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7/30 - Wednesday

Implant esophageal stent (via endoscopy).

7/29 - Tuesday

Getting better...managing pain a little better each day.  The tumor in the lower right quadrant is like a rock.  I can feel it...and it hurts.  Hope this chemo kicks in quick.

I still cannot swallow whole foods, so we scheduled to have an esophageal stent inserted into my throat.  That will be done tomorrow.  It is about 3-4 inches long and will reside permanently in the lower third ('distal third') of my esophagus.  It forces an opening so food can pass through.  Though I hate adding more permanent things to my body to remind me of cancer, eating is a priority.

Thanks for your prayers and support.

7/28 - Monday

Had an Upper GI test performed to determine cause of blockage in my throat.  I cannot swallow whole foods, and the likely cause is tumor blockage.  While we hope the chemo shrinks the tumors, I need to eat in the meantime.  Loosing calories means loosing weight...the start of a nasty downward spiral I don't want to ride.  Keep up my strength will enable me to keep up the fight...so I gotta eat.

I swallowed some barium constrast, which x-rays revealed was being blocked (presumably by the tumor at the base of my esophagus).

7/27 - Sunday

On the mend, 48 hours after chemo is still rough.  This chemo makes me nauseas again...so I'm back on the anti-nausea medication.  Pain meds are leveling out...things are getting better again bit by bit.

7/26 - Saturday

Thursday evening - a few buddies called from my home town and said they were showing up - the next day!  So Friday night, Brad, Dan, Joe and Jen's brother John all show up and hang with us for all day Saturday.  I didn't do much, but we watched Lance continue to win, and got to share some much needed one-to-one support.  I love you guys. Thanks for being here and making the trip.  And thanks to your families for sacrificing your time for a few days.

7/25 - Friday

Chemo #42.

PET scan results were not good.  Tumors continue to grow, mostly in the liver.  Most of abdominal pain is from that growth.  I'm on steady pain medication (OxyContin).  

I'm on a new chemo now - don't know how to spell it - and am still in the post-chemo fog so you won't get much out of me right now.  I think its Oxaliplatin + CPT-11.  It hits hard - lots of the post-chemo feelings.  Like I've been hit by a truck.   More details later.  Its been a rough morning...physically, emotionally.  

Need that miracle...keep praying.

7/24 - Thursday

Went to work for 3 hours - drive down and back just wiped me out.  Came home with another fever.  Coast Guard medical discharge paperwork is in progress...should take 4 weeks or so.

7/23 - Wednesday

Working from home today.  The new pain medication (OxyContin) works o.k. but gives me a bit of a fuzzy feeling.  I'm not sleepy, but I am slightly removed from the rest of the world.  There is a layer of felt around me...not so sure I like it.  I will likely use this drug at night, but return to the less potent pain drug (Darvocet) during the day.

7/22 - Tuesday

PET scan.

7/21 - Monday

Jen bought me a yellow jersey today.  She rides her bike as part of her workouts...and made a trip to the local bike shop to get something today.  They had yellow jersey's for sale with the U.S. Postal Team logo on them...so she got one for me.  I'm going to send it to Lance and see if he'll autograph it.  He's been a tough cookie in the Tour de France so far.  He fell twice today and still finished 67 seconds in front of the pack.  wow.

The only good thing about staying home to get over this pain is I get to see the Tour on TV.  Watching those guys suck it up for a few miles helps me a bit.

7/19 - Saturday

The only conclusion I can draw from the continued abdominal pain is that the tumors are growing again.  The pain, quite strong since early July, coincided with frequent fevers, an increase in difficulty swallowing, and a severe drop in my hemoglobin.  It seems to all add up to tumors growing, taking up space, and consuming my blood supply.  

I wish that weren't the case...but it is.  

By telling you this...I'm letting you in on my mental preparation for the PET scan on Tuesday.  I'd love a miracle...I ask for it every day and I believe God can wink his eye and take all this away.  Whether that happens or not is His call.  In the meantime, I just keep moving, keep believing... 

My pain medication is not that effective (I'm taking Darvocet).

