Cancelled

I am NOT having the operation tomorrow.

At midday today, I got a call from my radiologist that Blue Cross would not cover my operation. We spent the afternoon working with the doctors to try and get through an emergency appeal, but they couldn't make it happen in time for Wednesday.

The out of pocket cost to us would be in the hundreds of thousands of dollars so we need to get the coverage approved first. My surgeon said he has done 120 of these and they've all been covered, so we are all very frustrated.

We will go forward with the appeals process and hopefully reschedule soon.

Needless to say we are not happy, but this is the situation, so now we deal with it...

The mellow before the storm...

It seems odd to me, but I feel quite calm and peaceful as I wait for Wednesday's operation. I've been expecting sleepless nights and stress in my body, but so far I feel good, serene, really. I'm sleeping well... mundane dreams. Today I cleaned my studio and did restorative yoga. On Monday I'll teach and get reiki at school, then after school I have a pre-op meeting at MGH to go over the procedure, medications, medical proxies, living wills, etc...

Tuesday will be a quiet day with Amanda, hopefully a long walk with her and the dog, then acupuncture and a simple meal with Monika and Amanda.

My operation is first thing in the morning on Wednesday (6 am), which suits me just fine as I want to get on with it without all the waiting that often happens at hospitals. The operation should last around 2 or so hours, then I'll be 5 days at MGH before I get home.

During this past 9 months I've come to understand that if I do EVERYTHING I can to overcome this cancer, and it doesn't work, then I can face the last hurdle at least knowing that I did my best. Right now I feel happy, strong and focused. Since I don't feel sick, it's hard to feel like I have a terminal disease. I take the cue from my body, so I'm optimistic about the chances of this operation working. If it doesn't, I'll cross that bridge when I get to it.

We will try and have Deb make a post on Wednesday night or Thursday to give an update on how it goes, room info etc...

Looking ahead...

We met with my surgeon Tuesday at MGH and discussed the upcoming procedure... I'll be getting intraoperative radiation on March 3. The tumor is down to about an inch, and will allow them to put a cone onto it that will expose the entire growth to radiation, but spare surrounding tissue. If they don't find any metastasized cancer in other places as they go in, then they will remove my gallbladder and do some other plumbing related work, then zap the tumor directly for 1.5 minutes. The location of the growth in relation to the arteries in my gut make the removal of the tumor impossible, so there is no option for the whipple technique.

I will be in the hospital for about 5 days, then home recovering for another 3-6 weeks.

This procedure has a chance of killing ALL the cancer cells in the tumor, and represents a curative possibility for me. The surgeon told us that there is about a 6% chance of cure for people in my situation who are able to get this procedure. Considering the fact that the growth has been shrinking, we are hoping that any cancer cells floating free in my body have been killed by chemo and all the other work I've been doing, and that this gives me a solid chance to get out of this chapter of my life alive...

One disquieting fact is that this procedure represents the last operative or radiation procedure open to me through conventional medicine. If the cancer persists, my only options would be palliative chemo treatments to give me comfort and extend my days.

It's been almost 9 months since this odyssey began, and all my work has been to get to the next treatment option without having any doors to treatment close. It's a strange feeling to be at a place where my options have become finite, with the outcome still undetermined.

When I was diagnosed, I knew it was unlikely that I would ever get to this procedure, as my prospects were not good. The numbers suggested that I would die by this May or June. I wish I could just jump ahead 12 more months to see if I'm in the clear, but I know that the outcome to this journey may reveal itself in slow time, with my efforts having to continue into an uncertain future. I am pleased and grateful to be at this place, and am really looking forward to getting this done!

I have a week to get my classes prepared for my absence, and if things go well, I will be back to my old life by mid April, with plenty of time to teach, start spring seeds and plant the fruit trees I ordered a few months ago...

Some light at the end of the tunnel...

Some good news today.

We met with my medical team to go over the latest scan, and the tumor has shrunk a bit smaller and is stable (not spreading). My radiologist said that it seems to have shrunk off one of the veins, but not yet enough for the whipple operation. I am eligible for intra-operative radiation, which involves an operation that cuts down to the tumor and then uses a protective cone to apply lots of radiation right onto the tumor without doing much damage to surrounding tissue. Several approaches/outcomes are possible; 1. They go in and radiate the tumor for 1.5 minutes and try to kill all of the cancer cells. 2. They go in and see that the tumor is smaller than they thought and will go ahead and do the whipple procedure to remove the tumor and surrounding tissue on the spot. 3. They go in and see cancer in other organs, and stop attempting the procedure because the cancer has spread and containment is not possible.

