Sunday, June 30, 2019

Modes (With Clever Names)

You may have noticed the posts are slowing.  Or, and this is less possible, you may be actually just going about your lives and haven't noticed anything at all, except your usual life things.

I set myself up mentally for a bad July.  The bad last week of June has been a bonus.  Over the last several days, I have chronicled the specific phases I have been going through.  These are certainly not exhaustive, though this treatment is absolutely and without question exhaustive.  I will add to this as new fun modes arrive.  Or, to be honest, I will lay on my couch and think about doing that, but not quite have the energy to do so.

"Power Save" Mode - this one arrived after several days of treatment.  There are times I lay on the couch and find that is really all I can do.  Theoretically I could get up and do something if I had to.  Escape the house should it be on fire.  Pet a cat, especially that orange one who really does most of the work himself by rubbing against hands, glasses, really anything.  Cats must be very itchy.  But mainly, my screensaver is on, my CPU is on idle, and there I will sit till someone jiggles my mouse.  Sorry, that one got a little suggestive at the end.

"One Too Many" Mode - this was the first mode I encountered after I started chemo.  The low-level hangover comes and goes, but has not progressed to full on "Spring Break at Padre" mode.  Now there was a time I earned that hangover.

"Treacly" Mode - this was the first emotional mode I identified.  I love all of you.  Honestly.  I am tearing up while writing this.

"Wacky Shack" Mode - Six Flags (and Astroworld, and Disneyworld, and wherever) have these buildings built askew, where you walk through the building at a weird angle, and it's hard to find your balance or center.  I have spurts of everyday Wacky Shack, where I all of the sudden careen into a wall, or teeter and wobble while walking.  And for the record, Jill is my center.  And I love all of you!

"Deja You" Mode - admittedly, I have had this mode for some time.  It's now either just a bit more pronounced, or I am using the brain tumor as an excuse.  Did I tell you about this one before?  I kinda sorta remember talking to someone about this.  Maybe it was you.  Sorry if I am repeating myself.

"Staring Into the Abyss" Mode - fortunately, I haven't spent a whole lot of time here.  It's really not where I want to put my energy.  Assuming I had a whole lot of that.

"Pickling" Mode - this has been the most surprising one.  In which I have converted a plethora of homegrown cucumbers into a large number of jars of homemade pickles.  I feel like I might have told you about this one already.  Sorry.

"Robert Frost" Mode - my second identified emotional mode.  Again, not a lot of time in this one, but I've had a bit of time contemplating the roads not taken.  The most zen / spiritual / whatever I ever get is my belief that the path you are on is the one you are supposed to be on, no matter how messy the trip is.  So I generally don't find that I have that many regrets.  Certainly, I could have been a better friend/son/father/husband/person in many ways, but I don't regret my choices.  Except not trying harder to get out of Austin to go to college.   But, I was 18, it was so easy to get into UT back then, and it was $4 a semester hour (with books, I was paying around $300 a semester, plus room and board.  I have two kids going to college this fall, $300 represents about their first two hours). So, not a hard regret, just that I wish I had tried a bit harder to get into Berkeley, where I really wanted to go.

"Empowered but Stupid" Mode - I've been chronicling this a bit.  Proving that I can still do things for myself and/or things I used to do while serious drugs are coursing through my body and radiation is being zapped into my head.  Recent examples include my bike ride last weekend, which while it felt amazing at the time, will have to be my last until after treatment; my walk to the 383 bus on Thursday afternoon, which while doable was not advisable with a heat index of 103; and my recent realization that the doctor's recommendation of bland foods was in fact meant for me, the guy who likes spicy foods.  No additional details will be shared, except the conclusion that broth, jello, and the like sound like an amazing meal plan for July.

I love all of you.  Sorry, did I already say that?

Wednesday, June 26, 2019

Well Played, Austin Cancer Center

Six days into radiation.  I have the routine down.  No one suggested any additional songs for my radiation play list, so I just have the handful.  I really only get through a couple of songs each time, so 7-8 songs may be sufficient.  Weirdly, the machine that goes "Zap!" may be interacting with my phone.  Even though I have the playlist on shuffle, it keeps reverting to "Radioactive."  Whatever the machine wants.

I switched to morning sessions today, with the optimistic hope that I can irradiate, then jump straight into my CEO job.  Jill made the excellent point that if I get to the point where I need a mid-morning nap, likely I should work more from home.  Don't want to 1) model napping as an acceptable work behavior (that was so mid aughts), or 2) frighten employees. 
"Is he dead?" 
"No, radiation doesn't kill you." 

We walked into the Austin Cancer Center as they opened at 8:30.  They also play music.  We were greeted by "I Will Survive" by Gloria Gaynor.  I pointed this out to the receptionist and asked if they had a special gonna-beat-cancer playlist.  She told me that it was just a 70's, 80's and 90's Spotify mix.  Jill and I suggested that they keep the song on a loop, but then admitted that being forced to hear that more than say, twice, would likely lead to a terrible, terrible day.  They called me back to the "Zap!" machine just as the second song was starting.  It was (and I swear this is true) "Stayin' Alive."  Who knew there were so many cancer fighting disco songs?

Once a week I meet with the radiation oncologist and his Extender.  Today, the doctor let me know that hair loss is likely eminent.  I had thought my hair had been fighting the good fight and clinging on for dear literal life onto my head.  He praised my fighting hair, but let me know that their brave fight would be lost soon.  Jill had been spinning the potential hair loss as minor and not noticeable.  Dr. Radiation Oncologist said, in true doctor fashion, it's hard to know the extent, but to expect wide swaths.  My lovely wife winced.  I was briefly worried that she was picturing me side-bald, but she was worried that she had undersold the hair loss to me.

