[9-15-08] My First Labs at Stanford

[11:57pm]
     It has been a long day. I think that's how things are when it comes to these Stanford visits. Let's see... what did I expect? I wrote:

(9:30) To the ITA for labs, cxr, ekg. (11am) To Clinic E to
meet with Doctor. (2:00pm) To the ITA for catheter and self-injection class.

Arrival at Stanford: The Infusion Room

     In case you are wondering, ITA stands for "Infusion Treatment Area." I believe that's where I'll get my outpatient infusions, but, for today, that is where I will have my labs drawn. In addition to that, I'll have an EKG and a chest x-ray performed.

     After my name was called, I left the waiting room and had my identity verified by the nurse.
     "Would you like a bed or a chair?", she asked.
     I was kind-of taken aback. A bed... for labs?!? Sit me on a milk crate, or whatever -- labs only take 10 minutes or so! But I wasn't about to be taken by surprise... I didn't get much sleep last night and if I had to wait long, I would rather take a bed a catch some z's. "Well, how long will this all take?"
     "Oh, you're just getting labs. It wont be long."
     So I ask for a chair and get taken into the infusion area.

     It's not like at the cancer center in Berkeley. Instead of individual rooms, there are about 8 comfy recliners facing the center of the rooms. There are a lot of people wearing HEPA masks in here. We take a seat, and wait.
     I play my DS, and wait, and wait, and wait. Almost two hours have passed and I still haven't seen my nurse! Barbara and I leave the infusion area, but I decide to inform as nurse anyways. Basically, I said, "I was supposed to get labs drawn at 9:30am (time was 11:20am), but I'm already late for the oncology appointment and I haven't even been seen yet. We've got to go." The nurse told us to wait a few more minutes, and made a few calls. Meanwhile, Barbara scrambled to the downstairs clinic to ensure that all appointments would not be lost due to a labwork delay.
     The guy sitting next to me was a doctor. He was calling his patients, informing them that he would make appointments as-planned. I thought it was kinda trippy for a doctor to be sitting here with me, as a patient. Maybe that is silly, but still... kinda trippy.

The Oncology Appointment

     The meeting with my doctor was pretty straightforward. First, she reviewed my latest Pet/CT scan. "Your scan was fine," she said. In addition, she noted that certain parts of the scan seemed to indicate that there was still some chemo activity. Meaning that certain parts of the scan were "brighter" because the chemo was still working while the scan was being performed. This means that my results are likely better than indicated.
     Barbara asked if it was possible that my third ICE treatment got rid of all the cancer. "Sure," she said.
     thinking about ICE, I inquired about the possible 4th ICE treatment. Apparently, my local oncologist misheard -- after my second scan, she never planned a 4th.

     Next, she inquired about my health. So I told her all about the coughing and the throat (better, now) and whatnot. The throat soreness didn't phase her a bit, but the coughing, apparently, was cause for concern. If there was a viral infection, this could mean a delay in the treatment. A delay is no good. Still, she has to know... so she ordered a "nasal swab."
     Later, when the scheduling nurse arrived, she systematically laid out the tools to perform the swab. She said, in her bone-marrow-biopsy-tone, "*sigh* As you know, I have to perform a nasal swap. It's a bit uncomfortable." At this point, I'm imagining her sticking a corkscrew up my nose... my mind is trying to imaging biopsy-level pain in the nasal region... not good.
     Still, maybe I'm over-reacting. Hey! I've never had one of these done before! If a procedure is bad, then the nurses under-report the amount of pain. Otherwise, it's just-the-facts. Realizing this, I start to feel better. I even tell the nurse, "Hey, I haven't had one of these before. That means I have no idea what it's like... For all I know, the swab is fun!"
     She looks at me for a moment. "I'm just so excited to give you this nasal swab", she says. "I can't wait!"

