One Tube Down and a Barium Swallow to Follow ...

One of the tubes came out yesterday afternoon. This particular tube went in through my nose and into my stomach to keep it clear while it heals up. Not a a fun tube - you don't feel it that much but it's constantly in your way and gives you a 'borg' look and feel. One night I woke up around 3am and, while half asleep, convinced myself that I no longer needed the tube and pulled it about half way out before I woke up enough to realize what I was doing at which point I shoved it back in. That was a fun experience too, I tells ya. Told the doctor the next day and he explained to me that that was generally a bad idea, particularly shoving it back in because it can snag stuff and cause all kinds of damage - got lucky on that one.

Today they will do a barium swallow test. This is to ensure that my stomach and esophagus are recovered and functional. As long as all goes well, I should be able to start eating and drinking today. Amazingly, despite 5+ days w/o food I'm still not particularly hungry (though I was thinking some Superbowl wings or refried bean dip sounded awful good). But I am thirsty. Can't wait to have a glass of water or, dare I say it, possibly some juice. Or a beer ;p

I've been walking up a storm - 2 to 3 times what they set as a goal for me - and doing the recovery exercises they've given me but altogether it doesn't really take much time during the day. Also, every day they take me for an x-ray to ensure that I'm not developing pneumonia - it is responsible for most of the fatalities associated with this operation so they don't take any chances with it - I've been clear so far and most of the exercises I've been doing a specifically designed to prevent pneumonia.

Despite the record cold temperatures this weekend, I've had a plethora of visitors which has been really cool and helps pass the time. A big thanks to everyone who came out! Enjoyed watching the Superbowl last night though it was bittersweet watching the colts win - I like Tony Dungy and his organization quite a bit but they did have to beat the patriots to get there and I'm still smarting a bit about that. Of course, I hate bears even more than that ...

Have to go for my x-ray soon, keep them positive vibes heading this way because they sure seem to be helping.

--Dr. D

PS - They moved me out of my private room into a semi-private one; I'm now in room 1421B in case you're planning to visit. They had put me in another room initially but my roommate was an older, very sick fellow just out of icu (felt really bad for him but at least he had a lot of family around for support). After a while, my sister spoke w/my nurse and was able to get me moved to a different, considerably quieter room (my nurse and my sister are awesome). I don't have a roommate at the moment but expect I'll be getting one sometime today.

On the Road to Recovery

On Wed after surgery rather than keeping me sedated, they let me wake up late in the afternoon and I was able to talk w/Mom and sister M. Min showed up later as well but I was still pretty out of it. That night I was in a fair amount of pain and they worked with me to get it under control. Thursday morning Dr B dropped by and told me that the surgery went well, that he didn't find any further evidence of cancer, and that the analysis of the original cancerous areas will come back in 5 to 7 business days but that everything looked good - all of which was reassuring. Later I was moved from icu/recovery to my room. I got lucky because all they had was a private room so I that's what I got. I had actually considered getting a private room but it was an extra $500 a day and I couldn't justify that much extra to myself. After they got me settled in the new room they got me seated and, eventually, off for a bit of a walk. They kept me in a seated position most of the day as it's better for my lungs at this point and I went on a couple more walks throughout the day. By the end of the day, I was pretty tired and my visitors (Mom, M and Min) left around 8:30. Last nite I slept pretty well tho they got me up at 6:00 - again being upright is better but it doesn't mean I like it a whole lot. Today, I've gone walking a couple of times and will go a few more times. While walking, I have to stop every so ofter and cough to help clear my lungs - not a lot of fun but it's a lot easier today then it was yesterday. All in all, everyone says I'm recovering very well.


At this point, it's basically a waiting game again. I can't eat or drink at the moment - not particularly hungry but I sure could use a nice glass of water. On Monday they'll do a barium swallow test on me and, at that point, they'll hopefully let me start eating/drinking again. I'm up for visitors at this point so drop on by or give me a call.

--Dr. D

Out of Surgery

It's DR. D's sister GOC. I will be updating the blog over the next few days. DR. D is out of surgery and all went as expected. A bit over 5 hours. He is now in the ICU. Biopsy results will not come back for 5-7 days, but he made it through the surgery with no issues so things continue to look good.