Losing hair has been a detached, theoretical possibility.  I joke about it, but I actually don't worry that much about it.  Honestly, all of the side effects don't seem like a big deal until they are.  I found myself on the couch Monday after radiation, wanting to get up, probably able to get up, but without sufficient momentum or motivation to get up.  I eventually got up.  Made pickles.  Then went back to work.  Pickle-making was not listed anywhere as a potential side effect, but combining working at home with a crap ton of cucumbers in the garden, and there you go. 

So, my near future includes more time in what I am calling "power save mode"; more pickle-making (go to irradiated_pickles.com for pricing and flavor options), and more hair loss.

Even if I am not completely emotionally prepared for the hair loss, I am physically prepared.  I have a bunch of hats.  And a lovely new standing hat rack that scares the living crap of Jill and the twins at least 2-3 times a day.  Who would have imagined that a six-foot, multi-armed hat rack wearing a fedora might be disconcerting in the middle of the night in semi-darkness?  OK, I'll give you that one.

Sunday, June 23, 2019

Probably Need to Throw Away the Jersey

I was able to get out on my road bike today with Jill and her friend Jayna. They both wore Livestrong jerseys, while I had on my Team Mighty Fine Jersey, from riding the MS 150.  I have a Livestrong Jersey, but am not feeling strong these days.  At the moment, fine will do. Though bordering on Mighty Fair.  Admittedly not a great team name nor a great name for the burger joint for which the team gets the name.

Mighty Fair burgers.  How would you like your burger? A bit over cooked, too many condiments, a bit cold, and on untoasted white bread.

Jayna suggested I could alter the Jersey a bit to “Might Be Fine”. Sounds about right. Though it’s probably best to throw out the jersey.  We went 23 miles, and my sweat is literally toxic, and burned through the Jersey.  By the end of the ride, the front said Mi Fin, and the pictures of a burger, shake, and fries on the back (a design choice I always thought questionable) was down to a handful of day old fries.

We went on the Brushy Creek trail, which, upon reflection, was responsible for my three non-Honda Fit related bike accidents.  Certainly, I have some small responsibility for each, but mostly it was the trail.  And the rain.  And the Bridge of Doom.  Maybe 1.5% my fault, max.

I managed to stay upright the entire way.  I’ve been worn out all weekend, but when I’m on my bike I feel good.  It’s almost like, that saying, you know the one, with the bike.  Maybe “ a bike ride a day is worth a bird blah blah blah.”

There were many interesting things to see on this ride.  And Jill and Jayna confirmed most of them, so I am fairly certain they were actually there.  There was a massive snake on the trail, deceased.  There was a really cool, big roadrunner on the trail.  I did not ask about the cartoon coyote chasing it with an anvil, a trebuchet, and an Acme catalogue.  I am mostly clear that didn’t really exist and may need to report that to some medical professional.

Meep.  Meep.


Friday, June 21, 2019

That Might Burn a Little

The constant hangover lasted about two days.  I appreciate all of the margarita recipes sent my way.

Not sure if my body just needed a couple of days to get used to poison.  There is some empirical evidence to support this theory.  See college years.  Also see tequila.  Also see other things we won’t get into.

By no means do I think all is hunky dory.  See using the phrase “hunky dory.”  All of the warnings on my new medicines, coupled with the long lists of side effects on the waivers I signed for radiation and chemo, tell me that fatigue, dizziness, nausea, dry mouth, gingivitis, dandruff, hives, rash, constipation, toe fungus, death, jaundice, random accents, and death are all probable. Could be possible. I didn’t read them that closely.   It was a lot of reading.  The anti-nausea pills have the right idea.  The pill bottle has all of these extra yellow warning stickers.
“May Cause Drowsiness!”
“May Cause Headaches!”
“May Cause Dizziness!”
“May Cause Death!”

First, these are tiny little pills.  That’s a lot of may causing.  Second, maybe nausea is not so bad, considering.

The first new symptom to show up happened after the second radiation treatment.  That afternoon, I had a bit of a burning sensation on the side of my head.  That was fun.  Though in a way it did help me confirm that the machine that spins around me actually is doing something, and is not just the machine that goes “ping!”

The second new symptom happened today.  And it was not technically a symptom.  Jill pointed out the cross hatch mask marks on my forehead after radiation.  When they didn’t go away in 20 minutes, I worried briefly this was some new permanent pattern burned into my face.  I have been a strong opponent of face tattoos, so how ironic would that be?  But it did go away eventually,

I am settling into the routine of all this.  The technicians vetoed my request for headphones, as they wouldn’t work well with the mask.  And with my small irrational fear that things are now getting burned into my head, I am fine with that answer.  But they did tell me I could play music on my phone and just put it by my side so I can hear it.

So I built a radiation play list.  You may see the themes that run through this, so if you have any suggestions on what to add, send them my way.  The starting list:
“Radioactive”, Imagine Dragons
“Glow”, Sylvan Esso
“Hurt”, Johnny Cash
“Forecast Calls for Pain”, Robert Cray
“Stuck in a Moment You Can’t Get Out Of”, U2, and
“Don’t Give Up”, Peter Gabriel.  Because I’m an optimist.

And by the way, this is the actual playlist.  Plus Breezeblocks.  Because I like that song and have no idea what it’s about.  Could be radiation.

Abby suggested something from My Chemical Romance, but that might be more for my chemo playlist.