Jen, my ever-present coach, gently told me to get off the couch (where I've been the past 24 hours) and try to exercise...go for a walk.  She reminded me the chemo will not act alone to win this battle...I have to participate.  She told me that mild exercise is an immune system stimulant.

So I walked about a mile.  I hurt...but I did it.  And I'll keep at it as long as I can.  Thanks, Jen.

I hate cancer.

Sorry...I'll cheer up soon.  Keep praying...God's listening.  Life sucks right now...but I've got a long way to go before I hit bottom.  People have endured worse...Lance Armstrong climbing a mountain, POW in torture, Peter and Paul in prison, Mothers in labor, etc.

The only advantage Lance has over me right now...he knows where the finish line is.

7/18 - Friday

Feeling better, but gut still hurts like crazy.  Got the dry heaves before and during the blood transfusion yesterday.  Don't think it had anything to do with the transfusion.  Things are not right with my abdomen.  There is too much pain to feel even remotely normal...something's going on.

PET scan Tuesday should tell a lot. 

7/17 - Thursday

Got blood transfusion...took all day (9-5).  I was just too weak to keep moving.  Things went o.k. during the transfusion.  But I'm tired...headed for bed.  Canceled weekend plans.  Jen was by my side all day.  What a rock of a human being.

7/16 - Wednesday

Tried to work - what a stupid thing to do...could barely move.

7/15 - Tuesday

Afternoon update...I felt like a sack of potatoes the past 24-48 hours...barely made it through the shower this morning.  I was worried because Jen had mentioned before that fatigue might be due to the tumors bleeding.  

Anyway...I was headed for work - dragging my bones through a few errands on the way - and when I ran out of breath coming out of a store, I decided that's it....I need to see the doc today.  

I called, told him what was up...He agreed.  

An afternoon appointment and blood work revealed a big drop in my hemoglobin.  Usual count for guys is 14, mine was hanging around 12 during most chemo cycles, it had recently dropped to 10+ during the past few weeks, then hit 9.3 today.  At 9.0, I am to get a blood transfusion and bed rest.  

Guess I now know why I felt like a sack of potatoes.  

The hemoglobin drop occurs for one of three (3) reasons:  (1) either the chemo hurts my bone marrow production of blood products, (2) the tumors are bleeding, or (3) the tumors are growing and taking up a new blood supply.

To help get to the bottom of this problem...the doctor also performed a rectal exam.  This lovely procedure is to determine if blood is present in my GI tract - which it was.  That may indicate that my drop in hemoglobin is likely due to tumors bleeding into my GI tract.  We had to modify my meds accordingly.   No more Celebrex - its an athritis/pain medication that can irritate the GI tract and contribute to the bleeding.

Next PET scan is next Tuesday (7/22) - results due Friday (7/25).

Been watching lots of Tour de France.  I love really good athletes...purists.  Not overpaid prima donnas like many pro athletes in the U.S.  These riders have guts...lots.  I like to see raw ability and sheer will keep them moving.  Its inspiring.  They win with their mind.  Most have identical bodies, ability and training backgrounds.  Their success depends largely on how well they handle their pain.  I can relate.

I have been living on pain pills this week, not something I enjoy.  I have been trying to limit them to nighttime so I can sleep.  But have popped a few during the day at work.  They make me dizzy and drowsy.  Also hate the thought of addictions.

7/09 - Wednesday

Fever again last night...101.8...its becoming like clockwork from 7-10...then it breaks, drenching me in sweat...I get up, take a shower, change my clothes and get back in bed.  What a pain.  Then because of the effort of taking a shower, and fighting a fever, my heart rate increases and I get those vasospasms and chest pain.  Its just a circus.  I'm safest laying flat on my back doing nothing, waiting for everything to calm down...which is REAL fun.

Dr. call this morning confirmed that happens with tumors (mostly when they grow).  We cannot find any other source of infection, so he concluded that its tumor-related.  I'm on a general antibiotic for a week just in case.  No going to work today.  Maybe tomorrow.  I'm getting restless laying around waiting for fevers to come and go...

Keep up the prayers...they work...and I depend on them.

p.s.  I get all your e-mail.  I am so thankful to hear from each and every one of you...I share them all with Jen, and we're uplifted by your words.   I'll write back as soon as I can.

