Two down and two to go (in first round of Chemo)

I am very happy to report that I've survived two infusions of chemotheraphy so far!  The plan is for me to receive chemo every other week for a total of 8 weeks (four infusions in all) and then to wait another fortnight before I have another Computerized Tomography (CT or CAT) scan to see whether the chemo has been effective against my metastatic mucinous (and mutinous, as "Paddy" our iPad "corrected" its spelling appropriately recently) appendiceal adenocarcinoma.

So far, the side effects have been very mild, indeed.  After my most recent infusion this past weekend, the peripheral neuropathy in my fingertips and toes was a little more noticeable, as was the sensitivity to cold liquids that makes drinking iced drinks somewhat unpleasant.  I was warned by Nurse Ida that drinking iced drinks would feel like swallowing broken shards of glass, although it wouldn't really be causing me any physical harm.  When I drank an iced drink, it didn't feel like swallowing shards of glass, but the feeling was definitely unpleasant, almost like it was trying to trigger a gag reflex or something.  Reluctantly, I've decided to stay away from my beloved iced quad espresso from Starbucks until such sensations abate!  I fervently hope and pray that my tumors are being affected much more than I am!

Chemo-sabe?

I'm very pleased to report that I appear to have survived my very first round of FOLFOX chemotherapy and am not too much worse for the wear! Thank God I was spared the ravages of the many side effects of these wonder chemicals! The portable battery-operated pump and my Bard Power Port worked flawlessly to deliver 5-flurouracil into a catheter in my jugular vein at the stately and quite sedate pace of 5.2 ml/hour for 46 straight hours! Miraculously, I was even able to sleep on my back, placating my left arm in it's sling as well as the portable battery-operated pump slung in it's own fanny pack under my right arm! And I'm also getting used to my new CPAP machine, nasal mask, humidifier, and chinstrap. Somewhat surprising that I was able to get any sleep at all!

I'm also very pleased to report that I'm now able to update my blog using our new, beloved iPad, which was given to us by some wonderful and overly generous friends of ours! Thanks so much you all (and you know who you are!), you all shouldn't have (but we're so very glad you did!)--you all have warmed the chemo-basted cockles of my heart!

I Never Met a Metastasis That I Liked!

The start of my chemotherapy has been delayed a bit, and the nature of the mix of therapies that will be used has been changed, too, all because my stupid right foot hit an uneven place on the sidewalk outside of our church (Grace Episcopal) the day after Christmas 2010, making me lose my balance and fall over onto the grass on my left shoulder and left arm with sufficient force to fracture the "surgical neck" of my left humerus! I was supposed to start my first round of FOLFOX spiked with Avastin last Friday, New Year's Eve. Now, I'm scheduled to start my first round of FOLFOX without the Avastin this coming Friday, January 7, 2011 (the day after my Father's 80th birthday, which is also known as Epiphany!)--apparently, the Avastin would completely screw up the natural healing processes knitting my left humerus together again as long as I immobilize my left arm in a sling. The Avastin helps prevent the formation of some of the blood vessels that are needed to supply life-giving blood to both growing tumors and healing wounds! FOLFOX will also slow the bone healing somewhat, but not nearly as much as the Avastin would. Perhaps, after my humerus is all healed up, which could take up to 6 or 8 weeks even under normal circumstances, we can add the Avastin back into the mix for a further round of chemo, if needed. Most of the heavy lifting in the tumor-killing achieved by the chemo is done by the FOLFOX, with the Avastin adding some "icing to the cake," enhancing the effectiveness of FOLFOX.

Today, we got the results back from last week's needle biopsy.  It's now "official"--the appendiceal adenocarcinoma that originated in my "Benedict Arnold" appendix has metastasized!  Cells that were consistent with the appendiceal adenocarcinoma cells found in the biopsies from my colonoscopy (performed at Memorial Hermann Hospital on November 29, 2010) -- were also found in one of the 1 cubic centimeter (1 cc = 1 milliliter = 1 ml) "nodules" identified in my latest computerized tomography (CT) x-ray scan from December 13, 2010! As I wrote (on Skype) to the Contessa (yes, the Countess herself, the very same woman I was briefly engaged to for a few months over 26 years ago, when I was in graduate school at the Rockefeller University and had gone to a physics summer school in Erice, Sicily, despite the fact that I had no money -- "If you had no money, how could you want to get married?" -- and the fact that she had trouble remembering my name -- "I'm so sorry I forgot your name!"!):

