Counting Scars

I now have a grand total of seven TC-related sites (one of which, the port-a-cath, was actually used twice). Four are from this last trip to have the lung thingy removed.

I'm feeling pretty good, not even using my Norco/Vicodin/Lortab/Zydone pills very often. I take two tylenol as needed, and that's usually when I've pushed myself and feel tired more than anything else. There's a nice sized bruise among the incision sites, and a couple of them are a bit puffy still.

I'm more or less eating what I want and trying to take it easy. Today I had a pretty full plate: sunday school and church, lunch out, and a picnic for my singing group. Even with a 1-1/2 hour nap thrown in, I was still worn out after returning home from the picnic.

We're waiting for the gurus at IU to contact my local treatment team to see how we proceed. The probable options are continued surveillance or salvage chemotherapy. Salvage chemo (has a cheery ring to it, doesn't it?) generally describes of the second-line chemotherapy response to a relapse from a remission. In TC patients, it's usually VeIP (vinblastine, ifosfamide, and cisplatin).

I hate waiting. I don't know what the result will be; I'm hoping for continued surveillance, but we'll see what happens. Just a speed bump.

Cutting Loose

Frank just called me from the hospital. He says, "they are cutting me loose today."
I'll be picking him up after my morning duties have been completed.
The Rev.

Thursday Update

1^st for church members. There is a funeral w/ a meal following at our church tomorrow. If you are wanting to help with the meal (brining food/setting up/serving/etc.) please let Marjorie know. If you are on the church email list you need to make sure your responses to the email request were sent to Marjorie, not to me. There’s a few things on my plate right now and I *think* I’ve forwarded all the emails that came to me through 7pm last night (Wednesday).

Ok, Frank.

He had a good night—as good as can be experienced while on a morphine drip and being in a hospital where they take your vital signs every 5 minutes or so. (Ok, not that often)

He’s still requesting no visitors but thanks everyone for all their thoughts and prayers.

All tubes execpt IV were removed around noon today. He may get to go home tomorrow.

The hard stuff:

While the surgery went well, we have encountered a “speed bump”. His oncologist, who says we “pay to be paranoid” (Dr. V’s words) has indeed earned his money on this one. He was the one who insisted that the spot on his lung come out. The initial pathology results in the OR say that the spot was germ cell cancer. These are the same cells that were in his original tumor. It is a metastasis of his Testicular Cancer.

Yeah.

Kinda takes the wind out of your sails doesn’t it?

Personally I felt like someone was sitting on my chest all day yesterday.

Dr. V has a call in to IU to get “some hand holding on this from the experts.” The Dad, my mom and dad and I were all there when Dr. V gave him the news. Dr. V even called Frank's brother Dr. Scott so that Scott could interpret for the the ladies in Atlanta. (Frank's mom and sisters).

Today, we wait happy b/c it is out of him, but also anxious to find out what IU recommends.

Things we know:

• There were no tumor markers in his blood work when the CT was last done on April 5
• The spot did not show up as active cancer on a PET scan—but we also don’t know if germ cells show up on that type of scan—a question for IU
• The spot was small and the Dr. M, the surgeon, did get it all and with only 4 small incisions instead of opening him all the way up
• Frank has a great attitude
• And most importantly we WILL get through this

I’ve gotta run.

Peace to you all.

The Rev

Update!

I took an opportunity over lunch to buzz to the hospital to see Frank with my own eyes. He is indeed doing well. Currently sleeping the sleep of the well medicated.

He did, however, quickly ask the assembled to scram so he could rest. In fact, he asks that folks hold off on visiting.

In lieu of visiting, considering posting a comment here and I will print it off for him.

Surgery News!!!!

Hey all! I just got off the phone with Sarah and have the news re: Frank's surgery.

Things went well! The surgeon was able to remove the area using the VAT process (the video way) so Frank's time in hospital and doing the recovery thing should be on the shorter end of the spectrum.

Thanks for all you do (thoughts, prayers, jokes, food, etc) to hold my sister and dear bother in law in your arms!

Susan

Here we go!

It's almost time.

Here I was thinking that I could make a leisurely start to the morning and show up at 9 o'clock like they told me originally. But NOOOOOO - they had some cancellations so I have to show up at the butt-crack of dawn (6:30 AM). Well, I premedicated tonight at our local brewpub, so I think I'm ready to go.

Spent the latter part of the evening assembling a baby crib with my father-in-law, while my Dad napped in the living room. I think hanging with Sarah's folks wore him out.

See you on the other side. The Rev. or sinister-in-law will provide updates tomorrow afternoon.

