8-mile

So there was a little new news this weekend. Christmas was great - we did the 6pm evening mass at Incarnation - which, as always, was really packed, and a lot of fun. Christmas day was beautiful - the girls loved everything that Santa brought, and we had an excellent feast to close the evening out.

On Saturday, I brewed another American Amber ale - this one was hopped with my own Cascade hops from this Summer. That's fermenting happily away in the basement. This weekend I hope to bottle a little of what I have in the kegs. Bottles are always nice for giving (and storing away for later). Also on Saturday, I had some high school friends over, and that was loads of fun.  I got a 'Tree Cam', which I've placed in my woods to (hopefully) get pictures of that bear. I'll pass 'em on to you as I get them.

On Sunday, we lounged around, not doing much more than relaxing. I was able to take a really nice long run - which was wonderful, except for this cold I caught from the kids. It's my longest run  since chemo - somewhere around 8 miles. I felt great afterward, though my runs yesterday and today had me fighting some sore muscles.

The doctor's office at VCU called this evening, and I've been recommended to have the stem cell transplant. I guess there's some competition to get into a program like this. Apparently, I have what it takes (though, as you can imagine, it would be nice to an underachiever on this front). At any rate, I've been released from the expert care of Dr. Cirenza at Martha Jefferson to the equally expert care of Dr. McCarty.  More to follow on that.

Tomorrow is New Year's Eve. I can't tell you how different things are from last year this time. I've often thought at the end of the year, 'What will I be doing this time next year?'.  Always in the back of my mind I've thought 'at this time next year, my life could be radically different'. The funny thing is that it's always been a hypothetical proposition. This year, I got to see how much things can change.

Threatdown number 1!

It has been pointed out to me by one of my astute friends that bears are, in fact, omnivores. So, I guess I dodged a bullet on that one. I guess Colbert is right - Threat # 1 - Bears!

This Thursday, I took a day off and drove with Jane to Richmond to MCV. It was great to see downtown, Broad street, and the old hangout spots. Things have changed a lot in the city since I was there as a kid. But this was no sightseeing trip - our mission was to find out more about the transplant program at VCU. 

I think I've described the premise of this kind of treatment. But if you're new, (or if I haven't), here goes. The official term is 'high-dose chemotherapy with stem cell rescue'. The idea is that even with an effective chemotherapy treatment, such as the one I just finished, a cancer is not especially prone to remaining in remission. A good way to deliver the killing punch to such a cancer is to treat it with some hard-core chemo. The problem is that this level of chemo tends to destroy not only the cancer, but the patient's bone marrow as well. To keep the patient alive, it's necessary to regenerate the marrow by infusing a quantity of stem cells into the patient. These aren't fetal stem cells, but rather cells collected from the patient's own bone marrow or blood. If the patient donates these cells to him/herself, this is called an autologous stem cell transplant.

In my case, because there was extensive involvement of the lymphoma with organs outside the lymphatic system, there is a good probability that the cancer will return.  The doc estimated that this will boost likelihood of my remaining in remission by about 30%. That number sounded great to me, and so we're going to move foreward with plans to do it.

As a side note, I was finally congratulated on getting through the initial chemo, and the oncologist at VCU did use the word 'remission'. That made me feel pretty good, even though his plan he proceeded to describe wasn't so inviting.

So with the rationale for participating in this treatment out of the way, he proceeded to describe the procedure. 

In summary, here it is: 

1- I'll be assessed, to make sure the chemo to date hasn't made me unsuitable for the procedure. Being as healthy as I perceive myself to be, I think I'm a pretty good candidate.  It sounds like you'd need to be pretty sick to not get this one. I'll go to Richmond to get lots of pokes and prods at MCV for the assements.

2- A week or so later, I'll be given drugs to make my bones produce additional marrow, and push this marrow (in the form of stem cells) into my bloodstream. This will be an outpatient activity I'll do in Richmond over a few days.

3- My blood will be collected over the course of a few days and run through an apherisis machine (a centrifuge of sorts, as I understand it). This will separate the stem cells from the regular blood. The resulting cells from this will be collected and frozen.

4- I'm admitted to the hospital for the super-chemo. Over the course of the next week, I'm given 10-20 times the dose of chemo I received during my initial R-EPOCH therapy. The idea is that this will kill all of the lymphoma cells which might be hiding out in the marrow. This will wipe out my marrow, as well.

