1/3 of The Way Home & Sometimes you just Need a Sushi Roll

Sometimes you just need to eat a sushi roll. Jim Harrison often discusses the "restorative properties" of certain meals, and I have never felt anything more restoring than the California role I downed with soy sauce and wasabi this afternoon.

It is perhaps not the best idea to consume food that the general public is warned of consuming for the potential for illness when one has a compromised immune system, but then again it made for the most enjoyable sushi role I've ever eaten. If danger had a flavor it would be that of a California roll, and it would be delicious -- especially with soy sauce and wasabi.

The road to the sushi roll began Monday with labs, which revealed my neutrophils had jumped just high enough to commence the next round of chemo "Escalating Methotrexate." This is now round 3 of 6 heavy rounds of chemo which is followed by 3 years of "maintenance," which is much lighter.

Monday began with a spinal tap with chemo, IV methotrexate, and IV vincristine. Apparantly while sedated for the spinal tap, I discussed sushi with my Doctor for the entirety of the procedure often getting so excited that I'd lift my head up putting pressure on the needle in my back and causing all kinds of trouble. The good news was that the Doctor thought it would probably be all right to eat some sushi, which I took full advantage of today after recieving two shots of chemo in the 'ole glutes this morning.

It seems funny to say that having a spinal tap with chemo, two IV chemos and two shots of chemo within two days feels light, but so far my Doctor's promise that this will be an easier stage seems correct. We have 48 days before begining the next, heavier stage "delayed intensification," and I plan on enjoying each and every one of them.

It seems more than fitting that we began this stage of treatment the day classes resumed at UW. It was a wonderful "Spring Break," but I'm happy to be back on the grind again.

Comment question of the day:

What's the best spring break and/or vacation you've ever taken?

Take Care,

Sam

Spring Break '09!

Spring Break '08! And Good Riddance to Consolidation:

Last year at this time, I and three friends backpacked into the Adirondack mountains and camped in stormy, freezing temperatures for four days so that we could snowshoe to summits of mountains in the high peaks region.

The snow was 6 feet deep at camp, 8 feet deep at elevation. Our feet were blistered; our hands perpetually numb. A pesky and clever Pine Martin would find ways to raid our food supply every day at base camp regardless of how much time and energy we spent trying to outwit him.

The Lean-To we had chosen was too small for two tents to lay flat, so one tent needed to be laid over a log support. Each night two of us would have to sleep with our heads well below our feet, not exactly the most restful way to recover from a full day's snowshoeing and climbing.

Being spring break we brought a fifth of whiskey along with us. The whiskey was largely ignored, however, the bottle of IB-Profen would get passed around each morning with oatmeal.

We would stand atop peaks, freezing our asses off and joke about hot white sand beaches with cold margaritas and ladies in little bikinis. The joke quickly became to scream "Spring Break '08!" any time we were so cold that we could hardly stand it any more.

After four days, we hiked out and returned to my sister's apartment in Clinton, New York. We drove 20 miles to feast on massive, gooey burritos at Tex Mex, my all time favorite Mexican restaurant. On the return trip, I decided we had better stop at a liquor store to get some whiskey and Saranac Ale to wash down the tasty Mexican.

It was well passed two in the morning -- after the contents of the liter bottle of Seagram's Seven and box of beer were finally depleted, after the chicken nibbler eating contest had finished -- before someone finally bothered to ask me "what time are we leaving tomorrow for home?"

"Eight O'clock." I said.

"There's no way you're going to get up and be ready to go by eight!" another said.

"Oh, I'll be ready to go."

A moment from that infamous night is pictured above.

I awoke at seven to the sound of my alarm and hushed voices downstairs in the living room.

"Do you think Sam will be awake enough to drive?" I heard my friend Cavan say.

"There's no way." I heard Karsten say.

I took this as a challenge. I jumped into the shower, dressed, walked down the stairs and said with a gigantic smile "Mornin' boys. Let's get going," promptly at eight o'clock.

After drinking a bowl of coffee in downtown Clinton, I was not only awake enough to take the first stint of driving, I drove non-stop from New York to Wisconsin, through a blizzard. We arrived in Madison after sixteen hours, my point well made. It was a great trip.

I share this story because it is the best way I can describe the last round of chemo -- the "Month from hell" felt remarkably like it feels to drive 16 hours through a blizzard on 5 hours of sleep after spending a night of heavy drinking and 4 days snowshoeing over mountains and sleeping in fifteen degree temperatures and heavy winds.

But... The 57 Day "month of hell" is now officially over -- Goodbye and Good Riddance.

Spring Break '09 and a Medical Update:

The protocol that I'm on requires that my platelet count rise to over 75 and that my neutrophil count (infection-fighting white blood cells) rise to 750 before beginning the next round. While my platelets are in good shape (just over 100), we're still waiting on my neutrophils to rise in order to start (they're at about 200).

While I would prefer that my counts were a bit higher, this little break in chemo came at an opportune time as it corresponds not only with an abundance of sunshine, but also with UW's Spring Break meaning I've been able to spend a great deal of time with Katie and my buddy Phil.

Also, because my marrow seems to be revved up to kick out red blood cells and platelets, I've been feeling very well and having more energy than I've had in months. It's amazing how quickly the body recovers. Whereas a few weeks ago I had days when it was a struggle to remain conscious (this is not an exaggeration), now I'm feeling remarkably well. Certainly not "normal" but very, very well.

In fact, one of the struggles is remembering that I cannot engage in some of the behaviors that I used to. It's a sign that I'm feeling a great deal better when I find myself forgetting things like wearing a mask when I have to go to the clinic, and having to think things like "Sam, don't lick that doorknob even if it would be funny, you don't have any white blood cells, remember?" Or, "Mmmm, Whisky... No, you're liver's already in an endurance competition known as chemo -- you can't drink whisky, remember?"

