Long time coming...

So it has been a year since my last post... a very eventful and fruitful year... and one that has by no means been uneventful from a health and growth perspective! I have probably been running away from something; but not exactly sure what. I can share more on that front later, but in the meantime, here is a short update. Last night, my sister told me of a John Piper excerpt called "Don't Waste Your Cancer". Each of the take-aways resonate loudly within me:

1) We waste our cancer if we don't hear in our own groanings the hope-filled labor pains of a fallen world.

2) We waste our cancer if we do not believe it is designed for us by God.

3) We waste our cancer if we believe it is a curse and not a gift.

4) We waste our cancer if we seek comfort from our odds rather than from God.

5) We waste our cancer if we refuse to think about death.

6) We waste our cancer if we think that `beating' cancer means staying alive rather than cherishing Christ.

7) We waste our cancer if we spend too much time reading about cancer and not enough time reading about God.

8) We waste our cancer if we let it drive us into solitude instead of deepen our relationships with manifest affection.

9) We waste our cancer if we grieve as those who have no hope.

10) We waste our cancer if we treat sin as casually as before.

11) We waste our cancer if we fail to use it as a means of witness to the truth and glory of Christ.

A Marriage Journey With Cancer: Stuart and Candace Smartt 2009

IVIg: The more things change, the more they...

OK. So Monday reminded me quite a bit of 'the old days'. We woke before dawn and clumsily headed on the collection of back roads that lead us to Emory Hospital. We were late, which means we valeted. Went to the clinic, signed in, waited among all the sick and their caregivers.

When called back, it was a routine that I had followed countless times. While I was happy to be an outpatient and not checking in for the week, it ended up being a long day.

Check the vitals, weigh in. Get directed to the appropriate bay and chair. Don't forget to grab a hot blanket on the way over to your seat. Wait for the nurse, give your name and birthday to match your wristband and file, confirm why you're there.

Nurse places the IV in your arm. This was the first time I missed having a port.

Pharmacist comes over and offers a tutorial on IVIg. It is given based on body mass. One dose requires literally thousands of blood plasma donors. Not only do they need the diversity of donors, they also need that many to get enough of this stuff for one small dose. My dose is to be 35 grams. Mixed in a 10% solution, that means the bag will be 350ml.

The purpose of IVIg is to give someone a dose of the antibodies that one's own immune system is not producing. For me, I hoped it would mean no more chronic pneumonia and sinus infections, which have been the norm for the past 19 months.

The list of reactions that one can have reminded me of the chemo side effects. Anything from hives to a stroke. I was hoping for an uneventful infusion.

They pre-medicate me with Tylenol and 50mg of Benadryl, to preempt some minor side effects.

The infusion will start at a very slow rate, and then double every 30 minutes. They started. I napped.

I awoke from my nap shaking somewhat violently. Rigors, or severe chills, they are called. The last time I had these, I was in a similar chair, one row over... but that time I was halfway through chemo, neutropenic, battling an undiagnosed staph infection... and closer to death than I've ever been (medically speaking).

When the nurses saw me, three or four of them swooned over me. One of them immediately stopped the IVIG infusion. The other hung a bag of saline to hydrate me. Another walked up with a syringe of an additional 50mg of Benadryl. (If you've had a 50mg bolus of Benadryl pushed into your bloodstream, you'll never forget it. Well, I guess it's more appropriate to say you'll never remember it). Then 25mg of Demerol were pushed into my IV.

OK. Time to float away for a bit. The rigors mitigated in a few minutes. The nurses slowly faded away. After 15 minutes of feeling like Michael Jackson at bedtime, they came back over and re-started the IVIg infusion. They would knock it down to half the rate, and then start back on the same schedule of doubling every 30 minutes.

I made it through the rest of the IVIg dose and, after coming to my senses, I slowly stood up with the help of Candace and headed back for the valet stand.

In all, it was about a 6 hour 'episode'. Despite thinking I would be doing back flips on my way out that day, reality was a bit different. Since then, I've had some unenjoyable side effects, mainly fatigue, flu-like aches, headaches, dizziness. I missed a little work today to come home and rest.

I suppose we will see where this goes, but I'm scheduled to have five more rounds of IVIg- once each month.

Part of life is inevitably living through bouts of ill health. While I had expected to be more or less 'done' with cancer 20 months ago for good, I suppose cancer's 'collateral damage' is something that is still supposed to be part of my daily life. More to come when this plays out... I don't know what to expect next!

Anything worth doing is worth re-doing...