Sometimes, the cancer can be killed completely by the intra-operative radiation and if there is no other cancer in the body; it is cured... leaving only dead scar tissue.

This is what we hope for...

I am meeting with the surgeon on Tuesday and the operation will be scheduled ASAP.

In the meantime, I continue all the diet, supplements and alternative care work that has helped to get me here...

- David.

The drawing above was done by an old friend during the first week of my diagnosis. He did a bunch of drawings showing the cancer being purged or exploded from my body... it wasn't until we later learned about the intra-operative radiation procedure that we realized how similar his drawing is to where we ended up... He's going home tonight to do a bunch of drawings of me as an old man...

Normalcy

These weeks off are rejuvenating. I'm getting lots of rest and am able to teach without interruption. Today was the start of second semester classes, and I really enjoy these first days with new students. I do lament the fact that my best case scenario medically would be an operation that would likely keep me out of school for the rest of the year. Obviously I hope for that very thing, but I would miss the classroom. I draw LOTS of energy from students...

The fact that I don't feel sick right now, gives me some comfort. My doctors have told me that if the cancer is spreading, I should feel quite bad. So we all take this as a good sign.

I had a dream a week or so ago that I was lying down, feeling connected to the whole universe, and that a powerful white light was beaming into my abdomen, bathing me in bliss. I revelled in it until I was woken up by the sounds of Buddy struggling to stand (he's an old dog that lives with with us and has trouble standing up on wood floors). I went down and helped Buddy onto his dog bed then ran and dove back into bed trying to return to the dream. It was gone, but I vividly remember the feelings and sensations...

I'm taking it as an sign...

-D

Resting and Waiting

It's been a week since I ended the last round of treatments, and I'm slowly getting my strength and energy back. I've been sleeping a lot and I have a little more energy each day. Today I started back up with yoga classes; I've been feeling as limber as a bag of cement.

The Feng Shui Master came back last week. After learning that my scan from a month ago was good, he said he needed to follow up on his previous visits to do some new things to heal me. He is a complete mystery. The Master drives up in a big Mercedes, sports an Elvis like bouffant and a Chinese leisure suit, and uses i-phone apps to make his ancient calculations. This time he checked on the site of the animal ghost ceremony that he did the last time, making sure it was still fenced off from any human or animal contact. He also inspected all the other things he told us to do (most of which we did). He speaks no English, but says very little anyway, and explains almost nothing of the what's or why's of his actions.

This weeks action involved him making an alchemical mixture of various colored powders, mixing in some water, painting it on a large brass Chinese coin which, after a ceremony involving fire, bells, and numerous incomprehensible incantations, ended by me hanging the coin in the carefully chosen and measured spot on the wall, and then my carrying a laminated packet of something on my person and wearing a blessed jade and gold dragon necklace... I'm starting to feel like a Chinese Liberace... all in the name of healing...and fun.

February 11 is my next goal. It's the big day when I get the latest scan back and meet with my "team" to chart the next path...

This illness has changed the nature of "goals" for me. I used to think about long and short term goals; like what I'd like to accomplish in the next couple of years, and then 10 years and on retirement plans... Plans based on the illusion of unlimited time.

Now my goals are much closer to home... timed to help me make it through the next treatment, or through the few days it takes until a test or scan result comes in. These goals keep me much more focused in the moment, and consequently I feel more present and focused on each day. Grateful, really. (Scared, but grateful)

So February 11th is my current goal.

-D

Letting it do it's thing

Well, I made it through this round of radiation and chemo, and now have a few weeks rest from any treatments while the radiation continues to kills the cancer cells that have been damaged by those powerful, healing beams. I can get back to work helping my body recover, building up my strength and energy. And I can start up yoga and exercise again!

I will not miss driving in to MGH everyday, the hardest part for me has been sitting in the waiting room full of so many suffering people. It's a quiet, sad place... I felt like I didn't belong there, even though my prognosis is probably much worse than most of the people in the place... Ironic I know. It reminded me of a Bruegel or Bosch painting of the gates of hell. I got in and out as fast as I could, even though the people working there were very kind.

On February 9th I'll get new scans, and then on the 11th we'll meet with my medical team to see what happened, and decide what happens next...