Thursday, June 20, 2019

Agree to Disagree

Here we are in the "during."  Two doses of chemo, one of radiation, and another visit in a couple of hours.  An impressive array of prescription drugs of various sizes, shapes, and varying degrees of scary-ass warnings.  More than one says "do not drive or operate heavy machinery."  Not to worry, my driving has already been curtailed.  The problem is that I really need to bring out the tractor for my backyard garden.  Fortunately, even though some of the scary warnings tell me to "keep away from children", my girls are actually adults now.  And that is a warning I would ignore anyway.  I will not keep away from children.  OK, that came out way different than I intended. 

I had hoped for a beginning with little to no side effects.  In actuality, I've had a day and a half feeling like I had one too many margaritas the night before.  I'm guessing that's the chemo, since my minor hangover started before radiation.  I can theoretically function fine with a mild hangover.  I've done it before.  I call that 1987.  However, I'm guessing that if I start with a mild hangover, it will only get worse from there.  Not looking forward to the DTs (you may have to look that one up).

What sucks (apart from the tumor, not driving, and all the rest), is that if I am going to have a hangover, it feels like I should earn it.  By like, actually having margaritas.  Which I did last night (just one).

And that leads us to an honest difference in interpretation between my lovely wife and myself.  When talking to brave Dr. Valliant, he was relating the things that can increase the possibilities of seizures.  One thing he mentioned was alcohol consumption.  I asked if a margarita or three on the weekends count.  He discouraged that, telling me that the alcohol leaving my system is what leads to the increased risk, and that it's less of a shock to the body (and therefore less of a risk), if the alcohol consumption is more spaced out, and not all at once (like say, four margaritas on a Saturday).  Which I heard as "you should drink every day."  Certainly, not a lot, but very specifically he was telling me to drink a margarita a day.  Jill heard that more as, alcohol is bad, and if you must, have a weak drink once, or at most twice a week.

You say tomato.  I say cucumber.  Mainly because we replanted our garden this year with tomato and cucumber plants.  Cucumbers are the most aggressive plants, and have taken over the entire tiny garden patch.  And since I am banned from the tractor, looks like it'll be a banner cucumber year at Smith Farms.

Tuesday, June 18, 2019

And Here We Go

I’m about 10 minutes from the first dose of oral chemo.  And 13 hours from the first radiation treatment.  This is, by definition, my before.

At 9 this evening, I was finally able to finalize the replacement of Abby’s replacement phone. By no means is that my “I’ve put everything in order” statement, just a small win before treatment.

I worked a couple of 12 hour days Monday and Tuesday, with a board committee meeting last night and a presentation to a group of social venture partners tonight. I think I actually kinda killed tonight (language is acceptable as it is others dying). This ends my before.

Now about five minutes to my during.  My after comes later. Likely, you know, after.

I’ve worked up to mostly fine during my before.  Learned how to take the bus.  Learned to be more grateful.  Got a little better about being in touch.

All bets are off for my during.  Wish me luck.

Monday, June 17, 2019

Sometimes You Need the Run of the Mill Bullshit

Abby’s phone is not working.  I went with her to the Verizon store last Thursday, and the nice young man helped us get a replacement phone, which was being overnighted to us by 8 pm Friday.  Or that was the plan.  Friday - no phone.  Saturday - no phone.  I checked with the store, who gave me a tracking number from UPS.  I tracked it.  It was in fact overnighted and got to Round Rock Friday morning, where it remained.  On Sunday, with the phone still stay-cationing in Round Rock, we went back to the Verizon store.  The nice young woman called UPS and talked with someone who told her it got left off the truck on Friday, and would definitely be delivered Monday (today).  No word on why it didn’t make any trucks on Saturday or Sunday.

Today, no phone.  UPS online still says “In transit.  Please check back later for scheduled delivery.”

So I called UPS.  The dude (he does not get “nice young man”) looked up the tracking number.
“Yeah, at this point UPS considers it ‘lost’.”
“I’m sorry, what?  You no longer have the phone?”
“That is correct.”
“And what does that mean?”
“It’s lost.”
“And now what happens?”
“We will do an investigation.”
“So, when we talked with someone yesterday who said it was definitely coming today, that was a lie?”
“That individual didn’t have the most up-to-date information.”
“Like the website, which says it’s ‘In Transit’?”
“We now consider it lost.”
“And by we, you don’t include the website and automated tracking system?”
“Is there something else I can help you with?”
“Yes, you can answer me this. Were you ever going to let us know that you lost our package?”
“We aren’t saying we lost it, just that we consider it lost.”
“Fine (thought-bubble added “mother-f&#$er”), were you ever going to tell us you consider it lost?”
“Customers can track their packages on-Line. Typically, if it doesn’t arrive, they contact us.”
“So, no.”
“Is there anything else I can help you with?”
“Yes, one more thing.  This whole interaction is making my head hurt.  Can you give me your full name so that if I am diagnosed later with a brain tumor, I will know who to blame?”

Certainly, I likely won’t call back Joseph Krebs at UPS and tell him I do in fact have a brain tumor, but if anyone deserved the BT bomb, he did.

So I called Verizon customer assistance and the nice lady helped get things back on track.  A phone (we think) is back on its way.  I reserve the right to withdraw all the ‘nices’  if Verizon fucks us over.

Abby has been very zen.  More so than a teenager without a phone should be.  I asked her about this.

“You were on the phone for two hours dealing with this.  I think you are annoyed enough for the both of us.”

Thank you, Joseph Krebs at UPS.  You helped me be upset with something lower stakes than what I have generally been dealing with.

On a related note, but only because it involves a phone, I think my phone might be racist.  My cousin Jared married a wonderful woman named Guo Jing. She made some homemade dumplings and Jared brought them over this past weekend,  They were amazing.

