Health progress

[Tim Ford]

I've had some po lips, but just a flesh wound so far.

I really hated being on an annual plan. I don't like sedation, so I've done my colonoscopy's and endoscopies awake. If you're going to f me, I want to know.

I've done the same thing. It's not that bad. Easy, really.

Agree. The one that was a bit scary was the endoscopy. It's not small to go down your throat.

I couldn't do that. Stick anything up my ass you want but I have a bit of a choking phobia.

Agree and I want to be OUT OUT OUT when they run a scope up my pecker.

I had a cysto in my early 30's. No anesthesia. The urologist was/is sort of a famous character in Baltimore, Herr Doktor Rainer Marie Engel.

He still has the accent and wears a velvet bow tie. We get ready, I'm lying on the slab in the bowels of Union Memorial Hospital, which was a bit of pit back in those days, and he gets the scope ready, all greased up. I have no idea what he's going to do. He forces it in a little bit and says, "You might feel a litttel dees-cum-fert" (said like Sgt Schultz might say it).

I think they heard my reaction to "feeling a littell dees-cum-fert" out on St Paul St.

My internist always gets a kick out of any mention of Dr. Engel. He retells a story whereby Engel was leading a tour of Baltimore's William P. Didusch Center for Urologic History. Apparently one of the females on a tour of the museum remarked, unknowingly, on how primitive the equipment was back then, and no one had the heart to tell her the equipment on view is contemporary, too.

Good times.

[Ajax]

Hmm... Larry should have had all or most of his radiation treatment by now. I hope all is well.

[Orestes Munn]

Hmm... Larry should have had all or most of his radiation treatment by now. I hope all is well.

Word is he's doing well with minor side effects. Last Rx is today.

[LarryHoward]

Yes. Doing well. Not much to report. Generally just see the nurses and techs. Doc reviews setup and alignment electronically while I'm on the table and gives authorization to proceed.

Did meet with the doc Tuesday to review PET scan from the 8th and possible outcomes from this treatment. Basically, the PET showed what could be a defeated tumor. No metabolic activity at all. One impact of that is we may not see any further size reduction from the current therapy. If that's the case, he raised the possibility that high risk surgery to remove a inert mass may not be in my best interest and I could finish off with some additional Chemo sessions and be declared in remission or cured. The remaining chemo is strictly about chasing down any sub detection level cells remaining anywhere in my body to eliminate or minimize the chance of regrowth. Next scan and meeting with the Radiation oncologist and surgeon is on Halloween and we'll discuss the surgical option then.

Not really sure how I feel about that. Research says long term outcomes from Chemo plus radiation are equal to Chemo/radiation and surgery given the kinds of results I'm seeing. On the other hand, getting the tumor out of my body and into the hands of a pathologist has a lot of attraction. In either case, I'll face the anxiety of "what will the next scan show?" for some time in the future. On the positive side, having the doc look you in the eye and say "the treatments are effective and you have tolerated them extremely well so we haven't had to hold back. With or without surgery, we think you are going to be OK." Is pretty significant. Last radiation treatment at noon today. Chemo starts Thursday. Knowing the clinical oncologist pretty well by now, I suspect he will be an advocate for surgery if it's possible.

Great medical team all around and I trust them.

[Ajax]

Any cute nurses spotted?

Kind of a crummy choice- Leave that dead thing in place or high risk surgery to remove it. I hear you on the pathologist.
In any case, tumor is dead and you ain't! Whoohoo!

[Jamie]

Glad to hear the tumor is defeated and that the prognosis is positive. That's a tough choice. Any time you get opened up, there's a risk.

[LarryHoward]

Well. "Appears it may be defeated". I'm optimistic and hear you in the surgical risk. If we don't have surgery, it will shave a couple of months off the treatment schedule, possibly means finishing before the end of the year.

Did some serious walking in lower manhattan yesterday and a long climb out of the subway (escalator down). Impressed how much more energy I have with a few weeks off Chemo. Not impressed with the general decline in fitness based on low energy over the last 6 months.

[Ajax]

We'll whip you into shape.
Plenty of local sailing to be had, and it's a nice climb up and down from your house to your boat dock.

[LarryHoward]

Treatments complete. Back to Maryland tomorrow. Meeting up with our niece for dinner. Seems she is in town from SF to support the new iPhone launch. (Apple marketing type).

