Long Couple of Days

The day after my chemo I received a shot of Neulastin, which is supposed to help grow white blood cells. It can cause bone pain, particularly in the sternum, as the white blood cells are primarily built in the bone marrow. The other side effect is flu-like symptoms. No bone pain so far, but man did it knock me out. I slept all day yesterday and all night. I think this is on top of the normal fatigue from the chemo as well, but the combination really sunk me.

Today was better. The parents got me out of the house. We went to see Bad Teacher. It was ok. Not the best movie to see with your parents, but whatever, it was their pick lol. Afterward we went to a great Thai restaurant. I got the special curry. It had sea food. Including mussels, which I like, but one had the beard still on it. Mussels need to be de-bearded before being served. The beard means they were fresh, but it's basically the seaweed they were munching on when they got caught. The other mussel crunched when I bit it. I pulled out the crunchy bit and it was a tiny crab. A little gross, but whatever. Still great curry.

Had one more radiation treatment. Only 32 more to go. Back at home and starting to sink a little.

Of Chemicals and Radiation

Man, have I been lied to! Every movie these days seems to be about irradiated and chemically doused dudes becoming superheroes. Well, I'm here to tell you it's a load of crap! So far anyway.

I spent four hours hooked up to chemical waste and 5 minutes being irradiated and nothing! I'm still a boring out of work graphic artist painting stuff that mostly hangs only on my own walls. If modern culture is to be believed, I should be able to read your minds or at least make things move by thought.

Oh well. The day started out fine. Woke up and the parents drove me to Ironwood Research for my first day of chemo and radiation. I like the place, even though it's entirely too full of people with cancer. And it's only one of at least 15 centers in the Phoenix area. Today had less people in the chemo sun room than the day I came for teaching, but it was still disturbing to see so many people getting treated.

After about a half hour (there were only two women doing the duties and some of my meds hadn't been delivered yet), I was sat down and equipped with an IV. I hate needles more than anything but was glad to not be getting a port installed in my chest like the woman at the end of the row. I know it must be painful and the look on her face confirmed that. My ordeal was much less painful but still no fun. No amount of 'immersion therapy' will relieve me of my phobia for needles. The pain is never as bad as my fears make them seem and I know this both before and after the deed is done, but it still doesn't make the sweats go away. On the plus side, she let me keep the IV in overnight so I don't have to get poked again tomorrow.

After the nasty needle (it's really a small flexible hose that stays in after the needle is removed), I got a big bag of fluids and the big bag of Cisplatin, the chemo drug. When I say big I mean big. Looked like a flexible two liter. Just before this I was given three magnesium pills and one horse pill of Emend. The Emend is for nausea, specifically for late onset nausea, magnesium is to alleviate the loss of said mineral from the chemo. In the IV fluid bag I also get potassium for the same reason, and Mannitol to help prevent damage to my kidneys. Lasix is added to the IV about halfway through to help flush the kidneys. The tech called it Vitamin P because that's what it makes you do. A lot.

The chemo treatment takes about four hours. I was surprised the time went by so fast. It was helped by the odd but sweet lady next to me receiving her treatment for squamous cell carcinoma which, though in her throat and cleared in 2007 is now returned in the bone of her skull. The good news is that it's not the worst kind of cancer you can get up there, but it's still in her head and still f-ing cancer. She had a great attitude even though she was clearly weakened and I suspect a little slow or slightly confused at times. She admits her balance is messed up and she did kinda sway a little when she stood to leave, but I don't know how much of all of that is due to her cancer or her age. She looked to be about 65 or 70, but as she had no hair and had some weight on her, diminishing any wrinkles, it's hard to say with any certainty. Her name is Nancy, but I don't think our schedules will sync up and I doubt I'll see her again unless it's during my radiation treatments which take place every day but weekends and holidays.

I didn't feel any nausea during the treatment or since I returned home. The parents rented a house nearby (great rates as no one comes to Phoenix in summer, especially since today's 118 degree heat is high but not atypical), and no longer have to endure our decidedly sloppy bachelor pad. The only thing I have to complain about is a headache that's more due to having no more Percocet than anything else. My surgery pain has all but gone, except for some soreness in my jaw and lingering nerve damage in my mouth. Some of my surgery scars feel like the nerves are repairing themselves and they are starting to smart a bit. Hopefully the repair work is slow enough to keep that pain down, but I've been promised I'll need some strong, long-lasting pain meds in a couple of weeks, so whatever.