     The "nasal swab" was a piece of cake -- just made me sneeze a bit. Probably something like snorting pepper. Anyhow, after the procedure, I say, "I wish I had three nostrils!"
     "It's ok, I could just do it all again if you like."
     Sensing the attack on my established delusion, I offer up one final attack: "Oh, I wouldn't want you to have to go through all the trouble of getting new tools. I'm happy as-is."
     She nods... Victory!!! :P

     She then talked a bit about Cytoxan, and how I needed to drink 3 liters of water when I was not in the hospital. She asked me whether I was good at drinking that amount of fluid, I said "Yes, when I need to."
     Then Barbara said, "But not beer, of course."

*sigh*

     I then get a quick lecture on alcohol. Bah. What was cool was that she said, "I've couldn't possibly imagine anyone even remotely wanting alcohol after Cytoxan!" O RLY? Is that a challenge? :P Just kidding.. I promised to drink no beer once BMT was underway.

     Then, she hands us a whole heap of prescription orders and we run to the cafeteria for a quick bite to eat.

Catheter Maintenance and Self-Injection Class

     Drives me nuts how they call this a class. They should call it a tutorial. Classes have students, plural. Bah. I even asked the nurse; they only give about 5 of these "classes" a week. I'll bet ya that they all had only one cancer patient attending.
     ok.... let's try that again...

Catheter Maintenance and Self-Injection Tutorial

     That's better.

     So it starts with a video. I secretly wish to myself to see Troy Maclure (Simpsons) introducing "So, you've got a new catheter." It looks like a lot of work. And I can't go swimming, or have showers (without taping a bag over the catheter) -- I love showers! Bah. Oh well.
     Then the nurse brings out a bunch of materials. It looks like we're going to re-enact the tutorial. Great, I learn the best this way anyways. She brings out a rubber torso of a female with a catheter installed and says, "This is how it will look."

     I paused for a moment... "I certainly hope not!", I said. The nurse probably heard that a hundred times, but I couldn't resist. :P

     Then we're presented with a video and demonstration on self-injection. Kinda funny how the lady narrating the video looks totally stoned -- like she's "self-injected" quite a bit herself.

The Pharmacy

     We got tons of pills! Stanford wants Barbara to bring all my prescriptions to the hospital when I get discharged after Cytoxan. That's such a good idea!!! I remember getting out of my first ICE treatment, and having to scramble to get some Ativan. No chance of blowing chunks at the local pharmacy this time!
     Still waiting on the authorization for the Neupogen. Apparently, my prescription for Neupogen (for two weeks) costs about 15 grand. Ouch!

[9-07-08] Good to be Home

[2:47pm]
     With my sister's cold long gone and my WBC rising, I have now been given permission to return to home base. It's a good feeling. I've really missed my family... and my desktop. :P

     Tomorrow is the second Stanford appointment! Starting at 10am, I sign the consent form and hopefully get things under way. They also requested my Pet/CT CD, which I took a peek at...

     I thought the CD would be full of weird and inaccessible medical mumbo jumbo, but it was quite user friendly. Just plug in the CD, then it installs the software and loads your personal profile. There are cross-sections of your body on the left, and a vertical 3d representation of yourself on the right. I'll post some images sometime later.
     Anyhow, the tumor *is* large. And by looking at the cross-sections on the left, I can see the high-activity parts of the tumor. Interesting to note, however, that some non-cancer regions of my body have about the same activity. Also interesting is that the tumor itself is cone-shaped, not solid. It looks kinda like a coffee mug, and the regions of activity are along the edges of the coffee-mug, not the center.

     Anyhow, I just got home. So I'm going to get more settled in. More later.

[8-27-08] ICE again, naturally

[1:58pm]
     I need FOOD! On the hospital patient guide, it specifies that lunch is to promptly arrive between 11:00am and 1:00pm. Around here, in the oncology department, that usually means that we get lunch at 1:00pm. I'm used to that, so I've been patiently waiting... To my horror, I just learned that I've been forgotten! Even worse, they are prohibiting me from walking to the cafeteria!
     Fortunately, I've bribed one of the guards -- she's going to try to smuggle something in.

     Onto less important stuff...

