Pain in Nick's A**: Where the sun don't shine

So back in July I had my clearing colonoscopy. Finally the doc was able to go all the way to the Appendix and Ileocecal valve (where the small intestine joins the large intestine). I should probably be given a discount as the doc doesn’t have go to as far (since they removed about 12” of my large intestine) and the path is most likely less tortuous, but I doubt that will happen. Prior to the procedure I spoke with the Doc and told her that I remembered my last colonoscopy and I’d rather that not be the case this time. She said that must have been unpleasant…yes…yes it was. She knocked me out, took a look around, found the polyp that was seen on the virtual colonoscopy, clipped that sucker off, and sent me on my way. The polyp was determined to be a tubular adenoma with no evidence of cancer. So that’s good. In a year they’ll take another look around.

On Tuesday I had a CT to check for recurrences. There are some nodules in my lungs that the docs are keeping an eye on. They don’t think they’re cancer as they have been stable on all of the previous scans. Well this scan was no different. The nodules continue to be stable. They are the exact same size as the day they found them nearly a year ago. Seeing I went through some nasty chemo and they didn’t get smaller, most assuredly they are not cancer. No doc will give you a 100% guarantee, but I'll take a 'most likely not' at this point. So the scan came back clear.

So as of today I’m considered NED (No Evidence or Disease). They typically don’t start throwing around the ‘cured’ title for colon cancer until you’re out about 5 years without a recurrence. So surveillance mode it is. I’ve got another follow-up in 3 months for blood and a check-up, another CT scan in 6 months, and another colonoscopy next July.

In the meantime I feel great. So getting back to living a normal life is in order and hopefully the last year will just become a bad memory.

Pain in Nick's A**: Chemo...DONE!

So here I am...I take my last Chemo pills in the morning. DONE...Freaking DONE. Oh how glad I am to not have to feel crappy again next week.

Last Chemo Drip Treatment

During my last drip the Stanford Infusion Center staff sang me a little song.

So what are the next steps? Well on the 18th of July I get the pleasure of finally having a full colonoscopy, since they've been unable to get a good look past the first few inches. So that will be fun. After that I'll have a CT scan sometime in the fall just to keep an eye on everything.

As of now I look forward to recovering from the Chemo (little neuropathy in the feet), then hopefully this can all go in the history books as a bad nightmare.

Pain in Nick's A**: Senseless Violence

Right now by the thousands, my cells are being massacred. Destroyed by this nasty cocktail of drugs I'm taking and hopefully for absolutely no reason at all. One might wonder why I say that. Don't I want the drugs to be killing the cancer? Well yes, killing cancer is a good thing, I'm all for it. As a matter of fact I'm one of the biggest fans of dead cancer. But, my best shot of a long healthy life is that all of the cancer was removed by the surgery. Unfortunately there's no way of knowing if the surgeon got it all. So that's where the Chemo comes in, to mop things up. Chemo is good at prolonging life, which is a good thing. Unfortunately it is piss poor at 'curing' cancer, at least colon cancer. So here's for hoping there's some serious senseless violence going on.

I'm about 66% through treatment now, four infusions down, two to go. If the schedule holds, I take my last chemo pill the last week of June. So there's a light at the end of the tunnel. I can't wait, I feel so good during my off week, it will be nice to feel good for consecutive weeks. The side effects from the infusions are hanging on a little longer each time. This last infusion kind of sucked. I started getting a tingling sensation around the IV site, by the end the inside of my whole right arm felt like it was asleep. The cold sensitivity is the most annoying, feels like you're swallowing razor blades when you drink cold water. The peripheral nueropathy causes tingling in the hands and feet, isn't great by manageable. So far I've been able to keep the hand/foot syndrome (cracking, swelling and blisters on the palms and sole of your feet) at bay, by slathering up with bagbalm before bed. I think I'm also experiencing a little "Chemo Brain", my short term memory seems to be slipping and forming and saying words in a conversation is challenging from time to time. Telling someone a story I've told before doesn't seem to be affected, but with new speech sometimes the words just don't seem to flow. I see the words in my head, but they just don't get turned into sounds out of my mouth. Really kind of annoying. So if I seem slow from time to time, you'll have to forgive me. Luckily it seems to be temporary.

Once the Chemo is done I'll probably have some scans (CT and another colonoscopy) in the mid Oct. time frame. Oh how I'm looking forward to potentially two consecutive months of no poking an prodding.

Just in case anyone was wondering, I still don't recommend cancer. It's not that fun.

Oliver's Second Year

Here's the video of Oliver's second year on planet earth. The video is a bit long, but I don't know cutting a year of memories into about 20 mins isn't to bad.

