IT'S A FRIDAY! YOU KNOW WHAT THAT MEANS!

Caps lock ENGAGE!!

Well first, some preliminaries:

THIS IS WHY CANCER WILL NEVER DEFEAT ME:

Mitch Albom: Losing Sparky like losing one of the family

This is how it begins:

I had a dream about Sparky Anderson a few days ago. He looked old and his hair was brown, and I called to him, but he didn't recognize me. Only after I said my name did he smile.

And then it ended.

Hmmm.  Mitch Albom has a dream about a guy; a few days later, he's dead.   This is the Power of the Albom.

"WIDESPREAD COMMUNITY CONCERN" IS SO WIDESPREAD

33% is now the threshold for "widespread."  This comes from AnnArbor.com, based in a town that just banned couches on porches.  The message boards (which I sometimes read to feel better about myself) on MLive and Freep are similarly against the ban.

And by the way, this was a blanket ban on all alcohol energy drinks.  So whoever told me to shotgun a Joose on cancer-free day, I appreciate the effort, but thank god I have some prohibitionists looking out for my well-being.  I wish they would do something about my cancer though.

OH YES, SPEAKING OF THE CANCER...

It's Friday.  Three months since my diagnosis, two and a half since I started treatment, and two days after I ended treatment.  So you know what that means:  TIME TO COME UP WITH A NEW DIAGNOSIS!

I'll let the primary sources tell the tale:

From: Al-Katib, Ayad	Fri, Nov 5, 2010 at 11:38 AM
To: ncheolas@gmail.com
Have not heard from Dr. Anderson. The path review from NIH states that it is a special subtype of Burkitt lymphoma; one that is described by that group previously (2004 and 2005) associated with granulomatous reaction and has good prognosis. Will need to discuss with Dr. Anderson but my impression remains the same. AK

From: Nick Cheolas	Fri, Nov 5, 2010 at 12:00 PM
To: "Al-Katib, Ayad"
My one main question at the moment: if it is a "subtype of burkitts lymphoma," how does your impression remain the same?

Al-Katib, Ayad	Fri, Nov 5, 2010 at 12:07 PM
To: Nick Cheolas
Nick: based on: Clinical judgement (early stage, favorable (low risk) group) and response to therapy to date. Very little data available on this subset (see attached); 2 of 4 such cases described (and I think that’s all there is) in the 2004 paper were treated with CHOP +/- radiation (before the rituxan era) and were in complete remission for 1 and 3 years+ as of the time of publication. AK

So...that.  Wait, where's my picture of Dr. Ihavenofuckingclue?

 There he is.  I think he's got the right idea.  Onto the path report:

I don't know what most of those words mean.  How bout we take a look at some more words?

 

And finally!

If I were you, I would stay in this whole weekend and just read these things.

I've highlighted what I believe to be the important stuff in these documents, but I really have no idea what the important stuff is. But here are my thoughts on this:

• I am really glad we sent this out to Dr. Jaffe.  Take a look at your right hand and count the number of fingers.  That appears to be the total number of recorded cases - including my own - about which we have solid data.  Fortunately, Dr. Jaffe is familiar with those cases.  It appears this diagnosis differs from those offered by Henry Ford and U-M, but I'm not sure a) if that's actually the case or b) if it matters. 
• My pathology report and both of the articles listed above repeatedly refer to the "good prognosis" for this diagnosis.  Any way you slice it, that's good news. 
• The interesting stuff is in the details:  The first article concludes with the sentence, "In the future, it may be feasible to treat these patients with less intensive regiments."  The second article - which highlights four cases similar to mine - shows that that two later-stage patients were treated with a more intense regimen, and the two earlier-stage patients (like me) were treated with CHOP.  None of the patients had relapsed at the time of publication.
• Also, none of the patients in the two articles were treated with R-CHOP, as the studies were done in the pre-Rituxan era. 
• The bottom line from Al-Katib: "my impression remains the same."

So...I really don't know how to take this.  It could be that I have Burkitt's, and more intense chemo is needed to take care of that.  That wouldn't be great.  It could be that I have a certain subset of Burkitt's that combines the good prognosis of Burkitt's with the less-intense chemo regimen for B-Cell.  That would be really good news.

I think we're headed toward yet another week where the doctors duke it out, but I'm pretty sure I know how this will play out:  U-M will recommend treatment as Burkitt's, Al-Katib will stay firm with his recommendation, and Anderson will lean toward finishing up radiation and being done with this.  So this comes down to whose recommendation I place more weight on, and I really place equal weight on all three.  U-M is an excellent hospital with great doctors and a top-ranked cancer center.  Dr. Anderson knows more than anybody else about my history and has followed me throughout the entire course of treatment.  Dr. Al-Katib is a nationally renowned lymphoma doctor who has been doing this for 25 years.  I really can't elevate any one opinion over any other.

The way I feel now, I will almost definitely get a fourth opinion on this.  Where that will be, I'm not entirely sure.  But I will talk with my doctors before moving forward on that front.  We'll see next week.

OH: AND ON THE BAR EXAM FRONT:

Remember that Philadelphia Phillies fan who stuck his finger down his own throat and puked on a little girl's head?  That appears to be what the State of New York did to its bar applicants today.  I'll probably post something about this on Monday.  

And, of course, Maryland Bar Exam results will be released in about 45 minutes.  The possibility of receiving two life-altering documents from the state of Maryland in a single day terrifies me beyond belief.  If you think I'm going anywhere near that results page on a Friday, you're crazy. 

Well, that didn't take long

Sadly, it appears my first post-cancer drink will not be a Four Loko, because they will be banned in Michigan:

Alcohol energy drinks — the fruit-flavored, caffeinated, alcoholic beverages in brightly colored cans that have raised widespread community concern — are on their way to being banned in Michigan.