Tomorrow - The Big Day

Surgery is tomorrow. I'm supposed to arrive at the hospital at 5:30 am. *Yech* My mother and sister, M, arrived this afternoon and they will meet me at the hospital in the morning where they will spend a lovely day waiting to get progress reports which they will get updates every two hours until the operation is over. Afterwards, my surgeon, Dr B, will meet with them to discuss how the operation went. M will then contact my other sister, GOC, who will subsequently update this blog w/the info on my status. For myself, I get to spend the day doing what I like best, i.e. sleeping. They will keep me sedated and in recovery/icu overnight and then wake me the next day once they've moved me to my room. Shortly after they'll make me walk. Ugh - luckily I'll be hooked up to an epidural so I can float away as necessary.

Well, I gotta get some sleep. For people wanting to visit, anytime after Friday should be good. I'll be at the Memorial Sloan-Kettering Cancer Center, the address is:

1275 York Avenue

which is 67th and York. My room will be on the 14th floor, I'll update the blog when I get specific room information. I'll also have my cell phone w/me so you can call if you want/need to.

See ya on the other side,

--Dr. D

Surgery Set for Next Wednesday (1/31/07)

I had the meeting with my doctors yesterday and things were generally positive. The endoscopy showed that the tumor has not shrunk a whole lot more since the last time evaluation but the biopsies didn't find any evidence of cancer cells which is a really good result and Dr. I tells me that its not unusual to find residual tissue after treatment. The pet scan was also pretty clear - the metabolic activity in the area is pretty close to normal; there's a little bit of extra activity but this is consistent w/what happens from exposure to radiation. The upshot is that there's a pretty solid chance that I'm cancer free at this point however they cannot say for sure so we will be proceeding w/surgery next Wed, 1/31 (which they had always planned to do).

After the surgery, I will spend 10-14 days in the hospital and an additional 6-8 weeks at home for recovery. The good news is that after 2-3 weeks at home, I will be able to travel so I plan to go back to FL for final 3-5 weeks of my convalescence. Apparently they will have me up and walking the day after surgery (with all manner of tubes sticking out of me) and the pain should be bearable w/o significant pain meds about a week after. They will release me from the hospital once, and only once, I can start eating on my own (i.e. when they can remove all of the tubes). The rest of recovery is about healing up, getting lots of rest, and getting lots of exercise, particularly lots of walking. My sister, M, and my mother will come up here on Tuesday and stay while I'm in the hospital (M will go home at some point and my other sister, GOC, will come up to spell her). Once I go home, my father will stay with me at my apartment until I can travel to FL.

I welcome visitors to come see me in the hospital or subsequently at my place in the city - contact me for more information if u r so inclined. Visiting in FL is also possible, contact me for reservations :). This Friday will be my last day at work so I'll have a couple of days to prepare. I'll post updates as they come along.

cheers,

--Dr. D

P.S. my new speakers should arrive this Monday :):):)

Preparing for Tuesday Afternoon ...

and my meeting w/Dr's I & B. Had my cat & pet scans done on Thursday and my endoscopy on Friday; we'll discuss the results at the meeting so keep your fingers crossed. We're also supposed to set up the surgery date, I'll post here as soon as I know anything. Also, I'm putting together a list of questions for my doctors, if you have any suggestions for questions, post them here or send them to me via email.

Spent the weekend preparing for my surgery. There's a lot of things I want to get done beforehand to make things easier during recovery. Of course the first thing was figuring out what I wanted to do for a home theater system. In the end, I should be able to take what I have now and add some high-end speakers to come up with a kick-ass system but I was looking into a lot of alternatives (made my head spin). Think I had too much tea on Saturday because I ended up staying up all night playing with different audio components until I realized that thing annoying me was the sun shining in my eyes at sometime around 7. Nocturnal tendencies once again (jeez, I even love the word 'nocturnal'). Also got my satellite radio set up and routed through my stereo - it's awesome (except listening to the Patriots lose, which sucked).

Decided that I've seen way too much tv over the recent months so I'm going tv-free until after surgery. This is why I listened to the Patriots lose on radio. So it's already paying dividends because I woulda hate to have seen them lose. Still, I'm gonna miss 'The Daily Show' and 'Countdown w/Keith Olbermann' but I think I can get by (thought about dvr-ing them but that seems like cheating :) and I'm really sick of the commercials at this point. Send me a note if any breaking news happens that I should be aware of.

