Occam’s Razor

It’s that time of the year, folks.  No!  I’m not talking about taxes (though, MaryBeth and I started to work on getting our papers together in order to file our 2009 tax returns).  No, I’m talk about it being time for my quarterly bloodwork and CT scans.  I am in the bowels of the Winship Cancer Institute, waiting to be called back to be stabbed in the chest so the nurses can draw 3 vials of blood.  Actually, as bad as that may sound, I have a port in my chest, and it SOOOO beats getting stuck each time for an IV.  Of course, even though they do not stick me in the arm for an IV to draw my blood, they will still do so when I get my scans (they use the IV to inject dye into my system to provide contrast on the scans).  You may ask yourself, “But Merle!  If they’re going to stick you in the arm, why not have them stick you to draw your labs?”  Well, the simple reason is that I have to have my port line flushed every 6-8 weeks otherwise it could get blocked and/or infected (and I’m guessing that having an infection in a tube that runs into a major vein is a bad thing).

When last we “spoke,” I had been experiencing some pretty consistent nausea and that persists.  Recently added to that is a wave of fatigue that I developed over the weekend which persisted into yesterday (so much so that I came home early from work).  Yesterday was a good day nausea-wise; I only had to take my anti-nausea medicine once, but then again, I had to do so as soon as I woke up today.  The real question that has been on our minds, then, is why am I all of a sudden experiencing this nausea?  And thus we get to the meaning of the title of this post.

Occam’s Razor essentially says that if there are multiple possible answers to a problem, the simplest one is usually correct.  Put another way, if you hear hoofbeats, think horses, not zebras.  Just before my nausea began, I started on a new drug to help with my mood (Lexapro).  Shortly thereafter, I began feeling the nausea (the fatigue developed about a week after the nausea).  The simple solution to my physical symptoms is that they are in reaction to the new meds.  Unfortunately, these symptoms are VERY similar to how I felt in July, 2007 when all this fun began. MB checked me and determined I’m not jaundiced, but that does not mean the cancer is not back.

I wish I could be as optimistic with myself as I am with other people.  I will be relieved if I am wrong, but I cannot help think that this is a sign that the cancer is back.  We shall see.  If you have any happy thoughts / positive energies / prayers, please send them my way.  I will not receive the results of the scans until next Tuesday, so do not look for any news right away.  As soon as I can, I will post.

In the meantime, I would also ask that you keep my friend Kathleen in your thoughts as well as she is dealing with some difficult stuff, too.

Thank you for all your support.


Excitation Transfer

In psychology, there is a theory called excitation transfer. It basically says that we sometimes misinterpret our physiological arousal (due to exercise, hormones, drugs, etc.) to sources other than the actual cause of the arousal. For example, people tend to underestimate how long it takes them to recover from exercise. In many instances, people may feel like they are back to normal when their heartrate and blood pressure are still elevated. In these cases, the physiological arousal might be attributed to a source OTHER than the exercise.

What does this have to do with me and cancer? I’m glad you asked. My appetite has been “off” for the last couple of days. In fact, a couple of times today, I was afraid I was going to get sick. As much as I focus on the hear and now and all the positive things that are going on, this evening I spent a little time being self-indulgent wondering what if… What if this nausea IS NOT just associated with something I ate today? What if my not feeling well is a sign of something more sinister.

Again, intellectually, I understand that I am likely just attributing my physical symptoms to a very salient aspect of my life (the cancer), but knowing that does not make it any easier to not have that emotional reaction.

Just wanted to share that insight from tonight.


Going back

As a reminder to folks, when I first started having problems that led to my hospitalization in August, 2007 (which eventually led to my diagnosis in April, 2008), I was treated by Dr. Arvind Kulkarni (he just happened to be the gastroenterologist on call the day I was referred for the blockage in my bile duct).  As I have said previously, I like Dr. Kulkarni for several reasons, not the least of which is that he treated me as someone with an intellect.  For example, when he ran tests, he showed me the results and explained their meaning.  As it turns out, when MB was in the hospital last week, Dr. Kulkarni happened to be there, as well, doing some procedures.  He was kind enough to stop by and catch up.  I appreciated that, too.

Now when all this happened, I had been going to a “Doc in the Box” for my health care needs; I didn’t have a primary care physician.  As I continued my treatments with Dr. Kulkarni, I realized that I really needed to get a PCP, so I asked him if he knew of someone he could recommend.  Turns out that his wife was a general practitioner.  So after spending several months seeing Mr. Dr. Kulkarni, I started seeing Mrs. Dr. Kulkarni.

So the GP I have been talking about lately is Mrs. Dr. K.  This past week, I got a call from Mrs. Dr. K’s office regarding some tests that they ran.  The end result is that I have been referred to a gastroenterologist for a follow-up to these tests.  Now, I don’t think there is any reason to worry about this referral (heck, they didn’t tell me to go to the emergency room, yes?).  So, my journey appears to be heading back to where I started; I have an appointment with Mr. Dr. K. in a couple of weeks.  Of course, I’ll post when I know something.