A Michigan Liquor Control Commission order banning the drinks is expected to be signed today. Manufacturers of alcohol energy drinks will have 30 days from the date of the issuance of order to remove those products from Michigan, said commission spokeswoman Andrea Miller...

The commission's decision was made in light of several studies of the drinks, "widespread community concern" and the FDA's ongoing investigation of the products, according to the release.

By the way, here are the people this crack reporter from AnnArbor.com interviewed for this story:

• Mike Tobias, executive director of Michigan Alcohol Policy (from their website: "The purpose of...MAP is to advocate for laws and polices that reduce the illegal and harmful use of alcohol.")
• Justin Bishop, prevention specialist with a non-profit organization called Clean Teens.
• Therese Doud, a substance abuse prevention coordinator for the Washtenaw County Public Health Department.
• Brad Christman, an Ann Arbor Huron graduate and a current student at St. Olaf College in Minnesota who...formed a group called "Students on Alcohol Prevention" while in high school.
• Lorin Brace, manager at Village Corner in Ann Arbor. Who gives the most sane quote, but has it buried at the bottom of the article: ("I don't really see how (the packaging) would be misleading," he said. "Other alcoholic beverages have brightly colored labels and it says right on there the alcohol percentage.") 

To be fair, she did try to contact the manufacturers of Four Loko, but they did not immediately respond.  Because apparently there was nobody in the State of Michigan who didn't think this stuff should be banned.

The most distressing part of all this is that it seems the decision was made because of concerns about the drink appealing to underage drinkers.  Here's the picture that accompanies the article:

Which is apparently there to...ah shit, I don't know.  Make us believe this stuff could be confused with lemonade?  Convince us that this stuff appeals to underage drinkers? (Note:  "Underage drinkers" is the accepted phrase government officials use when describing 18-20 year olds whose minds are apparently so underdeveloped that they are lured in and deceived by bright colors and big letters and need to be protected by "commissions" full of adults who apparently think that kids haven't discovered every other type of alcoholic drink imagineable.  This is *NOT* the accepted phrase to be used when government officials arm 18-20 year olds and send them halfway around the world to have their limbs blown off.  Just so we're clear).

And I think this must be a picture of the "widespread community concern:"
 

Does it matter that this entire thing is a bunch of media-fueled bullshit with no basis in reality that was acted upon by a couple puritans who apparently think that 19 year olds are still irresistably attracted to Nickelodeon colors?  Of course not!  Why?

BECAUSE WE GOTTA DOOOOOOOOOOOO SOMETHING!!!! WE GOTTA DOOOOOOOOOOOOOOOO SOMETHING!!!! 

Random things that I thought of in the past 24 hours but was too tired to post

IT'S BEEN A PRETTY AWESOME 24 HOURS.  I finished chemotherapy and Lil Wayne got out of jail.  A report on the latter:

Rapper Lil' Wayne is set to walk out of New York City's infamous Rikers Island prison Thursday morning after serving an eight months on a weapons charge, and his friends are reportedly planning an "elegant, extravagant" evening of celebration and strippers to welcome him home.

Thanks a lot, friends.  Lil Wayne gets caught with a gun, he gets an "elegant, extravagant" evening complete with strippers (because nothing says "elegant" like strippers).  I get nausea and Prednisone.  The world: sometimes it ain't fair. 

My excitement at finishing chemo was slightly tempered by the fact that I may not, in fact, be done with chemo, due to the whole U-M/Burkitt's situation.  But more recently, it's been U-M who looks like there is a chance they will concede their recommendation.  U-M's recommendation was based in large part on U-M's the pathology report...but the U-M pathologists did not perform any of their own tests on my tissue - they just looked at the slides - and Dr. Al-Katib took issue with some of the phrases in the path report. 

Dr. Jaffe, on the other hand, is one of the most prominent lymphoma pathologists in the country.  She quite literally wrote the book on lymphoma classifications.  So if her report supersedes the other two pathology reports, and there is no mention of Burkitt's or Burkitt's-like lymphoma, then my guess is there's much less of a reason to treat it as such. 

Anyway, my current plan is to go on and get some radiation.  If, after consultation with all my doctors, other things need to be done, we'll deal with it then. 

IGORRRRRRR.  I really didn't know how the Igor Larionov thing was going to turn out; glad people enjoyed it.  Sometimes I just start writing and see what ends up on the page.  That post was one of them. I had no idea how I was going to effectively extend the Igor Larionov metaphor; I just wanted to post the YouTube clip. 

I NOW ASSOCIATE YOU WITH CHEMO, AND I SHALL BAN YOU FROM MY LIFE.  One of the things they warn you about in chemo class is forming "associations" between chemotherapy or cancer and things you like.  It's sort of related to Pavlov's "conditioned reflex."  Since I only feel really bad on treatment days, most things I have begun to associate with chemo are only things I encounter on the days of treatment.  Unfortunately, this inclused everything associated with the treatment process - my chemo bags, IV's, the smells of the treatment room, the chair, and so on.  I hate all of that stuff now, and I've become increasingly miserable in the treatment room.

But there are some other things:  Gatorade 3 (that protein stuff):  I had this once the day I decided to reject my stomach contents, and I honestly could not even look at the bottles of the stuff after.  Mike Posner:  I'm sure everybody thinks something horrible upon hearing his name, but when I was first diagnosed, that @!($!ing "Cooler Than Me" song was on the radio every time I tried to go to an appointment.  So he will always forever be linked to cancer for me.  Good work, Mike.  Chicken Noodle Soup:  Great when you're sick, not when you're nauseous, and now it's linked to nausea for me.

And the weirdest thing:  The icon for the app on my phone that I use to "tether" my phone to my laptop so I can use the internet in the treatment room.  Since I only use that app in the treatment room, I associate it with treatment.  I reset my phone last week, went to download the app again, and had to put my phone down because it actually made me nauseous.

