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Necrosis

Irinotecan / Avastin Milestone

Yesterday I had an MRI — the first one since going on the Irinotecan/Avastin infusion treatment plan two months ago. Specifically, I’ve had three doses of Avastin, four of Irinotecan.

For now, we’ll say the news is good. I’ll post more details tomorrow after our trip to Duke’s Preston Robert Tisch brain tumor center.

My last MRI was done at Northwestern in Chicago back in August. The radiologist at DeKalb Medical here in Atlanta apparently had a hard time comparing yesterday’s images because equipment and techniques may vary. There appears to be some progress but specifics are vague. The tumor measurement has increased, but it appears to include a lot of dead (tumor) cells — Necrosis.

Hopefully the brain cancer specialists at Duke will be able to better interpret the results. I need objective criteria to help decide whether to continue poisoning my body with chemo and Avastin or not. This is poisoning my whole body — not just attacking tumors. An impatient man could lose his cool wading through these precarious waters.

Other

The missing Kebostock banner has appeared. While some may claim it was stolen, others might say it took a road trip with friends.

I send my Love and Thanks to the incredible network of people who help support me. I compose a blog post in my head every single day. I work through my thoughts as though I’m talking to you. It’s helpful to me. Luckily, I’m wise enough not to publish all those random thoughts.

[edited to remove excessive rambling]

Guest Post from Caregiver/Spouse

I couldn’t let today go by without telling everyone that today officially marks the 14-month anniversary date from Ken’s seizure. Why is this information important, because Ken’s surgeon boldly let me know that the survival time for Ken would be 12-14 months. Of course we are not paying attention to statistics as Ken is a statistic of one and I’m sure faithful readers of this blog can attest to this fact.

Each and every day/moment I’m amazed by Ken and it’s hard to explain what I mean by this without sounding like a Hallmark card so I’ll spare you the details.

I wanted to also thank each and every one of you who read this blog, have donated money, food, etc. or attended the Kebostock event.

Please join me in celebrating this milestone with Ken.

Tina

Infusion #4

Today I had my fourth chemo infusion. This time, Avastin was excluded. This is not good news because Avastin is the key drug that everyone has their money on as being the most effective at fighting my tumor.

Below the Belt

So the abdominal pain I blogged about previously is cleared up. Drain tube is removed. No more pain. Doctors are not clear whether I still have an appendix or whether it perforated/ruptured three weeks ago.

Options Review

An MRI to see if this chemo regimen has been effective will be done in two weeks. Then we’re off to Duke to discuss options. Here’s a quick review of modern-medicine best-of-class tactics tried so far.

  • Temodar — FAIL
  • ICT-107 trial — FAIL
  • Novocure — FAIL
  • Avastin — FAIL

Shit, all the good choices are gone. Avastin MAY be reconsidered in the future. There are more clinical trials; more alternatives; MORE HOPE. I’m not concerned. At least, I don’t consciously think I’m concerned. I notice that I began erasing myself from LinkedIn — leaving Groups that are no longer relevant to me. I’m almost done creating succession plans for my freelance web and design clients. I’m not doing this because I think the end is near. Maybe I just don’t want to go back to that life or career. I have options for that when the time comes.

How am I Feeling?

Despite some bleak news above, I still feel physically, mentally and emotionally strong. The weather is fantastic. I’m dying to take my motorcycle out for a spin. The only thing stopping me is my own caution. No sense risking overdoing anything right now.

I was hyper-aware of motorcycles today though. On a walk today a bike passed by and I noticed how good it sounded as it’s deep rumble faded down the road. Same walk, I saw a young girl riding a Honda 50 that resembled the one I rode when I was 13. I vowed to revive my ’82 Shovelhead and do some Fall riding.

I may have wasted almost an hour creating this image. Actually it was fun. Superimposing two photos of me, forty years apart, and making a stupid shield. (Only thing missing is a Jim Benson critique). I think from time to time I miss playing in Photoshop. In a way it’s like reconnecting with my former life, working a job, not concerned with mortality.

