My Decision AndWhy I Made It

After my last visit to the surgeon, I was left with a very difficult decision to make. Go immediately to surgery or wait two weeks to see an Oncologist who might recommend tacking on chemo and radiation treatments.

The benefit of adding on radiation and chemo before the surgery is that it shrinks the tumor and and may mean less radical surgery (ie only removing half my esophagus along with half my stomach). Survival rates for those who have radiation, plus chemo plus surgery are slightly higher than for surgery alone. However, I would have to wait up to two weeks for the appointment and this approach damages my immune system.

The benefit of going with surgery alone is that it will be over quickly (if you can call two months in recovery quick); the survival rates, for the stage of cancer I have, aren't much less than for those who opt for the addition of three months of chemo and radiation. But it will mean removing all my esophagus and rebuilding it with half my stomach. However, it will leave my immune system in tact.

I was given two days to decide.

Although this is an aggressive cancer and Linda's first impulse (like that of the majority of bloggers comments I received) was to just get it out of me as quickly as possible, I decided to wait to see the Oncologist first.

A risk, I know, but everything to do with this disease is a risk. However, I intend to survive this and so I have to balance the quality of life I will have after treatment against the slightly increased risk of waiting to see the oncologist.

With chemo and radiation there is even a chance that this alone will eliminate the cancer and I might not require surgery at all. But even if I still do need surgery, it will be less radical.

Of course the wait could kill me. So trust me, a lot of thought went into this. I consulted with my family doctor who recommended waiting to talk to the oncologist. My sister-in-law is a nurse and she discussed my situation with one of her doctors, who is the brother of one of the most respected Oncologists in the States, who sent his brother a copy of my blog to describe the situation. His brother said I definitely should wait to discuss this with an oncologist.

Friends have also put me in touch with two people who are also fighting the same disease, and both recommended chemo and radiation.

Chemo is no longer as harsh as it once was. I won't loose my hair (what little I have) and the impact on the immune system is no longer as great.

If I have the chance to keep my digestive system in tact, I'm going to take it.

I've also decided to have a procedure next week to widen the closure in my throat to make it easier to swallow food. It is day surgery under a general anesthetic but it will improve the quality of my life while I wait for chemo to do its thing.

Although another unhappy wrinkle in this grand scheme is that the Oncologist could decide I'm not a good candidate for chemo or radiation and recommend going back for surgery. In which case I will have waited two weeks for nothing.

Decisions are never easy, but this one was the worst.

It was my call and I hope I got it right.

Lindsay Thinks Differently

Like all dogs, Lindsay is a creature of habit. She is acutely aware of life's routines and feels most comfortable deep within them.

But she's adaptable to change and life in her home has changed considerably over the past month. She can no longer predict when her parents will be going to work or staying home. She can no longer predict their mood. She can no longer predict the days when it will just be the three of them sitting at home in the evening. People seem to be coming and going at a rate she has never seen before.

She can never predict when she will be taken for a long run along the bluffs and when she will just be gong for a short walk through the neighbourhood.

And the normal smells of cooking are becoming a thing of the distant past. She can no longer remember the last time she smelled a steak cooking. Or even a hamburger. All meals now seem to consist of soup.

The phone never seems to stop ringing, tying her mom up in long and quiet conversations. Conversations that have their share of laughter but also, when her dad isn't home, often bring her mom to tears.

And she has never seen her dad gagging and throwing up before as he struggles to keep the most bland liquids down.

It worries her, this sudden change within her home, within her life, within the adults she loves and wants to protect.

So she has started to do some very unLindsay-like things.

She has never been a lap dog. She is too big to fit on anyone's lap and it just isn't in her nature to want too much cuddling and petting. Playing is more her thing.

But she has taken to hopping up on the couch beside her dad and resting her head in his lap. She sits and watches him as he sleeps, her face inches away from his own. And when he wakes she reaches out her tongue and licks his nose with great tenderness.

Until he bellows, "UGH! Lins what are you doing, girl! Yipes, stop that."

At night she has always slept on the floor at the foot of their bed, but now she lays through the night on the floor beside her dad, so that when he wakes up in the morning he has to avoid accidentally stepping on her, not being used to finding her there.

Lindsay isn't certain what's going on.

But it does seem to mean that her dad is home now much more than he used to be and he takes her for even more runs than he used to.

So it isn't all bad. And a dog has change her thinking and learn to adapt.

Answers (Part 2) And A Big New Question

I'm finally back from Centenary Hospital with some "good" news and a dilemma.