     I haven't really elaborated how I feel regarding my scan results. Truthfully, I am pleased with the results. Not ecstatic; not depressed... pleased.
     Apparently, this sort of casual attitude really annoys oncologists. It makes sense: they have to deliver so much bad news to so many people; any chance to deliver good news is a prized opportunity. It's a bit of a buzzkill if the patient already expects and calmly acknowledges the good news. Oh well -- I can't help that.
     But basically, I got exactly what I expected. Actually, not exactly. I expected the tumor to shrink, say, 35%. Not enough to head straight for Stanford, but enough to justify a BMT and continue ICE treatment. Technically, my results were substantially better than that. Even though the tumor only decreased in size by about ten percent, its metabolism went from a 5 to a 2. So I really have a 60% reduction. Call me old fashioned, but I want the thing to shrink a bunch too.
     Regardless, I can now go to Stanford (yay!), and I will get 2 more ICE sessions. Now that I think about it -- I am relieved. If the ICE did nothing, I would be in a very bad situation. But now, I can start making long-term plans again. So... good.

     but... I was just now starting to recover from the last ICE treatment! I mean, it wasn't all that harsh, but there were certain disadvantages... My stomach has just returned to me a few days ago: I can eat *anything* again! And, with regard to the opposite of eating, things have returned to nominal (mostly) functionality! It's one of those things that you don't miss until you lose it. Let me tell you, I can truly appreciate it right now.
     Now, I get to go back to the hospital and lose all that yet again. That sucks! Bah.
     Maybe this time, the ICE will put up more of a fight. In a way, I want my opponent to be more of a challenge. Like a ten year old beating up a heavyweight boxer... I'm kind of embarrassed for him. Let him get in a few punches just to keep up appearances...this is too easy.

     Anyhow, I forgot my notebook charger!! How could I do that?!?! I'm a nerd for crying out loud! That's like forgetting to put on pants in the morning! So, my battery has a few minutes left. So, ta ta for now.

[8-26-08] Scan Results!

[8:12pm]
     Sorry about the late post -- we just now returned from Berkeley. It's a 1.5 hour drive, but we stopped at several places to go shopping. It was nice to treat myself further :P

     Anyhow, onto the results! The doctor seemed to think that the scan results were quite good. The tumor size itself decreased by about 10%, but what really matters -- apparently -- is the metabolism, which decreased from a 5 to a 2.
     This more than justifies that I am responsive to ICE, and thus makes me eligible for a BMT! Woohoo! Anyhow, the plan is to try two more ICE treatments. Also, we need to further coordinate with Stanford to make sure the apheresis goes well.

     Ok, gotta celebrate my last day of freedom -- headed back to the hospital for more ICE tomorrow. I'll post much more tomorrow.

[8-25-08] Pet-CT Scan

[1:44pm]
     I just returned from my third Pet-CT scan! I'll just reiterate: This one is especially important because it determines whether I will be able to go to Stanford for their BMT program. There better be some progress! Naturally, I am sitting on the edge of my seat... metaphorically speaking. I find out the results tomorrow, and the next step of the big plan. That'll be an important day.