Just a quick note the video won't play on the mobile youtube app because of copyright issues with some of the songs we used for what ever reason (probably because they can't efficiently place ads on mobile devices but have no problem on computers). But you should be able to watch it on a browser on a mobile device just fine (worked on my Android phone using Google Chrome).

Pain in Nick's Ass: Serious Bussiness

So probably everyone realizes Cancer is a big deal. If you don't let me tell you from experience, it's a big deal. It's easy for cancer to become the 'elephant in the room', but one of the reasons I decided to write about it in this blog was to at least reduce the size of the elephant. I really have no problem talking about it, if you have a question and I know the answer, it's yours. Beware though, I'm am not a believer in the, "there are no dumb questions," paradigm. Yes, there are dumb questions, some really dumb questions. "Does having cancer suck?" Yes, dumb question. "Are you going to die?" Yes, we are all going to die at some point, dumb question. "Is Chemotherapy fun?" Yeah, I kind of like feeling like poop for days on end...No Chemo is not fun, dumb question. "Does it hurt to have a portion of your colon removed?" No, it tickles...of course it hurts, dumb question. I think you get the point.

One of the first things you do when you have a serious health issue, is you look at the odds of a good outcome. It's human nature to try and correlate those odds to your individual case. The problem is each case is individual. As of 2000 stage IIIB Rectal Cancer had a 5 year survival rate of about 45% according to the American Cancer Society. Yeah...55 out of 100 people with my Cancer don't make it 5 years. That number is a bit sobering, huh? On the other hand 45 do survive, unfortunately there's no way for anyone to know what group you're in. The 45% is a bit of a worst case number as it includes non-cancer deaths and the data is a bit old. A better number is probably is probably in the 60-70% range.  Even then I have a number of things on my side, my age being probably the biggest one. If the cancer comes back, I'll be strong enough to kick in the teeth again. But, the fact is, there just isn't enough data of people my age to get at the survivability rate for my little demographic for my particular cancer. In the end, I'm not sure it matters. What if the survivability is 90%, that is still 10 people dying out of 100. Is that suppose to be comforting? Not if your one of the 10. In the end the odds are what they are. It really doesn't matter what the odds of getting struck by lightening are to the guy that gets struck by lightening, because his day just got really bad. I have basically been struck by lightening. Out of 300,000,000 people in the US about 150,000 are diagnosed with Colon Cancer. Of that 150,000 only 10% are younger than 50. So that takes the 150,000 to 15,000. The numbers are a little sketchy, but of the 15,000 approximately 1500 are less than 35 when diagnosed. So, I'm one of 1500 in the entire US to get Colon Cancer under 35. About 400 people a year get struck by lightening. So really you have two options let the scary numbers scare you or not worry about them knowing that I will do everything in my power to punch caner in the nose over and over again until one of us wins. I'll choose the later.

One of the other things that go through one's mind is, "what caused this?" Unfortunately a question like this could drive you crazy, because no one knows what exactly flips the switch of a epithelial cells that gets them to start multiplying unchecked. There are risk factors like smoking, obesity, drinking, to much red meat, lack of physical exercise and genetics. But all they prove is correlation not causation. Maybe 'Fat Nick' and all those burritos I ate for lunch were the cause, but there are plenty of people who are infinitely less healthy than 'Fat Nick' ever was, yet they never get Colon Cancer. So in the end I'll never know what caused the runaway cells and it was likely some mutation that there was no way to control. With that said I'll probably be living a bit healthier, so don't expect the return of 'Fat Nick'. Yeah I know, he was a fun guy and his head doubled as a basket ball, but he's gone from this world.

I will say it sucks to have to start contemplating your morality at such a young age. No fun at all.  Lindsey and I were forced to have hard conversations about the future of our family. We were going to start trying for kid number two last October. But, "surprise you have cancer", kind of put a halt to those plans. So kid number two goes on hold, or is there even going to be a kid number two? It's really easy to say, "oh just live your life," or some other free spirit BS. To some extent I agree, you don't want every waking thought to be, "damn...I might die in a couple months." With that said a more than healthy percentage of stage 3 cancer patients, don't make it to five years. Would it be responsible of Lindsey and I knowing that, to pop out kids like Pez candy? I personally don't think so. If I'm gone who's going to kill the spiders in the house? It's crappy to have to think about these things, but in the end we both have responsibilities and not taking into account a future potential issue is irresponsible, in my opinion.

With all of that said given the free and clear signal, the significant reduction in the amount of crazy drugs I'm taking, and appropriate length of time to ensure there are no 3 eyed swimmers left in me, we are going to try for another kid. With Linds and I both having siblings and how cool it is, we just can't imagine Oliver going through life without that.