I'm staring out the window at about 5 inches of fresh powder, capped off with a sheet of ice. We in Atlanta are paralyzed by the weather -- trapped in our homes-- so what better time to blog.

So my oncolgist at Vanderbilt who decided to do those 'new' tests over the Holdiay sent the results to my hem-onc here in Atlanta. When they saw this info, the folks here at Emory decided to re-do the same test in their lab.

I went in on Friday to bleed yet again into a number of tubes. The test results will come in any day now. The logic, I am told, is that they need to have a baseline in their labs if I am to start IVIG treatment under my care team here.

They confirmed that if the IgG levels are low (they tend NOT to fluctuate, so we expect they will still be low), they will then make a case to insurnace to cover the treatments. Apparently this is normal for such procedures.

Since the average IVIG patient costs $120,000/year, I am sure my insurance carrier will be thrilled to see little ol' me asking for them to spend even more on my care. I bet they thought they were done with me and were only having to pay for 4 CTs, labs, doc visits, etc. per year at this point.

The most common blood cancer patients that end up neeing IVIG infusions are the chronic leukemias (CLL) and some of the follicular (slow-growing) lymphomas. It is rare that a patient such as me with an aggressive lymphoma would need IVIG.

So far, everything has been flawless with respect to my healthcare coverage, so I expect no less this time. I am a huge fan of health insurance, disability policies, and life insurance so if you want to talk about any of these, just email me.

They would concur that six months of infusions would be appropriate, proir to a remeasurement of my levels. All of the infusions would be outpatient. Awesome. And, unlike the chemo, these would be infusions that would theoretically help me feel better as opposed to feeling worse...so I am giddy at the thought.

OK- back to staring at the beautiful white landscape: we don't get this treat too often.

19 months out... and the battle continues

A quick recap: I had pneumonia in October and took an antibiotic for two weeks to address it. I slowly improved, but never really seemed to regain my energy. I got to 80% -- but never in range of 100%. This pneumonia came on the heels of chronic sinus infections and just an overall lack of feeling 'normal' for quite some time in 2009 and 2010.

On a Wednesday in mid-December, I woke with an acute achiness in my legs. While foot and leg pain is something that I've felt at some level every single day since chemo, this time it was very painful. I ached very intensely, deep within the core of my legs.

Things got worse as I felt more fatigued, got a bad cough, more congestion, and eventually decided that we had to see a doctor. Since it was a Saturday that I made this decision, we ventured to an urgent care clinic near our home. In the waiting room were half a dozen children between the ages of 4 and 6, looking like they had the stomach bug or strep throat... and me.

After the doc listened to my lungs, looked in my throat, & took an x-ray, he congratulated me on having penumonia again. This was 2 times in three months. Geesh. I told him that I have historically responded well in these circumstances to the antibiotic Clindamycin. He wrote me a script for that, as well as Lortab for my leg pain and sent us on our way.

As a side note, I've been told that pain medication is the only remedy for my foot and leg pain. I don't take these meds because they seem to give me a headache and make me loopy, and not really eliminating the foot pain. That's a poor trade-off in my book, so I wasn't really thrilled about his solution to the chronic foot pain.

So I took the antibiotic and waited for Christmas to arrive. While in Nashville visiting my family, I went to have a consultation with my oncologist at Vanderbilt-- the one who I met with two years ago just after my appendectomy and initial diagnosis, who insisted on additional testing... and ultimately saved my life by getting me on the right treatment path.

He is a great doctor: full of smiles, a gregarious spirit and deeply engaging. Upon entering the room, I promptly gave him a big hug. A small consolation for someone who saved this life. It was the least I could do.

Well after a good half-hour of listening to my post-chemo experiences, interspersed with him asking questions of clarification along the way, he offered some very good insight.

Before he began, he reminded us that aggressive Lymphomas, if they do relaps, do so "early and obviously". In other words, he did not think that I was showing signs of a relapse this many months out.

He asked if my foot pain was getting in the way of 'normal, everyday life'. "Yes, it is," Candace replied. She has a better perspective on this, so having her voice on these matters was essential. Sometimes I tend to gloss over things, minimize their severity... to round up. His response was that we should try Gabapentin (Neurontin). This is a seizure medicine that has an off-label use for nerve pain often endured by diabetics.

We would start on the lowest dose and see what happened. I am on day 3 of this medicine and will keep you posted on its efficacy. I am very excited that there may be a world without this chronic foot pain!

Secondly, he said that my chronic sinusitis and recurring pneumonia made him think there was something systemically wrong with my immune system. While my overall white blood count have been acceptable, there any many subsets of white blood cells that can be measured and have unique roles and responsibilies.