     The scan went well. Liz and I set two alarms because we were paranoid that something might make us miss this critical appointment, and I arrived there way early -- which was fine, because I got to amuse myself with my new blue Nintendo DS. The nurse checked my blood sugar level and asked me: "Did you have dessert last night?" Knowing that I was not supposed to eat or drink in the past 8 hours, I made it a point to emphasize that I obeyed the rules, and, in addition, did not have any dessert. She then asked me what I ate the night before. I told her, "Extremely spicy Mandarin Beef." Anyhow, the level was a tad high, but within acceptable range.
     She then injected the radioactive sugar and I asked her whether it was made at Lawrence Livermore Labs (since they have a cyclotron there). Apparently, everyone, including Livermore Labs, gets their Pet-CT sugar from a specialized place in Gilroy that makes nothing else.
     Then, I was to sit back and relax in this dark, and small room with an extremely comfy recliner. I fell asleep quickly, and had dreams where I was waiting in a dark Pet-CT room on a comfy recliner... except, the lights in the room were on and I didn't turn them on... I was panicking. I could turn them off, but then I would have to move. But, if I didn't turn them off, the nurse would come back and yell at me for turning them on in the first place. I would then wake up, fall asleep again, and have variations of the same dream.
     Then, after I was good and asleep, the nurse woke me up and told me to climb in the machine. A few minutes after the scan started, I fell asleep again. I mean, you can't wake someone up in deep REM and expect them to remain awake as you instruct them to lie down and remain perfectly still for 25 minutes. It's just not going to happen. Then problem was that there was microphones in the machine, so that the operator can talk to the patient. That was a problem because I caught myself snoring several times. Yes, I was snoring in the Pet-CT machine. The poor nurse... she probably had to put me on mute.
     Oh, and after the scan, the nurse asked me about my occupation. I told her I was a student, and she asked me when the fall semester started. I didn't realize it until then, but it was today. That kind of bummed me out.
     Anyhow... that's it for the scan. We'll find out the results tomorrow.

     Now, I know you all are just begging to elaborate further on my Nintendo DS. So, to appease the masses, I will do so now... It is super-awesome! I haven't been as excited about a toy like this for years now. The funny part is, I wasn't too excited about it as I purchased it -- I had to play it a bit to really appreciate it.
     (By the way, for the sake of record, Liz made me do it. So, I'm completely guilt-free for spending money on a toy.) :)
     I even got "Guitar Hero" for the DS -- which requires a strange little fretboard attachment. Then you take this stylus/pick and strum along to the music on the video game screen -- super cool.
     So, consider myself suitable distracted from all sorts of worries. I find comfort in the fact that, no matter where I am, I have complete freedom from boredom. Plus, having that thing in the hospital bed will help tremendously.

     Oh, and one last thing before I go... Last night, I had a huge craving for something spicy! Maybe it's the chemo; maybe it's my taste buds losing sensitivity. Anyhow, we went for Chinese, and I asked them to make my Mandarin beef extra spicy. They failed: it was pretty mild. But, they did include a bowl of pure Chinese pepper seed sauce. I dumped the whole thing on the beef and stirred it in. When the waiter returned, he was flabbergasted: "You put the whole thing in?!" It was awesome.
     As I ate more and more, the beef got hotter and hotter. Eventually, I reached painfully hot. It was great, and exactly what I wanted. I'm not usually into spicy foods, nor is my tolerance exemplary. Maybe it is the chemo.

[8-12-08] Troubleshooting Life

[6:06am]
     A little under four hours until the final is due... the pressure is on. Can he handle it? The judges are in-conference... they seem to indicate that...yes, yes he can indeed handle the pressure. The Swiss judge is citing a July term paper in which the protagonist chose to write on his own blog as a method of last-minute procrastination. It looks like the same strategy is in play here... how will it turn out?

[8:00am]
     Mmmm, just had a three-egg breakfast with potatoes and italian sausage. Large mocha for added caffeine. Yummy. Now what was I doing?

[9:28am]
     Just finished term paper! Wahoo! If anyone is curious about space-based solar power, it will be available at: here for a day or so.

[12:10pm]
     Bah! One hurdle ends; another begins... I just got a call from Dr. Irwin's office: One of the nurses (not Becky) just wanted to confirm a pet-CT scan for the 19th! That's too early! My ICE treatment is scheduled to go from tomorrow until Sunday -- more time needs to pass before a scan can be completed... Or *is* my ICE treatment scheduled at all?
     Just to be sure, I ask the nurse... "Oh, your treatment is scheduled for the 26th." WTF?!?!?! I'd like it to be known that I have mercilessly *insisted* to everyone that will listen that my ICE treatment starts tomorrow. Each time, both doctors and nurses have agreed. So again, wtf is going on? Grrr...
     *sigh* I really wanted to just come home and relax... I finished the term paper, the class is over: I should feel good! Now everything is up in the air. They give me control over one aspect of my treatment: 2 week, or 3 week intervals between ICE. Determinedly, I choose the 2 week interval, thus convincing myself (through cognitive dissonance) that the increased neutropenic risks associated with a 2 week interval is worth the added blow to my evil tumor. In fact, I could delude myself into thinking that treatment occurring just 1 week earlier would cause a net reduction between 50 and 75% (because there is no time allowed to re-grow)! In that case, the ICE treatment has yielded sufficient results and I can proceed with a bone marrow transplant one month earlier! Perhaps that one month will save my life!
     Oh wait.. They accidentally scheduled me for ICE a week from now, instead of tomorrow. I see. Scratch all that then. Grr.