Food Train

As much as I love cooking, I’ve noticed a decreased interest lately. Months ago a neighbor volunteered to sign us up for Food Train — a means for friends and neighbors to volunteer to drop-off a meal or some food. So I finally gave in. Here is a link for anyone interested in participating.

http://www.mealtrain.com/?id=m4c7myai51yt

 

Six

I’ve been critical, judgmental and one-sided in my latest posts. But I have now reconsidered my position on some things, such as salutations, generalizations and the effectiveness of universally recognizable emoticons. Thanks to those who shared an opinion. Sorry if my tunnel vision disrespected anyone. I think I should just keep this blog focused on my wellness updates. I’ll try to tone down the commentaries.

But first another apology. Sorry to the few ladies on my street to whom I’ve shown off my blood drain bag. It didn’t occur to me that you may not have been interested in seeing that. It’s kind of gross.

E. coli

We heard from the infectious disease doctor today. My infection is from basic E. coli.

Good, because it’s easy to treat and I am already taking the right antibiotics for it. And, there may not be anything wrong with my appendix.

Possibly bad because Avastin is probably the cause. I will discontinue using it (at least temporarily). The abscess caused by this bacterium may be from a gastrointestinal perforation. (Don’t search the Web for more details — it ain’t good). But, these are still just assumptions. More information will be revealed to me at my follow-up appointments on Monday.

My caregivers have to take care of each other too.

Caregivers

Tina manages my wound care with vigor and tenacity; without fear or hesitation. She takes care of everything. And Mila, tends to me just as diligently. Maybe that’s the female nature. They support each other too, which is good because I’m quite unreliable and selfish.

Drugs

I’m weakened by this injury and the drugs used to treat it. Synthetic drug treatments may be helping me but they are definitely hurting me. I wish I could just say no to these drugs1.

Maybe nature offers better hope. Cannabinoids keep coming up in cancer research2 — not just for the treatment of nausea and appetite, but to kill cancer cells. Many people hold some power to affect the repeal of marijuana legislation so more research and clinical trials can be done. It is my hope that all those people begin to use that ability now to implement change (even in Georgia) or else become intimately affected by the desperation of terminal cancer.

Conclusion

Most times that people see me – I’m a One. Lately Six has been common. I’ve had my fluctuations up to Ten though. May you be Zero. Goodnight. (Edited to add: I’m talking here about physical pain, not emotional or mental state. It was a reference to my previous post criticizing the standardized pain scale.)


Footnotes

  1. Pharmaceutical drugs I’m referring to include: hydrocodone, bevacizumab, irinotecan, dexamethasone, temodar
  2. There are probably better sources to reference, but this seems like a good start for the disinformed: New Study Adds to Research Showing Marijuana Could Stop Cancer, Mitch Earleywine, September 24, 2012

Released from the Hospital

CT Guided Aspiration Drainage

Blood bag strapped to thigh — My latest fashion accessory, just in time for Halloween.

I started my day with a gurney ride to Radiology. After downing a bottle of contrast, my food-starved, narcotic-fueled, sleep-deprived body was barraged by waves of trembling and voracious teeth chattering. Basically, reactions to being cold except they were very exaggerated. CT imaging revealed an abscess in the vicinity of my appendix. An area below my navel was numbed with topical anesthesia. I was infused with benzos to relax. I suggested they just knock me out! I really didn’t care to FEEL or remember the procedure. I did not get my way. But it was quick and mostly painless.

Two weeks ago, the oncologist assumed my GI pain was a kidney stone or urinary infection. Now, she suspects that my appendix ruptured. The goals of today’s procedure were to:

  • remove fluid, thereby reducing pressure and relieving some pain;
  • collect samples so that the Infectious Disease team can identify specific bacteria present as well as the proper antibiotics to combat the bacteria and remedy infections;

We need to treat infection with antibiotics to avoid, or at least post-pone surgical removal of my appendix. Avastin compromises cell health which would complicate recovering from surgery. Avastin is known to cause GI complications and is probably responsible for all this trouble.

Conclusion

I was released from the hospital today.
My own self evaluation of my overall wellness is entirely positive!

