Third time’s a charm?

March 29, 2013

©2013 L Joyce Croker I celebrated my 28th month of survival since diagnosis on March 26, but I was feeling a bit less celebratory than usual. A recent chest x-ray, ordered to determine the cause of increasingly severe coughing fits, came back with less than happy results. It seems my original, primary tumor, the one we hoped was dead, has resumed growing. We’re back in the business of fighting two tumors again. And fight, we shall!

I’ll undergo my third cycle of the new chemo drugs tomorrow, then another PET and CT scan after April 5th to see if the new drugs are working. In an attempt to diminish the coughing, I’m back on a high dose of prednisone. Not only have the painful fits that were preventing me from sleeping calmed, I have more energy than I’ve had…since the last time I was on a regimen of 60mg of prednisone per day. I still have cancer, but I’m merrily completing projects normally too tedious to contemplate. Example: all last Sunday was spent de-winterizing Maeve’s plumbing system (who knew she was even winterized), draining and sterilizing water tanks, etc. I actually kind of understand the sewage system (yucky, but necessary), and just what all those crazy water valves are for. Prednisone lends not only energy, but clarity in deciphering the most impenetrable of RV manuals.

My wonderful friend Tony will take me to chemo tomorrow, which I hope to follow with a late lunch at my favorite red-sauce Italian spot, Palermo’s. Then, Joan and I get to enjoy another Easter weekend in LA and hope that tomorrow’s chemo; the third cycle of the third line of chemo I’ve undergone since diagnosis; is a charm.

maeve_DV_joanie 001


Last year of the sprint

March 10, 2013

©2013 L Joyce CrokerAnother cycle of chemo down, one to go until they scan me to see if new drugs are diminishing the new tumor in my remaining, right supraclavicular node. The day of and day after chemo aren’t a problem except for insomnia from steroids. Usually by Sunday the frenetic energy starts dispersing and I can once again spend the night sleeping.

On this beautiful spring day in SoCal, the drugs and their side effects seem well worth it. Having passed 27 months since diagnosis, I am tickled to still be here. We’ll celebrate my 59th birthday next weekend during another road trip in our RV, Maeve. Joan, the dogs and I venture to Death Valley for sightseeing, photography and togetherness in a stark, bright landscape already up in the 90s.

Here’s hoping for starry nights and peaceful mornings on the kick-off weekend of my last year of Sprinting Towards 60.


Another bend in the road

February 9, 2013

©2013 L Joyce CrokerJoan and I traveled to Maui for our biennial 2-week vacation there. Awaiting us were leaping whales, rain forests, umbrella festooned drinks and ocean warm enough to bask in (even in January). This time we were relaxed into puddles of coconut butter by the 3rd day; a record! Then, on the day we were to drive that long, tropical twist that is the road to Hana, I checked my email to discover one I’d missed from my boss, Miss Z. She had just accepted a more lucrative job and her last day would be a day after my return to the office. Half way to Hana, as Joan and I slurped shave ice at a roadside stand, Miss Z called on my cell to fill me in. I was left saddened, but certainly understanding her decision. Oh well, Joan and I had another 10 days left in Maui. We vowed to focus on the present, not life after return to reality.

I returned to work on Tuesday, 2/5 after an early morning PET scan and a scant 3 hours of sleep the night before. The piles of work awaiting me didn’t surprise me at all. What did surprise me: how bereft I felt visiting Miss Z’s empty office and realizing the brilliant little fireball occupying it would soon be gone. It’s the complex relationships that sneak up on you; my 5 1/4 year working relationship with Miss Z went through many highs and lows (often in the same day). It wasn’t always a sunny relationship, but I’m grateful for what I learned throughout its duration. I’m also grateful that Miss Z and I avoided killing each other in a whirl of red hair, sparks and thunder.

I thought Wednesday would be better. It wasn’t. I started out rested and calm, intent on plowing through accumulated work, attending back to back meetings and calming down my somewhat alarmed staff. Then the email from my oncologist, Dr. B, arrived with not-so-happy news. She asked me to come asap to discuss a new treatment plan. Darn! More chemo…and just when I was digging having hair again.

Dr. B set me up today with a new plan, and part of it is exciting. There’s a new drug called MetMAb, now in Phase III clinical trials. Dr. B will bring up my case with the lung tumor board next week. If they concur, she’ll help me apply for the trial. Since qualifying will take time, I’m to start 2 new chemo drugs next week, Alimta and Avastin, since my last chemo session on the old regimen resulted in an emergency 3 day hospital stay. Her comment on giving me more carboplatin/taxol, “the next time would be death.” We’re happy my oncologist would prefer not to kill me. Yet.