(As a reminder, my Lymphoma was a cancer of the "B" white blood cells, which are an essential agent in ones immune system.)

One of the chemo drugs -- Rituxan-- specifically targets these white blood cells, so that they can be killed during the chemo protocol. The problem, however, is that Rituxan can linger around in ones system as long as 18+ months after administration. Additionally, it causes harm to some specific parts of the immune system that may not be able to recover until it has completely left the bloodstream.

He suggested we run some targeted lab tests and also get a CT of my sinuses in case there was something structurally wrong. They took 10 viles of my blood and sent me to get the scan.

On my drive home from the hospital, he called to tell me that, while the scan looked ok, the lab results indicated my Immunoglobulin G (IgG) levels were 286, though the low end of average was 700. (Immunoglobulins, which are protein molecules that contain antibody activity, are produced by B-white blood cells, which you now know were the cells affected by my cancer.) Insufficient levels of IgG make one prone to... wait for it... respiratory infections-- e.g. pneumonia and sinusitis! This has been my 'norm' for 19 months!

Ironically, while my cancer was characterized by pathologically excessive production of white blood cells, this was now a situation of aberrantly low production of healthy cells.

The solution? He recommended that I get 6 months of IVIG (Intravenous Immunoglobulin) infusions. I will get a 'boost' of the very cells that the chemo has depleted. In 6 months, we will re-test and see if my body is better able to make these infection-fighting molecules on its own. (IgG can be obtained from plasma of other people. I am informed that it is in very tight supply nationally, and each transfusion includes the IgG of over 1,000 donors!)

The oncologist mentioned that insurance companies often do not cover these infusions and they are very costly (over $10k per dose). After consulting my oncologist here in Atlanta, we will make a case on why this is an appropriate treatment and see what happens.

Though we are still waiting for the rest of the lab results, this preliminary indication is very helpful. I'm grateful that this doctor listened and was able to shed some very valuable insight into my post-chemo journey.

Having an 'immunodeficiency disorder' is not typically something to celebrate, but I am thrilled that we are getting smarter each day as we continue to fight against cancer and the collateral damage that it brings.

More to come in the weeks ahead-- but for now: Merry Christmas, Happy New Year, and all praise be to Christ Jesus for all He has done and continues to do for little ol' me!

16 months out: a net positive

Got my umpteenth CT scan (something like 10 of them thus far) last week as a normal course of post-chemo follow-up rhythm. Met with the Oncologist yesterday-- and got a clean report from a cancer perspective, but they did see a 'pulmonary nodule' which they suspect is pneumonia. They think it may be fungal pneumonia, but I am told by the oncologist that a CT scan doesn't provide enough info to call it fungal vs. bacterial.

Nonetheless, I feel like a pile of rocks and am taking the day at home to rest. I've coughed up some sludge that would be offensive to share via photo, so consider yourself spared.

I've felt achy for about 10 days now, and was starting to worry that something was wrong-- which seems to be a common theme coming into a scan milestone. Now at least we have identified the reason I don't feel good-- and it's NOT cancer!

Also of note was that I had my (second) chest port removed about 3 weeks ago. It was a great process, except when they were drawing labs prior to the operation they hit a nerve in my elbow. It lit me up light a light pole! Getting some residual zingers down my forearm, but I am told it will slowly heal. Matching port scars in my chest looks quite nice, and it'll just have to be my version of getting tattoos.

I am continually grateful to be healed of this illness. As you know, I have connected with a handful of Burkitt's patients over the past year or so and have been keeping in touch with people as they go through their journey. One of these young people I've come across, Brian Howell, died recently. He was mid-way through treatment, and things just started to fall apart, one by one. His wife Hayley is just trying to get through her days, without her beloved-- trying to re-learn how to spend her days and keep things afloat.

God's grace is all we have, and thankfully it's never-ending. Lord have mercy on us all.

1 year out: A CLEAN report!

Had my CT scan last week (I think this makes 9 scans in two years) and got the results two days ago: No signs of lymphoma...still!

Passing this one year-mark is not just a convenient anniversary, but it also carries some clinical significance in that most people who end up relapsing do so in the first two years, and so I am more than halfway through that zone.

Even better, my labs look good! I am at the low end of 'normal' for all the areas that were damaged during chemo (namely white blood cells, hematocrit, hemoglobin, platelets). Not only am I feeling more normal, I'm also starting to ressemble one on paper.

What does this mean? Well I am planning to get my chest port out at the end of the summer and will need CTs once every 4 months, as opposed to 3. A small, but meaningful, improvement in hospital visits and incremental radiation.