This all might sound a bit pessimistic to some, but it's real and sometimes reality isn't all that great.

Pain in Nick's A**: Adjuvant Chemo Started Today

So I started Chemo today...yippee. The first drug on the cocktail for the day is Oxaliplatin, it screws with the DNA synthesis in the tumor cells due to it cytotoxic (toxic to cells) effects. It's pretty nasty stuff, the nurse came in with a with a gown and thick gloves carrying the IV bag. Makes you feel real comfortable they're about to pump this stuff through your veins. Also got a steroid, Calcium, Magnesium and an anti-nausea drug. The whole thing took about 7 hours. I started getting some of the symptoms by the time the drip finished. Cold sensitivity, soreness in my arm the put it in. etc... There's a huge list and I had more by the time I got home. Good times...

I started the Xeloda again tonight, I only have one more pill to take a day than I did before, so I'm hopeful it won't be much worse than last time.

Found this little video on the Xeloda...kind of interesting.



With all of that said hopefully this is all for nothing and the radiation and surgery did the job to remove the tumor.

Oliver's First Haircut

Last week Oliver got his first haircut. He went from our baby to our little boy. It's amazing how a little haircut changed the look of our little monkey.

Getting ready for the cut, he got to sit in a car and watch Winnie the Pooh so he was pretty happy about that.

Getting the cut.

He had fun wearing his 'Batman' cape.

All done with the cut.

Our little guy...all growed up.

Pain in Nick's A**: T+24

It's been 3 weeks since the pain in my a** was removed, literally. Figuratively, it will continue to be a pain in my a** for months to come. With that said I'm feeling pretty good these days. There's no doubt in my mind that my wonderful nurse(Lindsey) has pulled more than her share of the weight these last few months and that has helped with my feeling as good as I have. Basically being a single mom taking care of two small children. Luckily only one in diapers though. I'm truly blessed to have found such a wonderful woman.

I didn't realize how uncomfortable I was the two weeks prior to surgery until I was able to compare it to the last two weeks. For the two weeks prior to surgery if there were feces near the tumor it was uncomfortable. How uncomfortable? Basically it felt like I had to take the a giant poop ever nearly all the time (even gas would cause this feeling as well as tiny poops) and if I didn't I'd start to get nauseous (I almost tossed my cookies the night before surgery). No more feeling like giant poops need to happen all the time and nothing coming out and no more nausea.

Bowel function was one of the things the surgeons warned about. You see I have about half the amount of rectum as regular person now. What does that mean? Well the rectum acts as a temporary storage site for feces. As the rectum fills stretch receptors in the walls stimulate the need to defecate. If you don't act on the urge, often the rectum pushes the feces back into the bowel relieving the urge. So since I have less rectum, it fills faster, the walls stretch sooner, which creates the urge to defecate more often, with less ability to push it back into the bowel. Both surgeons we talked to said it's not uncommon for people to have the urge to defecate upwards of 15 to 20 times a day (uh...that would suck) after this type of surgery and then ask for a colostomy after the fact. Both also said that it can be trained down over time, like exercising a muscle (which the rectum is), but after about 2 years it is what it is. So I'm ahead of the curve here. I'm probably averaging about 3 poops a day, which is entirely manageable. At the two week follow-up the surgeon said it's likely that this is the worst it will ever be and could get better. So going from having an urge nearly all the time to 2-3 time a day...I'm going to call that a win.

As many know, I'm a bit of a nerd. I mean how many people build a machine to dispense margaritas, just because they can? Yeah not many, just giant nerds like me. I wanted to see how the incisions healed so I took a picture nearly everyday from 2/1 to 2/10.  Below is a little animation of the change.

Incision healing

As a medical device engineer I'm always fascinated by how different things are accomplished in surgery. Connecting two tubular structures in the body is called an anastomosis. My surgeon used a intraluminal (circular) stapler made by Ethicon (J&J). The stapler places two offset rows of titanium staples to create a seal between the two sections of bowel. Here's a video showing the process (warning: a bit graphic as it's a real surgery).

I read a study that said that after 3 days post surgery the coupling is at 60% strength of the bowel wall and after a week the coupling is a 100% strength. Pretty amazing that after a weeks it's full strength.