So, I’m feeling like a survivor. So far, in the last 2 weeks we survived: the road to Hana, the loss of someone I was very fond of and a few vials of blood (not on the same day), AND the prospect of yet more chemo. But, there’s hope too. And hope, along with a modicum of curiosity, is what keeps pulling us down this winding, aggravatingly beautiful road.


Still waiting and happy to do it!

December 31, 2012

Caspar Beach before the stormMy MRI results arrived just before we left for a road trip to Northern California. The good news: no sign of metastatic disease (AKA cancer). The iffier news: abnormalities in both cerebral hemispheres that I can’t pronounce. (Foci sounds like some kind of pasta. Make mine al dente!) I’ll return to Kaiser twice in the next 2 months: a consultation with a neurologist on the 1/11; a PET scan on the 2/5. More stuff to get through, nothing to keep us from our Christmas road trip.
After a visit with my mother and sister, then a pleasant visit with friends near the Anderson Valley, we drove to Caspar Beach and stopped to wait out a rainstorm in our RV, Maeve II, for a couple nights. We were cozy sleeping and lounging in Maeve, but I prefer a stronger spray than her shower provides. So, it was off to the campground showers for me.
The prospect of removing my clothes to wait in the freezing shower room for—hopefully—at least warm water produced far more anxiety than last week’s wait for MRI results. Of course, for the shower, I was naked and shivering at the time…and standing barefoot on a cold, gritty cement floor. Feeding 4 quarters into the coin-fed shower produced a long, blissful HOT shower; well worth the goosebumps. Sometimes waiting brings happy results, sometimes not. Either way, it seems the best way to get through the unpleasantness is to just get through it.
©2012 L Joyce Croker
After the storm, we saw quite a few rainbows. Some of them were in unexpected places we passed; in sea spray off crashing waves; in mist rising off fern dells. We were able to take the highway all the way down to San Luis Obispo, which a landslide near Big Sur had prevented on the drive up. As many times as we’ve been up and down Highway 1, it never bores us. We stopped to watch elephant seals in San Simeon; something that’s become an annual ritual. Once again, it was worth the wait. Most importantly; we’re still here. Waiting for the next thing down this road we’re traveling.
©2012 L Joyce Croker


Knockity, knockity, bang-BANG Zzzzz!

December 14, 2012

MRI ScannerMy oncologist ordered an MRI this week to determine what might be fluttering around in my little brain…and to ensure the week-long headache I suffered recently was merely due to the flu.

This afternoon I spent about 55 minutes in the MRI scanner. It’s kind of narrow inside, but I fit splendidly. My little mantra of “Calm-m-m (breathe in), Rela-a-x (breathe out)” seemed to keep claustrophobia at bay, and the cacophony wasn’t as bad as forewarned. My MRI soundtrack seemed to involve everything from Japanese monks playing wooden instruments; to midgets with jack hammers; to the worlds largest vibrator. (Unfortunately, the vibrations were limited to the back of my head.) I kept my eyes closed and enjoyed the hour off from reality.

Another adventure in the world of medical technology, and price of admission didn’t even require a co-payment!


Staying on the ride

November 27, 2012

Joyce and Joan on the Bus2 years ago today I woke up from a medical procedure to some very bad news: advanced lung cancer. I was 56 at the time, and really didn’t think I’d change much at that age. Wrong! Cancer changed me, and most of the changes are quite welcome.

As the initial shock and grief faded, the positive changes began. I realized that even if I outlived the 12-18 month life expectancy I was given, life is very short indeed. Far too short to not enjoy every minute I have left to the max; far too short not to make sure everyone I care for is made well aware of it. Also far too short to hang on to anger, bitterness and disappointment long beyond the date of inception.

2 years later, I’m feeling fine; much better than I did when I got the awful news. I can breathe deeply and laugh hard without falling into a fit of painful coughing. The soreness endured through radiation treatments is less than a memory, and I got through nearly all my chemo sessions without discomfort or drama. My hair has defiantly grown back, twice as curly and a little bit darker.

Will the cancer that still lurks in my right lung get worse? Will I undergo more chemotherapy? All that remains to be seen. I’ll have regular scans every few months, hope for the best and enjoy this E-ticket ride just as long as they let me stay on.


Autumn Leaves

October 6, 2012

Fall woods. ©2012 L Joyce CrokerAfter a wonderful, chemo-free summer, I’ve learned I’ll be undergoing scans of some sort (PET or CT) about every three months. The results are in from my 9/25 PET scan. The good news: no new areas of avidity (glowing from intake of radioactive glucose injected before scan; one sign of cancer). The news I took as “uh oh!”: the area around the primary tumor is glowing a bit more; a ‘minimal’ SUV (Standardized Uptake Value) of 2.9 in March has increased to a ‘moderate’ 3.7. Mostly, the results are good; the evidence is that the cancer hasn’t spread. But perhaps the tumor I’d hoped was dead is merely dormant. Should I worry about this? Probably not. If worrying cured cancer, it would have been eradicated millennia ago.

