June 30, 2006
Similar to the endoscopy, I return to Alta Bates on June 30th, only a week and a day from finding out I have cancer. I can walk there, and simply arrange for a friend to pick me up since the “knock out” drugs make you a bit loopy after the procedure.
A chemo port is this thing that’s the size of a quarter, but maybe a quarter inch thick, and a slightly larger base. It’s inserted below the collarbone, and then somehow hooked up to a vein. It’s great — it means no needles in the arm! This breast cancer website has a really good explanation of what a chemo port is.
All the prep seems to be just like the endoscopy, except things are taking a bit longer this time. Just before the procedure, the anesthesiologist comes in and we start talking about how I like to be more medicated than less, and share my root canal story with him. He agrees. A weird thing happend, and the curtain seperating myself from the next patient opened. The guy was asleep, and really old and yellow — like the Cal basketball jerseys yellow — and I motioned for him to close the curtain. You see a lot of really sick people in hospitals. Not fun.
So the anesthesiologist wheels me into the room where they’re going to do the procedure. It’s a lot bigger than where they did the endoscopy, and have these interesting looking lights. I ask “that’s interesting, those lights, they look like the ones I’ve seen in the operating rooms on TV” and the doctor replies “that’s because you’re in an operating room”. A bunch of people start filing in, and I start asking them what their role is in the procedure. One’s anXray fluoroscopy guy, and of course I ask what that is. The next one does this and that. They’re all polite, but not really chatty people, and seem uncomfortable with so many questions. The anesthesiologist asks me how long did it take before the drugs kicked in during the endoscopy. I answered “about as long as it took for me to sing Oh Canada. Would you like me to sing Oh Canada?” — and that was the last thing I remember. He’s the one guy who’s figured out how to shut me up when I’m on a roll!! Drugs!
I woke up in the recovery room. I had a bunch of morphine and I was happy and singing — so much so I woke three people up. Ahh, morphine. It makes you do silly things. My friend Paul who picked me up said I insisted on showing him my new port, and then said something about wanting to run around and show all the neighbors. Luckily he stopped me!
June 27, 2006
Okay, so now I’m diagnosed with Cancer. Oh, crap. This week is a complete blurr. I can’t remember the order of the events. I end up getting a PET scan, and a CAT scan. I ask for a DOG scan, but they tell me one doesn’t exist.
I meet a surgeon, a radiation oncologist, and the head oncologist at Alta Bates Cancer Center in Berkeley. I don’t remember the order, but do remember a sense of urgency with everyone concerned. These guys were all quick, efficient, and decisive. The results of the PET and CT scans weren’t in, but the options all pointed to surgery. Doctor Stallone (rhymes with “baloney”, not like Sylvester) was rarin to go remove this thing… until the results came back and showed the cancer had spread to a couple of lymph nodes. That’s not good.
I think that’s when I saw the oncologists. Dr Swift, the radiation oncologist, explained how they have this high-tech linear accellerator from Varian that can pin-point areas targeted for radiation.
Dr Cecchi’s visit was different. This guy is a genius. You can tell, the demenor, the confidence, the conviction. The other Doctors are awesome, don’t get me wrong — but Cecchi is clearly the Michael Jordan of this operation. I got a long great with this guy — he’s very high energy (like me), and I just felt instantly comfortable that I was under the best care possible. He ran though a bunch of options, and set up treatment.
At some point, I went back to Stallone’s office and scheduled what later I would realize was my first operation: installing a vein port so I could get Chemo administered way more safely. All the Doctors thought it was a good idea, and I still freak out with the needle in the arm thing. The port is placed up near the clavicle, which really isn’t nearly as sensitive as the crotch of your arm, inside the elbow.
June 22, 2006
On June 22nd I was at a sort of make-shift conference where various software vendors give presentations. Skeptical at first, I met some interesting guys from interesting companies during the usual “breakfast schmooze” over free muffins and coffee. Gotta love the poppy seed muffin.
I’m first to go on stage with the presentations, right after the host gives his intro about the seminar in general. I’m running through my company’s sales schtick, and all goes well. From the questions asked it’s an interesting group, and I’m actually looking forward to hearng what the other companies are offering. At the first bio break, I check my cell phone, and I’ve got a message.