Francesca, Happy New Year to you all! We met with my GI (colorectal) oncologist, Dr. Imad  Shureiqi, to get the results from last week's needle biopsy and he confirmed what I'd expected for a while (ever since we learned from the CT scan that there were 1 cc "nodules" on my peritoneum), that the appendix cancer had metastasized and spread into at least the peritoneum! Bummer! But, at least we know for sure what we're up against, so we can go after it with everything at our disposal! I finally start my chemo treatments this coming Friday morning, at 8:30AM! I'll go in every other week for a total of 4 treatments in 8 weeks and then we'll take another CT scan to see whether or not the chemo has reduced the cancer any! If so, we might then opt for surgery to cut out every tumor they can find in my gut and then apply a warm chemo bath directly onto my peritoneum! If not, we can change to a different type of chemo until we find one that kills the tumors more effectively than it kills me! It's a very good sign that there don't appear to be any tumors anywhere outside of my peritoneum--all my other vital organs (heart, brain, liver, lungs, kidneys, pancreas, spleen, stomach, etc.) are tumor-free! So, I'm still very optimistic about my prospects and my prognosis--I'm relatively young (52.9 years old!), in relatively good health (other than my appendix cancer and my left arm!), we've fortuitously discovered the tumor fairly early on (thanks to my mysterious bleeding in November!), I'm at one of the best cancer hospitals in the world where many 100's of
people have been successfully treated for very rare appendix cancers, and I have so many wonderful friends and family members who are all praying fervently for my healing and wholeness and well-being--I can actually feel myself being lifted up by all the prayers and genuine, sincere concerns of others--lots of good karma! And, if worse comes to worst, at least Caroline and I had the good sense (actually, it was mostly Caroline's good sense!) to take out a large life insurance policy on me--at least she will be provided for, to some degree (to her credit, she tells me that she'd rather have me, with all my faults and failings, than the money)! Nobody lives forever here on good old planet Earth and we all have to go at some time or other and I've had a very good and very blessed life so far, already having lived to a ripe old age compared to most human beings who have lived on Earth for the past 40,000 years or so! Not that I'm at all ready to die and be no more (I can't even begin to get my mind around that concept of nothingness!), I'm quite happy to live as long as possible, continuing to love and learn and suck the marrow out of the bones of life here on Earth! But, I am at peace at the core of my being, quite convinced, in the very marrow of my bones, that the Universe is profoundly empty of insignificance and meaninglessness--the Buddha was right that we are all living in a state of perfection right now, just as we are! I do find myself appreciating each passing moment more than I ever did before--how awesomely precious is each inspirational breath and each beat of our hearts!--I offer up quick prayers of thanksgiving for all of
them! I freely admit that I love life more than I can ever know! I have no recollection of who or what or where or when or why I was before I was ever born and I likewise have no idea or conception of who or what or where or when or why I will be after I am no more (although I sincerely doubt whether 70 virgins will be involved, I believe, and am extremely encouraged and heartened by, the words of Jesus on the cross to the "penitent thief," according to Luke 23:43, "Truly, I say to you, today you will be with me in paradise!"!)! To some extent, I will live on in the memories and hearts of those who have known and loved me, whom I also have known and loved--I don't think any amount of love is ever lost or wasted or for naught! Some of my genes will undoubtedly live on and be passed down from generation to generation through my blood relative nieces and nephews (since I share a fair number of my genes with my blood sister and blood brother, all of us having descended from the same blood parents and blood grandparents, etc., etc.!)! Ineluctably and indescribably, subatomic quantum entanglements will always bind every bit of my mass-energy with that of everyone else and everything else in the Universe! Who knows, maybe even a few of my original thoughts and creations will survive into the mists of the ages! Whatever! Ciao for niao! Randall

Will Rogers may well have never met a man he didn't like, but I've certainly met a metastatic appendiceal adenocarcinoma that I don't like at all! Please pray for my wife, Caroline--she has a big job interview coming up at the University of Houston this coming Friday afternoon!