That's about it for now, until Tuesday (well, maybe Wed morn) ...

c u later,

--Dr. D

PS - hope u like the new profile pic, thought it was time for a change. And here's the best pic I took while in FL:

And We're Back

Have been back actually; made it back to NYC on sunday evening just in time to get hit by a case of food poisoning - blech - won't go into the gory details but, suffice it to say, I am back at work today and feeling fine.

Vacation in FL was everything I'd hoped for - it was great to be home for the holidays with family and, as and added bonus, Min came down with me and stayed for the first half of my vacation. While I was home, I spent my time going to the beach, went to Ringling Museum, the Salvador Dali Museum, out on Le Barge (booze cruise around Sarasota Bay). dining out (outback, el adobe, madfish grill, barnacle bill's, walt's, and, of course, Bangkok), dining in (GOC's xmas dinner, Richard's new year's dinner, Dad & K's steak dinner, etc etc etc), fixing everyone's computer problems (except GOC), playing pool, mudriding in an overgrown golfcart, kayaking, and any number of things I'm forgetting at the moment. I also slept a lot. Amazing how on vacation my nocturnal tendencies tend to re-assert themselves - by the end of my visit I was staying up until 3 and getting up past noon - good thing I didn't stay much longer. And to answer the big question, while on vacation I did drink a bit but limited myself to 1 drink per night. Worked out pretty well actually. All in all, I felt good during my time home tho every now and again I'd be hit by some fatigue or nausea or pain in my legs but it didn't happen too often and didn't last too long (nothing like what I went through during treatment). Got a bit of a tan but my head peeled :) Luckily I have some hair now so it doesn't look too bad (well, no worse than normal anyway). Took a bunch of pictures too, will try to post some when I have the chance.

So this week I have some evaluation tests scheduled on Thursday and Friday followed by a meeting w/my doctors on Tuesday. After that, my surgery will be scheduled, potentially for the last week of January. I will, of course, post any results/news as soon as I hear.

Finally, I did check my blog during vacation and appreciate the comments from Hong Kong and m/so.

regards,

--Dr. D

Florida Bound

in a few hours. And I can't wait :)

Feeling good overall, still have some minor problems w/fatigue but that's going away over time. Went to m/so on Wed for a Christmas party at bunnies - met up w/Dave and Jerry and a bunch of other friends. It was a really good time and I was very happy to see everyone (and they seemed to reciprocate).

As you already know, I'll be FL for the next 3 weeks. I do have my laptop with me and internet access so I'll be checking my blog and may post a time or two if I am so inclined. Mostly, I'm going to enjoy myself and forget about most everything while I'm there.

So Merry Christmas everyone, and if not before, I talk to you in the bright, shiny, new year :)

--Dr. D

Mostly Alive

Currently listening to the Smith's "How Soon is Now?" on Alt Nation - if there's a better song, I don't know what it is :)

So last Monday I thought a lot about Miracle Max's quote from The Princess Bride "mostly dead is slightly alive". At the time I felt mostly dead and it was good to remind myself that, indeed, I was slightly alive. Mostly had to do with fatigue and lack of sleep but generally feeling horrible overall didn't help much either. The week has made a huge difference; I feel a lot better now. My night fevers stopped on Friday so I believe my wbc count is in a decent range and I've been sleeping well ever since. Spent most of Saturday sleeping actually. My appetite started returning on Thursday and I had a ginormous lunch on Friday as well as a fantastic brunch on Sunday (with Min at a place called Annie's on 3rd & 79th - highly recommend - particularly the pancakes) along with a number of very nice meals in between - my weight has started going up again which is good news (I had gotten to the extreme low end of my weight range last week) except that I'm going to have to start watching what I eat (damn). Last week, my arms and legs were shaking a lot due to lack of strength - while my strength is not 100%, the shaking has stopped and I think in a few more days most of my strength will be there. At this point, my biggest problem is still w/nausea - while it's diminished it seems to recur. This morning I woke up w/that feeling and just didn't want to get out of bed but you gotta fight this stuff so I took some Zofram and got myself moving. Fatigue is the other issue that I'm going to have to continue to contend with as it also tends to recur. So while I feel a lot like my normal self most of the time every now and again a wave of fatigue just hits me.