My chemo treatment ended around 4:00 and my radiation was scheduled for 5:00. Fortunately they were able to take me early and I was called in to get weighed again and wait for the Dr. Woo (I keep thinking of the Steely Dan song, though it's spelled Wu). He breezed in as quickly as ever and went over the plan again, briefly. He asked if we had any questions (my parents came in with me) and he answered them as best he could. My father even asked about cell phones and the recent reports that they may be causing cancer. He shot that down without hesitation and explained a little bit of why. I'm still not entirely convinced and I don't think my dad was either, but only because recent history is full of pronouncements that have proven wrong in both directions.

Eventually they brought us to the treatment room and explained the procedure. They took a picture of me for the records and then strapped me down with "the mask". My parents had to leave, just as the techs had to as well, since the room would be exposed to high energy photons. The procedure should have taken about 3 minutes, but of course I was the patient the computer crashed for, resulting in a needed reboot and resumption of treatment. Still, it wasn't a long procedure by any means, even though I fell asleep a couple of times. That's how not-uncomfortable it was. And then it was over and we left. Peace of cake.

Still not feeling any side effects though I'm not thrilled that the burns I'm going to get from the radiation may be in the same places as some of my surgery scars, but the good thing is that Dr. Woo confirmed that the hair in my throat will indeed be eradicated by the radiation and never grow back. Still feels strange to root for side effects.

Busy Busy

Chalk it up to being in a bit of a down mood. I always seem to paint better when that's the case. I guess there's something to be said for the 'suffering' of the artist. I started and finished three paintings last night. The two landscape/abstracts are a continuation of the series I started with Crying Snow. The third I was inspired to start after seeing some images of some killer street art at Juxtapoz online. I still like the original image better lol.

Lots of Info

Had a lot of information thrown at me today. I met with my Medical Ocologist, Dr Szewczyk (pronounced Shevcheck) today. Like everyone else I've met at Ironwood she was very nice and explained everything in pretty good detail.

This morning I looked in the mirror to see how the inside of my mouth was doing. I haven't really been doing this because it usually looks bad and it stresses me out that something is wrong. Today was no different. The graft that replaced the tissue that was removed in surgery was a rather sickly looking grey with what looked like wrinkles or something in places, and I was freaking out that it wasn't taking or the graft was deteriorating or something. The margins of it were rather horrid and damaged looking but it's been that way since the beginning.

Anyway, Dr Szewczyk is doing the preliminary examination and she looks in my mouth and asks "How you doing with that hair there?" So I asked her, "That is hair isn't it?!" and she says yes. So the graft in my mouth looks greyer than the nice pink mouth tissue because it's skin not tissue. This explains why my chest skin feels really tight. He used part of my chest skin for the graft in my mouth and had to pull the remaining skin tight to fill the gap. It also explains why my nipple is so far off where it should be.











Don't click for a larger image if you don't want to be grossed out.









This is now in my mouth...

So down to the nitty gritty. Dr Gorgeous (she's a tall thin beautiful blonde but she reminds me a little too much of Linda, my ex), sat down and explained, after commenting on how young I was, that I was going to be having a pretty intense session of chemo and radiation. She said the reason for this is that my cancer is curable and when they have a patient who they are able to cure, they push hard for that curative treatment rather than the palliative treatment they would give someone who's cancer is not 'curable' but rather needs to be managed. This might be the case if I was older, say, in my 70's, but since I was young and had done so well with the surgery, they were going to push. So my chemo will be intense and my side effects may be equally intense. Nausea and vomiting, though she said the chance of vomiting was less and they would be giving me plenty of anti-nausea meds and there's a good chance I might not have too bad a time with it. She explained that the reason they do the chemo with the radiation is that the chemo messes up the cancer cells and makes them more susceptible to the radiation. Chemo alone would not help me and radiation alone would not be as effective without the chemo.

I asked her about my PET scan and she said it all came back negative. She showed me the scans and explained what they meant, but to be honest, the things I saw all looked like cancer to me. She seemed pretty confident that I was clear though, so all good.