[kimbottles]

EXCELLENT, BRAVO, Just the kind of report we love hearing.

(I really loved the part on how well you tolerated the treatments so they did not have to hold back!)

Go Navy!

[kdh]

I had a really easy cancer, Hodgkins 1B in 1980. I was 18. Somehow, through no surgery other than a biopsy the huge mass is gone. Just radiation. About as much as Kim Jong-un would deliver in a glancing blow.

I have a radiologist friend that says we have all kinds of weird stuff in our bodies. "Pristine" is not the goal. Benign is the goal. "Benevolent" maybe.

[Ish]

I had a really easy cancer, Hodgkins 1B in 1980. I was 18. Somehow, through no surgery other than a biopsy the huge mass is gone. Just radiation. About as much as Kim Jong-un would deliver in a glancing blow.

I have a radiologist friend that says we have all kinds of weird stuff in our bodies. "Pristine" is not the goal. Benign is the goal. "Benevolent" maybe.

I have watched my colonoscopies in full colour, it's weird watching them lasso a polyp and cauterize it. I'll probably have to settle for "tolerable".

Larry, glad to hear you're off treatment, I'm sure that's going to make life much more enjoyable.

[Orestes Munn]

I had a really easy cancer, Hodgkins 1B in 1980. I was 18. Somehow, through no surgery other than a biopsy the huge mass is gone. Just radiation. About as much as Kim Jong-un would deliver in a glancing blow.

I have a radiologist friend that says we have all kinds of weird stuff in our bodies. "Pristine" is not the goal. Benign is the goal. "Benevolent" maybe.

I do maybe 200 brain MRI scans in healthy people each year. My favorite part is calling them up the next week and saying, "Umm, we found something a bit wrong in your brain, but don't worry about it."

[Tim Ford]

On the other hand, getting the tumor out of my body and into the hands of a pathologist has a lot of attraction.

Not being an oncologist, I may be out of my league here, but the remaining cells might not be worth much in terms of a histological look-see.

Widespread cell death and loss of vascular infiltration probably had a pretty devastating effect on the blob being zapped by lethal doses of radiation and nasty chemicals. Seems like the results from your original biopsies already have the cell-types and effective therapeutic strategies pretty well nailed-down.

IN other words, my hope is: the radiation and chemo fried the little bastards into thinking: "this is pointless, let's call it a day and quit screwing with this fucking guy...he's made of better stuff than we are and his friends with the I.V. bags and guided ray guns are even worse!"

(On the other hand, maybe there is some histological importance to examining shrunken, defeated, fried, dead sarcoma cells....may their evil little souls rot in hell. How the heck do I know, I'm not an oncologist)

But I am thrilled to hear your good news!

[Olaf Hart]

On the other hand, getting the tumor out of my body and into the hands of a pathologist has a lot of attraction.

Not being an oncologist, I may be out of my league here, but the remaining cells might not be worth much in terms of a histological look-see.

Widespread cell death and loss of vascular infiltration probably had a pretty devastating effect on the blob being zapped by lethal doses of radiation and nasty chemicals. Seems like the results from your original biopsies already have the cell-types and effective therapeutic strategies pretty well nailed-down.

IN other words, my hope is: the radiation and chemo fried the little bastards into thinking: "this is pointless, let's call it a day and quit screwing with this fucking guy...he's made of better stuff than we are and his friends with the I.V. bags and guided ray guns are even worse!"

(On the other hand, maybe there is some histological importance to examining shrunken, defeated, fried, dead sarcoma cells....may their evil little souls rot in hell. How the heck do I know, I'm not an oncologist)

But I am thrilled to hear your good news!

Makes sense to me, first do no harm ...

[JoeP]

Happy to hear the good news Larry!

[Tucky]

Congratulations Larry- you have worked hard.

[LarryHoward]

It's not over till it's over. Certainly, things are looking positive but still have more scans, definitive decisions and Chemo to go before we really know. These are the best specialists in the country and I trust they know what they are doing (and all the research I've done says they know their stuff).

Olaf. Good point on the "do no harm" and where they may be thinking. CT at the end of October will better tell the tale on what is happening and we'll go from there. I have another round of chemo starting this Thursday and will have more Chemo over the next several months, surgery or not.