I met a few weeks back with the neurosurgeon who installed my brain reservoir and he said there is more risk in pulling it out than leaving it in. He said I can get brain hemorrhaging or menengitis... so why risk it. For now, and as long as I have hair-- I'm indifferent. I don't mind a permanent reminder here and there.

It's all good on this end... thank you, thank you.

9 months out: A clean report

So Dr. Flowers (I can no longer associate him with Tiger -- oh, how much has changed) came in and cut right to the chase. "Your scan looked good," he said, with his borderline awkward indifference and focus-less stare.

Wooo hooo.

At this point, my platelets are a little lower than yours, but they are not low enough to worry. Hope I don't cut my knee on the playground this weekend.

Otherwise, my liver, kidney, red blood, yadda yadda yadda function all look good.

He said I can meet with the neurosurgeon about getting my USB port out of my skull. No more awkward cowlick.

I celebrated with... you guessed it: fish tacos. Well, I did a pre and post celebration, both with fish tacos. An addict, I admit.

After getting the good report, I walked across the street to the main hospital where I spent my 45+ nights over 8 rounds of chemo. I sat with my buddy Khadar Hassan, who I came to meet right after he was diagnosed with Burkitt's. He is 22 and from Somalia.

This guy is a fighter. Like me, he got a nasty Staph infection during treatment, coincidentally also after his 4th round of chemo. Though I was in the hospital for a week getting pumped up on antibiotics, getting my port ripped out, having blood cultures and a 104+ fever, he was in for two.

They got the MRSA under control, and started round 5 today. What a fighter.

While I am honored to be on the back side of such a hard fight, I don't stray too far from what it's like to be in the bed, flat out on my back, getting pumped full of toxins.

Khadar is in the thick of it, and I yearn to walk through that valley with him in whatever way I can.

I also met an 18-year old named Austin Saunders in the clinic who was laid out on a bench with a pillow over his head. An anxious woman sat beside him, rubbing her bloodshot eyes.

"Lumbar puncture?", I inquired.

"Yes," she murmured softly. "He has a rare non-Hodgkins Lymphoma and just started chemo last week."

My heart sank. That was me! The very same thing! Laid out, miserable, ready to give up, though things had only just begun. I was right there on that bench beside him, in my heart.

Poor kid was throwing up every 3 minutes. I am that kid.

I made every effort to console Mom and tell her some lessons learned from the road I had ventured only twelve months prior. I jotted down my contact info and offered prayer and whatever practical support I can provide. I sure hope they call.

Lately, I am playing tennis, exercising, eating well, and joyfully employed. God is so merciful.

Lord, please don't let me forget that I am one breath away from being on the other side of this thin veil of good health. Oh, my.

Daily bread.

I am prone to spend more time worrying about the future than I should. If I really do trust that Jesus is Lord over my life, has conquered death and all fear, then what's the hold up?

A thought came to me this week about the concept of daily bread. We are instructed to ask God for our daily bread. Manna was gathered up daily, for that day only. Any 'extra' provisions would go bad and ultimately become useless.

So if each morning, before I roll out of bed, I ask myself, "Do I have enough to get through the day?"

"Do I have what I need to make it until I return back to this very same bed, at the end of the day?"

The answer is simple. It's 'yes'. It has been 'yes' every day thus far in my life. The answer this morning, was also 'yes'. Tomorrow? Well, I'll know come tomorrow morning what the answer is, but I am fairly certain the answer will continue to be... 'yes'.

As I consider only the very day in front of me, I need not worry about having enough bread for future days. Of course this doesn't mean I am to squander all that I steward in a profligate way. Rather, it simply means that I need not have fear, anxiety, concern or worry about whether the bread will last beyond today and today alone.

The Lord has promised to be faithful in giving us our daily bread, and so I'm not going to keep doing my best to ignore this promise in worrying about some distant day that may never come.

I'm a 'yes' today. I'll get to tomorrow when it gets to me.

Four months, to the day: that should be enough of a hiatus

So, at the nudging of my wife, Candace, I am going to fire the blog entries back up. I had felt for quite some time that this blog would be limited to my experiences with and during Cancer, but it seems that my short-term memory isn't conducive to living life completely apart from some sort of chronicle.

Too, I suppose that every part of my life in some direct or indirect way really is connected to this life-altering (and sometimes ending) illness. My prior life was B.C. where the 'C' stands for Cancer, of course.