Regarding Frank’s Upcoming Surgery

First, thank to all who have offered or thought about offering to sit with me during his surgery at a local hospital. For the record, his dad Todd and my mom will both be here to keep me from climbing the walls. I won’t be by myself (which would be ok too—I don’t mind being by myself--even at times like this) and hey, I’ll have the bonus of being entertained by two young acting “old people.” (They are both over 60!)

Seriously, having spent time in many waiting rooms with families myself as a clergy person I recognize that there is a “critical mass” of people that can be present and I think that the three of us will be plenty.

You can best help me by keeping him in your thoughts and prayers. I promise that I or one of my minions will post on the blog as soon as we know something so that you can know just about as fast as I will know and possibly faster than Frank will “know” how his surgery turned out.

This is not a big deal, preventive and all will be ok. Just another hill to climb on the rollercoaster of life.

Now follow me:
Throw up your hands, yes, right now where you are sitting ...
hear the click/click/click of the car as is climbs the track? …
Anticipation’s building…were’ close to the top ….
Now hang on and scream
WHEEEEE!
The Rev.

Fortunately...

The Rev and I are two ships passing in the night sometimes. Mondays are generally included in those times, so we decided to meet for dinner before heading off to our respective commitments. I suggested Chinese (I had Thai for lunch, if I had been thinking I would have had Korean or Japanese for breakfast to pull the full oriental cuisine trifecta).

When we eat Chinese, we generally shy away from "American Chinese" and go for something a little more exotic, like curried Taiwanese noodles or fish in black bean sauce or Jam Bong (which is technically Korean, I suppose). At one restaurant we always make the wait staff giggle when we order off the Chinese menu.

Anyway, we got the bill and the obligatory fortune cookies. My cookie had two strips of paper, neither of which I would call fortunes. One was a proverb, yadda, yadda, yadda. The other was a bit odd:

"Maybe you can live on the moon in the next century."

WTF? Was I supposed to take this as a hint to vacate the planet? Plus, you really can't do the bit where you add "in bed" to the end of the fortune - it wouldn't make any sense at all. It was humorous, anyway. The Rev.'s fortune was a bit closer to home:

"Your dearest dream is coming true."

Chew on that for a while. By the way, did you know that the largest fortune cookie manufacturer in America employs a middle-aged white guy to write all the fortunes? (He also serves as the company's vice-president and is in charge of accounting.) It was in The New Yorker last year sometime, so it must be true...

Meanwhile, my Dad is planning to come into town next week while I'm laid up - I think he's trying to escape baby duty since my sister delivered her triplets this past weekend. Regardless of his motives, he's planning on hitching a ride into town with Sarah's mom, so hilarity should ensue. Now this is when this whole living on the moon thing would come in handy.

The Plan

Met with surgeon today. It’s a go for April 26 at a local hospital. Lung spot of ~1 cm will be removed. Dr. will attempt VATS but will open him up more if the situation calls for it. If it is VATS, Frank will be in the hospital 2-3 days, if opened up all the way it could be up to a week in the care of nurses. I’ll make sure to request he has male ones that pull bandages off slowly so he won’t get used to the 24/7 treatment.

He has a lung volume test this Friday and pre-op stuff next week.

Now if anyone has answers to how to deal better with allergy season in Missouri – I’ve been doing it for over – choke – 35 years and still haven’t found anything that works besides going into a benadryll coma for a few months….

Keep his sister, preggers w/ triplets, in your prayers. She been confined to a hospital room for the duration of her pregnancy—it could be a few days or a few weeks….I get to be an Auntie soon!

Tis all for now.

The Rev.

update

Monday’s visit to the oncologist confirmed what we suspected. The spot on Frank’s lung is not cancerous—it didn’t show up on the PET scan. What the scan did confirm is that he has a brain, kidneys, and a bladder—the trifecta of organs that collect the radioactive solution coursing through his body.
We still visit with a surgeon on Wednesday afternoon as the spot could still be teratoma (pre-cancerous cells) and needs to come out.
The Rev.

Yet another iron in the fire

I have (finally) been given permission to leak the following classified information to the press:

The Rev. and I will be adopting a child.

We're working through a private adoption agency to adopt a domestic infant. We've finished a home study conducted by a social worker, and are in the process of creating a profile of ourselves that will be distributed to potential birth parents.

It's an exciting thing, perhaps the most exciting thing we've ever done. We're slowly getting the house ready; bought some baby furniture, preparing to paint the nursery, started looking at all the baby goo-gaw at the stores. Did I mention how much we love Target?

Still, I would be lying if I didn't say I have an intense dislike for the hoops we have to jump through in order to adopt. Some examples:

• fingerprinting and criminal background check
• copies of income tax retuns and certification of income
• multiple letters of reference
• letters from doctors
• dog's shots up to date (I am NOT making this up)

Anyway, it's worth it.