I was texting with my aunt, and was telling her about the amazing dumplings. My phone would not let me type her name. It changed Guo to “Gun”, then to “You.” Then to “Duo.” Then to “GUI.” What the hell is GUI?

So, I ended up telling my aunt your son’s wife sent us some wonderful dumplings, which made it seem like I didn’t know her name.  I explained how my phone would not let me type Guo, and she told me she also goes just by Jing.

So I tried.  I got “King.”  I got “Jong". Oh, for fuck’s sake.  You change Jing to Jong?

I related this later to Jill, who told me I can turn off auto correct. Yes, but then how will Siri learn how not to be racist? Which the phone changed to “fascist.”  Really, Siri? You’d rather be fascist?

Sigh.

The Rideshare Sadness Does Diminish

Jill is with Alex in New Orleans today and tomorrow for Loyola orientation.  College beckons!

Abby had a work shift this morning (she works at the City pools as a cashier) that started at 7:30.  Meaning that if she took me to work, we'd be getting up at 6:15 to leave by 6:45 and I'd be at work way too damn early.  I wanted to sleep in, so Lyft seemed a better option.

Of course, the other kid may have silenced her alarm yesterday morning, but didn't take the extra time to turn it off.  To be fair, it was at 5:15 am, since she and Jill had to catch an early plane.  How do I know it was at 5:15 am?  Because it went off again this morning at 5:15 am.  Thereby destroying all sleeping in plans.  And speaking of destroying, it's not going off again tomorrow morning.  Certainly, I could have turned on the light and figured out how to turn the alarm off.  But it was 5:15 am.  Unplugging the alarm clock was justified.  Smashing it?  Probably less so.

My morning Lyft commute was less sad than my after-work Lyft commute.  Perhaps it was Paul, or his Chevy Malibu. Paul asked zero questions, which, if I'm being honest, is the exact number of questions I want to answer in the morning.  His music choices were questionable, as was his route choice, but I opened the app at 7:40 and was at work by 8.  That still seems unbelievable to me.  It's almost as if Paul was hovering around the corner, even before I asked for a Lyft. 

If I told someone yesterday on my cellular telephone that I was planning on using Lyft this morning, could Facebook have heard that and pre-positioned Paul?  Certainly, there's a great deal I am messing up here, but mark my words - my television tonight will have many more Chevy Malibu commercials than normal.

So, today I am coming to terms with the gig economy.  And tomorrow night, I start ingesting poison (prescribed).  And Wednesday, I start getting irradiated.  All in all, a week.

Friday, June 14, 2019

Chocolate Chip Cookies and Zika

I met with brave Dr. Valliant yesterday to finalize plans for treatment.  When we met before, he had said they were doing genetic testing of the tumor to see if it had DNA or proteins that could be more amenable to chemo.  When his office called telling me about the chemo drugs (that are free!), my assumption was that this could be good news.  In the context of treating a brain tumor good news.  It turns out, it is exactly opposite that.  The other possible outcome of the genetic testing was finding out what the tumor did not have.  It turns out that there is a specific mutation that causes things to grow slowly.  My tumor lacks that particular mutation.

He then gave me the analogy of the biopsy as related to drilling into a chocolate chip cookie.  You might drill into the chocolate and think the entire cookie is chocolate.  While I am thinking that an entire cookie made of chocolate is a good thing, the analogy turned on me.  Somehow this means that my low grade tumor has moved from a low two to closer to a high two, approaching three.  I still don’t know how the thought of a warm, gooey chocolate chip cookie turned from good to bad so quickly.  Dr. V tried to explain the biology of it, and I appreciate his assumption of my basic knowledge of biology.  The problem is that I hated biology.  Mr. Lytle, my high school biology teacher with the long bushy sideburns never ignited my science passion the way that Mr. Mayhew, the Chemistry teacher did.  So, I am going to just have to take his word for it that the full chocolate cookie is a bad thing.

So, the recommendation to add chemo was not an extra, targeted punch to a vulnerable foe.  It is a more aggressive treatment for a more aggressive tumor.  So that sucks.

I start everything next Wednesday, and now have such a long list of prescriptions that I need to prepare a list and timeline.  With adding chemo, fatigue is much more likely, and there are a plethora of possible / probable side effects.  So that sucks.

My window of how long to expect “normalcy” after treatment shrank from 5-7 years to 2-5 years. We just spent a boatload of money to upgrade our windows at home, so I know the importance of a good window.  So that sucks.

When discussing what happens at the end of the normalcy window, Dr. V was still vague, and while reiterating we could do some of the same things, did add more about things that are in process and experimental, like virus therapy. Like Zika.  Dr. V is now telling us about things that may eventually be a useful therapy, like somehow injecting Zika into it.  So that sucks.

No pithy wrap-up here.

Wednesday, June 12, 2019

The Old White Guy and the Bus

The epic saga continues.

I learned nine things today on my second mass transit encounter.  Perhaps you know now that it’s very likely not going to be nine things.  My estimation skills, while formidable, aren’t infallible. Leading to #1:
1) my estimate of the bus stop being an additional 4/10 of a mile from the Red Line (which is about 1/2 mile from my office) was off. It was 7/10 of a mile further.
2) while that may not sound like a big difference, the distance determines the time needed to get there. I left my office 28 minutes before the scheduled bus departure time.
3) I needed at least 28 minutes and 30 seconds*, as I got there just in time to see bus 383 leave.
4) the North Lamar transit station has a lovely waiting area, including multiple vending machines with a wide variety of snacks and drinks.
5) after I caught the next bus and took it home, I found I was right.  Taking just the one bus did shave about 40 minutes from the commute.
6) I learned that I could think of no legitimate reason for the big, hairy man with a security guard shirt and a five-point real metal badge to have his hand down his pants.
7) I found that it is absolutely fine on a bus to get up and move to a different seat so as not to be sitting across from a man with a hand down his pants.
8) In my new seat, I found that even though someone is talking to me, they may not actually be talking to me.
9) and I determined that this does not violate my 0 to 4 questions rule.
10) I added a new rule about avoiding people with hands down their pants.
11) And finally, I realized that while my moderate walk home takes me by all of the places I needed to stop at for errands, that carrying a work bag, groceries, dry cleaning, and a stack of books off of library hold reminds me why I used to do all of these things by car.