What's more, in one of our perennial Spring cleanings, I stubled across a sprial notebook that appeared to have been collecting dust for decades. Sure enough, it was (one of) my previous attemtps to white-knuckle a regular and consitent journal. As with every other attempt before and after, it devolved into one or two daily entries and then hundreds of empty, unmarked sheets follwing it... with nothing noted, nothing remarked upon.

It seems as though there was something magical (that's probably not the best word) about the days leading up to the sole journal entry in this notebook, but it was nonethless life-changing for a 7th grader. I will dig it up and post it, verbatim, at a later date... if nothing more than for your pure entertainment. (Turns out that, if you get past all the melodrama, even pre-teens can have some pretty profound thoughts.)

Getting to the point, it was a reminder that we go though all kinds of experiences, both the meaningful and mundane, and if we do not stop to reflect on them, they can easily be integrated into who we become without a trace.

That's me. That's what I'm good at. Ask me about pretty much any part of the last 32 years, and I can't tell you much. Weak! But in spite of this dearth of communicable information, I am unavoidably the sum total of every single experience up until this very moment.

So firing back up this blog is my puny effort to memorialize life as it happens. I will do my best to spare you the details of what I eat for breakfast or what my cat does, that is, unless he demonstrates more acts of genius as he sometimes does.

I can think of a few things that have already happened in the prior four months that are noteworthy... namely being convinced of a relapse, some lingering medical anomalies, baby steps to physical recovery, ongoing fertility challenges, a faith-fortifying trip and a few really amazing fish tacos. Oh, wait... no meal-centric blogs. Sorry.

If you (anyone) in cyberspace ends up taking a read, thank you. If not, this will be fodder for my descendants one day, at a minimum.

Video - Stuart and Candace 2009: A Journey

CLICK HERE TO SEE VIDEO IN YOUTUBE



So when my best friend turned 40 this weekend, he had a great big party. It was amazing. It was a talent show, whereby all his friends would get up in front of the crowd about nearly 100 people and perform a song, video, dance, skit, act, or otherwise unique talent. The cake, the people, the food, the event-- everything was just delightful.

Well, toward the end of the party, I was caught completely off guard when the next video in the lineup started with my name on the screen... and a comment about my cancer.

Then, as I realized what was happening, my whole body went numb. And has been numb ever since. I've been at a loss for words to fully describe just how special this reverse-gift was to me. I had been tricked. They had taken all the chemo video footage, which I had never seen, and put together a chronicle of the entire experience.

What's more, they included some footage of our wedding day over six years ago. I have never seen video from our wedding -- so it was like getting married all over again. I melted when I saw Candace's expression as she walked down the aisle, with her late father.

So why would someone take a milestone birthday party in their honor, and devote all of their precious time preparing a gift for someone else at the party? I just don't understand this kind of selflessness.

This video manages to capture an entire year of emotion and healing in one sitting. I have lost count of the number of times I have watched it.

Shane and Kelle, you two are most thoughtful and dear to me and my wife. I love you so much.

I'm posting below my wife's response to this video, as it captures what my numbness has thus far precluded me from being able to articulate:

"It is 2 am and we just watched the video for the 5th time. We have cried and laughed and kissed and hugged. We are in awe...we keep saying, "I just can't believe it....I can't believe all this is on this video".

There are so many emotions - I can't even process them all now.

When you walk through something hard, you just walk through it. But, when you have a chance like this to go back and revisit that hard time - it takes your breath away.

How did we do that? How did we get through it?

The video did a beautiful job of answering that question.

God, family, friends, some tears and some laughter and our love for each other.

And then our wedding... wow. I think I was the happiest girl in the WHOLE WORLD! You can see it on my face.

And my dad - right there...walking, touching me, smiling. I crave so much to remember him - his walk, his smile, his sweetness. You gave me that tonight.

There are no words.

This is THE BEST gift anyone has EVER given us. EVER. There is no way we could ever outdo this one.

It has been a very sad week for us. Shoot - it's been a sad couple of months. I have felt forgotten by God...confused by Him...unsure of Who He is and why things happen...I have not felt him close in a while. But tonight - this video - reminded me.

It reminded me that He is close and He has a purpose and He is weaving a beautiful tapestry, a story of the Smartt's, that no one could ever imagine in their wildest dreams.

It reminded me that His glory and good will come out of all things.

I needed that. This filled a place in me that was very empty.

Thank you. Thank you. Thank you....a million thank you's...

And all this on at YOUR birthday party.

We love you crazy Ortizs.
You bring life to us.
Thanks for being our friends and thanks for one great party."

It has been a year...

Today is the day... one year ago. Whew. We made it!