Particularly special this week was that I was able to ride my "Soma" a single speed mountain bike that Phil and I spent last summer finding parts for and building. We finished this bike shortly before I was diagnosed, and I was able to ride it only once before starting chemo -- Then it sat in my basement this winter for months. Getting out on three rides on the Soma this week in the Springtime sun felt symbolic of a comeback in so many ways.

Also, it occured to me this week that I had not left the city limits in months. It was a beautiful day, and I immediately jumped in my car and headed for my favorite trout fishing stream on a scouting mission and a short hike. It felt great to walk next to the babbling stream in farm fields as well as to drive far too fast down old curvey country roads with the window down while listening to the likes of Bruce Springstein.

Any writing without the mention of food is, in my opinion, a waste of words. If you ever leave my blog without feeling at least a twinge of hunger, then I fear I have failed. So, the food report:

Although my slender appearance may suggest otherwise, those of you who know me well know that my affinity for good food is surpassed by few others, and this week I've really enjoyed some great food. I'm getting better and more creative with the neutropenic diet and it's making life a lot easier.

Figuring I could use the luck of the Irish, on St. Patty's Day I enjoyed the best corned beef and cabbage I have ever had -- salty, filling and delicious. Last night, I grilled out with Katie and Phil and had a grilled portabella mushroom cap with grilled zucchini served on a toasted italian role with mayo and roasted red pepper -- It was amazing to eat something comprised almost entirely of veggies. Tonight, Fish and Chips, a classic that is hard to beat.

Overall, I am extraordinarily grateful for my "Spring Break '09." It's been one of the best Spring Breaks I've had as the events of the last 5 months have magnified my appreciation for the little things in life to an extent that I never imagined possible. A meal, a dance, a song, drive, walk, rainstorm, moonrise, or moment can be more beautiful than words can describe -- and for this perspective, I am thankful.

Happy Spring Break,

Sam

"I'm still Kickin,'" a Few Fill Ups, and a Big Bag of Platelets

When you start getting the "Are you still alive?" emails, it's probably a sign the time has come to update your blog. I must, once again, apologize for the blog update blackout, or "blogout." I am happy to report, however, that whereas the last blogout resulted from being in rather rough shape, this blogout resulted from feeling quite well and devoting my energy to getting work done, getting outside, and doing my best to respond to individual emails and calls -- things I hadn't been able to keep up with in the previous month.

Furthermore, nothing terribly exciting or humorous has happened in the last two weeks to share with you. No blood spurting on walls, unexpected blagojeviching, or late night needle runs. Boring is good. I hope for much more boring in the coming months.

There is one entertaining story to share with you...

While I've been feeling rather well, my blood counts have been hammered by the recent round of chemos and I've needed a few fill ups. Since my last post I've received 4 pints of platelets and 2 more pints of red blood cells.

Last Thursday my platelet count had fallen once again and they brought me back to the chemo room where my transfusion was to take place. I asked my friendly nurse Suzanne if I was to get one or two bag of platelets...

"Just one bag today, you can't get to stingy on us now, Sam," she joked.

After taking pre-meds (Benedryl and Tylenol) and waiting a half hour for them to kick in in order to prevent an allergic reaction, the bag of platelets arrived from the blood bank. It was HUGE. Suzanne held it up and stared at it in disbelief.

"I've never seen a bag of platelets this big," she said.

She began calling other nurses over and I watched in a bene-drilled haze as nurses gathered with comically shocked expressions on their faces.

For the next hour, as the platelets dripped, nurses from all over the chemo room came to my bay having heard the rumor of the giant bag of platelets.

The truly amazing thing is that it was all from a single donor. To use one of my favorite expressions, someone joined the "man-up club" at the blood donation bank, and to the mystery donor I am forever thankful.

All right: the medical update:

Let's see, its just after midnight meaning we just entered Wednesday, day 56 of the 57 day "month from hell." On Thursday I am scheduled to have a bone marrow biopsy to see how we're doing with treatment. Any good vibes, thoughts, positive energy, prayers, ritual dances or ceremonies you can send or perform would be much appreciated.

If my counts are high enough, we will begin the next stage of treatment on Thursday as well, however, my labs on Monday showed that they were still very low, so this is exceedingly unlikely.

Fun Stuff:

Comment Question of the Day:

I'll be sedated for Thursday's bone marrow biopsy which is always interesting because, try as they might, they can never seem to give me enough to put me to sleep, only enough to make my recollection of the event hazy. I end up talking, and talking, and talking throughout the entire procedure and often have rather comical things to say (I know this because I've tape-recorded it in the past.)

In an attempt to save myself the embarrassment of rambling on for a half hour about "the therapeutic qualities of beer and wine," I now usually listen to soothing music while under sedation. I was rather content with randomly picking an album off my ipod until I was driving recently, heard The Ramones "I want to be sedated" on the radio, and decided the irony was just too great to pass up -- the time had come to compile a "Sedation Playlist" on my Ipod.

So, the comment question of the day: What songs (ironic, soothing, or otherwise) should go on the "Sedation Playlist?"

Shout Outs:

SO to Sharky -- I love the shadow box and can't wait to see you.
SO to Philly -- Hope you excelled in Saturday's beer pong tournament.
SO to Shelly -- Thinking of you and sending good vibes your way.
SO to Stuart -- Congrats on hitting the halfway mark... hope you're home and comfortable.
SO to P. Taglia -- Thanks for the prompt and thourough answer to the efficiency question.
SO to Johnson -- It's great to hear from you... hope you have a great break in New Orleans.
SO to Schmidty -- Congrats on Teach for America... Can't wait 'till your back in the Midwest where you belong.

Take care,

Sam