If it's not obvious, the meaning of the title of this post, Mostly Alive, is that while I don't feel completely recovered, the scales have tipped in my favor. I am optomistic that over the next week I will continue to improve such that when I get to FL on Sunday I should be pretty much back to normal (so head's up down there).

--Dr. D

A Good Meeting w/Dr. I

So I met w/Dr. I this afternoon. While I continue to feel a bit better each day, I've had a few concerns that I wanted to discuss w/him because the last thing I want is for something to happen that would cause me to have to delay my vacation. My primary concern was that I've still been having fevers at night - they don't get that high but they're to the point where I would have to get them checked out at urgent care. Dr. I said that it is not umcommon for people to have this kind of reaction to radiation and that he's confident that the fevers should go away over the next week or so. My feeling is that it is possibly a wbc count issue as well, given my history. Today my wbc count came in at 2500 which is decent but still in the range where my temperature fluctuates. He broke down the blood cell counts even further and the number of disease fighting cells is quite good and the number of new cells that will develop into wbc's is high - Dr. I sees these as very positive signs and expects I will feel much better over the next week. My red blood cell count is quite good too, despite the fact that I no longer take iron - he says this is a very good indication that the tumor has reduced a lot more. We're both hoping for total elimination, of course, but I'll take what I get. Another problem I've been having is that I feel nauseas and don't really find anything appealing to eat - each meal is a bit of a struggle to force myself to ingest enough to keep from losing weight. Dr. I says this is pretty standard and not to be concerned about it - it should also go away in the next week or 10 days. Finally, I've been having trouble sleeping - part of this has to do w/the fatigue (which, ironically, makes it difficult to sleep) and part of it has to do w/the fevers - Dr. I has recommended that I take tylenol before going to bed which should take care of the fever issue. In fact, last night I took some tylenol and had a great sleep so I was happy that he was cool w/it. Fatigue is still a problem but as I do more, it gets better incrementally - once I start getting some good night's sleep it should improve even quicker. I just gotta keep moving :) My hair seems to be coming back w/a vengence. My facial hair had gotten a lot thinner and lighter (almost the color of my skin, so you could barely see it) - the other day I woke up and, to my amazement, once again had a visible goatee (well, van-dyke for those of you who have been following this blog). The hair on my head is also coming back much thicker - it's been just over a week since I had it shaved and it's already pretty fuzzy all over. Still not quite normal thickness but getting there.

Dr. I and I also discussed the schedule for the next portion of my treatment. I will be returning from vacation on 1/14 so here's the overall plan:

Week
------
1/15 tests - cat scan, pet scan, endoscopy
1/22 consult w/Dr. I and Dr. B (the surgeon) based on the tests
1/29 surgery

I have tentatively scheduled the dates for the tests and the consult w/Dr. I and Dr. B and will publish those once they've been confirmed. The actual date of the surgery won't be set until the consult the week of 1/22 but will be for the following week.

So I won't have any evaluations before leaving for FL - would like to have had some indication of progress but it makes the most sense to have the tests done as close to the surgery as possible. For now, it's time to relax and forget MSKCC for the next several weeks (Dr. I's orders :).

cheers,

--Dr. D

... And Then There Were None ...

Had my last radiation treatment today. Yehaw! Afterwards I met w/the Dr covering for Dr. M along w/the nurse I've been seeing since treatment began. All in all, I've dealt w/ the side effects of the radiation pretty well so there wasn't much to discuss. They also performed some blood work on me to check wbc count etc - I haven't got the results yet but if there were any problems they would have contacted me. Didn't sleep well last nite, think I was too excited about the last treatment, so I ended up staying home rather than going to work today. I'll play it by ear tomorrow depending on how I feel but I expect I'll go in for a while anyway.

--Dr. D

... 1 ...

tho I do have to wait until Monday for that last one. Doh!

Overall feeling okay. Yesterday I felt tired and nauseaus and ended up leaving work early. Had a slight temperature in the evening but not enough to have to go to get evaluated (thankfully). Today, I'm doing pretty well - no temperature, bit nauseaus but better than yesterday, and a bit fatigued but better than yesterday. Going to go for a walk in a little while - not sure how far I'll get, it's still kinda cold out today :) Hopefully I'll keep improving through the rest of th weekend and will feel pretty good next week.