The good news is that the cancer has not spread and is still localized in my esophagus. My lungs are clear, my Lymph Glands are clear, my liver is a thing of beauty. The Cancer is a stage 1 or (at worst) stage 2a out of four. The Surgeon will have to spend more time with the CT Scan results to be sure.

The dilemma is that, because it isn't as severe as they originally feared, I now have the option of going straight ahead with surgery immediately instead of going through chemo and radiation and then the Surgery. Surgery alone will involve 2 months off work, the addition of chemo and radiation would involve a further 3 months off.

The benefit of adding on radiation and chemo before the surgery is that it shrinks the tumor and and may mean less radical surgery (ie only removing half my esophagus along with half my stomach). Survival rates for those who have radiation, plus chemo plus surgery are higher than for surgery alone. However, this approach destroys my immune system.

The benefit of just going with surgery alone is that it will be over quickly (if you can call two months quick); the survival rates, for the stage of cancer I have, aren't much less than for those who opt for the addition of three months of chemo and radiation. But it will mean removing all my esophagus and rebuilding it with half my stomach. However, it will leave my immune system in tact.

I have two days to decide or the Surgeon will be referring me to an Oncologist at Princes Margaret Hospital, because this is an aggressive cancer and he can't wait around for a decision. So I need to make my mind up before Wednesday.

Reading between the lines of our talk, the surgeon seemed to be opting for going straight to surgery (but then he is a surgeon).

Decisions. Decisions.

And not one I want to get wrong.

Some Answers

I never use an alarm clock to wake up in the morning. But I did today.

I have no trouble waking up in the mornings. But I did today.

Good job Linda insisted on setting the alarm anyway, although it took both of us pouring over the bedroom clock before we figured out how the alarm was set.

I can have no food or drink this morning before we leave for the hospital at 6:30. Outside an icy cold spring rain hits the window with the scratchy sound of sleet. Snow was predicted and the roads may be slick and hiding dangerous patches of black ice.

At the hospital I will be having a CT scan and then going immediately to the surgeon's office, where he will call up the results on his computer and, together with the results of the other tests I've been having, put together a treatment plan.

Whatever the results, whatever the plan, today will be life changing.
************************************************************

Water

It began with water, it ended with water. It was raining when I awoke on Friday morning and it was raining when I went to bed at night. By four o'clock in the afternoon it had reached the highest measurable rainfall for the day and kept right on going.

By this morning the super saturated ground could take no more and ponds began to form in my back yard. If it keeps on going, by tomorrow I may take out my rod and reel and do a little trout fishing from my deck!

I got soaked taking Lindsay for her morning run and had to completely change my clothes to go to work. I got soaked running from the car park to the GO train for the morning commute, the sharp new crease in my pants washed away by the deluge.

I was Baptized yesterday by nature and I was Baptized by man--or, at least, by wife.

The best friend of a teacher at Linda's school had taken her arthritic mother to Lourdes hoping for a miracle to ease her mother's pain. This being the modern electronic age that it is, the teacher and her friend kept in touch through twitter. And through Twitter the conversation turned to me.

Or at least to Linda. The teacher told her friend that a fellow teacher had just learned her husband had cancer and the entire staff are just devastated. She asked if the friend could bring some Holy Water back from Lourdes for her to give to Linda. The teacher offered to pay. The friend, being on a Holy quest, waved away all thought of payment.

On Thursday Linda received a hug from her fellow teacher (one of hundreds of hugs she has been getting at work recently) and a plastic statue of the Virgin Mary filled with Holy Water from Lourdes.

On Friday morning I sat the quiet of the living room peacefully listening to the sound of the endless rain outside and putting together the elements of the Friday Shoot Out post. When suddenly my head felt wet. I reached up and water splashed on my hand. I turned and got a face full of Holy Water.

"What the...glub...ack..glub...!"

And I was blessed.

"Lift up your top," Linda said, "This is Holy Water all the way from Lourdes and I want to pour it on the spot where your cancer is."

So I lifted my pajama top and she poured the waters over my chest. Since I failed to ignite, the way vampires do when touched by Holy Water in the movies, I guess I must not be a vampire.

At least that worry is now off my mind.

I'm not a big believer in miracles but I have to confess, with my CT scan set for Monday, a part of me wonders what they will now find?

After all this rain.

And if the cancer is still there, well, Linda still has 3/4 of a bottle of Holy Water left.