[1:38pm]
     Ahhhh, relief... Please excuse my momentary psychosis. All is right in the world. Becky has confirmed a 9:00-9:30am arrival time to summit hospital for ICE treatment for tomorrow, the 13th. There was some confusion about a mysteriously early pet-CT scan. It was not Becky's fault, and she is looking into it. Good.. Good. Pulse returning to normal...

[4:12pm]
     I'm off to go buy a nice robe for tomorrow. Down to hospital gowns! Maybe I'll be able to find those fuzzy Odie slippers too. :P

[5:46pm]
     Can you believe it?? Bed Bath and Beyond refuses to sell bathrobes for men! I guess Hugh Hefner has gone out of vogue. Oh well, I'm probably more comfy in pants anyhow. Truthfully, I'm just trying to find things to occupy my time until Christmas morning.

[8-10-08] Back Pain ER Visit

[6:05pm]
     I just got out of the ER a few hours ago. They gave me some very strong pain medication, so putting this entry together is taking a little cognitive effort. I feel like I'm in a medical drama or something -- all this action lately. The story starts yesterday afternoon...

     Dan gives me a call: "Are you bored? I was thinking of getting a hotel on the Oakland waterfront." Awesome, I was truly stoked. The last time we celebrated like that was in San Francisco, like 5 years ago. I remember drinking beers in the SF hotel lobby, and getting chocolate ice cream all over the place. It was awesome.
     So, here's yet another chance to live it up. Plus, it's never been just the two of us. This was a special treat. Yet one more chance to "pull one from the Devil's teeth." I agreed. "Beer's in the cellar around 5:15pm. Chopper is inbound." Six months without alcohol. I've got to live it up while I still can.
     The hotel room was incredible. There was a balcony with a view of the waterfront, a giant bathroom, and the room was huge! So, we had many beers, ate excellent meat, and had a great time.

     I woke up the next morning with terrible back pain. Usually, I just have to sit up, or walk around, and the pain will subside. If it's really bad, a warm bath always helps. Two warm baths later, and the pain was getting worse. I told Dan that I had to go, and left with the intention of getting some pain meds and returning later. My aunt was having a birthday party, and the plan was to head over there later in the day.
     By the time I was in the hotel lobby, I knew I needed to go to the hospital. I interrupt the concierge's conversation with a customer... "Sorry to interrupt, but can you give me directions to the nearest hospital?" I then drove my motorcycle there. In retrospect, perhaps I shouldn't have, but I wanted relief fast. I didn't want to wait for anything!

     I arrive at the hospital around 7:30am. I wait in line for the triage nurse, and explain: "I am experiencing tremendous back-pain." I knew it sounded trivial... I mean, I wasn't gushing blood or having a heart attack or anything. I half expected him to be like, "Go take some Tylenol, there's a 7-11 around the corner." It's back pain.
     When he asked me what I would rate the pain, I said "an eight." To illustrate, at that moment, the pain was at a level where talking was difficult. I would frequently gasp, twitch, or spasm. It was simultaneously muscle and bone pain; pulsating and constant. I was trembling and sweating. I've never experienced this type of pain before. Yes, the bone marrow biopsy was a 10, but this pain had no end in sight -- it just wasn't going away.
     After filling out all the forms and whatnot, I was directed to wait in urgent care. I was too ecstatic at the prospect of pain relief, at that point, to fully understand that if was a very bad thing to be sent to urgent care. This is emergency pain. Nevertheless, I waited in the lobby.