Pain in Nick's A**: T+7 Days

So things are healing pretty well. Everyday I'm feeling a little less sore. I walked a mile the other day (slowly, very slowly) and felt pretty good. Planning on another walk today. Right now I'm just on Ibuprofen, haven't take a Norco (aka: Vicodin, hydrocodone and paracetamol (acetaminophen)) since the first night. Some may wonder why I'm skipping the 'good stuff', two reasons. First, the main reason, one of the main side effects is constipation. I'm just thinking that I should be as easy as possible one my new plumbing. Second, I'm just not a huge fan of narcotics. I also like to 'feel' my body, as I believe it gives the best information on how things are going and I don't want something masking those feelings unnecessarily. Sounds a little hippy like now that I've re-read it. Oh well.

So I've gotten through a about a half a stack of previously unread magazines and have nearly drained the DVR of unwatched shows. Next on my list is starting to design the mechanical structure for my future 3D printer. So I'm not quite bored yet, but definitely getting a little cabin fever.

People keep asking about the incisions, here they are, in all of their glory. Little bruised, huh. No wonder it feel like I was kicked in the gut, looks a little like it too. Well what I imagine a good kick in the gut would look like. The three little upper incision are the laparoscopic incisions where they put in the various instruments and cameras. The lower one is about 3 or 4 inches, is where they pulled out the bad portion of colon.

The incision.

Home Sweet Home

 Hooray! We are home!! It has never been so good to be home!

Nick is incredible. He is now the star patient for two of his doctors. First, he was the first patient of his radiation oncologist to work the entire 5 weeks of treatment. Next, his surgeon told us to expect 4 to 5 post surgical days in the hospital and Nick was discharged at the beginning of his third post surgical day. He is strong, determined, and positive.

The day of surgery was by far the longest day of my life, but it was such a relief to see him come out of recovery with a grin on his face! The tumor is gone and we are one step closer to him being well. The team at Stanford was amazing and we were so blessed to have support and help from our family and friends. Oliver loved all his special dates too. Love you all.

day after surgery

 walking around the unit with Mom and Dad

 walking around the unit with me

making a card for daddy on one of his dates ;)

 first meal at home

Pain in Nick's A**: Going home

Well after three nights and four days all of my liquids/solids/gases are entering and exiting me in the right places, so I'm headed home. My pain has been managable with a little medication and the nurses have been great. All in all it has gone pretty smooth, outside a noisey roomate.

Thanks everyone for all of the support.

Pain in Nick A**: I'm alive

I woke up from surgery. So that's a good start. I feel pretty good other than the fact it feels like I've done about a million crunches. I am also a bit sleepy right now, but that's to be expected. Had a little chicken noodle soup and saltine crackers for dinner and everything its staying down.

I asked the surgeon to take a picture of the removed tissue. Check out this, it is about 12 inches long. The darker red portion on the left side is where the tumor is. The first pic is the back and second is the front.

Thanks for all of the well wishes. It is a wonderful feeling knowing I such a large support group.

Christmas

Normally we spend Christmas up in Seattle, but with the 'Pain in my A**' we decided to stay local. Sitting in car for 14 hours probably would not have been the most comfortable thing in the world  with a 'fire in the hole'. Luckily Lindsey's family, my brother and his girlfriend were able to join us for Christmas. Oh and my brother's dog Lucy, can't leave her out, Oliver is quite obsessed with her.

**Side Note**
Want people to come and see you? Get cancer. It works really freaking well. Just saying. Side effects are a bit of a bummer though. Pros and Cons...Pros and Cons.

Anyways, the 23rd we had the family Christmas party. Little food, some drinks, and the 49ers absolutley getting their a** handed to them by the Seahawks. Didn't phase the munchkin though, he still walks around saying 9ers at everything football. Maaco LV Bowl...9ers! Rose Bowl...9ers! Fiesta Bowl...9ers! Golden State Warrior game...9ers! Yeah we're still working on all the teams and sports. Huskies, A's, pro-basket ball (who cares), but he's got the 9ers down,


On Christmas Eve Chris, Ric and I built Oliver a play kitchen, while Lindsey and Nancy took Ollie to the park. That evening we spent at my Aunt Barbra and Uncle Jim's with both of their families.

Oliver hiding from me in Lindsey's cloths.

Chris, Ric and me building Oliver's Kitchen.

Oliver and Nana headed to the park.

All dressed up for Barb and Jim's

Christmas day we woke up and headed over to my folks house. We got a Nespresso machine for Christmas (early Christmas present), I have to say it's pretty awesome. Nothing like having a way better than Starbucks quality Latte or Cappuccino in about 3 mins.

Oliver checking out his stocking.

Lucy Playing with a new toy.

Making Lauren a Latte with the Nespresso machine.

Hard to get everyone to look at the camera at once.

Oliver playing in his new tunnel.

Oliver checking out some new cars (Uncle Brian would be proud).

My beautiful wife and little monkey.

Meme and Oliver jumping on the trampoline.