The Last Four Innings of Treatment

Innings Five, Six, Seven and Eight

It's seems, on reflection, that the third and fourth treatment routines made reflection and writing about them, well, not possible. So, here I sit, some two months later in the comfort of Sam's Tours Digital Internet in Koror, Palau, trying to close out this period of my life.  

The blood pressure machine is still a fixture in my life, but being in the tropics has certainly contributed to its decline. 

I can honestly say that I do not miss the Chemo treatment room where caring people gave me what I needed. If I had my way, everyone treated there would be out in the world doing what they wanted to do. I am fortunate to. so far. have the freedom to do what life brings to me. Many peers in this room do not. 

To the Southwest commercial that asks, "Wanna Get Away?", I nod my drug-laden head with what seems like enthusiasm. Yet, my kidneys say, "Not so fast." This sent me to the Scripps Institute to a nephrologist. You remember, the nephron is the functional unit of the kidney, so a nephrologist is one who knows all about those little buggers. Enter Dr. Melanie Farrell.

Dr, Farrell took on the responsibility of bring back my kidney function from the abyss.  Here she is with her favorite organ in the background. Talk about thorough... this woman is the exemplar and I offer her many thanks. 

So Linda and I live on our boat in Palau, 500 mile east of the Philippines. The every-other-month blood tests show improvement, but not perfection. We swim and bike and snorkel, sail and explore, letting the body do its healing thing. The PET/CT in May indicated I was free of disease. The next is scheduled for September in either Guam or Manila.  It's weird having to wait four months between score cards when the "in your face" contest against the pirates seemed to have ended so long ago. 


Details will be shared when we know.  My thoughts and well wishes go out on a daily basis to Jen Moeckel and my buddy, John Dyer.

View From The Chair: Innings Three and Four Are Complete

Innings Three and Four
Are Complete

I have completed days three and four of chemo treatments a week ago. Only four days to go! It has taken almost the whole week to get back to "normal."  The side effects of the the treatments are not always pleasant, but what strikes me from where I sit today is the good fortune that continues to follow me.

Sharing the chairs around me this week are people much younger than I and much more ill than I. They experience much longer daily chemo treatments that last for months and months and months.   Their courage and endurance is inspriring. I can only imagine the struggles they face.     

So...thanks to all those who help...like Sylvia pictured here.

Thanks to Lisa and Jeremy and Ian, Remi and Bergen and Punky Brewster, who share their home with us.

Let us not forget that Dr. Charlat and his nurse practitioner cleared the way for these treatments as they performed and analyzed test results indicating that my heart was clear enought to proceed. I thank you for your guidance and expertise.


Thanks to all of you who send your good wishes...each one is a pick-me-up!

The pirates lay quiet for now, what will the scoreboard show in two more months? In the meantime...we review wines at http://www.dailywinos.com/. Check it out!

It's An Eight Game Series Against the Pirates: A View From Field-Level Box Seats

Pacific Oncology and Hematology, Encinitas, California,   Host  to the Eight Game Series of Four Double-Header Battles Between The Pirates of Melanoma and the Skallywags of Creola.  The Skallywags Are Looking For a Clean Sweep!   

This ain't no cheap seat, fans! My cost is $240 bucks a day with Medicare taking care of rest of it. The Snack Bar is close by, but no Polish Dogs or Garlic Fries. Lines are short, Coffee is good. Crackers are chrisp. No complaints. And you get two really expensive pink pills that you would hate to drop down the sink.

Jane sees to the details, hooks me up the IV Pump and makes sure that all is going according to protocol.

Sara, the nurse practioner is at the right She is trying to get the IV Pump to stop beeping. These are perfect members of the Skallywag Crew.

The score of these sessions will not be known for some time. Future Pet/CT scans will show the score. Two years of no returning pirates are a really good sign of a win. Patience and keep the long view, baby!

Scandalous Results

Scandalous Results From January's Scans

Nothing But Good News

The Results from January's PET/CT and Brain MRI are in and the news is all good. Dr. Edward McClay, Head Scallywag of the Pirate-Fighting Crew, examined the PET/CT results and found them to be identical to the scan completed in Manila last October. This means that, at this point, some mischievous mutant melanoma cell has not meandered to some distant point in my body to  set up residence.

The spots found on the lungs in Manila have not grown in size and do not appear to "take-up" the tracing sugar compound at the rate melanoma cells do. We are beginning to feel confident that they are from previous infections are unrelated to this dance we now do.

 My blood pressure was a little high...very high actually, when I entered the examination room and Amy did the preliminaries. It must have dropped considerably when Dr. McClay announced that the Brain MRI showed some indication of a brain and nothing anatomically abnormal.

Those of you who know me well will surely question the results of this scan. I swear that's what I was told.

Bottom line... Within the limits of the technology, there is no evidence that the invasive pirates have migrated to anywhere else in this old body. To make sure they are not hiding in small Al Queda-like clusters preparing to pounce when the guard is down...we will strike them beginning February 3, (insurance issues/resolved).  

Linda and I learned something exciting today...Dr. McClay's clinical trial of 400+ patients has resulted in 80% of them being cancer-free after two years. The trial that I have entered has added a third drug in an attempt to increase the cancer-free rate to 100%. We like those odds.