Other than the “Should I be worried about this?” note I have in to my pulmonologist, my intention is to focus on enjoying my favorite season. Joan and I will be joined by friends at Santa Anita today where we’ll bet on long shots and enjoy gorgeous views and cooler Fall sunshine. Tomorrow we’ll put up the Halloween decorations and Monday will be the start of another challenging work week.

In other words, I’ll put one foot in front of the other and enjoy my metaphorical walk through these ever-changing woods.


To wait or not to wait…

April 27, 2012

"Roses to smell." ©2012 L Joyce CrokerRather than agreeing to the “wait and watch” approach to the new mass that lit up in my last couple of PET scans, I sought a second opinion. The “Tumor Board” (a group of doctors specializing in cancer treatment) at Kaiser-Permanente reviewed my case and recommended surgery to remove the tumor, followed by radiation/chemo or straight chemo. Sounded like a plan to me! Despite the saying, “all good things come to those who wait,” methinks this doesn’t apply to tumors. Untreated tumors seem to just get bigger, and I have no desire to have a large, obstructive tumor inside my neck pushing into my throat and major bundles of nerves.

I checked in for surgery on Tuesday, 4/17 at 5:30am. Despite the hour, Joanie got her sleepy, caffeine-deprived spouse to the hospital right on time. I have no memory even of being wheeled into the O.R., so the drugs they gave me seemed plentiful and strong. After a night spent in the hospital on heavy antibiotics and more pain pills, then a bout of extreme nausea finally controlled with more drugs, Joanie took me home to spend the rest of the week recovering. Aside from the usual side effects of the anesthesia and pain medications, which wreak havoc with my digestive system, I emerged on the other end of the week eager to return to work. I haven’t been so delighted to drive to work on a Monday morning in eons. It was truly wonderful to be back; not nauseated, not in pain and reasonably alert.

The biopsy revealed that the tumor had grown since March and was metastatic adenocarcinoma; a new variety of lung cancer for me (my other tumors have been squamous). Despite variety being the spice of life, glad that the nasty little bugger is out! To zap any lingering cells, next is more concurrent radiation/chemotherapy beginning in June. This gives more time to enjoy having energy, hair, and a quick road trip to the Indie 500 with my wife and dogs. (My wife is a huge Indie-car fan.)

I wish there were a button to slow down the clock until new treatment begins. I want to savor every minute of feeling healthy and happy with my life…even the frustrating parts. This disease has made clear what I suspected all along: feeling all the way alive isn’t something one should wait too long for.


Hair today…

March 24, 2012

I just returned from a consultation with Dr. Katz, a radiation oncologist at Kaiser-Permanente. I wanted to know whether that new lesion in my right supraclavicular lymph node could be eradicated through radiation.

She agreed that we probably didn’t want to just wait and see, as another doctor initially recommended. She says the spread of the cancer from my lung to this particular node is a common pattern, and that cancer often keeps traveling…up. Radiation might be a good next step, but chemotherapy combined with radiation could be more effective. She’ll be consulting with other radiation oncologists next Tuesday, then get back to me with a recommendation.

Dr. Katz showed me my recent CT and PET scans. The new tumor is this scary little lump next to my throat. Apparently, it’s also very near nerves controlling my right arm, which could make surgery challenging. I’d prefer to remain in control of my right arm as long as possible, thank you very much. Give me baldness over a limp right arm, anytime!

The fun part was seeing the PET scan: a 3D, semi-transparent Joyce who could be rotated in cyberspace. It’s reassuring to see I still have a heart, along with other crucial parts. While the cancer is still visible in my right lung, it’s greatly diminished. As fascinating as 3D digital-me was, don’t expect to see her posted on my Facebook timeline.

Yesterday I had my first haircut since January 2011: really more of a trim. After a year of being completely hairless, I mightily enjoy having something besides my poodles to wash and comb. Unfortunately, if I have more chemo, I may be canceling all my hair appointments for 2012. Now that I know it’ll probably grow back, not so bad a prospect. The clean head ‘do saves LOTS of money at the hair salon.

So, hairy or shiny-pated, here’s to a cool-headed spring and summer…and another year closer to that 60 mark I’m still sprinting towards.


Black or white, or somewhere in the middle?

January 22, 2012

OK, I’m in a decidedly prickly mood today. This may be a reaction to having one person too many gaze at me with wet eyes and the “poor doomed you, Cancer Victim!” look on his or her face. Usually, these well meaning people give oodles of advice on all the alternative treatments I should be trying, be they spiritual, material or behavioral.