****************************************************
Image of the Virgin Mary courtesy of Photobucket

Friday Photo Shootout--Wild Animals

I've accepted a challenge from Patty to post photos of our local community every Friday. This week's theme challenge is to post photos of wild animals in my town.

There are links to all the Friday Shoot Out participants from around the world at the bottom of my left panel. Maybe you'd like to join us as well and post photos of your community? If you do, let me know so I can add your names to the list.

I live in Toronto, in the Scarborough area of Toronto, in the West Hill area of Scarborough. So West Hill will be the focus of my photos.

I needed to cheat a little with this one, having very few wild animal photos and no time to stalk the wild beasts this week. So I thought, since I had to cheat anyway I might as well go all the way: one of the animals is actually stuffed, one is a "wild" Lindsay, one is of the mother of a new puppy that will belong to my brother in 5 weeks time, the photograph of Charles is from photobucket and the article that accompanies the pictures is a reprint of a very early post of mine from several months ago.
***************************************************************




She told us her secret during a visit with Charles. My daughter knew Charles personally, having worked with him for several years while she was attending Ryerson University.

He was temperamental, but what artist isn't? He was used to throwing his considerable weight around, but never with her. He always treated her with great respect.



As an artist, Charles has a world wide reputation. His paintings are in great demand but sell for a modest price between $400 to $1000 dollars. Charles may be intimidating, but he isn't greedy and his needs are simple. An abstract artist he is noted for his use of colour, and the violence of course.



With Charles the potential for violence is always there, just below the surface. And when you weight over 400 pounds, all of it solid muscle, that makes you very dangerous indeed.

Except with Kathy, whom he always treated kindly and with grave courteously. Part of her job was to clean his windows while he sat and watched her with intense fascination. Sometimes they sent a guy along to help her, but that always made Charles fly into a violent rage. Any male coming close to the windows of his cage would rouse him to a ferocious anger and he would charge the window throwing his full weight at the bullet proof glass. Over and over again.



The resounding impacts would reverberate through the African Pavilion at the Toronto Zoo, frightening many of the patrons. Parents would have to explain that Male Silver Back gorillas were very protective of their children and didn't take well to male intruders. And Charles has over ten children.



Today there is no protective glass between us and Charles. The Mountain Gorilla exhibit has been moved to a new enclosure, the worlds largest indoor gorilla exhibit. It is height that protects us now, not bullet proof glass.



Kathy likes the new display. It is much larger than the old one and she always worried about Charles hurting himself with those frightening charges at the glass.

She's feeling a little protective of children these days herself, she tells us, now that she is pregnant again.

My wife stops. Her heart skips a beat. There's the need for a wrenching adjustment in thinking from gorillas to babies. What? Pregnant again? Kathy?

My daughter has a huge grin on her face and suddenly there are hugs and tears all around. I shake her husband's hand while their son dances around us with a big "we gotcha" smile on his face.It had been seven years since her first and only child, so we are very surprised and pleased by the news.



This will make four living grandchildren for us. There was a fifth, my youngest daughter's first son, but that was over nine years ago now and is not a story for this happy time.

In the distance, Charles takes the news in his stride, lying comfortably on his back beside a log, arms akimbo, one leg pointed straight toward the sky,giving himself an occasional lazy scratch.



Kathy gave birth to our granddaugther Hailey in September 2008.

Lindsay's Greatest Trick

Some of Lindsay's best tricks she taught herself.

If we're going in the car and we've put her in the back seat and she immediately jumps into the front seat before Linda and I can get in the car, we only have to say, "In the back seat!" and she immediately hops into the rear of the car.

We never taught her that. She taught herself.

She listens to us. And she watches and she learns.

If we're out for a run and we come to a fork in the path, I only have to tell her "Left!" or "Right" and she zooms off in the correct direction.

We never taught her that either.

If it's getting near time for her run and she is starting to be a pest, sitting and staring at me with loving eyes and slightly cocked head, I only have to say, "Be patient, Lindsay" and she will go away and give me another ten minutes.

But her greatest trick was one I discovered by chance when she was four years old.

For whatever reason she had more energy that night than two long runs could burn off.

All night long she had wanted to play. We played Catch, we played Tugs, we played Chase but every game only opened doors to new energy levels.

I was getting tired. And frustrated.

What had gotten into this dog?

"Oh Lindsay," I said. "Go to sleep!"

She gave me a quizzical look and I could see the little translator behind her eyes, translating the English into dog.

And then she laid down and immediately went to sleep.

On command.

From a body pumped with adrenaline to sleep in 30 seconds.

It is her greatest trick.

And I love it.