I SUPPOSE I SHOULD THROW OUT A COUPLE WORDS ON TUESDAY NIGHT.  As expected, I had no real reaction to Tuesdays election results.  Entirely expected; entirely uninspiring. If anything, it reminded me how much I dislike Republicans.  

But dear lord, I handled my cancer diagnosis with less whining than liberals/Democrats handled that election.  I watched most of the ’06 election – when Republicans got roundhoused – unfold on Fox News with a bunch of conservatives, and there was nowhere near the level of pouting that I witnessed on Tuesday night.  Half the people in that room in ’06 hated Bush anyway.  

But my real question is this:  Do people actually watch MSNBC?  I haven’t watched that channel since college – I really don’t watch any cable news, nor do I really have any affinity for anybody on cable news except for Anderson Cooper.  But those people on MSNBC the other night were HYSTERICAL.  Chris Matthews, Keith Olbermann, Rachel Maddow, Lawrence O’Donnell, Eugene Robinson and Ed Schultz were out of their freaking minds.  Is this what they’re normally like?  Or was it just because it was election night?  

There was zero coverage of the election results.  That was jettisoned in favor of teary-eyed rants about just how awful the Republicans were.  Seriously.  I think they were almost in tears.  The anger was palpable.   They would interview Republican winners while the rest of the panel laughed in the background.  O'Donnell declared that nobody should  have politicians on their show if they're just going to give “talking points” responses, which apparently means MSNBC will never have another politician on TV.  They handled Tuesday night with all the grace of a four-year-old who had his toy taken away.

The thing is, I agreed with the vast majority of their substantive criticism.  This newfangled Republican “we care about the deficit” is BS when a) they spent 8 years spending like it was Christmas and b) virtually no candidates can name a single, significant and specific budget cut.  You were elected because people decided they wanted to hate Democrats this year, not because you are awesome.  In four years, the people will hate you again.  So shush.  But the sheer volume of tears produced on the MSNBC set Tuesday was pure schadenfreude for me.  

Other notable points:   

• Michele Bachmann is the Lou Holtz of politics.  And buy another "L" for your first name, for Chissakes. 
• Alvin Greene got 358,000 votes.  That is terrifying. 
• John Boehner lost a ton of hydraulic fluid Tuesday night and I kept waiting for the other Oompa Loompas to come out and join him to sing a goodbye song to the Democrats.
• Screw you, California.  You're a blue state who gave us Pelosi, you elect a Democratic governnor, you return Barbara Boxer to the Senate...and you can't even legalize pot.  I thought you were a real blue state, unlike Michigan, where a social issue comes on the ballot and everyone just throws their Bible at the voting booth.  Oh, and giant middle finger to the baby boomer generation who voted heavily against this.  Really, 45+ crowd?  You think pot is so dangerous that people should be thrown in jail?  Enjoy the chunk of my paycheck that you get to spend every month. And you too, Republicans. Way to tell that overbearing federal government that we're not going to let them come in here and tell people how to live their lives!

WHAT THE #@%^ HAVE YOU DONE SO FAR, BESIDES POST A LINK ON FACEBOOK, THE POINT OF WHICH I CANNOT FIGURE OUT. 

I think a few more people should post this link on Facebook.  That way  I might be able to figure out the point:

www.whatthefuckhasobamadonesofar.com

At first I thought it was criticism of Obama, levied by some of those people (the Paul Krugman types) who believe Obama's real error has been that he hasn't been awesome enough during his first two years in office.  If only he had been more awesome - and possibly murdered large chunks of the Republican opposition - everything would be much better.   Of course, this argument is quite non-falsifiable, but whatever.

But then I realized it was a site supporting Obama and proving that yes, if you have total control of the White House and both houses of Congress, and you spend a couple trillion dollars, you, indeed, can "do stuff."  It's all a bunch of worshipful drivel.  I'll summarize the whole thing for you:  Obama has (verb) (good-sounding program) for (disadvantaged group).  There.  Saved you some hours. 

Also, it's a good time to review Nick's Inalienable Rule of Politics:

1. Something bad happens.
2. WE GOTTA DOOOOO SOMETHING!!! WE GOTTA DOOOOOOO SOMETHING!!!!
3. Do "something."

And apparently people will love you for it and make websites.

What I don't get is this:  Who on Earth is this website aimed at?  Who the hell is it meant to convince?  Is there anybody on this planet (besides Paul Krugamn) who thinks the current President's biggest problem is that he hasn't done enough stuff or spent enough money?  That is ostensibly the entire reason for the Tea Party (I know, I know, that and eliminating all non-white people) and the main reason the Democrats just got spanked in the midterm elections by a party who spent 8 years doing the exact same thing and can't even articulate how they aren't going to do the exact same thing again.

Sometimes, politics is almost as much fun as cancer.  Almost. 

Igor Larionov

I know exactly where I was in the early morning hours of June 9, 2002.  I was at a buddy's house watching a Detroit Red Wing playoff game.  Which I've done hundreds of times over the past 25 years.  But this game was different.

The Wings were playing the Carolina Hurricanes in the Stanley Cup Finals.  Carolina stole game 1 in overtime, Detroit came back to win game 2, and the series returned to Raleigh tied 1-1.  Game 3 was pivotal.  If Carolina won, they would have the series lead and home-ice advantage.  If Detroit won, they would have home ice advantage back and a chance to clinch the series back at home.

I watched every period of game 3 in a different location.  I think I watched a period at home, then a period at my buddy's place.  Then a bowling alley, a random bar on Jefferson, a random dude's house, another friend's house, and finally, to the place where we watched the second period.  I have no idea why I remember all of this.  I just do.