It's a good thing that we can't see into the future of our lives, otherwise we'd be left to process -- all at once -- the joy and anxiety of everything. What a waste that would be! No, thanks. I'm happy with the day-by-day approach. (I say this as if I have a choice...)

Yet I don't feel great, I do feel gooooood enough. And for thank I am so thankful. Many, many days in the last year were pretty rough, as you know.

I'm having a challenging time doing this 'reflection' that I had hoped to do. Perhaps it's the steroid I'm on? Either way, the impact is still a story unfolding as we go.

I confess that I did honk aggressively at someone on my hour-long drive home today (for blocking traffic while they made a left-hand turn out of the far right-hand lane!). That's the barometer: I must be hardening up formidably. Dang it.

But tomorrow I will go to Emory to get my port flushed, and I hope to be reminded of my parole status once again so I can shed a layer or two of this hardness in the process. Such a predicable creature, I am.

My friend is putting some chemo video footage together that I hope to post to this site. I will be the pale, puffy one you see.

Well thanks for hanging with me this past year. Whether you've read this site once or weekly, I am honored that you shared it with me.

I felt lifted up and supported by so many.

Thank you so kindly.

ENT, BKO, and 1YR...

Had a visit to an ENT yesterday at Emory to further diagnose my chronic sinusitis (Oto-rhino-laryngologist). I must admit, I don't really enjoy seeing cross-section diagrams of what's anatomically going on inside one's throat and head. Seeing all the cavaties and tissues and bones kinda weirds me out.

Nonetheless, I had to be there. I sat in the chair for quite somet time awaiting the ENT doc. When he came in, he immediately started grabbing 'tools' out of his drawer and throwing them onto the counter - one by one. No room for chit-chat here. Even though there was no real bed in the room, his bedside manner was lacking.

He probed some metallic holepuncher-looking device into each ear and made a 'hmmpf' sound. Then grabbed my tongue with gauze and stuck a mirror to the back of my throat. 'Say ahhh.' I tried, but gagged. He commented on how I had a sensitive gag reflex. Thanks, doc. Could've told you that.

Then he fired up an electronic machine and said he would spray something up each nostril to numb it. And that it does not taste good. Felt like someone blowing up each nostril with chemical-breath.

Then he said he was going to take a look. Jammed some sort of little camera up there on a flexible line. Geesh. 'Hang with me, hang with me. A little swollen in there,' he said. The sensation was... unenjoyable.

So he said I needed more antibiotics, this time to be combined with a steriod. Only then would he know if I needed surgery. Keep in mind that I've already been on three rounds of antibiotics for this... so this will make four. Given that I have some side effects from the steroid used during the chemo, hearing this prescription made me ancy. MORE pills? MORE drugs? Hmmmm. I dunno.

I am supposed to take three weeks of Augmentin (AMOX/CLAV) coupled with a round of Prednisone and then return for my zillionth scan.

Trying to keep a positive attitude on things... but as you may be able to tell, I'm pretty much ready to be done with this!

'BKO'... My employer is in Ch. 11 bankruptcy, still, but fortunately there's no additional drama to report on this front. I marvel daily that I have a job at all, given the 17.5% unemployment/underemployment rate. WOW.

Tomorrow is the one-year anniversary of this roller-coaster. It was Nov 12th, 2008 that it all started... the stomach pains, the emergency appendectomy, the diagnosis, the re-diagnosis, the chemo...

It's a year that has flown by, nevertheless. I am compelled to reflect on the past twelve months -- and see if I'm able to assess just how I feel about it, and how it has affected me and how I view life, faith, and the world around me. I'm not naturally prone to do so, so I will force myself in the coming days!

Projectile...vomiting?

So *that's* what they mean by this choice of words.

I got hit hard around 9pm last night with some projectile vomiting and relentless diarrhea (sorry if that's not PC). I had just downed a nice dinner and come home, when it all came back up. (Any chance I can petition for a refund?) And I mean ALL of it-- lunch, too. It was a long night- marked by fevers, bathroom trips, tossing and turning. $40 bucks... down the toilet. Literally.

For obvious reasons, I stayed home from work today. Been laid out on my back all day long. Brought back memories of chemo life.

Tried to nibble on a piece of toast -- bad idea. Bouts of vomiting were almost instantaneous. I did manage to pull off a deft move whereby the vomit was mid-air over our carpet and I grabbed the trash can and caught it just before things got completely ruined. I have lost 6 lbs in the past 24 hours. Who knew weight loss was this effortless!

I will say this: despite this being no fun whatsoever, it sure does beat a normal day during chemo. Allllll relative, my friend!