The voicemail is not good. It’s the cute receptionist from Dr. Berjis’ office, saying that she knows I’m in meetings all day, but the doctor really wants to see me that afternoon. Uh oh, what the hell? I’m not a happy camper. I call back and confirm the 1pm appointment. I know something’s not right. Why else would they call and want me there that day? Yikes. I’m starting to freak, and need to leave. My sales guy is cool, and understands. I head home, and then on to the doctor’s appointment.
When I finally meet the Doctor, he seems relaxed and happy to see me. I bluntly ask — is it a tumor? Yes. Is it malignant? Yes. Oh crap. I have cancer.
June 20, 2006
The endoscopy wasn’t really that bad at all. It was roughly in the same place at Alta Bates hospital as the barium swallow, which means I could actually walk to the morning appointment. They didn’t take long to prep me (basically just getting the IV inserted), and since they were able to administer the drugs via the back of my wrist, there was very little stress. You see, I have this phobia of needles in the crux of the arm — it’s weird, I can watch the Sopranos and have no problem with them whacking other mobsters, but when Christopher’s character shoots heroin, I cringe and can’t watch.
A few months back I had a root canal done, and since I’m a wimp when it comes to pain, had them knock me out. The anesthesiologist made a clear distinction between this type of knock out and “put you under”, which really means they control your breathing and other functions, with “machines that go ping”. For the root canal, the last thing I remember was taking off my head phones and saying “doc, I can still tell what you’re doing” had having him say “that’s because I haven’t begun the sedation, I’ll do that now” and I was out.
For the endoscopy, they wheel you into what looks like just another doctor’s office, except with some special equipment. They show you the tube — a snake like black tube with some attachments at the end — not horribly unlike a miniature version of the weird snake-like probe the aliens used in “War of the Worlds”. They started the sedation, and for some reason I was compelled to sing “Oh Canada” to see how far I’d get through the song before getting knocked out. Surprisingly, I finished the anthem, and then asked “okay, now what?”. That’s the last thing I remember.
I have pictures from the endoscopy that I’m tempted to scan and post for the curious. Write a comment if you want to see what the tumor acutally looks like. In the meantime, click here for a link to the wikipedia site, or a link to the NIH site here for more fascinating endoscopy information!
June 14, 2006
It’s Wednesday, and I meet Dr. Berjis for the first time. He talks to me about what an endoscopy is. I sign something authorizing a biopsy, if he thinks it’s needed. The doctors still say I’m too young for cancer, it’s gotta just be a blockage of some sort. But they want to be sure, so they gotta stick this tube down my throat with a camera attached.
Now, I’m such a wimp, I get knocked out for a root canal. Hey, insurance doesn’t cover it, but it’s totally worth it if you have to have one of those things and a crown put on. Getting knocked out turns a horrific experience into one you don’t remember and then you’re really loopy for a few hours afterwards. Cartoon network rules!
Anyway, “Doctor B” assures me that I’ll be “out” and won’t remember a thing. I’m apprehensive, but he’s a cool guy and seems really smart and competant. After all, he IS a specialist, and I’m used to deferring to specialists all the time. So, the endoscopy is scheduled for Tuesday of the following week. Again, like the Barium swallow thing, nothing to eat or drink in the morning. So no coffee. Darn.
June 9, 2006
So the biggest drag, I figure, about this Barium Swallow thing is that I have to get into the hospital at something like 9am with no coffee. Alta Bates in Berkeley is a quick, short drive from my house, so there’s no drama there… just no coffee.
I’m fairly jovial with everyone since I’m still thinking this is nothing. The X-ray machines are really cool these days — huge beasts made by Phillips that can take 8 frames a second. Cool, I think, an X-ray movie! Here’s what the machines looked like, for the geek at heart:
I’m told in advance how vile this Barium stuff is supposed to be, but I’m a bit strange and actually like the taste and consistency ofPepto Bismol. I also can’t drink or eat dairy (lactose intolerant), so I’m also used to things like soy milk, soy yogurt and soy ice cream.
So I get presented this rather pleasant, berry-flavored “milkshake”, and told to take a sip. The technicians start to film, but I keep drinking it — gulp, gulp, gulp, yum! It’s really not bad, from what I understand the berry flavored is much better than the banana. The tech’s ask me to only gulp once — but I’m hungry, this is breakfast, and it’s after 10am already! “Only one gulp at a time, please”, I’m told.Mmmm, berry-flavored barium… mmmmm.