While I am getting closer to sixty, an age that used to be referred to as, “elderly,” I do not delight in conversation about medical conditions; mine or anyone else’s. And, particularly if I just met you, I probably really don’t want to dwell on the subject of cancer. A brief mention is ok, then on to other things.

One thing about me remains unchanged since B.C (Before Cancer): I’ve never subscribed to “black or white thinking.” Meaning, I believe neither in all things AMA nor all things holistic. It’s not that I don’t have some hope for surviving my disease longer than the stats dictate. It’s just that I’m trying to achieve a little serenity by not obsessing about an outcome that is ultimately out of my control.

When I was 19, I lived for about a year in a commune in Palo Alto. Everyone in the commune, with exception of me, was a vegetarian. Most of them were vegans, although that term wasn’t widely used in 1973. There was absolutely no meat allowed in the house. Of course, when the other commune-dwellers were gone for the weekend, guess who bought herself a nice big steak to throw on the broiler? I was very careful to air out the house after grilling my steak; I’d never have dreamed of inflicting the sight and smell of that charred, bloody goodness upon anyone’s delicate mung-bean-loving senses. But, I never tried to turn myself into something I am not: a vegetarian. I’m willing to try a mung bean or two, but do enjoy a little animal based protein along with any vegetation I ingest.

Neither am I drawn to relying only upon macrobiotics, mega-vitamin dosing, treatments at some allegedly miracle clinic in Mexico, magical tea or other ‘alt’ treatments. That isn’t to say that I only believe in what is prescribed by the American Medical Association. I believe in the power of faith, prayer and meditation, at least to comfort and sustain. However, when and if my health deteriorates to the point that there are no AMA-backed treatments left to try, I’d be open to participating in a clinical trial or two. I do believe in scientific process. Even if the scientific process doesn’t specifically save me, it’ll save someone in the end.

Of course I appreciate the caring all that wildly varying advice shows. My would-be advisors want to fix what ails me. And…maybe they want to assure themselves that cancer might be curable after all, just in case they get it, too. Meanwhile, I accept that I have lung cancer, that it may eventually kill me. Worrying about what comes next will not take up the rest of my life. Better to stand firm; throwing my energy into living rather than running away from death.


2012: waiting to see what happens next

January 1, 2012

©2011 L Joyce Croker2011 was a year of discovery, adjustment, and growth. For me, the year always held an air of suspense. At the end of 2010, my doctor mentioned the 12 – 18 months life expectancy statistics. I wondered: would it be 12 or 18 months? Even during the worst bits, I never lost the urge to hang around to see what would happen next. So I did.

The saddest part of 2011 was losing people who seemed too tenacious to ever let go of life. The hardest part was facing and dealing with the reality of an aging parent in need of medical care. The most surprising part was finding help and caring where I’d given up ever finding it. The most triumphant part was when medical treatments allowed me to breath without pain for the first time in years. The biggest challenge was prying off and discarding old resentments I never had time to carry in the first place. Again, nothing like that statistics-imposed ’12-18 months’ deadline to shake a sense of perspective into stubborn old me.

The deadline thing has an up side: my lifelong stance of cheerful hedonism finally seems justified. While I may not indulge in the same pleasure-seeking activities I did at 27, enjoyment is still to be pulled from life with just as much gusto. Decadently long bubble-baths, the rush of endomorphins after a good workout, the sound and smell of the Pacific, the excitement of photographing places never seen before, love for my wife and friends; all enjoyed just as intensely as those riskier activities of yore. Better yet, I’m no longer ashamed of loving wonderful food; who criticizes a cancer patient for having a great appetite? And shopping? Ha! Let them think, “poor dear, let her splurge in what little time she may have left.” Luckily, my wife, who also serves as the family CFO, doesn’t subscribe to this; she still expects me to roughly conform to a budget.

So, I’m looking forward to seeing what 2012 will bring. My mid-December PET scan brought a moment of relief with an aftertaste of anxiety. Relief for how the chemo has knocked back cancer activity in the originally affected lung. Anxiety over a tiny new spot at the base of my neck. Will there be more radiation, more chemo? 2012 should provide some answers. Meanwhile, I get to stick around for the duration. Waiting to see what will happen next.


Anniversary: 12 months and counting

November 27, 2011

Joyce and Joan at Fred and Aidan's Wedding12 months ago today, at approximately 8am, I underwent a bronchoscopy; a procedure my pulmonologist ordered to look for the cause behind the painful cough I’d had for nearly two years. When they wheeled me into the OR that morning, I wasn’t terribly worried. Instead, I was hopeful my doctors might discover what was wrong so they could fix the problem.