My employer is now officially in Ch 11 bankruptcy. TIme will tell what this will eventually mean, but for now -- I am still employed!

2009... who could've predicted the excitement!!

Watching game 6 of the World Series through one eye... while I nap with the other... lovely evening!

A camera-shy cat...

So whenever the camera is off, Dude acts in his normal, peculiar ways. But when it's action time and the camera is rolling, he pretends he's a normal cat. Still trying to capture him doing his quirky things. By the way, ever notice how many cat videos there are on YouTube... and better yet, how each of them seem to have millions and millions of views? Huh.

I am feeing pretty good! About 80-90%, I'd say!

The nerve pain in my feet is slowly improving... and I even spontaneously jogged across the church parking lot today when two little girls were chasing me down. It was epic, relatively speaking.

The docs put me on an antibiotic called Omnicef for 21 days, as well as the steroid nasal spray Flonase, to see if that clears up my sinusitis. Things are better, but far from fixed. Same with bowel problems... gotta diagnose that one further. We've been trying to experiment by removing dairy and/or gluten from the diet, but that's HARD to do!

THANK YOU for checking in!

A clean scan! Three months down...hopefully a long lifetime to go...

Just back from my doctor's appointment at Emory. The CT scan shows no signs of recurrence of the cancer. Candace and I are elated!

The good news doesn't stop there: my white blood count (my immune system), which had been at 1.7 and then 2.0, jumped all the way to 7.4! The normal range is 4.2 to 9.1, so I am smack-dab in the thick of it. While my platelets dropped a little, they are not in the critical zone and this type of drop is less of a concern than my whites. Other counts looked great: Hematocrit (46.7%), Hemoglobin (16.5), RBC count (5.04).

I'm going to get scanned in three more months, and hope for the same result. In the meantime, I have to get a CT scan of my sinuses this Friday, as I've had chronic sinusitis for several months now. I will see an ENT doc to try to figure out what's going on. Since my bowels have been a bit unpredictable (read: irregular and irritable), I am probably going to have to see a GI doc. The sinus and bowel 'problems' are minimal in comparison to the good news related to recurrence and white blood counts!

God has carried me through some fearful nights this past week. All the scenarios running through my head of a possible relapse were playing like a double-feature in my head. At one point, I even remarked that this post-chemo period has been more challenging from a fear and trust perspective, as one fully expects to feel crummy during chemo... but not for months and months after the chemo has ended.

I walked the Light the Night event this past saturday and, of course, didn't take a camera. My feet were burning in pain, but I completed the entire 2-mile walk and enjoyed it thoroughly. Each person was a given a colored balloon: Red for family/supporters, white for patients/survivors, and gold for a lost loved one. There was a sea of red balloons, a few white ones, and many gold ones. Lots of people don't make it. Like Richard. I walked with him in mind, and his name written in marker on my shirt. It was a moving event.

My employer is still on the verge of a major restructuring, or bankruptcy. This is great news. Why? Because coming 'back' to work has been such a nice thing, given the temporary holding pattern we're in. Whenever I feel unproductive or like I'm not 'where I need to be in life', I am reminded that there could've been NO BETTER TIME IN MY LIFE, or even the series of world events, for me to go through chemo and recovery.

The opportunity to see the 'good' coming out of this, and the invitation to give all glory to our God, abounds at every single turn in the road. I am so, so grateful.

Next post to include a Dude (cat) video. He is working on a trick that he wants to share with you.

CT Scan, a new friend with Lymphoma, and a smart cat...

So I had my three-month scan today. Not a PET/CT, but a standalone CT that covered my skull, neck, chest, abdomen, and thighs. I had the tasty two bottles of barium contrast, and also got the IV contrast this time -- which was a first. When you're in the middle of the scan and they inject the IV contrast, it sends a burning hot sensation up your arm, and then into you chest and abdomen. At one point, I thought I had gone to the bathroom on myself, but fortunately it ended up being just a mixed signal to the brain somehow.

The scan results are in, but I won't know them until I sit down with 'Tiger MD' next Wednesday morning. Why rush it? Won't change 'em...

On a less enjoyable note, some close friends introduced me last night to a guy who was just diagnosed with Lymphoma. After speaking with him for what will be the first of many, many conversations to come, I hung up feeling a tinge of anxiety. It was almost as if I was reliving the uncertainty that comes with this sort of life-changing new information. He, like me, is in his 30s, lives in Atlanta, is married and has no children at this point.