As you can see, I watched this game in about six places.  That was because the game went six periods.  Tied after 60 minutes of regulation, Detroit and Carolina played another 54 minutes and 47 seconds of sudden-death hockey.  Until Igor Larionov did this:

 

I imagine when I walk out of the treatment room for the last time tomorrow, it will feel something like that.

***

I've been grinding for a bit more than 114 minutes and 47 seconds.  102,817 minutes, to be precise, since the first dose of chemo drugs entered my bloodstream.  Since then I've lost my hair, a ton of cells, feeling in my fingers, the effectiveness of my left arm, and most of my potential children.

But I've also lost a lot of cancer.  All of it, I hope.  I feel a hundred times worse than I did on August 23.  But I'm a thousand times healthier than I was on that day. Maybe not at the moment, considering all the various substances running through my body at any given time.  But in the long run.

In a way, this thing is an endurance test.  Either you outlast the cancer, or the cancer outlasts you.  There really isn't much of an in-between.  And back in August, this thing was buzzing.  That was one aggressive tumor.  It wouldn't have been long until this thing progressed to stage 3 or 4, and then we're looking at a different course of treatment, a different prognosis, and so on.

But like an NHL playoff game in overtime, it's all about dodging bullets.  I got on things in a hurry.  I didn't have to be hospitalized for treatment.  I was an early stage 2.  The stuff wasn't in my bone marrow.  I don't know if any of that was the result of luck or my own doing.  But in hockey or cancer, it doesn't really matter.

People ask me all the time, "How is it?"  That's a little different question from, "How are you doing?"  The second one I always answer with some variation of "fine," with more or less detail as the situation requires.  But the first question is more difficult.  It's hard to put into words what this entire experience has been like.

On one hand, it's hell on earth.  To go from where I was to what I am now is a tough pill to swallow.  Cancer, you see, requires a bargain.  Cue Hitchens:

The oncology bargain is that, in return for at least the chance of a few more useful years, you agree to submit to chemotherapy and then, if you are lucky with that, to radiation or even surgery. So here’s the wager: you stick around for a bit, but in return we are going to need some things from you. These things may include your taste buds, your ability to concentrate, your ability to digest, and the hair on your head.

It's the least fun bargain I've ever been involved with, but I'll take it.  I'll give up anything, and cancer, in a perverse way, makes that tolerable.  I didn't really have a choice. 

I think giving up that which the bargain requires you to give up is what scares people the most.  Can you really imagine what it's like to lose all your hair?  To watch it fall out bit by bit every morning for a week until a massive chunk falls out and then you say to yourself "I look like a clown.  I gotta take the rest of it out right now."?  Could you give up drinking, smoking, fast food, and whatever other vices you enjoy, all in an instant?  Can you give up your taste buds, your appetite, your ability to digest certain foods? Can you imagine a situation where the bar exam results mean nothing to you because the results of 5 other tests you've taken in the last three months are exponentially more important and life-altering?  Do you like needles?  Well then you'll love the daily shots, weekly blood draws, and bi-weekly IVs.  Even when I go out with friends, I never feel like I'm with them.  I just don't feel "normal."  Ever.  I never realized how much I would miss a stupid Wednesday night of quarters at the Jug.  And so on.

Add everything up, and I really don't have a good answer to "How is it?"  I've tried as best I could to convey the reality of the experience here.  But it really can't be put into words.  I can't chronicle every side effect here because some of them are so absurd and specific, I don't think most people can even imagine them.  Like "my eyes feel tired" or some weird hybrid jaw/ear pain that almost made me keel over when I was eating a bagel.  I didn't even know the human body could feel some of these things.

And that's just the physical stuff.  The mental stuff...well I can do a better job of conveying that.  But that's at least 50% of the battle.  Add both sides up, and it's indescribable.  Nothing can prepare you for this, and nothing can replicate the experience.  And that, I think, really scares people.

The answer I give when people ask me "How is it?" is generally this:  It's not that bad.  You know why?  Because it's really not that bad.  I write a lot about context and equilibrium and relativity, because that is a major part of this game.  You can't analyze your own situation in a vacuum.  You can't, as a perfectly healthy individual, simulate the experience or how you would feel if you were in this sort of situation.  I know this.  I've often thought about people with serious diseases and wondered how on earth I would react to something like that.  I'm sure you all have as well, either on account of me or somebody else in your life.  And you just don't know.

But now I do.  I know in agonizing detail what chemotherapy is like, what a bone marrow biopsy is like, what a PET Scan entails, what surgery is like, and so on.  I know the mental aspect of this better than anybody because I spend an enormous amount of time describing it and writing about it.

And you know what?  It's not the end of the world.  So there's no sense in acting like it.  I would estimate that I feel "fine" or better at least 95% of the time.  I'm never 100%, but oh well.  I'm nauseous on the day of treatment for a few hours, and that's it.  I deal with bone pain occasionally (and not really at all these past two cycles) and a general crappy feeling occasionally.  The numbness in my fingers hasn't interfered with anything, and my left arm was useless anyway.  And now I save money on shampoo, razors, and shaving cream.

It's tough.  It really is.  But so am I.  And I have a ton of people supporting me in every way shape or form, even if it's just people who comprise the audience around here to whom I can always vent about anything I'm feeling.  I try to describe the experience in as much detail as I can without sounding too whiny, and sometimes that's hard.  That's the reason I often waver between "Shit don't bother me" and "This is the worst thing ever."  Because there's truth in both of those things.  Cancer is weird like that.  It's hard to overstate the gravity of a life-threatening illness.  But I also realize how lucky I have been throughout the course of dealing with that illness.  And that's what I try to describe here.

***

When I applied to Northwestern in high school, the application listed a series of questions for applicants to answer.  One of those questions went something like this:  Are great leaders born, or are they the product of circumstances outside their control?  The answer, of course, is a little bit of both.  Success is often the result of having the right talents in the right situation.  It's a pretty simple formula.