My OR nurse was a youngish woman with a big smile and a wry sense of humor. When I mentioned my wife in passing, my nurse made a point of mentioning the lady she’d lived with for over two years. Hey, jokes and bonding in the OR: sweet! When I went under, I felt secure, surrounded by an upbeat, confident medical team. I awoke to a more somber vibe. The nurse who had been so chatty seemed sad and suddenly had few words for me. When I saw her face, I remember thinking, “Uh, oh…this can’t be good.”

Back in the recovery area, a young doctor broke it to me: I had lung cancer, probably stage 3. He showed me pictures taken of the blockage to the middle lobe of my right lung. Having never smoked in my life, I was surprised and devastated by the seeming unfairness of it. The people I’d known who had lung cancer had died; painfully and in a matter of months. When Joanie came to check how I was, she found me alone in my curtained off cubicle, quietly crying and clutching bronchoscopy printouts. After yelling at the nurses for leaving me alone with such horrible news, she took me home. We took to our bed for the rest of the day, me shaking while she held me. All I could think was, “so this is how it feels when you find out you’ll be dead soon.”

Luckily, the next day came and I felt more myself. Perhaps not the jolliest form of myself, but definitely not the trembling, hopeless creature of the day before. Googling non-small cell lung cancer informed me life expectancy for stage 3 is 12 to 18 months, with treatment, not exactly cheerful statistics. Still, it looked like some people lived months; some going into remission, living a year or 2, occasionally 5. A few lucky souls made it years beyond that grim day of diagnosis.

12 months, 30 radiation treatments, and numerous chemo sessions later: I’m still here. I have less hair than before, but I’m neither shaky nor depressed. Frankly, I’m feeling pretty grateful. Saying I’m thankful for having cancer because of all I’ve learned might sound Pollyanna-ish. Let’s just say I’m thankful for all I’ve learned over the past year, however that knowledge was gained. I’ve learned how many true friends I have, and how much they mean to me. I’ve slowed down enough to enjoy those friends, my wife and my life more consistently than I did before November 26, 2010. While I previously gave lip service to the notion that life is precious and to be savored, now I feel it in my bones every day. Through friends who are living with cancer, I know that absolutely nothing is guaranteed with this disease. Following doctor’s orders and having a positive attitude seems to help, but cancer kills even those who do. So, we grab life while we can with both hands, great appetite and gratitude beyond belief. If all goes well, that’s exactly what I’ll be doing next November 26.


Shut up and dance!

November 19, 2011

Joyce at Renaissance Faire, 1981The last month has been stressful, in my personal as well as professional life. The good news is that my mind has not been on cancer…or at least not MY cancer. The bad news is that most nights were spent tossing and turning and obsessing. Over what? Over real and anticipated encounters with people in my life, who, while very important to me, are often not the easiest to deal with. After about a solid week of insomnia, one becomes too exhausted to worry anymore. Leading to chronic punchiness and the usual fantasizing to cheer myself up.

On my long commutes to and from work this week, an old habit returned. When upset with seemingly insolvable relationships, I visualize a huge dance party, starring all my best friends and some of the folks whom I find most challenging. Mind you, I never imagine dancing with people I dislike. To want to touch you, I gotta like you. It’s those I hold great fondness for, but have a less than even keeled relationship with, whom I engage in my imaginary dance therapy.

This is what I propose: when business meetings get really tense, when you’ve just confronted your boss (or vise versa) with issues that arouse their inner porcupine, EVEN after a rough day waiting in line at the DMV; wouldn’t it be great if everyone could just find their places and break into dance? How easy is it to keep glaring at someone while leading them in a spirited cha cha? How irate can you stay with someone you’re twirling around your head in a mad Volta or holding in your eyes during a particularly close tango? By that point, your focus will be back to harmonizing with your now-partner and obeying the music. No more adversity; only music, rythym and heavy breathing of the sort one can do in public.

And, really, in this big dance hall we all seem to be milling about in, what else could be more important than that?


An odd thing to be grateful for

November 5, 2011

Joyce CrokerLast Friday found me moping along, feeling physically well, but frustrated over my lack of influence over the same people/places/things various 12 step programs tell us we’re powerless over. I was mad enough at someone I work with to start dragging out the black candles and myrrh, and just couldn’t let go of the anger, as silly as I knew this obsessing to be. To improve my mindset, my plan was to bury myself in the whirl of social activities planned for the weekend. Then I noticed a voice mail that had just come in on my iPhone. The message was semi-coherent and difficult to understand. I knew it was my mother, and she sounded frightened and weak. She has resisted medical care for years, and also refused moving closer to either of her two daughters, of which I am the elder. My nearly 81 year old mother lives 350 miles away from me, in San Jose. She has cherished her independence, even while she has lost the ability to care for herself and her home. Finally, she was asking for help.