Next: Heading To California

The Mac Attack

Continued from- FedEx Is Fast...Right?,

Tuesday, January 12, 2010

Warning: This Blog Contains Photos That Might Be Sickening

Or Offensive To Sensitive Stomachs,

AND The Lesson Is An Important One

Through the doors of the lobby of St. Luke's Medical Center, Manila, Philippines, (the only hospital in my experience with a grand piano in the lobby and various pianists to actually play it),   came the "good news" that the diagnosis of malignant melanoma had been "CONFIRMED," the Mac Attack Surgery could begin.

Dr. Uygonco, the oncological surgeon, and Dr Sibulo, the plastic surgeon, took charge. Dr. Melvin Sibulo and Linda enjoy a laugh.

Of course, in the behind the doors of the Cancer Institute was Dr. Gorospe leading the charge in  her magical slippers.  Photo to come

The strategy with melanoma is to cut it out of the skin. The surgeon finds the lesion and takes out his handy-dandy pen and draws a circle around it so  that has a distance of at least 2 cm away. This is where he/she plans to carve away. Of course, she/he must get at least 2 cm of flesh beneath the lesion, too, so sometimes you have to cut DEEP and WIDE. The margins must "Be Clear of Disease."

Lesson: Catch a melanoma before it gets big, so they can "excise" it easily and without it getting so big that it might spread to some distant place in your body you don't want it to be.

This melanoma got too big for its britches so "excision" was about the size of a small quarter-pounder (no cheese, lots of secret sauce). Thus the Mac Attack. Thank you Dr. Sibulo, you did a great job of making of hole disappear. 

But if you ever think you have it bad, check out this little boy building sand castles on the polluted beach of Manila Harbor. I am sorry for two disturbing views in a row.

The post-operative care was excellent. This is Miguel. He is  not only tall and handsome, but a commensurate professional nurse.  Someone has developed an excellent nurse-preparation program in Manila.

Wherever you are in the world it is the people that make the difference in what you expereince. St. Luke's has a wonderful collection of people that you make your stay positive and enjoyable.

Steph and Linda "enjoyed" caring for Bill at St. Luke's. (left) Chris, Bill's very own Customer Care Officer smiling because Bill had finally been released! (right)  A hardy to thanks to both of you.  
Tricia, Linda's Customer Care Officer, often assisted with challenges that both of us presented. She provided absolutely wonderful support, even checking in me on her one day off. We cannot thank you  enough.

Dermatology contributed, too. Removing a basal cell carcinoma from my forehead that had grown back from its laser destruction in Panama City two years ago and identifying other curious skin irregularities as not harmful. Yeah...good news.

Dr. Gorospe's support team was very special as you can see.

 
 
 
 

The busy nurse's station on the fourth floor, our home for weeks and weeks

Next: Heading to California

So What's Up In California

Bill and Linda Find Pirate-Fighting Crew

in Encinitas, California
Dr. Edward McClay, Head Scallywag

Bill and Linda have selected Dr. Edward McClay of Pacific Oncology and Hematology, in Encinitas, California, to serve as the head of the mercenary team to fight of melanomatic pirates that invaded Bill's shoulder.

Offering a clinical trial with greater success rates than the current FDA Approved strategy, Bill, along with Lisa Darner and Danny McKeever, met with Dr. McCLay to learn the ins and outs of the trial.

Basically, the treatment goes like this. A combination of two cancer-fighting pills are taken for four months and a third is given intravenously on two consequitive days, once a month. The day following the IV portion a third injection is given. This process is repeated for four months. Then Bill gets a couple of weeks off to travel, rest or be miserable!

A PET/CT scan and MRI have been completed to give a "baseline" of data and physical exams and blood work will occur throughout the four months. 

Poor Creola lies on a mooring in Koror, Palau awating our return. As everything lines up, Bill and Linda should be back in Kororr, Palau before June.

FedEx is FAST...Right?

Trying To Get Surgery Done
With Ghosts and Saints All Around...
It's Enough To Give You Vertigo

In order to make the scheduled surgery date of Novemeber 3, a Tuesday, biopsy slides from Hawaii must arrive in time for pathologists at St. Likes to confirm the melanoma diagnosis. The weekend is made up of Halloween on Saturday, All-Saints Day on Sunday and Monday, of course, is a national Holiday of recovery.

The samples had been ordered by phone at 3 AM on Wednesday October 28...That's Hawaii at 7 AM on Tuesday October 27. I know..wierd. A request is for an overnight delivery; Hawaii to Manila, is just a hop skip and a jump.  Little did we know.

My chunk of shoulder has more airlines miles than my whole body. From Hawaii it flew (probably first class) to the deep south of the USA. From there, after being searched for explosives, the slides flew to Japan. From Japan these thin slices of meat went to Shanghai, where they were mistaken as rare form of sushi. Back to Japan the gourmet treats flew and then off to Guam. Finally from Guam it was booked to Manila.

 A cab was hired on Sunday for the 45 minute ride to FedEx at the airport, where an agent and his young son met us...you see, they made a special trip and opened the office just for us. Prettyu nice of FecEx. Back to St. Lukes we flew with the goods. What a way to spend All Saints' Day!

Tuesday morning, the pathologist gave out the "good news." It was Melanoma!  I could have surgery at 4:00 that afternoon. But first a few other necessary  steps. Belle wrote it on the board. Nothing to eat. Nothing to drink.  Map your sentinel node, etc. etc.  I love Belle.

Next: The Mac Attack