Another Sidebar on Ethics

As some of you may recall, I am a CPA in real life. As such, I have to live by certain rules that govern the accounting profession. One of those rules is that I am supposed to be in a process of continuous learning, so that my accounting knowledge never goes stale. Granted, there are a lot of areas of accounting knowledge, and I have probably forgotten more about accounting than I have learned since passing the CPA exam.

I'm getting off on a tangent, so allow me to back up a bit. We are in the process (at the foundation) of having our financial statements audited, and this week was the time for the auditors to do their field work. So, in addition to this business about my lung rising to the surface, I also had accountants poring over all our records, asking probing questions and demanding evidence about various the way we do things. A very low-stress environment, you understand.

Anyway, the auditors were planning to be done by Thursday so that they could attend an ethics seminar at MU on Friday. (Part of the continuing education CPAs are required to have every year is at least 2 hours related to ethics). Well, it was free, and there's nothing an accountant likes more than free CPE, so I decided to join them. I figured at the very worst, I would have my ethics requirement done for the year in April. One of the scheduled presenters (Lynn Turner, former chief accountant for the SEC) couldn't make it, so the other speaker modified his presentation to fill the entire two-hour slot. Now, most CPA ethics seminars are interminally boring, so I was a bit concerned about my ability to stay awake for a two-hour presentation.

I needn't have worried. The fellow's name is Patrick Kuhse, and he has quite an interesting history, including a four-year stint in the federal pen for bribery, plus the three years he was on the lam in Costa Rica and various Central and South American countries before he got tired of running and turned himself in. He also owes the government (actually, the state of Oklahoma) about $4 million in restitution, which he hopes to have paid off in the next few years.

During his time in prison, he interviewed his fellow inmates, both white-collar criminals like himself and violent criminals. Based on his interviews, he developed a set of lapses in critical thinking that can lead to unethical actions:

• Entitlement. The idea that you are owed something because of who you are, and that you are justified in taking it for yourself.
• Rationalization. Making excuses for your behavior.
• Victimitis. Rather than taking responsibility for your actions, you play the part of the victim instead.
  
• Super optimism. Thinking that you can do anything just as good as an expert, and that you can do no wrong or not get caught.
  
• Situational ethics. A sliding scale of responses to ethical dilemmas depending on your stake in the outcome.
• Affection Disconnection. Getting so caught up in pursuit of your goal that you ignore the advice of your mentors and loved ones or don't realize how your behavior is affecting them.
• Laziness and Sloppiness. The way most criminals get caught, it happens because of arrogance.

All these breakdowns can lead to seemingly unimportant decisions that can snowball and cause your moral compass to stray from true north. Important lessons to remember, and not just for CPAs.

Woods. Again? Yes.

So, we’re not out of the woods.

Remember back in April 05 when we were surprised to hear that Frank had a dot on his lung that was “unchanged” and we didn’t even know he had one to change? At the time the doctors determined it was probably nothing, but vowed to keep an eye on it; if it changed then they’d do something about it.

Well, Frank went yesterday for his 4 month CT/blood work check up. Good news: tumor markers are not, I repeat are not elevated. However, said dot has grown from .9 to 1.35 cm. As far as Dr. V is concerned that is in the wrong direction. So, it will come out; how is yet to be determined. (When will that Star Trek technology be made real so they can just “transport” the bad stuff out?)

Frank has a PET scan (Positron emission tomography scan) on Friday afternoon to determine if there is anything else in his chest that needs to be addressed while the surgeon is inside him. Monday morning we will go see Dr. V (the oncologist) and Wednesday we will go to visit a thoracic (meaning related to the chest) surgeon here in town to inquire about the surgery (when, how extensive, do we need a 2nd opinion?).

In other words in the midst of other big huge life plans: Frank has re-entered “the zone”. It’s that place where he finds out as much information as he can about the options available to him and he sets the course for treatment to cure. (He’s even looked up the different types of surgery this may require—because as my mom said, he needs to know so he can let the doctors know what they should do.)

When in the zone Frank is determined and focused. When he’s there I try real hard not to “spin” or go into “hover craft mode”. Wish me luck. The surgery (because he’s shared with me too the information, because there is a part of me that will want to be in the OR helping) could be as simple as a few incisions, done in laparoscopic fashion called video-assisted thoracic surgery, or he could have an incision from his arm pit to his waist line. Either procedure means a stay in the hospital from a few days to over a week. BUT, do need to say that this information is not based upon my discussion with any surgeon, just what Frank is finding out in "the zone" and relaying to me.

All I have left to say is: I’m gonna be really happy when he stops this habit of collecting scars! This silly competition with my mom has GOT TO STOP.

The Rev.