     For perhaps the longest hour and a half of my life, I waited in the lobby. I expected to be called any minute. I mean, the guy *saw* how much pain I was in -- you can't just ignore that! There were many people in the urgent care waiting area, all of them looking pretty OK. On the other hand, they probably thought I was crazy. I would sit down, stand up, sit on the floor, pace the floor, walk to the triage nurse, visit the coke machines, walk around a pillar in circles, etc.. I had to keep moving. Through all of this, I'm also making little grunting noises. Suffice it to say, the security guards were keeping a good watch on me.
     Then the pain began to get worse. My chest began to hurt as well -- probably due to all that labored breathing and whatnot. I couldn't handle the wait anymore. I wanted to start punching walls, or go rob a pharmacy or something. I was so frustrated with the utter relentlessness of the pain. 7th tear this year. But then I got a desperate idea! Chest pain = ER. I had chest pain. So I ran back to the triage nurse, and explained my new symptom. The triage nurse sent me back to urgent care at the front of the line, and then the urgent care nurse said: "You have chest pain? We're not equipped for that here. You need to go to the ER and get hooked up to an EKG. Go back to the triage nurse."
     The triage nurse was inept. Not an uncommon trait in this hospital. At that moment, I noticed that it was a county hospital. Nevertheless, I was then escorted into the ER.

     Finally! The nurse had me change into a gown, and check my vitals. No pain meds yet, but the end was in sight! I was being treated, and knowing that the pain would soon end made it much easier to handle. At around 10:00am, the doctor arrived.
     He was a nice guy. He got my history and symptoms, and then immediately recognized how much pain I was in. "Well, your pulse is 133 -- that's probably because you're in so much pain right now. Your temp is 99.5. Nurse, get him 8mg of morphine. You can handle morphine, right?"
     In an effort not to look like a drug-seeking morphine junkie, I tried not to smile. I failed miserably.
     "Well, we can't diagnose if there's any cardiac problems at the moment -- you're trembling too much for the EKG to generate good results. Let's get you some relief, and then proceed with the tests." Works for me.

     The nurse took 30 minutes to come back with the morphine. I was pissed. After she injected it, I was shocked to notice that I felt no relief. "How long does it take to have an effect?" She says, "About 30 minutes. That's because I did it intra-muscular. If I had injected it into a vain, it would've been pretty instant. Maybe I should've done that instead..." Uh, yes. You should have.
     After about 30 minutes, another friendly doctor checked in on me. "How's the pain," she asks. "Still ridiculous," I say. She smiles. "Well get you something much stronger than morphine, then."
     30 more minutes pass, and the doctor checks in again... "Feeling better?" "Uhm, nope -- I haven't received any more pain meds." Shocked, she storms off and finds my nurse... "Get this poor man some [name of drug], stat!"
     After the nurse pokes me a few times for the IV, and gets blood all over, she begins to administer the drug (it's like 11:30am). After about 5 minutes, the pain went from a 9 to a 4. I was so relieved. I started to breathe normally, my pulse started to go down, my trembling stopped... It was so nice to be with less pain, after all this time. The drug made me really tired, but I couldn't get to sleep -- it was still too painful to doze off. But at least I felt somewhat human again.

     The first doctor returns, and I express my overwhelming gratitude to be without pain. He proceeds to order scans to see if the tumor has metastasized into the spine, or if there's a clot in the lungs... They perform the tests, and give me another shot of the pain med about an hour later. At that time, the pain was nearly gone -- it was great! It did make me sweat profusely though -- that was annoying.
     The doctor returns yet again, announces that all my scans were good, and writes me a prescription for vicodin. He was unable to determine what caused pain, and simply said, "If it returns we'll dig deeper. Perhaps you slept awkwardly or something." I told him that sleeping oddly doesn't cause this amount of pain. He agreed.
     Then he discharged me, and told me to "Say hello to Doctor Irwin." Apparently, they knew each other.