It’s interesting how quickly one can drop all the ‘urgent’ plans one makes when there is a real emergency. Social obligations? POOF, gone! Work-related deadlines of doom? I’d already delegated them mentally before I finished listening to my mother’s phone message. All previous plans dropped, we boarded the parrot, packed up the car and got ready for an early morning drive up to the Bay Area. Luckily, my mother had managed to contact paramedics and was taken to the emergency room. Her leg wound was so infected it caused her heart to go into atrial fibrillation; which could have led to a stroke or heart failure. At the very least, her leg was so bad they were considering amputation. We made it to Santa Clara by 11am, Saturday morning.

My mother is probably the stubbornest person I know. It made me sad, but relieved, to hear her admit that she needed help. After trying to get her to see a doctor for over a year, she was finally agreeing; there was hope!

My sister, Kathleen, rented a car and drove down from Oakland Saturday afternoon to visit and begin working on cleaning the house up. We were able to have a pleasant belated-birthday dinner for her, and it feels like we’re working on the same team. Tah dah– the Croker sisters: united again! With my mother agreeing to stay put in the hospital, Joan and I felt it safe to drive home on Sunday afternoon.

Mom was released to an acute nursing facility Wednesday afternoon. Thanks to the folks at Kaiser-Permanente Hospital in Santa Clara, she left with a normal heart rate AND her leg, which is healing. After a month or so, we hope to move her back home, which will probably involve engaging a home health care worker. Meanwhile, Kathleen has been dealing with plumbers and repair people and applying much elbow grease towards getting Mom’s house livable again. We’ll figure out the rest as we go. The plan is now to spring my mother from the nursing home for Thanksgiving and have the first family Thanksgiving in years at my sister’s.

So, besides the obvious, what am I grateful for this Friday? I’m grateful that life sometimes comes along and kicks some much-needed clarity into one’s obsessive little head. The process of caring for my mom won’t be easy for my sister or me, but it’s worth the energy expended. I’ve saved the black candles for a future, less trivial cause.


Hope and a little peach fuzz

October 15, 2011

Lighthouse by L Joyce CrokerI’ve been a little blue over the past month. The atypical glumness came with the deaths, in rapid succession, of several people I cared for. Despite their passion, humor and tenacity, they didn’t manage to hang on to the life they loved so fiercely. Perhaps I believed deep down that, somehow, fighters will prevail; against disease, against the ups and downs of life. How true my former belief is not saddened me for weeks. It all seemed overwhelmingly unfair.

Then this week arrived, and my scalp started sprouting baby-fine peach fuzz. I was initially elated, then depressed thinking that it’ll soon fall out once chemo begins again. Baldness isn’t the end of the world, but I really do miss my hair. Today brought some good news: Wednesday’s CT scan showed normal sized lymph nodes, and a minuscule reduction to the primary tumor. My oncologist will have tissue from January’s biopsy sent for ALK mutation testing to see whether I’d be a candidate for that new wonder drug, Crizotinib. I’ll begin a new regimen of prednisone to reduce lung inflammation, undergo another PET scan in two months. Oh yes, AND for now we’re holding off on more chemo. I may have hair by Thanksgiving!

So, I get to spend the next few months buzzing around like the Engergizer Bunny (side effect of prednisone). This means that all my clothes will soon be mended and ironed, we’ll have an extremely clean house for the holidays, and maybe we won’t have to cancel our Christmas party, after all.

Nothing has really changed: Those who recently died are still dead, I still have cancer and we haven’t hit the super lotto just yet. What I do have more of this week: hope and a little peach fuzz.


Remembering Lia

September 26, 2011

Fern in WA RainforestOn September 8 my inspire.com friend, Lia Orlando, left this planet for good. She was 46, and had battled NSCLC since the summer of 2009. Her grieving husband, Mark, let her online friends know the next day. I read the news after I arrived in Utah on the first day of our vacation. I’d been thinking of her all day on the 8th, and planned to email her the next day from the road. Although I only knew Lia from her spunky online posts and emails, I still can’t think about her death without crying. I find this embarrassing; I feel that I don’t really have the right to mourn someone I knew so slightly. Embarrassing or not, I’ve put off writing about her long enough.

Lia’s feisty and caring nature attracted quite a few friends. She loved camping and being on the water, and looked forward to returning to outdoorsy pursuits. Robust in spirit even at her sickest, she made us believe she’d eventually lick the cancer. When she wrote in July of her doctor “using the H word” (recommending she enter hospice care), it pissed me off. It seemed they were writing her off prematurely, in essence burying this vibrant ball of energy alive. I’d managed to ignore how far her disease had progressed and how battered and tired the two-year fight had left her body. Whether or not we were ready to let go of her was never the issue; it was her fight, not ours. She fought hard, but when the fight was over, it was over. During her July hospitalization, we started referring to her as “Tinkerbelle,” telling her we were clapping for her to keep going. We never imagined her as the dainty, Disney-esque version of Tink but the passionate hellraiser J.M. Barrie wrote into existence in 1904. This 2011 version was just as playful, but was larger, tattooed, and rode motorcycles.