But I'm beginning to think the "proper" mix includes more of the latter than the former.  That is, there are a lot of intelligent, well-spoken, hard-working, generally decent people on this earth.  The only way to differentiate many of them is by experience, and so much of our experience just happens to us.  Even the stuff we choose to do has a tremendous amount of chance involved. 

Take my life in a nutshell.  You know that question on the Northwestern application?  Well I must have answered it wrong, since I was denied admission.  As I applied early decision, had I been accepted, I would have had to attend.  As it was, I ended up at my safety school.  In hindsight, I consider this one of the best things that ever happened to me.

When I applied to law schools, Georgetown was my top choice.  But I was waitlisted there.  A week later, I got into a MUCH HIGHER RANKED (rankings matter to me now) law school.  So I decided to go all Van Wilder in Ann Arbor, enrolled in the 7-year-plan, and the rest is history.  Also one of the best things that ever happened to me. 

When I showed up for my third year of law school, I walked into the Michigan Innocence Clinic office to find out I had been assigned to a case in which our entire case - a recanting eyewitness - had decided he was no longer talking.  Six months later, our client was a free man.  How?  We worked hard and got lucky.  I somehow tracked down a police officer by sending handwritten notes addressed to the wrong person to the wrong precinct.  Another student stumbled onto key documents while talking to a mother of a convicted murderer.  Other students tracked down a homeless man by driving around to random offramps.  

The point is this:  We don't have much control over many of the things that happen to us in life, but we have all the control over how we respond to it.  Some obstacles are going to be bigger than others - I certainly think cancer is a bigger setback than being waitlisted at a MUCH LOWER RANKED law school.  But it's often these times when we are facing obstacles, when we get knocked down, when our backs are against the wall, that we can really excel.  Sure, you can be the best hitter in the world.  But that pitcher has gotta throw a pitch for you to do anything worthwhile.

That's all I've ever thought I am:  A decent guy who is good at some things and not good at others who has been placed in an extraordinary position and done the best he could with it.  When I started this blog, I was adamant that this would not be a "normal" cancer blog.  It is not that.  I'd venture so far as to say that it is one of the most popular cancer blogs on the interwebs.  (Again, I'll place that prize next to my 4th place kindergarten soccer trophy, but it's still going in my case).  And I'm very proud of that.  Because I took something terrible and turned it into a situation where people can understand what I'm going through, understand more about this disease, and maybe, possibly, that will help them in the future.

***

Igor Larionov was a great hockey player.  But on that night in June 2002, he was in the right place at the right time.  The puck bounced to him and he had one guy to beat.  The defenseman went to the ice too early; Larionov stickhandled around him, avoided a jumping Mathieu Dandenault in front of the net, and sent a backhander into the top corner. 

And Igor Larionov was just a man who had made the most of an extraordinary opportunity, waiting for his friends to join him in celebration. 

***

There's a feeling, unique to hockey, in the ensuing moments after a playoff overtime goal.  The winners are overcome with such a release of emotion and joy that it's impossible to contain.  The losers are absolutely soul-crushed, saddled with the feeling of having so much invested in something one moment, and having it all shot to hell the next.  I know of no other situation where two groups of people go from feeling exactly the same to polar opposites in a matter of seconds:

I don't think triple overtime is a great analogy here, since the cancer is probably long dead at this point.  But Dominik Hasek will certainly symbolize my emotion when I walk out of the treatment room for the last time.  

Like that triple overtime game, I've given it my all for five grueling cycles.  I'm hurt, I'm tired, and I want to be somewhere else.  Physically, I'm exhausted.  Mentally, I'm drained.  But I keep on going.  For me.  For the people around me.  Besides, I have no other choice. 

Because it gets better.  I'm going to take one more dose of poison, and then it starts getting better every day from there on out.  And two weeks from tomorrow comes and goes, and I don't get another dose of poison.  Because I'm still standing, and cancer is not.  

***

I was reminded of Vince Lombardi's "What It Takes to be Number One" recently.  Reading it again - and having compared so much of my current struggle to aspects of my athletic career - I found parts of it very relevant to my current situation: 

There is no room for second place.
...
The object is to win - to beat the other guy. Maybe that sounds hard or cruel. I don't think it is.
...
It is a reality of life that men are competitive and the most competitive games draw the most competitive men. That's why they are there - to compete.
...
And in truth, I've never known a man worth his salt who in the long run, deep down in his heart didn't appreciate the grind, the discipline.
...
But I firmly believe that any man's finest hour - his greatest fulfillment to all he holds dear - is that moment when he has to work his heart out in a good cause and he's exhausted on the field of battle - victorious.

This is a battle.  And second place is not an option.  Do I appreciate the grind?  I'll certainly be a different person because of it, and I really do think I'll be a better person.  Besides, the grind is all for a purpose - to reach your "finest hour."  I know what my finest hour is going to be, and that's why I keep on the grind.  Because sooner or later, that hour will arrive.  And I know how I'm going to feel then.

It's Election Day! Nick reminds you to...sit on your ass and don't go anywhere near a voting booth.

If there's one thing that amuses me about Election Day, besides the fact that it means election season is over, it's this constant drumbeat of "VOTE!!!" emanating from anybody with a mouth or keyboard.  Not "VOTE FOR X," which is fine.  But just "VOTE!!!"  I don't get it.  I mean, if you've spent the last year screaming about the Tea Party until you're red in the face and little drops of spittle come flying out of your moth, your "VOTE!!!" command is certainly not directed at the Tea Party crowd.  And if you've been screaming about Obama the Muskenalist (that's Muslim, Kenyan and Socialist rolled into one; I created a shorter word so simpletons won't have to scream as much), you don't want busloads of people from Ann Arbor to hit the polls. 