     So, I drove home, picked up the Vicodin, took two preemptively, and here I am. The pain is pretty much gone. I don't know what caused it, but I'm certainly glad it isn't there anymore. So, that's my adventure! I'm a gonna try to get some sleep now.

[8-06-08] Term Paper and Appt. Results

[11:53am]
     Well, I just received my term paper back. I got somewhere between an A- and a B+, whatever that means. For some reason, every grade I have received has been some sort of hybrid of some kind; no point scale.
     Anyhow, what caught my attention was what was written in the margin below the grade... It said, "Good Work, Mr. A., no doubt under trying circumstances -- to say the least."
     It made me smile to read that. That was better than the grade, you know?

[4:49pm]
     After getting my labs done, I spoke with Dr. Cecchi and got the plans rolling. My labs were good: RBC falling very slowly, while the WBC was up at 13.7 (due to Neulasta shot). In other words, I was good to go.
     They're scheduling me for more inpatient ICE at summit (on the 13th), a pet-CT scan to verify ICE is working (around the 20th), and a follow-up oncology visit to discuss results (before 26th). The thought being, if I have clean scans after the second cycle(probably not likely), then I can skip the last two cycles of ICE and go straight to the bone marrow transplant part. If, after the next cycle of ICE, the pet-CT scan shows significant reduction (which I think is most likely), then we continue with two more cycles and finish with the BMT. Lastly, if the scans indicate little or no progress, then that's no good -- from what I read, response to ICE is necessary to indicate the BMT procedure. In other words, I'd have to look for different options. But that's getting ahead of things. I'm just hoping the next scans show a reduction.

     So, that's the plan so far!

[7-31-08] Delusional Optimism

[3:54am]
     I'd like to demonstrate a little known strategy known as "Delusional Optimism." That, combined with several other, uh, peculiar aspects of my personality enable an unprecedented amount of satisfaction from the most terrible of things... and the more crazy you are, the better it works.
     For example, consider a patient who just experienced some nausea due to the first day of treatment on a new chemotherapy regimen. A sane person might say, "this sucks." Rightly so. A delusional optimist, however, will be pleased because he feels that the chemotherapy is "working well" if he notices unpleasant side effects (delusional), even if countless literature indicates that this absolutely not true . The optimist then kicks in, and because of the delusion, begins to feel that "everything will turn out ok" because of all this. It's a very effective way stroll through many of life's difficulties -- I'm thinking of Bullwinkle's famed innocent ignorance, here (which is a similar, albeit different strategy).
     Ok, we now return to your regularly scheduled program...

     Woohoo, I'm feeling some nausea!!
     I just had some ativan to combat the nausea, and it will help me combat this darn insomnia. I've only had three hours sleep: I keep having nightmares where I read a study which clearly indicates that the doses and scheduling of my ICE treatment were clearly ineffectual. Doctors are unavailable on the phone or email, nurses insist on continuing with set treatment... stuff like that.

[8:00am]
     Just got my CT scan. They left me in a waiting room for a bit, so I had time to practice my freestyle wheelchair moves. It takes a lot of effort to move one of those around! If I didn't have the ICE-machine on the back, I would have tried some wheelies.
     I had to drink this odd contrast material so that the CT machine could see my organs and whatnot, then the proceed to inject me with the IV dye -- my favorite part! Toasty :P
     I know I'm not supposed to shower with an accessed port, but to hell with that! That's gross! I'm trying to smuggle some soap from the hand cleaner, and use a spare blanket for a towel :P