Came home yesterday and got a care package from my sister M. Always a nice surprise.

--Dr. D

... 2 ...

One more down. Ran into Dr. M's nurse afterwards, she asked how I was doing, told her I was pushing through it. She told me that the side-effects of radiation generally peak and recede during the first 2 weeks after the final session - luckily I haven't been suffereing too much from side-effects from radiation (probably maksed by the side-effects from chemo) but I don't want to take anything for granted so I'll be prepared for it (e.g. - keep walking, be careful of spicy foods, etc).

Feeling kinda rough today but a pretty standard Thursday overall, bit of cramps being the worst of it so far today. Slept pretty well last night but I think fatigue is starting to catch up w/me again. Plan to take a long walk home tonite to fight it (but not too long - getting cold out). Lorraine is going to drop by this evening w/some chili (and a bit of company) for me - sure appreciate it on these kinds of days. I probably won't be very good company myself but it will be nice to have someone around for a while.

Can't wait for tomorrow - and another one down :)

--Dr. D

... 3 ...

So this morning, when taking my anti-nausea meds, I discovered that I'd forgotten to take my anti-naseua meds yesterday. Result - felt kinda nauseaus yesterday but slept quite well last night. Today, I took the meds but felt pretty nauseaus all day - think that's because I forgot the dose yesterday and it caught up - not something I'd expected. Still, not any worse than a standard Thursday or Friday so a bit of ginger ale (and ginger candy from chinatown) helped alleviate the problem. Still having the standard side-effects too - legs feel kinda like lead, hands shaking a bit, some difficulty concentrating and lack of appetite - but they're easier to deal with knowing it's the last time. Eating's the biggest problem - very easy to skip meals when you're not hungry at all but you ultimately feel worse for it - finally forced myself to eat some beefaroni tonight. I know what ur all thinking - ughh - but it has a good amount of calories in a relatively small amount of volume which is perfect for this kind of situation. Currently drinking some high-calorie cranberry spritzer, also good for this situation. My throat is getting a bit more sore now from the radiation, going to be a race between the number of treatments left and the effects on my throat - hopefully I won't have to go to pureed food but, even it I have to, it shouldn't be for too long and, if starts getting too uncomfortable, they have meds to help deal w/it.

Dr. I's office called this afternoon to schedule my appointment for next week - turns out it will be on Wednesday rather than Monday so I won't have much info from him until then. Plan to ask him about the effects of skipping the anti-nausea meds on Tuesday to see if he has any thoughts about it.

BTW - I've taken up the hobby of watching old music videos from the 80's on YouTube - if you haven't checked it out yet, I highly recommend it :) Well, youtube anyway, you can pick ur own kind of videos.

--Dr. D

4 Left

Radiation treatments, that is. Today's treatment was also delayed as two machines were down for the count - pretty unusual, I've only seen machines out-of-order due to scheduled maintenence up to this point but I guess they have to be pretty cautious when they're dealing with these types of machines (I know *I* want them to be cautious when they're aiming them things at *me*).

Afterwards, I went and got my head shaved again. It was really starting to look fuzzy. The hair is still thinner than usual and a little thicker around the ears so it looks a lot better now. It should start coming in a lot thicker and more even over the next couple of weeks given that I've finished chemo tho I haven't decided what I want to do w/it long-term - still kinda diggin the smooth, shiny look :)

When I spoke to Dr. M yesterday he told me that Friday would be his last day at MSKCC; he's moving to the medical center at the University of Chicago. Defititely a loss for MSKCC, I'm glad he was there for me. We discussed my surgeon, Dr. B, and he said that if he had esophageal cancer, he'd fly back from Chicago to be treated by him. Everyone says Dr. B's the best.

Finally, next Monday I am scheduled to meet w/Dr. I to discuss what's next in terms of scheduling evaluations and the surgery. Will keep you posted on that.

--Dr. D

Chemo Done!

Long day today (started at 9:15 and ended at 6:30) but I got radiation in the morning and (final) chemo in the afternoon. The day went long due to a number of delays - one of the radiation machines broke down which slows things quite a lot and then my chemo meds were ready by 2:30 but they weren't able to get me in until 4 due to a large backlog of people - both unusual occurences but I didn't care so much as I just wanted to get the treatments.