Whether she was wood sprite or woods-woman, I’m honored to have known her, even in passing.

You managed to fly off, Lia, but we’ll never stop clapping for you.


The best laid plans

September 2, 2011
Joyce, not to happy how things are going...

This is NOT how I planned to spend the weekend!

I had planned to get through last Friday’s chemo session without a hitch, then rush home and begin packing for our vacation, which was to have started today. Yup, that was the plan. However, sometimes one’s plans don’t matter too much in the overall scheme of things.

Last Friday found me in a private room in Kaiser’s infusion center, administered to by Nurse Joyce, a diminutive, Filipina ball of energy who’s taken care of me a number of times over the past six months. Everything was going as scheduled, the Carboplatin flowing smoothly into my new power port, my iPad propped in my lap as I answered email and reviewed layouts from work. Nurse Joyce was asking me the usual questions about my health, side effects, etc., when I found I couldn’t think of words. The first word I couldn’t think of was, “neuropathy.” Soon, I was too cold to think of any words at all. At the time, it was 91° F outside, and probably in the mid-70s indoors. I was shivering like it was mid-winter in Maine. Nurse Joyce asked me if I wanted to stop the chemo, but Ms Stubborn-Beyond-Belief insisted she continue the chemo. She switched me to the bag of Taxol.

Two-thirds of the way through the Taxol, I became violently ill, the temperature in the room seemed to plummet further, and my entire body began shaking violently. In between heaves, I noticed I couldn’t breathe and began wheezing. Joan arrived in the room around that time and noted that I had turned very white. She also noticed that I couldn’t talk; something she’s never seen in the 20 years we’ve been together. The chemo was stopped and it became evident that my plans had just flown out the window. My oncologist arrived, took one look at me and sent me to the ER. Besides not being able to breathe, the thing that scared me most was the look on her face.

At the ER, I was proclaimed “neutropenic” (having a dangerously low white blood cell count), and was discovered to have a fever just below 103°. I was given oxygen, hooked up to an IV and administered a strong antibiotic. After many hours and a rather unpleasant incident involving a flimsy plastic bedpan (“You’ve gotta be kidding, you want ME on THAT? Do you know how much I weigh?!!”), I was admitted to the hospital.

My neutropenia (no, this is not something one buys at The Pleasure Chest and enjoys in the privacy of one’s bedroom) earned me a nice private room with a view. Anyone entering the room was required to don an over-gown, gloves and a mask. They even gave me menus to choose my 3-meals-per-day from. Except, when I ordered something not kosher on a neutropenic diet, such as a green salad, I got something else, like canned peaches. Oh well, sort of felt like a return to my childhood. Yes, they even had Jello for dessert!

After 2 days of enforced rest and the attentive care of Dr. Mike Chang, a smart and funny intern who looked all of 14 to me, I was released from the oncology ward. Although last Friday didn’t go the way we intended, perhaps enough carboplatin/taxol got into my system to bash more cancer cells. While we didn’t get packed for vacation, which we’ve moved back a week, I actually got the rest I needed. It just didn’t happen as I had planned. And, maybe it was better that way.


Instant bliss: just add (salt) water…

August 21, 2011

Joyce's catchOn January 2 of most years, you’ll find me down at the nearest sporting goods store buying my annual California State Fishing License. This has been true since I ‘discovered’ saltwater fishing about 15 years ago, after my wife gifted me with saltwater fishing tackle one Christmas.

This year was the exception to the rule. In the midst of all the getting-used-to-having-cancer hubbub, I managed to forget all about fishing. Yesterday, my friend David treated me to a half-day trip on the Monte Carlo, a local ‘party boat’ out of San Pedro’s 22nd Street Landing.

We traveled up the coast a short distance and fished just off Palos Verdes. The morning cloud cover had lifted to reveal brilliant blue skies dotted with wisps of cirrus clouds. The breeze was faint, allowing us to fish in shirtsleeves while enjoying the sun (I’m a 70 spf gal, myself). Even the tide was helpful, sending our bait out to the kelp where calico bass, aka kelp bass, waited to pounce on our bait. Oh yeh, NOW I remember: I really, really love saltwater fishing!