* bonus realization - doing the math, I realize that I’m roughly walking at a little over two miles per hour.  And I realized how enormously pitiful that is.

What the Fork!

Getting back to that whole gratitude thing.  A couple of packages arrived for me in the last few days that have been enormously touching. 

I am so not a sentimental, emotional or treacly person by nature.  Since the May Adventure, I have noticed about a 12.6% increase in emotional reactions.  Possibly the medication.

Certainly, it is an open pharmaceutical question when I am tearing up during America's Got Talent.  And yes, I just publicly announced that I watch, and almost cry during AGT.  And don't get me started about my dance shows. 

I know.  Your assessment of me just went down a measurable amount.  And now, you are thinking about if my love of AGT, American Idol, So You Think You Can Dance, and the Amazing Race is connected to the slow-growing infective lesion.  But let me ask you this.  Do you want to be judged by the most obnoxious television show you are addicted to?  And to be clear, for me that's actually Storage Wars.  And it's possible the Chevy Astro Cytoma may have started growing right at the end of Downton Abbey.  So, I kinda blame PBS.

But I digress.

On Friday, a package arrived for me at work.  Inside was a gift basket and a get well card.  It was from the entire staff of my Houston office.  The get well card was signed by all and was tremendously uplifting.  But the thing that really got me was the gift basket.  They sent me a collection of hats.  Specifically ball caps, and more specifically, caps from every Houston major league sports team.  The Rockets.  The Texans.  The Astros.  The Dynamo (soccer, I think). And even the Skeeters (which I believe is Jai Alai.  Or maybe Pickleball).

And then yesterday, a package arrived for me at home.  It was from my former staff at Austin Child Guidance Center.  It also included a touching card signed by my friends and colleagues.  And it also included a ball cap.  This one had the simple message:



This requires a bit of explanation.  Which I did several years ago on that blog I can't edit anymore.
https://cornerpieces.blogspot.com/2016/11/oh-fork-you.html

I swear this is not some thinly veiled effort to re-publish the "Best" of cornerpieces.  Because that might include these:
https://cornerpieces.blogspot.com/2006/12/tivo-no.html
https://cornerpieces.blogspot.com/2007/04/field-testing-your-message.html
https://cornerpieces.blogspot.com/2014/12/maybe-i-should-go-back-to-work.html
https://cornerpieces.blogspot.com/2013/09/persistent-bastardo.html

Eventually I will have to link to this blog from butIdigress.blogspot.com.  Freaking Interweb.

But the gifts and cards were so very thoughtful.  And really helped pull me away from the the dark place I was headed (see blog a few days ago). 


Tuesday, June 11, 2019

Agency 1, Intelligence 0

I was dead-set on figuring out how to get home from work through public transit.  Again, language!  Re-starting.

I was bound and determined to figure out how to get home through public transit.  Even if it killed me.  Dang it.  Moving on.

My office is about a 1/2 mile from one of the six stations of the one rail line in Austin.  The Red Line.   Optimistically named for a color, possibly with the thought that others would follow*.  The Green Line.  The Yellow Line.  The Fuschia Line.  The Orange-Yellow Line.  Not to be confused with the Yellow-Orange Line.  Though I was always confused by those two.  If Crayola is to be believed, there are potentially 128 possible rail line names.  And possibly a weird little hole that will sharpen the trains.  But I digress.  Which, if I was re-starting my blog, would be the perfect name. And since it is likely I will again lose the ability to log in someday, bookmark butIdigress.blogspot.com today.

So, half mile walk to the Red Line. That was my starting point.  Then a 45 minute rail trip to way beyond my house.  Then bus #383 back toward my house, which would deposit me an hour later within a mile of my house.  About 2 1/2 hours of transit, a mile and a half of walking exercise (a mile if I catch the 300 bus to the Red Line), and it only set me back $4.75.

I regained my agency.  I can successfully get my ass home on my own.  In one additional way, besides friends, family, and the Wall-E service.  But I am re-empowered.  And wet, because it was raining today.  A glorious, victorious rain.  Like from that movie.  Flash Dance?  No, Chariots of Fire.

But agency doesn’t trump stupidity. [I will let you parse the political meaning of the last sentence, depending on your own persuasion.]. On my long, long, circuitous bus ride home from way past my house, I had lots of time to review bus 383’s route.  They have these helpful maps! [Said the privileged middle-aged white guy on his first bus ride.] After traveling from damn-near Waco back to near my house, the bus actually keeps going.  It terminates (I know, language) at a transit center less than a half mile past the Red Line station I started from.  Meaning, if I had walked an extra 4/10 of a mile, bus 383 would have taken me straight home, in about 40 minutes.  For $1.25.

It’s important in science to be clear about your research question and assumptions going in.  Just because you are near the Red Line, doesn’t mean your plan must include it.  Also, look at a map.