I don't get it.  Voting is a right.  It is not a "duty," as I've heard it described by many people.  In fact, it cannot be both of those things.  If people choose not to exercise it, so be it.  There are usually only members of two parties running for every available office.  So you get a "choice" between a party who spent 8 years spending like madmen, running roughshod all over the Constitution, fighting two wars, accumulating power until about half the country was pissed off beyond belief, and yelling at Mexicans for stealing our jobs, or the party that spent two years doing the exact same thing except they yelled at the Chinese for stealing our jobs. 

Nobody votes for John Dingell because they like John Dingell.  You can't honestly have an actual affinity for John Dingell.  Think about it:  He's an old, rich white man who attended private school and first came to power in the pre-civil rights era and likes spending other people's money.  He is literally everything the people of Ann Arbor hate in a human being.   You think Ann Arborites like voting for that?  I doubt it.  I think they just really really hate Republicans and will vote for anybody who's not one of them. 

Actually, I think that's most of politics:  "I really hate the other side, so I'm voting for my guy, no matter how big of an idiot he is."  I can't tell much of a difference between the two major parties, but I can tell a significant difference between the people that tend to associate with the two parties.  Sure, they're largely the same in substance - which is why liberals just had a Tea Party last weekend and pretended it wasn't a Tea Party - but they yell different things at rallies.  And put Hitler mustaches on different people on their signs.  So I guess those are differences.  But it's really just a bunch of "Us vs. Them" and "we" need to beat "them" or else this country is going to regress for the next X number of years.  And then one party wins and the other party cries for X number of years, and all this goes on without noticing that both parties govern in more or less the exact same manner.  Because we're all too busy hating the other side.  Because we hate "those" people.

So I don't get the fascination with today.  I think it's a lot of hullabaloo (yes I'm 72) over sticking it to the other side.  The same way it was in 2008.  The same way it was in 2006. 

For my part, I'm going to vote...but you don't have to.  In fact, I would probably prefer most people do not come within 500 yards of a voting booth today.  It's not because their political views don't align with mine - that's rare.  But because the overwhelming majority of the electorate does not have any real understanding of the issues or people they are voting for and against.  That's while political ads are so knuckle-dragging and cliche - that's the level of understanding that most people have of politics.  "X likes working families!"  "Y fights for our children!"  "Tough on crime."  "Shipping our jobs to China."  I just don't think going into the voting booth and filling out random bubbles is an important civic duty or good for democracy.

And if you think today is the be all end all or even "very important," you need to reevaluate your life and figure out what is really important to you.  The people around you and the things you control, not some asshole who wins a popularity contest. 

Hell Week

If I go the rest of my life without having another week like last week, that would be outstanding.

I made it through last weekend ok.  I was excited at the beginning of last week.  But as Monday dragged into Tuesday, and Tuesday dragged into Wednesday - with absolutley nothing resolved - I wasn't doing too well.  Wednesday was the worst day I've had since all of this began.  Mentally, physically, I just felt like complete hell.  I had no idea what was going on.  If I had to pick a point in time and say, "that was rock bottom," Wednesday is your leader in the clubhouse.

In hindsight, a lot of little things added up, and I finally reached a near-breaking point.  I was just sick of everything.  I'm sick of being at home.  Not because of anything or anybody around here - everybody is great, and I understand how lucky I am to be here.  But my tolerance of any situation in which I'm a 25 year old with two degrees living with his parents and wearing sweatpants everyday is limited, cancer or no cancer.  I'm sick of my left arm being all messed up.  I'm sick of not feeling my fingers.  I'm sick of not having hair because now it's getting colder and this is becoming an issue.

I went ballistic on my Facebook news feed last week.  A ton of people got canned.  If you bitch and moan about every little mundane thing that goes wrong in your life, you're gone.  If you post stuff from a NY Times columnist, Mother Jones, or Huffington Post without comment - as if the inherent gravitas of the piece itself obviates any need for additional words - you're gone.  (I would have done the same for any friends that repeatedly post conservative crap, except I don't have any).  I'm not in the mood to hear about you passing the bar, especially when my bar admission is being held up because I have cancer.  (Literally - I MUST, according to Maryland, complete my character committee interview in person.  I cannot be sworn in without this.  Which is bad news if I'm undergoing chemo and daily radiation through the end of the year.  By the way, a friend recently completed this interview.  She was asked two questions - "What does professionalism mean to you?" and "What stands out to you in the Maryland Rules of Professional Conduct?" - and the meeting took less than 15 minutes).  Posting bar trip photos?  Gone.  Emo music lyrics as a status message?  Bye.  Assholes who throw every post from their cancer blog on Facebook?  Automatic de-friend. 

What did these people do to me?  Absolutely nothing.  Most of them are good people.  I was just mad at the world. 

By Wednesday, things had reached a boiling point.  I felt pretty crappy on Tuesday, but I usually never feel bad two days in a row.  But Tuesday night, I didn't sleep at all.  I couldn't get my mind to settle down.  I fell asleep around 4am.  I woke up every hour; two of those times, I woke up completely disoriented (this happens occasionally, especially when something is weighing on my mind - I'll wake up completely confused, often times after having what seems to be part dream part overwhelming thoughts about something.  It's a really weird sensation.  But I just could not get my brain to relax on Tuesday night).  And then I woke up for good at 8:15am on Wednesday, as this seemed like the best time to mow the lawn for an hour (literally an hour, I laid there until 9:15 listening to it).

And then I tried to get my pathology slides out to the NIH.  This was hell.  I can't even describe it.  I just know that there I was, 65 days into chemo, feeling like hell, trying to coordinate things with four doctors and two pathologists.  I think I'm a moderately bright guy, but people would say entire sentences to me, and I would have no idea what they were saying.  I knew what I needed to do, but no matter who I talked to, it wasn't getting done.