My physical health remains the same, though, the stress level is starting to go up as I get closer to March 30 (the date of my next set of scans).  As always, I take each day as it comes and try to enjoy it as much as possible.  As one of my older son’s shirt says, “Don’t sweat the petty things and don’t pet the sweaty things!”



A scouting we will go…

This weekend, I am on a scouting trip to the Chickamauga Military Park near Chattanooga.   The scouts will be playing “Capture the Flag” and I will be enjoying what I hope will be a cool, but sunny weekend.  It’ll be nice to get away to spend some together time with my younger son.  I’m looking forward to the trip, as well, as I am the “grubmaster” for the adults (meaning, I got to set the menu and will organize the meal preparation during the trip). 

As I may have mentioned previously, I realy enjoy Dutch Oven cooking, so my menu planning revolved around what I could prepare in my dutch ovens.  Here’s what I am planning:

Though I have helped prepare the Jumbalaya before, all the other recipes are new to me.  It’ll be fun to see how they come out. 

Whenever I have to prepare a Dutch Oven meal, I typically go straight to the Net to see what interesting recipes I can find.  Two often visited sites is Byron’s Dutch Oven site (a lot of really good recipes) and the website for the International Dutch Oven Society .  Both sites have a lot of good information about dutch oven cooking, including recipes (though, the IDOS website has not been as consistently helpful as Byron’s).  There are any number of other websites to visit (just Goggle ‘Dutch Oven scout’ and you’ll get bunches). 

This most recent episode of searching, however, uncovered a site about which I was unaware (but, in retrospect, not surprised).  As many of you may know, I love (LOVE) watching the Food Network (Challenge, Iron Chef America, Chopped, Dinner Impossible, Ace of Cakes).  I’m not a “foodie,” but I do enjoy the entertainment value of the various shows.  At any rate, it turns out that the Food Network has a list of 100 of their favorite dutch oven recipes.  None of these recipes are written for a camp dutch oven (one that is made to use with charcoal in the outdoors), but if you know how to regulate the heat around a dutch oven, adapting the recipes for scout outings seems pretty easy.

Anyway, I just thought I would share my most recent Dutch Oven find with you all (and spend an entire post NOT talking about cancer!  Woo Hoo!)  Hope you are having a great weekend.



Latest Milestone

I know it’s been over a week since I last blogged.  These things happen. 

Yesterday I celebrated another milestone in my journey with pancreatic cancer!  It was one year ago yesterday that I had my LAST chemo treatment.  At that time, I said:

I have to say, though, that I am feeling particularly angst-y with this last treatment.  This treatment represents the last thing I am scheduled to actively do to fight the cancer (beyond the general eating right, exercising, taking my vitamins, and saying my prayers — some of you might get that odd reference).  Moving forward, my fight with cancer becomes passive; I live my life, keeping up hope, but there are no plans to have any other treatments unless something shows up on a CT scan…I don’t like waiting, but for all intents and purposes, that’s what I’ll be doing from here on out.

Well, here it is 366 days later and I have dealt with and survived the waiting (as I continue to say, “I’m not dead yet!”).  Over the past year, the waiting has gotten easier.  As the time in between scans has increased, my anxiety level about my cancer has been reduced.  I continue to get anxious about my scans, but instead of getting anxious for 3-4 weeks every 2 months, I am getting anxious for a couple of weeks every quarter.  Ideally, however, there will come a time when I will not get anxious at all. 

I celebrated yesterday by getting to work early; working all day on statistical analyses; having lunch with Jennifer, a good friend and colleague at CDC, and then having a date with MaryBeth.  Unfortunately, MB had the beginnings of a migraine when we got home from dinner, so she went to bed.  I, on the other hand, fed by ‘Lost’ addiction and watched several episodes after MB was asleep.  I had heard all the hype about the show, but had never watched it.  One day I was cruising www.hulu.com and I noticed that full episodes all the way back to season 1 were available for viewing.  I gave it a try and was quickly sucked in. 

More later.



Over the past week, I have had a couple of realizations that sort of took me by surprise.  The larger of the two is that at the end of this month, I will have been a full year since I stopped active treatment of my cancer.  For whatever reason, I have always just thought of my having stopped chemo recently.  At some point, though, recently became last year and that realization gave me a bit of a shock (but in a good way).

On March 18, 2009, I had the following to say:

I have to say, though, that I am feeling particularly angst-y with this last treatment.  This treatment represents the last thing I am scheduled to actively do to fight the cancer (beyond the general eating right, exercising, taking my vitamins, and saying my prayers — some of you might get that odd reference).  Moving forward, my fight with cancer becomes passive; I live my life, keeping up hope, but there are no plans to have any other treatments unless something shows up on a CT scan.