The experience did provide one additional opportunity to mess with a twin.  Abby told me she would text me today when she got home from work, in case I needed a ride.  I told her that I was going to take mass transit for the better part of the evening and wouldn't need a ride.  She said she'd text me anyway.  She forgot to text me.  When I got home, I was very clearly wet.  An empowered wet, but very non-dry.  I knocked on her door, and she apologized for not texting as she opened her door.  She was stunned to see her wet, bedraggled dad (I was faking bedraggled).

"Where the hell were you?"

I didn't let her suffer for long, but that was way too easy too pass up.

* Being a native Austinite, I can tell you with 100% certainty.  No other rail lines will follow.

A Small Revelation

A friend asked me yesterday if this experience is helping to clarify things for me, or helping to put things in perspective.  My honest answer was "no."  I don't drop the wry, sarcastic facade long enough to have found any deeper meaning.  As treatment gets closer and more complicated, it's been harder to keep some of the darker thoughts out.  Between my adventure on 183 and my biking encounter with a Honda Fit last July, it's not an overstatement that I have had two experiences in the last year that could have killed me.  And that's before even getting into the tumor, treatment, and aftermath.  I only had a small window between seizure and diagnosis / treatment planning.  There was really only about a week of not knowing whether this was something that would cause me to start saying goodbye to everyone.  After diagnosis and treatment planning, that part went away and I have jumped into 'What's next?" mode. 

I don't think my "no" was inaccurate, but maybe incomplete.  A very weird irony is that the brain tumor has me writing again.  I work things out through wry and sarcastic musings on the mundane, the ridiculous, and the profound things going on.  I feel less anger these days, and much more gratitude.  People reaching out and wishing me well is energizing.  People liking my writing makes me happy.  I so appreciate all offers of assistance.  I don't yet know all that I need, but the offers and the thoughts are amazing.

I don't know that I will get any enlightenment out of this, but perhaps it is bringing some clarity.  And that's not a bad thing.

All of that is sincere.  It is also the exact definition of "treacly".  You had to know that was coming.

Monday, June 10, 2019

Like Twina and Twinby, only not

Readers of my first blog (cornerpieces - the one I can't quite access anymore, and the one that is one full cornerpiece less than cornerpieces2), may remember the story of how Jill and I found out we were having twins.
https://cornerpieces.blogspot.com/2006/09/twina-and-twinby.html

[I can actually still find the blog, just not add to it.]

Short version - the ultrasound technician told Jill "Twin A's heart beat looks fine."  First notice of twinage.  Jill calls me in California, where I am drunk in a Greek restaurant (and have retreated to the bathroom to hear her).  Second notice.

Just got news in a similar, allied-health professional relating things best left to doctor news.  A call from the Cancer Center let me know that they were sending through a prescription for oral chemo medication that I will likely take while I am doing radiation.  She didn't have any other answers for me, but wanted to make sure I knew that they had run it through my insurance and my co-pay will be $0.  While thoughtful, I think I'd prefer my "look on the bright side, it's not going to cost you anything" news to be delivered after I hear from the doctor about the decision to put me on chemo, what it means, how will it make my bad July even worse, and be able to answer the thousand other questions I now have that will not be answered till I visit my brave Dr. Valliant Thursday. 

"How much will my co-pay be?"  is not only way down my list of questions, it may not even make the list.

Opa. 

What to Keep, What I am Fine Without

I am probably now less than a week out from starting radiation.  I went in to get the mask made a couple of Fridays ago.  The best description of the mask is a combination of a fencing mask and Han Solo stuck in carbonite.  Though it's only a good description if you know the reference.
Jill: "I never watched Star Trek."

After the mask and the new 3-Tesla scan, the doctor (kinda lost track of which one, but I think he had "radiation" in his title), said he would take up to a week to build the precise map of where to focus the radiation during treatment.  Please, take as much time as you need, doc. 

Ever since he told me about the precision mapping process, I have been a bit obsessed with thinking about things I hope they don't actually irradiate out of my brain, as well as the things I'm fine with losing.  And to be clear, no one has given me any indication that it works like this.  At all.  But still.

So, my lists. 

What I am fine without:
1) my irrational anxiety about radiation taking out specific memories or skill sets
2) my irrational anxiety in general (leave me my rational anxiety. No one would recognize me if it all went away).
3) the entire Marvel Cinematic Universe.  I watched all the movies, all the Netflix shows, even Agents of Shield.  There is likely way too much MCU in there, and I'd be OK without it.
4)  somewhat related to that - the finale of Game of Thrones.  Not the series, which was amazing, just the finale.  I'd like to go back to a place where there is a possibility of a non-stupid ending.
5) the last presidential election.  I'm not saying I'd be OK losing the last two years, but I'd be OK not remembering the actual election.  And maybe the few weeks that followed.

What I'd like to keep:
1) I feel like over the years I have acquired an impressive, intermediate knowledge of Microsoft Excel.  I would hate to lose that.
2) My math skills in general.  I often think in numbers.  If I lost some of that, not sure what my brain would do when idle.
3) Cooking - both my skills and my enjoyment.  If I stopped being able to cook, my value to the Smith household drops precipitously.
4) My ability to use ridiculous words in the correct context, like "precipitously". I won a $5 bet with the family the other day on the word "treacly."  As in, "Ed Sheeran's songs are treacly."

I think that's about it. Oh, except:
5) my memories, my intellectual capabilities, my sense of humor, and pretty much everything else in there.

Take your time, doc.

Sunday, June 9, 2019

Damn You, Zuckerberg!

Along with the physical changes, my digital life has been changing in ways subtle and glaring.

The ads that show up in my Facebook feed are much more cancer-y these days (cyber knife, all vegetable diets, supplements and the like).