But most of all, it was the uncertainty.  I was fine last weekend because I thought things would be resolved soon.  But I underestimated how much the uncertainty would bother me.  I couldn't stop thinking about how excited I was after PET Scan #2 revealed progress.  I thought I was clear from there on out - or as clear as you can get during cancer treatment.  But then it was "your treatment is inadequate" time, and like what the hell man?  I thought I was good.  I thought things were working.  And now we're throwing around terms like "Central Nervous System relapse" and "three weeks in the hospital" like they're handing out Halloween candy. 

I needed context.  I knew I shouldn't freak out, but I didn't know why I shouldn't freak out.  And as the days went by without an answer to that second question, I started to doubt the answer to the first.  And yeah, I asked "Why me?"  I asked it when I was diagnosed, and determined that there was no answer and the question was stupid and that was that.  I came to terms with the diagnosis.  It sucks, but it happens.  People get cancer.  Even young people.  Rare, but not terribly uncommon.

But how many people find out nine weeks into treatment that, oops, we're not quite sure what lymphoma you have and we think you were treated incorrectly and here's the worst case scenario that I'm going to dangle in front of you at 6pm on a Friday ok have fun with that!  I mean, only people who have a borderline case of non-Hodgkin's lymphoma, get a second opinion early on from a renowned specialist, see that specialist agree with the proposed diagnosis and treatment, then, for whatever reason, decide to get a third opinion four cycles through treatment, only to see that third opinion contradict the first two and blast everything to hell sixty days after you thought you had everything figured out.  How many hoops are we jumping through here?  I began to feel singled out for specific punishment by cosmic powers.  As I wrote back in September:

There's a point at which enough bad/unlucky/unfortunate things happen, in succession or with such absurd timing, that you stop believing in things like fate and chance and start believing that something is out there has a plan for you, and that plan most definitely does not take your physical or mental well-being into consideration...  

...At some point, there's nothing left to do besides gaze aimlessly into the sky with outstretched hands and upward palms and ask, "What? Why?"

The worst part of all this:  For the first time since my first meeting with Dr. Anderson, I didn't want to write.  Writing helps me because it forces me to organize my thoughts, to get them out, to think about things calmly and rationally (except for the Friday 6:30pm post) and put them out there for others to digest.  And it makes me feel better to know 1) that there are people out there who do care and read this stuff and 2) that people will have a better understanding of this entire experience because of what I'm doing.  And maybe, the next time they have to deal with this sort of stuff (god forbid) it won't be as terrifying as it was the first time I heard the word.

But I didn't even want to deal with the shit in my own mind in the middle of last week.  That was the first time I had that feeling.  I'm really not interested in feeling that way again. 

***

But Wednesday night, things started turning around.  The pathology slide issue went from FUBAR to resolved.  I had a meeting with Dr. Al-Katib coming up the next morning.  I forced myself to go the gym for a bit.  I got sorta angry at myself for letting myself have such a terrible day.  I didn't know if my physical condition wrecked my mental state, or my bad mood me feel like crap.  Either way, the mental/physical link that I have written about before was on full display on Wednesday.

And by Thursday and Friday, after meeting with Dr. Al-Katib and Dr. Anderson, I was fine.  I had context. Even if that context is "you are a borderline case and there's no 'right' way to proceed here," that's fine.  At least I know for sure that I'm a borderline case and there's no right way to go.  At least I know why we did what we did.  At least I know what everybody is thinking.  I can handle information - even bad news.  I can't handle partial information without context.  That's why I avoid cancer resources on the internet and other cancer patients.  I can't take what those things give me and immediately figure out how it applies to me.  So I stay away from that stuff.

Now, I'm fine.  Uncertainty has been reduced to a manageable level.  I'm going to finish R-CHOP.  I'm going to go through radiation.  And if, during that time, we decide it's necessary to proceed with another form of treatment, we'll do that after the other stuff is done.  What will that entail?  I know the range of options, but I'm not going to speculate.  And hopefully it won't matter. 

Weekend Update wants your vote

[Football stuff early on here, then on to more Halloween and more cancer-ish stuff.  I know some people skip over football content (you shouldn't)].

THEY DISCOVERED A NEW CATEGORY OF LYMPHOMA.  IT'S CALLED "MICHIGAN'S DEFENSE."  I can't make jokes like "I would rather kill myself than watch this football game" anymore.  But if I could, I would have made them Saturday night.  I might just go through with the Burkitt's treatment to avoid watching our defense anymore this year.  At least I'd be out of the hospital in time to see us give up 73 points to Akron in the Avis Rent-a-Car Bowl.

Saturday night was an abomination and officially bumped me into the "On the Fence" category of the Rich Rodriguez experience.  I know people have been screaming for his head for years; I think they have been wrong and are still wrong.  But it's getting harder and harder to oppose them.  I still don't think Rodriguez should be fired, for a number of reasons, but if he was, I would completely understand it.

What I have always disliked about Rodriguez opponents is their inability to articulate why they want him gone.  You gotta give me something beyond "Rich Rod doesn't care about defense!!" or "I haven't seen enough progress!!"  Those don't mean anything.  And you have to account for the obvious deficiencies this team has - particularly, the horrendous attrition and recruiting malpractice that lead to us playing about 8 guys that are 6 months out of their high school prom on defense.  You gotta say something beyond screaming "IT'S THE SCHEME" at the TV screen.