So my wbc count today was at 2700 - more than enough for chemo but still kinda low. The rest of this week is likely to be rough as it will be combined chemo and radiation but, as of next week, I should start getting stronger and feeling better. Can't wait for that :)

Keep sending the positive vibes,

--Dr. D

Treatment Schedule

When Dr. I cancelled my chemo last week, he also took me off of my radiation treatments. Both chemo and radiation can negatively affect your wbc count (chemo much more so than radiation for my particular treatments) and so they don't do either until your counts come back up. On Thursday, they started my radiation treatments again so I only missed 2 days last week (Tues & Wed). Overall, these kinds of minor delays in the treatment don't affect the efficacy of the treament or the number of treatments (for either chemo or radiation).

I'm scheduled to have my final chemo treatment tomorrow and, given how well I'm feeling, I'm pretty confident the my wbc count should be more than enough for me to receive it. As for radiation treatments, I've now had 22 and have 6 left to go. If all goes well, I should get 5 this week (i.e. m-f) and have my last one a week from tomorrow. This week is likely to be pretty rough but things should start improving thereafter.

I'm scheduled to go home for Christmas 3 weeks from today - here's crossing my fingers that all goes well and I can catch that flight.

--Dr. D

Out of the Hospital

And you probably didn't know I was in it. On Tuesday, my temperature spiked to 101.5 and I was concerned that my wbc count was going down rather than up so I ended up going to MSKCC's urgent care center. There they checked my wbc count and it actually was up a bit to 1200 but they were concerned about the fever as it could indicate some kind of infection so, after consulting w/Dr. I, they decided to keep me for a while and run some blood cultures to see if there was anything going on biological-wise. Other than my temperature being all over the place, I felt pretty good so I wasn't thrilled w/being admitted to the hospital but I figured it was the best way to get well enough for chemo this coming Monday. Wed was pretty boring but I was still running a fever and Thursday was similar. By Thursday, they had run the complete blood cultures and they were negative and my wbc count was up to 2200 but I was still having some small fevers so they decided to keep me until Saturday. Luckily, today the doctor decided to let me go, since I was doing so well, as long as I promised to come back if any more problems occurred. So here I am, home :)

--Dr. D

WBC Count @ 900, No Chemo This Week

Once More unto the Breech Dear Friends, Once More

So tomorrow is it - my final chemo session. Everyone's been saying 'already, that was fast'; I guess my perspective is a bit different :). My only concern is that I have had some slight fevers over the last few nights (not enough to get checked out) which usually indicates that my WBC count is down so I'm hoping that it's not down so far that they won't perform chemo because, as I've said time and again, I certainly don't want any delays. Wish me luck.

Thanksgiving was good. A number of people invited me over, which I really appreciate but, ultimately, I decided that, given that it was Thursday, I didn't want to get too far from MSKCC. I try to push myself but I don't want to be stupid, particularly in these last few weeks. Min ended up cancelling her plans so that I wouldn't have to spend the day alone which was really cool of her. Given that it was kinda last minute, I ended up going online and ordering all of the ingredients to make a Thanksgiving dinner and it was all delivered a few hours ealier - there are some things I really love about living in the city :). Dinner came out well and we just ate and watched movies since it was a rainy day. And, as is typical for Thanksgiving, we had way too much food. I debated whether or not to go to work on Friday but when I got up in the morning to go to radiation, I felt exhausted and kinda blech all over. After radiation, I just came home and went to sleep until about 3 at which point I forced myself to get up and go for a long walk in the park as a way to combat the fatigue. It helped but I was still pretty out of it and did run a slight fever that night. Saturday I felt a bit worse actually and the fatigue was really heavy. Eventually I forced myself out of bed so that I could eat a bit and go for another walk but I spent most of the day in bed feeling exhausted to the bone and still kinda blech all over. Finally got to sleep around 2:30 and had a good night sleep - when I woke up this morning I felt much better than I had in the last couple of days and the fatigue had mostly lifted. Met Min and we went to chinatown for lunch - I hadn't really eaten enough over the last few days and it made a huge difference (went to a place called 'Congee Village' - food was good but the service sucked).

Going to get some sleep now, more tomorrow once I've gone for chemo.

--Dr. D