My aol spam used to be: Silver Singles, Russian brides, Africans trying to get money out of failing states and/or to their rightful owner (being me), women who have seen my profile and want to "hook up" (I can only imagine it must be my LinkedIn profile), and keto-based diets (whatever the hell that means). Now, it's Silver Singles, Russian brides, Africans trying to send me money, networking naked women, keto-whatever-the-hell, and an occasional message about a "cancer diet."  My guess is that it's to ward off or rid one of cancer, versus the diet that gives you cancer.  Certainly, this is not a huge change in spam variety, but I have had this aol account for 35 years or so.  It will take more than a brain tumor to significantly impact the volume and tenor of my aol spam.  I'd get rid of the aol account, but it's the only way I can access Friendster and MySpace.

I have noticed a bunch of ads on television for prescription drugs, all telling me to "ask my doctor."  To be fair, these might have been there already, but were more the background noise and punishment for watching things in real time.  So, I started a list.  There are so many things to ask my doctor about.  When it got to about 30, I went in to check.  My doctor (or more accurately my singer-songwriter PA), was very patient.
"No, you don't need that."
"Nope, not that one either."
"Definitely not that one."
"Never even heard of that."
"No."
"Do you think you might be pregnant?"
"Absolutely not on that one."
"Maybe you should DVR the television shows you want to watch and skip the commercials."

I even asked her about the drug that is supposed to help with memory issues (can't remember the name) that comes from "an ingredient originally found in jellyfish!"  This particular drug (dang, what is it called?) is particularly proud of it's jellyfish origin.  Their ads stirred some long-buried memory from a masters' level marketing class from ages ago.  Throw in something scientific-sounding and people will think it has to be effective.  That's why I buy only gas with Techron, buy only skincare products endorsed by the Ponds Institute, and stopped going to my dentist who was that one out of five who was pushing sugary gum.  Turns out he was getting kickbacks from Wrigleys.

The thing that still eludes me, is why jellyfish?  Is it because people associate them with power?  These m-f's can sting you, even after they are dead!  And if that is the case, I also would trust drugs that feature an ingredient "originally found in skunks."  Talk about power even after death.  One dead skunk can stink up a two-mile radius for weeks.

But alas, apparently I don't need the drug-whose-name-I-can't-remember or any other jellyfish-based drugs.  And I looked, and so far, there are no skunk-based pharmaceuticals.  Not to say there aren't skunks in the industry,

I also have been getting weird new spam phone calls.  The are still spoofed to look a lot like my own number, but lately the voicemails they leave have been in Mandarin.  That has to be something, right?

But the most egregious example that confirmed for me that my digital self now has a brain tumor was when my cousin texted me asking me to lunch next week.  I responded, "Certainly.  How about t..."  My phone is ever helpful, suggesting words to use so I can save precious seconds.  My phone's very first suggestion was "tumor."  It thought I was writing "Certainly.  How about tumor?"  To be fair, the other two suggestions were Tuesday (where I was actually headed) and Thursday (which would have also been acceptable).

Et tu, Siri?

Wednesday, June 5, 2019

HIPAA, FERPA, and FOIA

Each doctor visit generally starts with a check of my vitals.  From what I can gather, it's blood pressure, temperature, height, weight, something about the circumference of the tip of my index finger and pain.  It always starts with pain.

"On a scale of 1-10, what is your pain level today?"

When you set up the scale like that, it assumes there will always be some level of pain.  Zero is not an option.  Certainly, life contains pain.  Our choices, regrets, missed opportunities, lost connections...  But they aren't asking about the gestalt kind of pain.  Their scale assumes everyone has some baseline level of physical pain.  I have to say, I'm often at 0.  Lately I've had some spikes to possibly 3 or 4, but nothing to get an opiod addiction over.  Now, tooth related pain can take me to 11.  But surprisingly, the aftermath of my exciting May adventures never put me over a 5.3.  My recommendation is to ask about bureaucratic pain.

"On a scale of 1-10, how annoying are our systems, forms, billing and processes?"

Sometimes the medical professionals will ask for self-reports on the vitals.

"How much do you weigh?  How tall are you?  What is the circumference of your index finger?"  That last one might be 'pulse'?  Again, not a doctor.

When given the option to self-report, I generally report the weight I hope I could be in some not-too-distant future.  And that's usually about 5-10 pounds lower than my actual weight.  I am more consistent with height, as I don't believe I'll grow much more.  Though shrinking is a possibility at some point.  I also generally self-report my temperature as 98.8 degrees.  Seems within the margin of error, and I think I am likely more of a little-bit-hot person than a little-bit-cold person.

The problem with the self reporting is that every once in awhile they do quality control.  They actually check.  But I get up on the scale with complete self-deluded confidence that my clothes and contents of my pockets weigh at least 15 pounds.  I do carry a lot of change.  But they never actually measure height, so maybe I should start envisioning myself taller instead of lighter.

One thing I always think to do, but never have, is to learn what normal blood pressure should be.  They measure mine, and report a couple of numbers that mean nothing to me.  I generally assess things by the way those numbers are reported.

"200 over 600.  Hmmm" - means it's probably not where it should be.  "150 over 5.  Not bad" - much better.  I did actually ask one time, and the nurse told me that the standards keep changing, so it's really unknowable.

My adventures came with new doctors and new forms with thousands of new questions.  The imaging place wanted to make sure I had no metal in my body or face tattoos that could interfere with the 3-Tesla.  The neuro-something office asked about a whole list of disorders I had never heard of.

Jill's good advice "If you can't pronounce it, you haven't had it."  