5- No marrow - no blood cells, no immunity, no oxygen to tissues, and no immune system. This is not a state you want to remain in for long. At the point at which the chemo has passed from my system (a day or two later), I'll be given back those frozen stem cells. This starts what I'm told is called 'Day 0'. This is when the fun really begins.

6 - It takes some time for the marrow to grow, and for the 3 weeks following Day 0, I'm to remain at MCV under supervised medical care. This is good, cause it sounds like I'm going to get all kinds of drugs to keep me from getting infected. And if this period is anything like my original post-chemo period, it promises to be pretty unpleasant.

7 - At day 21  or so, I'm released under my own recognizance to an apartment in Richmond. I'm to remain here for at least 3 more weeks. The doc says that this is absolutely necessary, as it's very common for infections emerge at this point. I need to be within 30 minutes of the hospital for this period. Woohoo - Shockoe bottom - here I come! :) 

8 - I get to go home. This is going to be nice, since I'll have been away from my family for almost 2 months. But for the next month or so I have to stay at home. No going to the office, and I'm to have no contact with anything remotely unclean. No trash, no cats or dogs, no snotty child kisses - nothing. 

9 - I follow up with my primary oncologist, and get released to go about my life as though nothing had happened. :)

So there you go - a simple 9-step program to get everything back in order. Sure, it may be a little more complicated, but now we have a plan. We'll find out more in the coming weeks. Thanks again, as ever, to all for your support, kind words and friendship!

Cells - I expect you all to cooperate!

Cow? Dog? Sheep? Bear!!!

With the holidays approaching, the past few weeks have been nice. Apart from the standard aches, pains and colds that the season brings, we've all been doing ok.  So what's happened? Well, in a nutshell, my parents have come up for the holidays, we had our office holiday party, we cut and decorated the tree, and the girls have gone caroling at the local retirement home. It's been busy, but we've been having a great time.  

This evening I took the dogs for a walk and we ran across a black bear. It was dark, and he was about 30 feet away, so all I saw at first was shadow. At first, I thought it was a small cow, and when I figured out that cows are never that small, I thought that it must be a big dog. When I figured out that dogs are never that fluffy, I thought it had to be a sheep. And when I realized that sheep don't have legs that are the diameter of small tree trunks, my mind decided that 'Bear' was the best name to assign to this creature. Fortunately, he was not interested in us, and we were allowed to pass without trouble.

I think black bears only eat fruit, anyway :)

Men's 4 Miler

I've been trying to get back up to speed with my running over the past couple weeks. I've been encouraged that I don't have any trouble running a couple of miles, although my pace is much slower than it was. So this weekend, I asked the family to come out and watch me run the men's four miler. It's a race to benefit the UVA department of Urology's prostate cancer program, so I felt like it would be a cool one for me to participate in.

It was very cold this morning. Jane got up early (as usual) and the temp was 16 degrees on the front porch. But after a hot shower, a couple of cups of coffee, and making some cocoa for the kids, I was ready to run. We all bundled up and headed out to Free Union for the race. I ran into some of my friends from work there - which is 

All in all, it went well - I think I ran it in about 30 mins - a 7:30 min/mile pace. I looked it up and in '06, I was at 6:13 (24:51).  So I wasn't ecstatic about the time, but I figure that I get a few points for being 5 weeks outta chemo.

Jane and the kids were great - they cheered me on as I crossed the finish line - seeing their faces after the race meant a lot to me.

Margaret's birthday was yesterday, so afterwards we took everyone to the Discovery Museum and lunch at Revolutionary Soup to celebrate. Now we're back home and watching Muppet Treasure Island on the sofa.  This is relaxation.

I'm a lucky man to be able to run this race. In the next one I hope to be a little faster. 

Brief update

I haven't posted in a bit because, believe it or not, I don't have much to report. I'm slowly getting back to my good old self. In a couple of weeks or so, I go to see a doc at MCV to talk about what comes next. That I am not looking forward to, as I expect it will involve some unpleasantness and a lengthy hospital stay. But we'll see...

As for now, I've had an exciting two weeks since I last posted. There was Thanksgiving - with lots of family and loads of food. 

I got to go mountain biking with my brother in-law through Charlottesville and at Ivy Creek . That took a lot out of me, and reminded me that I need to get back in shape. Thanks for your patience, Mike. :) I've been running more, trying to gradually build up my distances. I'm starting slow, but I think I'll be back to my old self in no time. 

I brewed a batch of American pale ale last weekend - that went well - and it's fermenting happily in the basement now.

This weekend we'll probably put up the tree and start getting ready for Christmas. I can't believe it's December already.