When unexpected complications arise, I’m reminded that October is the month for me that corresponds with the ominous 14 month death statistic. Despite a few recent hindrances, my physical, emotional, spiritual and mental well-being remain great. Plus, the tremendous outpouring of love and support for Tina and I is like a vaccination against despair. I don’t claim to be self-actualized or enlightened. I still fall prey to petty annoyances.*** But all-in-all, Everything’s Gonna Be Alright.


Too Much Information

A drain tube protrudes from my lower umbilical area and empties into a collection bag that I can strap onto my leg. Tina was instructed on how to flush the drain twice a day to keep it clean and clog-free in order to collect excess blood, pus and who-knows-what. I’m not sure how much fluid is expected to collect in this bag. It could turn out to be a good Halloween costume. Actually, it brings to mind, artist Andres Serrano!


*** some hospital experience examples, for the fun of it (and to waste more time)

#1  I understand that the statement, “How are you,” is a common and friendly greeting. But if I’m having an off day, it irritates me when hospital staff casually ask. I’m not going to retort with, “Fine! How are you?” if I am not. So I respond with, “Hello.” Or I deflect by asking them the same question. Most often, I don’t respond at all which is probably perceived as rude. I don’t know why I let this bother me. But I disappoint myself when I succumb with a fake, pleasant answer? Honestly, I’m not an advocate of political correctness but I think it would be reasonable for hospital management to suggest to employees that maybe a neutral greeting would be more appropriate when addressing their customers, the patients. Something like, “Hello” is probably fine. I know the topic doesn’t deserve this much consideration. What’s wrong with me?

#2  During my overnight stay in the hospital, I was checked on by a nurse every hour throughout the night either to change IV bags, evaluate pain status, take vitals, etc. So, it wasn’t a very restful night. When the morning shift change happens, it’s like the party gets going and the noise level cranks up. Then the new nurse comes in the room and greets me with a chipper, “Good Morning!” which sounds to me like encouragement to get up. Sorry — I’m laying in bed for two more hours. Can you keep it down!?

#3  I won’t go into a rant of the deficiencies of patient profile questionnaires, but that’s another hot button topic for me.

Hospitalized

All day Monday, I was couch- and bed-bound from severe pain in my lower right abdomen — right where my appendix is (or should be). My body temperature teetered around 99-101 degrees. Luckily I had some Hydrocodone left over from my craniotomy and it helped me make it through the night. This is the same pain feeling that happened two weeks ago after the second infusion. Last time we just made assumptions about it being a urinary infection. I took antibiotics, but the blood culture did not confirm an infection, so we assumed it was a kidney stone and that I passed it. I HAVE had a stone a long time ago and the pain was really that bad. It was at least three days of agony.

So, today, in anticipation of another painful episode,  Tina took me to the doctor’s office for routine blood work. It was decided that I should get a CT scan to determine what’s going on. The CT scan was not very useful. It showed fluid — that’s it. In fact, it was not possible to even make out the appendix.

So, I was admitted to the hospital this evening. I tried to send Tina home to get some rest, but of course she refuses. It’s the couch for her tonight.

Tomorrow, I will get a CT-guided aspiration/drainage. It’s been a long, rough day, but at least I’m still here to talk about it.

Are you in pain?

Some GOALS were written on the whiteboard of my hospital room. So, what is the nurse’s number one priority?

Pain level < 10
That is, to keep my pain level less than a 10* (see chart)

Take a look at their chart. I think it could use an overhaul. The expressions of the levels are horribly inaccurate in my opinion. Think about “severe pain” (#6) and take a look at that face. This guy looks despondent at best. Worst pain imaginable (#10) looks like a tween going through his first heart break. One’s first pubescent break-up could SEEM like the worst pain imaginable, but come on. This face does not represent excruciating physical pain.

So I asked the nurse about this goal. She asked what pain level I would like to be medicated for. Really? Does anyone answer something other than NO PAIN (#0)?

My pain is now under control. Hopefully tomorrow, we will be able to figure out what’s wrong with me.

Infusion #3 and Kebostock Review

Medical Update

My third infusion of Avastin and Irinotecan went well. I felt lousy for a couple days but seem to be back to normal now.