7/08 - Tuesday

Chemo yesterday sucked.  I got through it alright, with Jen by my side and the awesome nursing staff there as always.  But after being up all night last night in the ER (got there at 8pm, left at 4:45am) and then getting a gallon of poison poured into me today...man, these last 48 hours have been a challenge.  

By the way, our all night ER stay was under the expert care of a good doctor friend, Dr. Jaime Alvarez.  He knew my situation well and ran us through a CT scan and blood work.  He concluded with our oncologist that nothing on the CT scan looked abnormal.  So with the fear of something ruptured in my abdomen now put to rest, we left for home and got a few hours of shut eye before the chemo session at 9:30 a.m. 

At our 9:30 appointment before chemo, Dr. Niederman concluded that dying tumors just wreak havoc - they bleed and fall apart, they calcify and turn into little stones rubbing on nerves and cause pain, etc.  He said the pain needed to be managed, since I might be living with it for awhile.

Sooo...pain medication is now part of our home pharmacy.  I usually shy away from pain drugs - wanting to experience what I can stand and be able to fully describe it to the doctors for a better diagnosis.  But when it kept me awake at night - I gave in.  

After getting home from chemo - I ran another fever.  At about 7 p.m., it hit 101.8, we called the doc and he prescribed antibiotics just to be safe.  Jen ran out to the drug store, and I hit the sack.  By 10 p.m. she found me drenched...another episode of "Joel broke another fever, time to change the sheets and clothes" .  

I was again woken up at 3 a.m. with that same sharp abdominal pain.  After popping one of those new pain pills, I crawled back in and assumed the fetal position, hoping for some relief.  The next thing I remember is Jen brewing some coffee and feeding the cats at 6:15 a.m.  I guess the pain pill worked o.k. 

7/07 - Monday

Chemo - #41.

There's supposed to be an ESPN Classic about Lance Armstrong on TV tonight.  The last ESPN Classic I watched was about coach Valvano.  It should make for good post-chemo viewing.  I have mixed feelings about Lance.  He seems a bit self-absorbed.  But he's a public figure, so you never really know what they are going through.  And he made it through chemo...so I give him credit for that.

7/06 - Sunday

Have been nursing a mild fever and intense abdominal pain for a few days.  Not sure what's up...will pose some questions to the doc tomorrow during chemo.  It doesn't feel like before when the tumors were growing.  That just felt like I was getting bigger.  This feeling is just pure pain.  Its like having gas the doesn't go away, and then having someone stand on your abdomen at the same time.  Yawning hurts since taking deep breaths pushes down on my diaphragm.  Being quietly curled up in the fetal position feels really good.  What would I do if I had kids to chase feeling like this?  I have the utmost respect for parents with cancer...especially Moms.  I'm trying to just keep going, assuming its just another crappy symptom from the tumors or chemo.  Neither of which I can do anything about.  So that means suck it up, and just keep moving.

Didn't mean to complain.  But I hate cancer.  (...I was shouting that, by the way)

p.s.  some people ask me..."How long will this chemo last?"  The answer - as long as it takes.  You might hear stories about early stage cancers that have a prescribed number of treatments for only a certain length of time.  But as a stage 4 stomach cancer patient, the medical community has the mindset that I'm on death's door.  Therefore, expecting an end to chemo is a myth.  My choice as a patient is to take chemo, or not.  Absent God's healing miracle on my body, the outcome of not taking chemo is fatal.  So I'll take the chemo until my miracle shows up.  Presently, the tumor load within my body is the same as when I started chemo last March.  The tumors have shrunk a lot, then grown a lot, then shrunk again.  We'll see what happens next...I'll keep you posted.  Its been a learning experience, that's for sure.

7/04 - Friday

Happy Fourth of July!  

I'm proud today - its why I still wear a uniform.

7/01 - Tuesday

Angiogram went smoothly.  The cardiologist said my coronary arteries are "pristine".  The angina (chest pain) I've been feeling is therefore almost certainly caused by chemo-induced vasospasms.  I essentially have to continue medication to keep my vessels dilated (calcium channel blockers), and reduce my exercise a bit.

I'll be limping a bit today, working from home tomorrow, and back in the saddle at work Thursday.  

yahoo...