Well, it’s been almost a year, and I am feeling much LESS angst ridden about not doing anything active to fight my cancer.  As the months since last March have progressed, the reality of my cancer has, for all intents and purposes, been relegated to my need to continue taking pancreatic enzymes (which, is NOT a function of my cancer so much as a function of the surgical procedure to treat my cancer — is that splitting hairs?).  Physically, I’m generally back to where I was before my cancer.  Prior to my diagnosis and surgery, I was able to lift heavier weights and run longer distances faster.  I continue to go back to the gym regularly, but my strength is not what it once was and I am still having trouble running for more than 10-15 minutes (at 6 mph — prior to my surgery, I was usually running 30 minutes starting at 7 mph and getting up to 8 or 9 mph before the end). Nevertheless, I’m pleased with my progress.

I had the other realization the other day when I was looking through my calendar at upcoming appointments.  I realized that my next set of scans is scheduled for the end of this month.  As I said up above, my cancer has become a non-issue in my life (c.f., my enzymes), so seeing that I have scans coming up was the first REAL reminder that it still IS an issue.  Again, I have no reason to believe that anything has happened, but the other day when I saw the appointment, my initial reaction was, “Oh crap!  I guess I do still have to worry about the cancer.”  Again, I am not spending a lot of time obsessing about it, but the reaction did take me by surprise.  As with my scans in December, my hope is that I will be busy enough to keep me distracted from worrying.  Certainly, with scouting activities scheduled for the last 2 weekends of the month, that shouldn’t be too difficult to do (and of course, we have to start planning for TumorPalooza II, as well).

Thus, I will look forward to celebrating my 1 year anniversary of ending my chemo and will try to ignore the upcoming tests for as long as I can.  Thank you for your continued support for me and my family.


MB Update

Well, MaryBeth has successfully completed both of her procedures.  I spent some time with her in between her first and second procedure and she was enjoying her medications quite nicely.  When she was moved up to Day Surgery for the 2nd of her procedures, her nurse asked her how she was feeling.  She said she was stoned and feeling fine.  The nurse responded, “And it’s legal, too!”

I just spoke with her doctor and he said both procedures went well and were successful.  He was glad that we decided to do both procedures.  MB is going to be uncomfortable for the next couple of days <insert pain in the ass joke here>.  Thank you for your caring and positive energy.  If MB is not feeling up to par by Sunday, though, I will likely see if we can get some meals via the Hamburger Helper’s (WOW!  We haven’t had to do that for a while, huh?).


A sure sign

As I indicated yesterday, MaryBeth is at Gwinnett Medical Center today for a couple of minor procedures.  This is the same medical center, though, that I came to (in 2008) when I was having my ERCP procedures (prior to my diagnosis with pancreas cancer).  In total, I had 6 ERCP procedures, most of which were conducted at GMC.  It is a sure sign that I came to this hospital entirely too often when the receptionist in Day Surgery and most of the nursing staff in the endoscopy suite not only recognized me, but were able to address me by name.  Everyone, though, was happy to see me and congratulatory about my continued successful battle against PC.

By sheer luck, the doctor who started my journey with me (Dr. Arvind Kulkarni) is in the hospital today.  One of the nurses who assisted him with some of the ERCP procedures told him I was here and he took time to come visit.  I have to say that I was surprised that he remember me and my case, but I was pleased with how much he did remember.  As he was leaving, he said it made his weekend to see how well I was doing.  That made me smile!



You know, by and large, the medical concerns at Casa Hamburger have focused primarily on me for the last two years (c.f., my daughter’s surgery to have tubes put in and my older son’s ongoing issues with is autism).  MaryBeth (MB), apparently, felt jealous of all the medical attention I was getting and has decided to get some medical attention for herself.  I type this as we sit in the surgical interview office at Gwinnett Medical Center.  Yesterday, MB had an appointment with our general practitioner.  The GP sent her to a surgeon and the minor procedure was scheduled for tomorrow (Friday). Again, this is a minor procedure, so there is no need to worry (beyond the general concern one has one someone is having ANY surgical procedure).

If you have been reading for a while, I have commented on several occasions that it has been difficult for me to be on “this side” of the bed.  I remember it was hard to watch my father go through his LP last summer; I would have preferred to have been the one in the bed.  Similarly, when my daughter had tubes put in, I remember thinking it was hard to watch her recovering from her surgical procedure.

My wife is very similar.  She said (on several occasions) yesterday that she is much better at taking other people to the doctor than going to the doctor herself.  She recognizes the necessity of the procedure, but would prefer if she could somehow find a genie that could just blink and make the procedure unnecessary.   I asked how she would like me to react. She told me that if I was empathetic, she would say I was patronizing her and if I was not reactive, she would just “whine” more.  Thus, by and large, I am just keeping my mouth shut during this whole procedure.

I will be sure to blog about how she is recovering from the procedure tomorrow (again, there is no reason to believe there is anything too serious going on).  However, if you have some extra positive energy, healing thoughts, prayers, or loose change laying around, perhaps you could send it MB’s way.