Benefit Events Update

The two-day benefit, Kebostock, was a success — good weather; nice turnout; great music. At the end of the day, it hit me. I realized the immense effort, love and generosity put forth by organizers, sponsors, family, friends and the community. All in all, we estimate about 300 people showed up. I wish I could have spent more time visiting with everyone. Thank you!

The rest of this post is just personal or fun stuff — no relevant medical information.


What’s the story behind Ken’s goofy outfit on Saturday?

A family friend graciously let Tina and I stay at their lake house. The morning of the event was so lovely that we decided to eat breakfast outside. We inadvertently locked ourselves out of the house. We had no keys and no phone — and no clothes really. We had no choice other than knocking on a neighbor’s door and explaining our situation. The neighbor turned out to be a member of the band Drop (dropatlanta.com), an Atlanta-based funky, psychedelic, improvisational jam band (think Grateful Dead). He extended every hospitality to us, clothed us in brightly colored hippy shirts and drove us to the festival. He brought along his guitar and played a set of music along-side Albert. Thanks, Craig!

Did someone really get a Kebostock tattoo?

Not someone — two people did!

I thought they were crazy but Matt and Will got tattooed prominently on their chests. I’m blown away and honored at their gesture. The coolest thing is that the tattoo artist, another good friend of mine from the 1990’s allowed me to tattoo my signature on Matt. I had never touched a tattoo gun before! I got a 20 second lesson on tattooing and was let loose. It was a lot of fun.

What happened to the Kebostock banner?

Friday night at Back Forty, there was a nice big banner hanging. Why wasn’t it displayed on Saturday?

The banner may or may not have been “stolen.”

Suspects under investigation.

How did this event come to be?

I think credit for the idea belongs to my brother-in-law, Albert Simpson. He’s a musician who has played at other benefit events. He had the connections and know-how to get it done. When he recruited my mother, Cheryle Maudsley, to help, there was no stopping the event from becoming a success.

What will the donated money be used for?

To live!

Kebostock Countdown

All is well on the health front. So far so good on round 2 of chemo. This post is mostly an update on the upcoming benefit event.

Second Infusion

I’m writing this update from the doctor’s office, while undergoing my second infusion of chemo.

About nine days into my first round of chemo, two weeks ago, I began having some lower abdominal pain. Pain and discomfort steadily increased over the next several days. I barely got any sleep the past three nights because of the pain and getting up frequently to use the toilet (or at least TRY to). I thought it may have been an expected side effect — constipation. But this morning at my doctor’s appointment, a urine sample revealed I have a urinary infection. That should be easily cleared up with antibiotics.

So all in all, so far, so good. Unfortunately I won’t get an MRI until six weeks from now, which is to say, we have to wait to know whether the chemo is effective or not.

Post Chemo Update and Site Revisions

Medical Update

It’s been four days since I received my Avastin and Irinotecan infusions. So far, it has been very tolerable. I’ve experienced some times of being very tired where my body felt like a lead weight and I slept or napped more than usual. No nausea or any other ill effects to report. If this therapy works and I can continue to tolerate it well, then I’ll be very happy. I have to give credit to Tina for making sure I stay hydrated, eat the right things and walk and exercise.

Site Revisions

We now own the domain name, glioblasted.com. It’s just a little easier to type glioblasted.com into a browser  instead of glioblasted.wordpress.com, but either URL will work. To be honest the decision kind of had to do with branding. Since I worked in advertising and web strategy before my cancer, I guess it’s kind of ingrained in me to think like that. One difference is that usually you WANT your site to get lots of page views. In my case it just means way too many people are affected by this horrible cancer.

In the beginning I wasn’t sure what the purpose of this site would be. It’s more clear to me now so I’ve begun to go back and edit some of the pages and posts in an attempt to make it easier for the disturbingly high number of people affected by GBM to distinguish useful information from my introspective ramblings.

Event Update

The event plans for September 21 and 22 in Gadsden are coming along great. Some fantastic sponsors have been very generous, donating venues and services as well as items to auction or raffle off, including: music equipment, artwork, memorabilia, printed t-shirts and more. But the main attraction will probably be the bands that have volunteered to perform and getting to reconnect with old friends and my hometown community to celebrate life.

I’ll post more details soon.

Happy Labor Day weekend!