’ hero. There was much less &%$@#$%! with this method.
  • Cass got up to ride Alli for the first time in more than a month on Sunday. Between our vacations and the weather it just has not been conducive to horseback riding. He’s been longed 3 times this week so she’s got his condition and flexibility up and it was time to ride him. They both looked good and he looked happy to stretch his legs.
  • We met the previous owner of the barn where Alli now lives. She is in remission from breast cancer and is looking well. Her and I were comparing our stubbly hair styles  and swapping stories about our treatment and side effects. She seemed well and full of energy. It was a pleasure to see someone else who was having some success fighting back.

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This will be my last post for a little while. We’ll be on vacation for the next 4 weeks and may be out of contact with the internet during much of that time. However, I promise to post whenever it is possible.

Because I was ill and undergoing treatments through the time when we had our summer vacations planned, our time off work piled up to the end of the year. Tuesday morning we leave on Darwin’s Folly for about two weeks of cruising. We’ll sail when the weather is good and hide up when the weather is not. We’ll head towards Pender Harbour where Cassie’s manager has been kind enough to allow us to use her dock and vacation home there. Our first stop will be Westport Marina for a haulout. We’ll get the bottom cleaned, I’ll change the zincs on the prop shaft and Joel from Raven Marine will repitch our two-bladed Max-Prop to match the gear reduction on the new engine’s gearbox. Tuesday night we’ll spent at Poet’s Cove and Wednesday we’ll head towards the Maple Bay Yacht Club and use our reciprocal privileges. From there our schedule will depend on the weather. As the great Poseidon permits we’ll proceed to Nanaimo, cross the Straight of Georgia and then on to Pender Harbour. Our intention is to return to Victoria on or around December 21st.

We’ll have a little rest, get the boat cleaned up, and pack the truck to go over the Rocky Mountains to Edmonton. We’ll spend the next week staying with Cassie’s favourite aunt Tina and visiting with our Alberta relatives. We’ll return to Victoria around New Years Eve, have a few days to hang out and get used to being home before the new work year begins.

So, as I look forward to the end of 2008 and the start of 2009 I would have to say I’m still not “myself”. However, I’m not really sure what my post-treatment and (hopefully) post-Hodgkin’s baseline condition feels like. I still have tension in my throat that becomes much worse when I am under the least bit of stress. I tire very easily. If I don’t get a good night’s sleep or have a few extra drinks the night before, I am in very sad condition the next day. My “bottom end” may never be the same again (‘nuf said). I have hope that I will get better than this progressively but I’m also resigned that if this is “as good as it gets” then that’s ok. I’m just happy to be here. 🙂

As I said, it is likely that we will get online a few times in the next 4 weeks. We’ll post pictures and a trip log for the cruise as soon as we possibly can. My love to all until the next post.

“I’ll teach you to ride on the wind’s back, and away we go!” Peter Pan

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Friday night we drop in on Lucy and Gary and their two boys Aaron and Marcus. Cass gets her hair cut and it looks wonderful as it always does after Lucy has her way with it. Over pizza dinner the adults kill a bottle of wine and make our guts hurt laughing at stupid stories. That’s living!

Saturday we have Dim Sum and then do a little shopping. Afterward it’s home for a rest, then to exercise Alli and finally to Van Isle Marina to meet Rob and Hilary at their boathouse. They have decorated their Camano 31 for the Sidney holiday sailpast. We join the procession. Hilary has made mulled wine and Cassie has brought some tasty finger food. It’s a beautiful mild night for the lighted sailpast. Even Otis tolerates being decorated with lights (for a few minutes anyway). We pass the reviewing stand and round the coast guard RIB and finally we return to the boathouse. Afterward there is a chili dinner at the Capital City Yacht Club clubhouse. I’m tired out though, so we don’t stay long.

I seem to be fighting a very small cold. Sunday morning I feel poor and take a cold pill which seems to really whack me out. We go for Dim Sum (again) to meet Mark and Diane. We want to see Mark again before he goes away on business because he will be combining this with a visit to his family in Britain. We won’t see him again until the New Year. After Dim Sum we go for a coffee to Bean Around the World. After this I am whacked. Cassie has to drive me home and I get in bed. After about an hour lying around I feel much better. I’m still having trouble getting used to the up and down nature of my constitution at this time. Sigh.

For Sunday dinner Cass makes a yummy beef roast with Yorkshire Pudding, squash and mashed potatoes. So wonderful!

Today is the five year anniversary of my father’s death so I find myself in a reflective mood. This has been a trying year full of challenges for me and Cassie. I like to think that we have managed to meet them with energy and humour. There is reason to hope that this coming year will allow us to rebuild and continue our love of life.

“And it’s been a long December and there’s reason to believe,
Maybe this year will be better than the last,
I can’t remember all the times I tried to tell myself,
To hold on to these moments as they pass,
And it’s one more day up in the canyon,
And it’s one more night in Hollywood
It’s been so long since I’ve seen the ocean…I guess I should.”
Long December by Counting Crows.

William Petrachenko Sr. : September 19th, 1921 – December 1st, 2003

dadinuniform

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This last week has been an interesting experience. I’ve had some very good days and some bad days. On one of my good days I feel like I am done with the effects of my cancer treatments. I have energy, my thoughts are clear and I have positive emotions relating to the future. This is then followed by a day when I feel crappy and disoriented.

When I felt down every day I formed a layer of acceptance to that condition. I lowered the bar of what I expected of myself to a level that I thought was reasonable for my relatively stable, crappy condition. Now that I am vacillating between quite well and fairly crappy it’s hard to know where to set the bar of expectations. Last Sunday I was ready to hope that it was “over” and I was going to be “normal”. However, after the last few days, I have to accept that the fatigue and poor condition may continue sporadically for a longer period. Externally, Cassie assures me I am better: that I look better, am more engaged and engaging and spend more time being active. It’s peculiar that my perception hasn’t caught up with that yet. I think it’s because my expectations are impatiently setting the bar higher and higher, which leads to disappointment.

I can see how a relapse would be more emotionally difficult than the initial diagnosis. After the initial diagnosis you focus on what is to be done and accept that it will be difficult as you fight the cancer. With Hodgkin’s Lymphoma the statistics in favour of a cure are good so you take heart in that even though you feel poor. A relapse would compound that feeling with a despairing feeling of failure. It would seem that all the difficulties of the initial treatment had been for nothing.  The treatment of the relapse will be harsher than initial treatment. And, to top it all, the statistical probabilities of survival plummet. So, let’s hope that doesn’t happen.

I think the best way to handle a relapse would be the way General Teddy Roosevelt Jr. handled having his troops landed on Normandy beach. They were miles from where they were supposed to be without most of their supplies and no armoured support. His demoralized officers clamoured for orders as to what they should do as the defenders hammered them with deadly fire. He just told them, “We’re starting the war from here”. And they did. And so will I if it becomes necessary.

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