Cancer Update (emphasis on the Up)

For anyone who’s been curious about my health status over the past 6 months since my last post, know that much has occurred and many profound lessons have been acquired (and lost).  Because our time is agonizingly brief, I’ve whittled down this update to one item — a piece of advice, one that I’ve wrestled from the gnarled hands of this disease.  The most vital nugget of information I have gleaned during this entire cancer saga (and when I say vital, I mean for the love of mother nature, once you read this information, cling to it with the strength of the creature-spirits of a thousand-kajillion galaxies lest it be torn from the consciousness of the very universe) is as follows:  never give a drugged up post-op patient access to their own smart phone.  

Alas, if you fail to adhere to this edict, the consequences are unspeakable.  May god shield your eyes from stupid images like this:

You may ask yourself: where on earth did that stupid self-aggrandizing smirk-selfie come from?  What a Jabroni with a capital “Jet-the-fuggouttaheyah”

Where indeed.

At that moment, it was a little before 6AM the morning after my second surgery at MSK.  Second, you say?   

To catch you up: 2 weeks after my last blog(lamp)post in May, I got another PET Scan.  A small but now legendary bright spot remained in my chest.  Bright on a PET Scan in this case = “we’re not sure but probably you still have active cancer” = “you probably need a lethal chemo regimen followed by an autologous bone-marrow transplant" = “but that’s a tall glass of eeek-uh-oh-this-is-dicey so we better be sure and did we mention we’re not sure?” = “we have to be extra sure so let’s do surgeries to be sure before we nearly kill you so you don’t die.”   

In case you didn’t follow that, after you finish the initial treatment protocols for Hodgkin’s Lymphoma, if the PET shows brightness, they sometimes run pathology on the remaining mass before engaging in further high risk treatment.  Pathology means surgically going in with instruments to take some of the mass and run it through special magical medical devices which magically spit out magical results.  Or, like in the Willy Wonka machine that claimed to locate the remaining golden tickets, they take three weeks and then don’t.

But before doing surgery, let’s wait.  Why wait?  There was some fair speculation that the brightness could be something called Thymic Rebound Hyperplasia.  Basically, during radiation, chemo, even pneumonia, the thymus gland (which matures T-cells, sits superficial to the heart, same zip code as my cancer) can shrink down to about 50% of its original size.  After treatment, the thymus grows back to its original size and can look like cancer, but it’s not.  All of which is great PR evidence for my new self-help cancer book, “Quit Fucking Panicking: no one knows anything about anything.”  

So we waited 3 months, did another PET scan in August, and, ta-da, brightness was Rhianna bright like a diamond-worse.  

Cut to the surgeon smiling at me maniacally like Willem Dafoe in Platoon before he dives head first down into a Vietnamese tunnel.  

The first attempt to retrieve a biopsy was straight forward, and by that I mean straight forward through my sternum with a large gauge needle.  Thanks to a combination of different meds, you can be awake enough during such a procedure to hear and watch a little metal hammer strike the needle over and over and over again until it penetrates the marrow of your sternum and then the soft tissue underneath; so awake indeed that you can answer in the affirmative when the interventional radiologist reacts to your grimace and asks, “Can you feel that?”

Why, yes, sir, thanks for your insightful query, I can feel that.  Turns out, if you’re not under general anesthesia, you can feel a needle when a hammer pokes it into the marrow of your sternum.

I’m very fortunate to know what that feels like.  

Biopsy results typically take no less than 3-5 business days.  Three weeks pass and I am told the results were “non-diagnostic,” which sounds good but basically translates to the dude in Willy Wonka saying, “I can’t tell you, that would be cheating.”  

For whatever reason, there was not enough tissue in the needle-core biopsy to make a clear cancer / no-cancer call, so we had to go in deeper.

Deeper = Video Assisted Thoracoscopic Surgery = VATs (See rudimentary diagram below). In so many words, they go in with a camera crew and mine for anything that looks like cancer.

Despite my longing to watch the surgery live on screen, I had to be under general anesthesia (primarily because they had to deflate my right lung to access the mass; apparently this sensation doesn’t promote the stillness necessary to not knick a major blood vessel).  

I despised the idea of being under general anesthesia.  Not because I was stubborn, although I am that.  Why?  Because I was afraid.  That’s right, for the first time during this entire sick-tale, I was afraid.  How did I know?  Because I’d felt it before.  Back in high school, I’d be lying in bed and suddenly I’d be overcome with a surefast sensation that I wouldn’t wake up if I went to sleep.  So I’d stay up all night writing my own eulogies and wills & testaments in my journals.  You know, just in case.

I had that feeling in the days leading up to this surgery.  The procedure was relatively routine, but I wasn’t ready to go yet.  In part because it would be such a dumb way to die.  

((

How’d he die?  Cancer, right?  

Well, no, they weren’t sure if he still had cancer, so they were doing a biopsy to find out and he just… didn’t wake up.  

Huh, that sucks.  Didn’t he write for TV or something?  

Yeah, I think so.  

But I heard he had a cleaning business and hung TV’s for people occasionally and was, like, a mediocre soccer player with a bad hip.  Didn’t he act too?

Nah, I don’t think so.  Nothing that I saw.

Hm.  What was his name, Chris… Carbonara or something?  

Yeah.  No.  Chad Car something.  Carlisle…

Carpile? No. Carfires, Carfirestein, Carswanson, Carswampsonite, Carpenter…

Carpenteria!  

THAT’S IT! Chad Carpenteria!!!  Now I remember him.  Sort of.  Nice guy.  

Yeah, sorta nice-ish. With a lot of hair. Chad.

Yeah… Chad Carpenteria with a lotta hair.  Well, he lost the hair, I think.  

Yeah, chemo. Shame. Think of all the shampoo saved though.

True. Well, wanna finish watching the last episode of The Irishman?  

Episode? Isn’t that a movie?  

Ah, shit.  Yeah.  Wow, long movie.  Jesus, even for Scorsese.  So what?  Let’s finish it.  

Wait, let’s watch something on TV.  Ya know, for what’s-his-name.

For Carl?  

Yeah, for Carl.

))

My name is not Carl.  And I’m not dead yet.

That’s where the stupid smirk in that hospital selfie came from.

I was just so happy to be alive.  And to not be named Carl (no offense to the Carls).

And, it turns out I’m not going to die from Hodgkin’s Lymphoma just yet.  The surgery was the day after my 34th birthday.  A week later, my oncologist called me and said, “No Lymphoma, come see me in 6 months for a CT Scan.”

The brightness on the PET was inflammation from radiation treatment and scar tissue.  4 months of asthma, several ounces of blood coughed up, 2 months of chemo, 2 more months of more intense chemo, 3 weeks of radiation, 3 months of waiting, 3 months of more waiting, 38 science credits, 2 surgeries, and here we are: cancer free. 

For now.  

There’s your update.

Until next time, this is Chester Catfires bidding you happy holidays.