So here's my football-nerd case.  Four things that bother the living hell out of me, all present on Saturday, but by no means exclusive to this game:  1)  Third and short, we run 170lb Vincent Smith up the middle out of the I formation.  Mind-boggling stupidity.  We have done this on multiple occasions this year.  2)  The pass patterns on offense seem insanely simple.  We run vertical routes, two-receiver combo routes, and screens and swings.  I don't think we have a play in our arsenal that requires our quarterback to sit back, survey the field, and go through a progression, or wait for a route to develop, or wait for a receiver to make a double move.  I mean, maybe we do and we just don't run it with Denard.  But I haven't seen it.  3)  We don't just get burned on most screen passes thrown by the opposition.  We get horrifically disfigured by every single one of them.  4)  I can handle giving up 10 of 16 third downs if we just couldn't get pressure and the QB found open guys, or we blitzed but the QB read it and hit the hot route.  I cannot handle repeatedly giving up easy yards on simple out patterns (which we've been doing for years), to the point where I am telling the TV, "That receiver right there is going to run one yard past the first down marker, then he will turn and run to the sidelines and catch the ball for a first down" and that exact thing happens.

Maybe I'm wrong on some of the above stuff.  But I think those are things that are not borne out of obvious physical deficiencies.  Or lack of experience. 

Whatever.  I really don't want to see Rodriguez fired because I really don't feel like going through another rebuilding period.  But it's getting harder to defend him every week.  And giving up 41 points and 435 yards to a previously craptastic offense led by a walk-on quarterback named McLovin is not helping things. 

MY LEAST FAVORITE HOLIDAY IS OVER.  Halloween is right up there with Willy Wonka and the Chocolate Factory on the list of "Things That Everybody Else Seems to Love But I Hate."  I have despised Halloween for quite a while now.  Trying to find a costume is a very stressful experience for me.  I can't just not wear clothes like most women.  I'm supposed to be creative.  Which I have always struggled with when it comes to Halloween costumes.  So I spend most of the holiday trying to avoid costume parties.  I haven't had a good costume since I duct taped flip flops all over my body and went as John Kerry in 2004.

Anyway, this year, the possibilities were endless.  I didn't go out, because, you know, I hate Halloween.  But if I did, I could have made a killer cancer patient.  Or I could have put on a wig and gone as somebody without cancer.  Or I could have gone as Sydney Crosby.  Why would I go as my least favorite hockey player and second least favorite human being?  Because my chemo beard looks like Sydney Crosby's playoff beard:

By the way, that's his playoff beard on day 55.  No wonder he gets facewashed by Jimmy Howard and the refs step in to restrain the goalie. 

In other costume news, some of the oncology nurses were in costume on Friday.  Including one who was dressed up as a ghost.  In an oncology clinic.  Dear lord.  At least I left my Grim Reaper getup at home for the day.  Otherwise I would have thrown it on and gone knocking on patients' doors.  But really...there's gotta be a list of costumes that oncology nurses are prohibited to wear at work.   

SLICED TUMOR: 2010 WORLD TOUR CONTINUES.  Dr. Jaffe will provide very valuable information on the pathology front, but pathologists do not offer advice on treatment.  Of course, her work will go a long way to help determine the course of treatment, but pathologists themselves cannot say, "You should treat this as Burkitt's" or "You will be fine treating this with R-CHOP."

So that leaves me with three opinions on the treatment issue.  While it seems two of my doctors are pretty comfortable with R-CHOP, it's a little more complicated for me.  Once U-M put all those scary thoughts in my head, it will take more than a couple doctors to talk me completely off the ledge.

Also, there are some complicating issues with the three actors and their current positions.  Dr. Anderson and Dr. Al-Katib developed and agreed with the original course of treatment, so I can't really expect them to change their positions now.  And U-M, in its second opinion wisdom, did what it is easy for second opinion givers to do - second guess.  Of course, having listened to all three doctors explain their positions, I know for a fact they are all reasonable.  But there are issues that complicate the debate.  A fourth hospital, at this point, wouldn't have to affirm or criticize a single course of treatment, but could select one or the other, or, god forbid, come up with a third way.  I could go to a fourth hospital and say, "Here is option A, here is option B, which do you think is better and why?"  Whatever answer they choose would go a long way toward settling this debate.

So after talking a bit with my docs, I think I've narrowed the choices down to four places:  Stanford, the MD Anderson Cancer Center (U Texas) the Mayo Clinic, and the Memorial Sloan-Kettering Cancer Center (New York).

How am I going to make this potentially-life-altering decision?  No clue.  All these places were recommended by my doctors, so I have faith in all of them.  I know these places would prefer I come in for an exam, but I'm not flying out to California.  Austin is a pretty cool town; I'd like to go there.  I've never been to Minneapolis, so that should be interesting.  New York is New York, and I'm not sure if that's good or bad.  Two of my doctors (Dr. Al-Katib and my Radiation Oncologist, Dr. Kim) trained at Sloan-Kettering.  MD Anderson is the "highest ranked" cancer center, followed by the Mayo Clinic.  Stanford is possibly the best place for Lymphoma.   I'll probably draw names out of a hat or something.

Oh and I'll make this question this week's poll.  See what you folks think.  Give you an active role in my treatment.  Honestly, if there's no "best" way to treat this thing, I might as well leave important questions to online polls.  Can't hurt. 

THIS WEEK.  Cycle 6 on Wednesday, possibly getting a report back from Dr. Jaffe, hopefully making progress on an additional consult.

Oh and I get bar exam results on Friday.  I don't plan on posting anything anywhere for a couple reasons.  First, virtually everybody passes the bar, so I don't think doing so is that special. Second, I honestly don't plan on looking at my results on Friday.  I'll be two days out of cycle 6, so I'll probably feel like hell.  Also, I expect to pass, so passing wouldn't really have much of an effect on me. But not passing would be a stunning and crushing blow.  So my options are "no impact" or "crushing blow."  No real gain there.  Finally, I continue to really not care about this stuff right now.

I assume some of the other people in my life will nag me to the point where I check the results just to shut them up, but I still don't want to.  So maybe I'll post something down the line, but as of now, don't plan on seeing anything here.