In addition to the pages and pages of medical forms, I get asked a bunch of questions.  Since the original seizure, I think the only thing I got wrong was the year.  This was reported to me by my blind-date EMT right after we met.  He asked me more questions, and while my answer of "Voldemort" to his question "Who is the President?" raised some concerns, I followed it by reciting the last several presidents (Obama, W, Clinton, HW, Reagan, Carter, Ford, Nixon), their wives, children, and electoral college totals.  To be honest, I did forget one Bush twin - "Barbara and the one who got a DUI", but as this was part of the answer to questions he did not ask, he let it slide. And no one asked me about the current president again.

They do generally ask me to smile.  While I thought it was a mental health assessment, Jill pointed out it was much more likely to be checking the motor functions of my face muscles.  Jill also chronicled the contraction of my drinking over time.

1st time: "How much alcohol do you drink per week?"  Probably 6-8 drinks per week.
2nd time: "How much alcohol do you drink per week?"  Probably 4-5 drinks per week, mostly on the weekend.
3rd time: "How much alcohol do you drink per week?"  Not more than two drinks per week, and then generally only sacramental wine.
4th time: "How much alcohol do you drink per week?"  Never touch the stuff.  It's the devil's water fountain.

I didn't notice the change in answers myself.  But if I did shave off a bit over time, it's just that the question sounds so judgmental.  And if I did that with my alcohol consumption, I probably did the same thing with the question on meth.

As I am filling out the forms, Jill acts as my own quality control.  She emits a very specific noise when an answer is more aspirational than actual.

Jill: [skeptical noise]
Me: "What?  It asks about changes in cognition"
Jill: "You said you have felt like it's harder to concentrate and you feel more fuzzy sometimes"
Me: "But not today.  And it's more like, that thing, you know, where you...you know what I am getting at.  What was the question?"

Jill: [skeptical noise]
Me: "What?  It asks about behavior change.  I haven't had any behavior change."
Jill: [skeptical noise]
Me: "That's a FERPA violation!  Stop looking at my answers!"
Jill: [skeptical noise mixed with "yep, told you so" noise].

What was the question?


Tuesday, June 4, 2019

Free Socks!

For my two visits to the hospital, I ended up with two pairs of warm socks that have little anti-slidey things on the bottom.  Free socks, like all those free robes I've gathered from hotels over the years!  Jill is collecting the bills, so it's possible Seton charged me for the socks, or that my insurance company paid for them.  Or that I've already reached my out-of-pocket max for the year, and that not only the socks, but every other medical thing I do this year is free!  Though that's probably not how things work.

I got my latest MRI today (also possibly free!).  The Radiation Oncologist and, by extension, his Extender, sent me to a place with the highest tech 3-Tesla imager.  It's like the 2-Tesla imager, but with one full extra Tesla.  I changed out of my clothes to the provided tie-up clothes, and then noticed the basket of individually wrapped free, warm, non-slidey socks.  In blue!  My others are in white.  Certainly I knew I could not keep the tie-up clothes (nor did I care to), but my sock collection was about to grow to three.

The technician brought me into the 3-Tesla Imager room and placed me in the photon torpedo tube.  She gave me about half of the instructions, and then handed me earplugs and helped me put them in.  She then gave me the rest of the instructions.  Those earplugs were amazing.  I heard nothing else she said.  She put this push button thingy in my hand and then said words about what it was for.  I deduced that I was either supposed to push it every time something specific happened, or that it was my safe word, like "pineapple," in case things got too intense.  Since I didn't hear the words, it seemed best to go with the pineapple explanation.

She pushed me into the torpedo tube and left the room.  She then got on a loud speaker (future tip - maybe do the second part of the instructions over the loud speaker, or perhaps before the ear plugs.  Again, I'm not a doctor, tech, or even an Extender).  She told me that they had built mirrors so that if I looked straight up I could see a beach scene and focus on that for the time of the scan (which was in the second half of the instructions and therefore unknowable).

I thought to myself "Wow, they put mirrors in exactly the right place and angle so that I could focus on a picture that was behind me on the wall."

Then I added "Yes, you are in a 3-Tesla imaging machine that will provide a comprehensive 3D map of your brain, and you are amazed by two fucking mirrors and a picture from a magazine?  Idiot."  Harsh, but fair.

I don't mind enclosed spaces, and I can lie still for long periods.  Especially if I'm on the beach in Traveler's Quarterly!  My main thing is that my nose itches.  And what helps make sure it continues to itch?  Trying to ignore my nose itching.  In my 20's, I had a college friend with cancer that needed regular platelet infusions.  A couple of times a month I would go donate.  They take platelets by taking the blood out of one arm, sending it through the platelet extraction machine (likely back then not more than 0.5 Teslas), and putting the platelet-less blood back into the other arm.  This necessitated both arms being immobilized, and the process took 3-4 hours.  Hey, the platelets didn't go willingly.  That's a full 3-4 hours of nose itching.  I am sure the technicians grew to hate me, as every 5 to 7 minutes I would call out for nose scratching.  And since I was wearing headphones and listening to loud music, it likely was at that way-too-loud volume of people wearing headphones and listening to loud music.

We got through the 17 minutes (I counted to 1,020), and she pulled me out of the tube.

I changed back into my work clothes and took off my new, warm, non-slidey socks. There was a bin for the tie-up clothes. And there, next to that, was a bin for socks. No! Mine. On the side of the bin was this sign: "Place socks here. We wash them and donate them to the Salvation Army."  What is the better use here - clean, warm, non-slidey socks for the homeless or adding to my new collection? It was a close call, but I’m still at two. And actually not looking to add to the collection, as that generally means hospital visits and tube time.

Bucket List

 With time now awaiting, seems like I need a bucket list.  There are domestic and international trips to take, people and places to. See at ...