[BeauV]

It's not over till it's over. Certainly, things are looking positive but still have more scans, definitive decisions and Chemo to go before we really know. These are the best specialists in the country and I trust they know what they are doing (and all the research I've done says they know their stuff).

Olaf. Good point on the "do no harm" and where they may be thinking. CT at the end of October will better tell the tale on what is happening and we'll go from there. I have another round of chemo starting this Thursday and will have more Chemo over the next several months, surgery or not.

Larry, great to hear that things are going well. The only good tumor is a dead tumor! Glad you found some folks who know what they're doing.

[Jamie]

It's not over till it's over. Certainly, things are looking positive but still have more scans, definitive decisions and Chemo to go before we really know. These are the best specialists in the country and I trust they know what they are doing (and all the research I've done says they know their stuff).

Olaf. Good point on the "do no harm" and where they may be thinking. CT at the end of October will better tell the tale on what is happening and we'll go from there. I have another round of chemo starting this Thursday and will have more Chemo over the next several months, surgery or not.

This is great news on an otherwise not so great news-day, personal or public.

[Rob McAlpine]

IN other words, my hope is: the radiation and chemo fried the little bastards into thinking: "this is pointless, let's call it a day and quit screwing with this fucking guy...he's made of better stuff than we are and his friends with the I.V. bags and guided ray guns are even worse!"


But I am thrilled to hear your good news!

I love the way you think, Tim.

I, too, am thrilled for you, Larry!

[Slick470]

Larry, Glad to hear that the progress/prognosis is looking up. Keep it up!

[LarryHoward]

Well, the doc decided I was feeling too energetic. Just as I was starting to sprout peach fuzz and my RBC was approaching normal, I’m back in the hospital today for 4 day’s of chemo since I have time to recover prior to my next round of appointments (scan, surgeon and radiation oncologist) on the 31st. Should the decision on the 31st be no surgery, I’ll have another 4 rounds of chemo and be done for initial treatment and start periodic scans to monitor for regrowth.

[Ajax]

Sheesh...4 more rounds just to chase down errant cells? Sorry to hear that, but better than the alternative!

[LarryHoward]

Sheesh...4 more rounds just to chase down errant cells? Sorry to hear that, but better than the alternative!

Well, on Wed I finish round 6. If the “no surgery” option comes true, 4 more Chemo sessions is nothing and i’ll finish up in early Feb and be feeling pretty good and sprouting hair by Lynne’s and my 30th on 19 March. Seems like a nice time to celebrate.

[Jamie]

Well, the doc decided I was feeling too energetic. Just as I was starting to sprout peach fuzz and my RBC was approaching normal, I’m back in the hospital today for 4 day’s of chemo since I have time to recover prior to my next round of appointments (scan, surgeon and radiation oncologist) on the 31st. Should the decision on the 31st be no surgery, I’ll have another 4 rounds of chemo and be done for initial treatment and start periodic scans to monitor for regrowth.

No good deed goes unpunished, right? This is fabulous news. To my arm-chair amateur understanding, it sounds like you are headed for a very clean prognosis.

[BeauV]

Larry, this sounds pretty good. We'll need pictures of you with peach fuzz at your 30th! No getting out of that! B

[JoeP]

Go Larry!

[cap10ed]

Good report card Larry. It might make it easier for me to find you at home now.

[LarryHoward]

Well, just to prove I don’t have a clue. Had a CT and met with the surgeon today. No changes in the scan but he wants to go ahead with surgery and clinical thinks we may be done with chemo as they have hit my reserves pretty hard.

Basically, the thinking seems to be that the tumor may be dead but they can’t prove it and it’s aggressive enough that only a small remnant is required for it to regrow. I may not have the reserves to deal with a repeat of the high dose course of chemo again so based on that, the surgeon is planning to take it out 27 Nov. In the next couple of weeks I will meet with the vascular surgeon from Cornell (I think) who will be in the OR to do the possible/probable aorta to arterial graft. Surgeons comment was that it’s a tricky surgery but not overly risky other than normal risks of major abdominal and vascular surgery on a 63 YO. They will evaluate what they see when I’m on the table and tell me what happened when I wake up.

So as of tonight, it appears I’m done with chemo and will be up and about from the surgery and back home by mid December. Might even have some hair by Christmas. I need to confirm that with the Clinical tomorrow or Thursday and have lots to ponder and clarify over the next week or so.