We’re all joking around and watching blobs of dark goo get processed by my esophagus. It’s really neat — first your whole mouth is silhouetted by the barium, then the throat. The esophagus is really like a snake, pushing food all the way from the turn in the throat down into the stomach. I had no idea that it really does grab the stuff and push it down. Its neat to see in action. If you wait long enough, the stuff goes into the stomach and then it gets silhouetted too, along with the small intestine. Really very cool.
This was all fine until the goo hits the stomach. Then we saw a considerable, well, something. Kind of like an uneven funnel or something. There was a blockage of some sort, all right. The tech’s faces completely changed expression. I got apprehensive, but they said there’s no knowing it could be serious or not yet, but there’s something in there. That meant more barium, which was fine with me… more creamy berry goodness!
But it did mean drinking this thing from all angles while they took more X-ray movies. The techs were nice enough to point the screen over my way so I could watch, but the bottom line was I drank and swallowed this stuff in virtually every position imaginable. They told me I’d need to have an endoscopy, which is where they stick a camera down your throat. That got me nervous, although in retrospect getting “scoped” is nothing.
Things started to kick into high gear. My Doc Rothman, my GP, got notified immediately, and he referred me to Doctor Berjis, the GI specialist. I got an appointment just a few days later, Wednesday the following week. I thought that was quick, but there was a sense of urgency around this now I could feel, and it started to make me a little nervous….
June 8, 2006
I saw my doctor today, the very fine Doctor Al Rothman, my GP. He’s a great Doc. Naturally, I figured it was more aging things. You know, stuff like my eyesight going bad, or at least needing reading glasses in dark restaurants. Or my back bothering me, or knees, or what not. Or the time I complained of chest pain, worried about my heart… and it turned out I was drinking way too much caffeine (the EKG showed perfectly healthy, as opposed to the 4+ cups of coffee a day before heading into the office and at least another 4 before lunch). Or the first time I started peeing in Morse code. You know, start, stop, long, long, short. Hell, even Billy Crystal and David Letterman joke about peeing in Morse code. But boy, is that disturbing the first time it happens. So bottom line, I’m thinking this is nothing.
So I tell the Doc that when I wolf my food, it sometimes feels like it “gets stuck” going down. I need to wash it down with something, water preferred. I did a bunch of experiments, like eat a nice meal slowly and politely, as if I were in England or something — and no problems. I thought maybe my throat or something was drying out, so I went to Trader Joes for some pita bread, and ate a pita very slowly on my drive home from work. No problems. But if I wolf food down, as guys will do, yikes! And at the Macaroni grill with colleagues, it actually was a bit painful.
Doc always takes my complaints seriously, and said “okay, go have a Barium swallow”. I get it scheduled for 8am tomorrow, bright and early. But I’m told “don’t eat anything before hand”. Great. No morning coffee. Sigh.
June 1, 2006
I’m not sure if this took place June 1st, but it’s close enough. I had been noticing on occasion that food gets stuck if I eat too fast. And guess what… I often eat too fast! Wolfing food down is a family trait. I think we all eat pretty quickly, and in this case the bad manners pays off…
So I’m at a Macaroni Grill with two colleagues, Mike and Jeremy. They bring that nice hot mini-loaves of bread over, and we immediately start munching away. Mmmmm, nice hot bread….
This is when a piece of the bread gets stuck. Uh, oh, I recognize this and ask the wacky “feaux italian” waiter to bring some water. The conversation goes something like this…
Ahh, water, what would others like to drink? Should I take your drink order? No, bring water, no ice, now please. Ahh, can I interest you in a nice Chianti? Perhaps a soda or ice tea? No, I need water NOW, just water NOW, no ice. Oh, okay, you would like some water to drink. And how about your friends here? What are they having? Coca Cola? Ice Tea? Chianti? No, DAMMIT, I need a frickin’ glass of water NOW!!! (I think this went on a few more rounds, debating the virtues of water with or without ice, until I started pounding at my chest, and the idiot finally clues in, and brings me water). Grazie!
Afterwards, Jeremy starts to bug me about a doctor’s appointment. I think about making the appointment for Monday, June 5th… but something’s up at work. He keeps nudging me, in a good way, much like the time about getting my tires properly inflated (he’ll do this for other things too, as it turned out I had nails in a tire and it needed to be fixed). What a great guy, he’s like a little French Jewish mother. Very European. Such a mensch!
Anyway, I arrange for a late in the day appointment on Thursday, June 8. Depending how long I would have put this off, Jeremy’s friendly nudging could have saved my life. Who knows.