I asked him to read me the details of his pathology report. He has been diagnosed with the same Lymphoma as I was initially diagnosed- diffuse large b-cell. Similarly, two oncologists told him to get started with R-CHOP. When he read that his Ki-67 stain, a measure of the proliferative rate of cancer, approached 100%, I insisted that he ask his docs to tell him why he DOESN'T have Burkitt's. For me, the corrected re-diagnosis to Burkitt's from a plain vanilla diffuse large b-stell was only possible after additional testing was pursued. I am very curious if they will request that same additional testing in order to rule out -- or in -- Burkitt's While I certainly hope it's not Burkitt's and that he is able to pursue the less toxic chemo, it will be quite ironic if his experience parallels my own in this aspect. I'll keep current with him, without a doubt.

On a final note, I am very fond of cats. Probably borderline 'cat whisperer'. I try to sweet-talk stranger cats I meet on neighborhood walks, and tend to take pause and consider what to do when I see a mangey dumpster stray scurrying about. So we have two cats-- Dude and (Fat) Mama. Dude is a very needy and loving cat. He meets you at the door, follows you around the house, and insists on nibbling on your ear when you are seated.

I rarely lose my keys. I tend to put them in the same place on the countertop every time I come home. Last week, I had a problem: I lost my keys. How was this possible? I looked in all the likely places, but had no success in finding them. After starting to wonder how in the world I'd find my way out of the predicament, I looked over at Dude, who was sitting still, watching my fruitless search.

I inquired aloud, "Dude! I've gotta find my keys!!"

Though he normally doesn't meow excessively, he let out a long, awkward, labored cry. "Merrreeoooowwwwoooowwwoww."

As he let out this protracted sound, he walked a few steps across the room and rubbed his body against a bag of dog wee-pads (don't ask) that was opened and mostly full. My eyes, as they made contact with his, saw a slight metallic reflection nearby, peeking out from in between these pads--- IN this bag.

Of course. He was showing me where the keys were. He had known all along where they had fallen, out of my pocket several hours earlier that day.

I had to take pictures to prove it -- because it was certainly absurd. Even better, my wife Candace witnessed the entire episode. See the keys hiding in there??? Thanks, Dude!

Counts are... sideways with an uptick!

Just got back from Emory where they drew more blood and ran some tests. The white count is now 2.0, up from 1.7.

The upward direction is good news, but they are still low enough to watch a bit more closely. I will get word from the doctor on Monday regarding how he wants to approach things.

I am grateful for so much. I am saying that mostly to remind myself of this. How easy it is to be at '80%', and focus on all the things you're missing out on within that last remaining 20%. Why can't I focus on all the amazing improvements captured in that 80% and just let the 20% come when it will? I'll try to do so.

My wife is soooooo beautiful. I am a lucky man.

Counts are down...

My bloodwork this week revealed that my white blood cells, i.e. my immune system, is low. In fact, it's unfortunately in the 'critical' range (1.7 vs. 4.0 the last time I was tested). This isn't a good thing, especially since they were trending upward since chemo ended.

They suspect I have a virus of some sort, but are going to see if my body can fend for itself.

I am scheduled to go back in for more testing next Friday.

Getting this news, coincident with Richard dying, has left me a little numb. But I strive to lean even harder on the peace that is present, abundant, and available to all of us through the overwhelming love and tender care from God Himself.

A loss.

My friend Richard died today.

He and I met while we were getting the chemo at the same time from the same doctor for the same cancer at the same hospital. He and I shared stories... both good and bad... that only someone going through the same circumstance could appreciate. He and I are the same age, as well.

I was actually across the street at Emory getting blood work today when he died. His father called me right after he died and told me that Richard had been doing well, but all of the sudden, the cancer took over and consumed his bloodstream. It only took a couple of days for the wheels to fall completely off the situation.

While I knew all along that this cancer could and can kill me, it had not really hit home until today, right now. There is something impossible to explain about all of this. It's like going down in a plane crash, whereby one person lives and the person sitting in the seat right next to them doesn't make it. I really can't make sense of it.

On Day 99 of my blog (April 6), Richard left a very kind comment that I will cherish for years. His screen name is "BlackGTO" in case you care to go read it

He wrote, "Maybe at some time in the future we'll be in at the same time, and I'll be able to stop in and say hello, or walk a lap or two with you. Without your knowing it, you and your wife's faith have helped me beyond words, my friend."

I felt honored when he wrote this. Now that I see the wake of his death, I am even more honored to have met him and shared this part of our lives together.

Here are some photos of Richard. One right when his hair started to fall out, and the other showing off his brain port scar. God bless Richard's family. I take comfort in knowing that Richard loved the Lord and is in His arms this very moment.