[3:10]
     Just started chemo again, and at terrible timing. I took a nap around 2:00pm; well, when I seem to wake up, I have some moderate nausea. The key is to move as little as possible when you call for the nurse. Strange how, nausea with the Stanford V was way more mild and way more predictable. This type disappears, ebbs and flows, or goes from mild to something tougher if you make the wrong movement. But I'm confident the anti-nausea meds will do the trick: Ativan Zolfran, and the killer Emmend. I think they've just been giving me ativan until now.
     Anyhow, bad timing I think. Nausea so close to *more* chemo, and just as I'm recovering, the chaplain walks in. I'm prepared for all sorts of religious stuff, but he just calmly professes "spiritual comfort" when I state my, uh, "nondenominational and individualistic spiritualism." I tell him that I basically do not want to "go there" at this point, maybe if things get more pessimistic, but I invite him to sit down and have a chat about anything in particular (For some reason, I'm starving for conversation around here. My nurse Alicia is a gem). So, I basically talk about my past and my current situation... from diagnosis to where I'll be in a few months. Nice guy. If only chaplains were ministers, we'd have way more mello religion.

[4:29pm]
Barbara's coming, and I think Liz too! Yay, a visit! I didn't realize how social I'd find myself in here.

[1-31-08] It begins...

[1:00am]
     Guess the pills the doctor gave me are ineffectual: another night of restless and scattered sleep. I'm getting so little sleep lately, making it impossible to do my new and routine 8am exercise.
     Maybe the insomnia is a symptom of the disease.

[7:00am]
     Thursday, sweet Thursday! I've been waiting for this day. Today I get a CT scan, and I get a chance to talk to my new oncologist. Even better, is that the scan is before the appointment -- the diagnosis and prognosis will be even more accurate.

[7:30am]
     Here I am, at the CT center. I'm excited -- this is going to be so cool. I mean, I designed software to calibrate x-rays: could this device be using some part of my software?

[8:10am]
     They take me to this room with a huge, white and doughnut-shaped device. It looks like something from a bad dream out of a science fiction story...
     Suddenly, I get a smile on my face, thinking: "Ha ha (teasing), all you people in front of me have to use the lame x-rays. I get to use the bad-ass one!"
     The technician put me on the conveyor belt/bed and told me that he was going to inject me with iodine, and that it would cause parts of me to feel warm. So, as I was fed into the machine, the machine started to spin very quickly. I was instructed to hold my breath, and the iodine was automatically injected. I didn't really feel warm, but I was getting a metallic taste in my mouth. Then, all of a sudden, my balls were getting nice and toasty (excuse me for being candid, but that's the truth!). Then, when the technician helped me out, I said: "I'm not going to tell you where I got warm." He looked at me with an expression saying, "Sheesh, I wish all these patients would stop making that joke."

     New experiences and interesting stuff. Plus, who says cancer can't have humorous parts?

[11:00am]
     I just attended my Artificial Intelligence class, and now I am waiting for my appointment at the Alta Bates hospital. I have bad memories here...
     Anyhow, I get to see the oncologist -- how exciting! Now I get to find out a qualified opinion of what this is. It may not even be cancer. If it is cancer, I hope it is Hodgkins (that one has a 5-9% mortality rate!). Apparently, it is the best lymphoma to have.
     But even if it is something else, I know I'll be fine. I can just see myself bald and puking all over the place, supporting myself with an arm on the doctor's desk, saying, "Is that all ya got?!?" It'll suck, but that's what makes the victory sweeter.
     Buddhism says that without suffering, there will be no happiness. This experience will make my life better in the long run.
     Ugh, when I get home, I'm going straight to bed.

[11:30am]
     Well, I just got out of the oncologist's office -- the nurse is going to set up a whole mess of appointments: pet scan, heart scan, HIV test, blood work, bone marrow sample, and chest biopsy (big needle + chest = bad). Ack. Then there's the appointments to see the nutritionist and social worker...and that's all before I start chemo.

     It's definitely a lymphoma cancer: the doctor said it was "extremely likely, but that there was a non-zero chance that it is something else." Alright... LET'S GET 'ER DONE!
     I feel really scared to tell my family... I hope things can be as close to usual/fun as they usually are. I know now that I have to tell them. They have a right to know, even if they don't like the news. I just don't want to be the cause of anguish...especially not now.

     I need to take at least 2 technical classes for the semester. Considering the circumstances, I suppose I should drop a class.