When I fish, I don’t worry about work, lovers, friends, politics, global warming…or even whether I catch a fish. The fascination is in the ritual: choosing the right hook and sinker, putting the bait on the hook so it doesn’t fly off before it hits the water, casting so your line doesn’t tangle with another fisherman’s. Then…you pay attention. And wait. With live bait, you can tell when you’re about to get a bite when your bait starts swimming crazily through the water trying to escape the oncoming fish. The trick is in hesitating just long enough for the fish to bite the baited hook, then swing, set the hook, and reel the fish in. Usually you know what kind of fish you almost have by the quality of the bite; bass slam the bait, perch peck at it, halibut hold it in their mouths forever before a few heavy yanks tell you they’re hooked. Still, you don’t really know what’s hooked until you see color (the fish in the water beneath the boat). And you don’t actually have the fish until you’ve gotten it on deck. Watching it swim off your hook as it nears the boat doesn’t count as catching.

David and I both left the Monte Carlo as happy fisher-people, fresh-caught filets bagged securely for tonight’s dinner. We’ve agreed we’ll absolutely be doing this more often. I’m even planning a trip in September for six of my female friends, all novice saltwater fisherwomen.

Who knew that relaxation, camaraderie and fish for dinner were so easy to achieve in one afternoon? Just add salt water!

David Nakase with Fish

My friend David with fishy friends.

Squid on hook

Mr. Squid; the only unhappy guy on the boat.


The Next Big Thing?

August 6, 2011
Joyce's new Power Port

Nurse Maria using my newly installed PowerPort for the first time.

OK, I admit it: at heart, I’m a total techno-junkie. I’m all about any new hardware that takes care of the tedious, repetitive tasks taking up so much of life. If it’s latest and greatest, I probably own one…particularly if it has an Apple logo on it.

Before Wednesday, all my chemo was being administered via needle-stuck-in-my-hand. Unfortunately, the drugs used for chemo scar the walls of the veins, narrowing and possibly collapsing them over time. Enter the PowerPort, a device that routes drugs directly into the big vein going to my heart. It can also be used for dye-injection in upcoming CT scans, and for the mandatory blood-draw prior to chemotherapy.

Unlike the PIC line I wore earlier this year, the PowerPort involves no dangling tubes and little risk of infection. Once the small incisions made to insert the device have healed, I’ll be back to boogie boarding, long bubble-baths, and all the other summery sports involving beach and sand I’ve been enjoying this season.

Long live technology! Now, if only Apple made these things, it’d probably have on-board video AND allow me to phone home. Mr Jobs…could this be your Next Big Thing?


Back on deadline

July 23, 2011

Dr. Chang's latest drawing of Joyce's lung.For the adrenaline junkies among us, there’s nothing like a deadline to get us focused and back on schedule.

The news received Thursday morning brought me another “wake up and smell the coffee” moment, making me feel my personal deadline more intensely.

Joan and I met with Dr. Chang, my thoracic surgeon, to get his read of my last scans (CT and PET), what he thought the glowing meant (cancer or merely effects of radiation treatments), and whether they’d ever opt to operate.

The verdict: can’t really tell anything except there are no new spots of cancer. Cancer seems to be shrinking, but hard to see how much. Can’t presently tell whether the FDG (glowing Fludeoxyglucose) activity in lung obscured by radiation damage is cancer or merely pneumonitis. Even if cancer appeared dead on scans, making surgery an option, they’d only do if a biopsy proved the cancer ousted from lymph nodes. Downside: after radiation, lung tissue is damaged enough to impact healing. So, what would have been a six week recovery time, pre-radiation, would be longer and recovery dicey. Bottom line: would I want the surgery even if the situation were go? Hell, no!

We asked whether the second tumor (which had blocked airway to middle lobe) is really gone. Dr. Chang whipped out his ballpoint and drew us a diagram on the examining room table showing what he thinks happened: the blockage was probably from a lymph node adjacent to the bronchus, not within the lung. Radiation had either eliminated it completely, or shrunk it down so far that the airway is now wide open. Is the cancer still there in the lymph node? No way to tell without biopsy.

We left Dr. Chang’s office strangely relieved. We don’t really know exactly what’s going on in Joyce Croker’s right lung, but we have a better idea of what MIGHT be going on, and how to proceed. Plan of action: complete the chemo and prednisone treatments, wait a while for pneumonitis to subside, then another PET scan. Then…we’ll see.

Meanwhile, I’m taking full advantage of the elevated adrenaline levels the prednisone affords. Most mornings I’m up (way too early), zipping around getting stuff done like some hairless version of the Energizer Bunny. Those yawner tasks I’ve shoved into a closet for years are being ticked off my list, the house is becoming more organized, and I’m tackling issues at work (mostly people and personalities) I’ve long hidden from. Life, while more sharply felt, is sweet and available RIGHT NOW to be grabbed by great big handfuls. Just being able to breathe without pain makes my day. Even the mundane, the day to day, has become a comforting ritual. Is this all related to being hopped up on prednisone? Don’t think so, my friends. I believe I’m back on deadline.

And Joyce loves her deadlines.