Then it was off to meet Shirley, for a teaching session. Very nice. She explained how the chemo process works, how long it takes (3 to 4 hours!!) and about the various drugs and IVs I would be getting. I have to take a series of 3 pills called Emend before the session. These will help with delayed nausea. Some people don't feel nauseous after chemo until 3 or 4 days later and these pills help with that. Then I will have a normal saline drip or some other type of fluids as well as a 'breakthrough' drug for nausea (she didn't give the name) and another drug, Deladol, which is a steroid to help with nausea and swelling. This is all in addition to the actual Chemo drug, Cisplatin. It's a common cancer drug and one that works particularly for head and neck cancer.

While explaining this, I was visited by Jennine Zumbuhl, director of research. She wanted to know if I wanted to be part of a study for a rinse that helps with the mucousitis. Basically the chemo and radiation will cause my mouth to be very dry since my salivary glands will be taking a hit from the treatment and this mouthwash (goofy name I can't remember) is supposed to help. It's already used for other treatments and the pharma company is trying to get its usage extended to cancer patients like myself. Ah yeah, I also have to have a shot in my arm of some junk. I hate shots.

Shirley continues, explaining the rest of the chemo session and I head over to the scheduler to try and figure out when I really need to be there. My radiation starts at 5pm every day, but on Monday and Tuesday I have to be there at 11:45am. It takes about 45 minutes to set up, apparently. Afterward I head over to Jennine's to talk about the research study, which means I need to actually be at the office at around 10:45am.

In addition to all this, I have to have blood work done at a different lab and it was too late to do it today so I have an appointment tomorrow at 2:00. More needles.

Waiting part 4

I don't know what part it is, really. Seems like the fourth. No word on the PET scan. I'm taking that as good news so far. Monday will be here soon enough. The tech, Tina, I don't know what her title would be; nuclear medicine technician? Radiotherapist? Anyway, she called to ask if she could make my second appointment, and every one after, a 7:20am appt. Nightmare! My first appt is 5pm! I begged, I'm so not a morning person. Please find a later one. I told her I could handle it if I had to, but if there was any way to swing it, please, later. eh. It's something I can control I guess.

Simon

16" x 20"
Acrylic on canvas

This is a painting of Simon. He was the first dobie my daughter felt was 'hers'. He died yesterday while playing in the pool with his family. Heart attack they figure. He was a very high strung boy. Lost his mind during thunderstorms or fireworks. Always figured he'd die because of that stress. It's nice knowing he died while he was happy, playing in the pool, friends around. Much better than passing on a metal table in some scary vet operating room.

My Life Mask

Home from my appt with the people at Ironwood Cancer & Research Center. Pretty much just to fit me with the mask they're going to use during radiation treatments to keep my head still and in the same position every time.

It was a little weird at first as the tech led me into the same room they did my PET scan in. I asked what was up and they seemed like I should have known why I was there. They finally said they were going to fit me for my mask. Couldn't help telling them that it looked like they were already setting me up for a rad session.

They were both very nice and explained everything as they went along. The one's name was Jamie, I didn't get the other girl's name. Basically they soak a big sheet of malleable plastic in hot water until it gets soft enough to bend and then they pressed it down over my face and clamped it to the table. If I were claustrophobic I would have completely freaked out. When they pressed it down it immediately felt like I was suffocating, but breathing was not a problem since it was full of decent sized holes.

Again, I had more problems with my back than anything else. That and my sinuses. Having to remain still meant no big swallows either and I could feel my sinuses draining into the back of my throat, making it feel a bit like I might choke. The whole thing was about 15 minutes.

I'm calling it my "life mask" even though it feels more like a death mask. Not trying to be morbid, just that people used to have masks made of their face after they've died. This is the mask that's going to help make sure I don't die, so...

No word yet on the PET scan results. I have another appt with my medical oncologist on June 23rd, then my first radiation treatment is on the 27th.

6/19 edit - the other tech's name is Tina

Names

Squamous Cell Carcinoma.

Every time I hear it I think of sharks. Squamous, because the latin word for shark is Squalous, and Carcinoma because the latin name for the Great White Shark is Carcharodon carcharias. Like I've got a shark celled Great White in me neck. Awesome!

PET this

I had my first PET scan today. I've had a CAT scan, and MRI (for my back) and now this. Working the alphabet. Positron Emission Tomography. I get there early. It's 108 degrees outside. They actually call me in early. Torri or Tori, is very nice. I get radioactive sugar injected into my arm while I'm bundled and warm and left to sit for about 20 minutes. No talking or moving because the sugars tend to settle in the muscles too much if they've been used. Could produce a false indication of something wrong. Then I get the scan. It's nothing bad, I just have a bad back and laying down on flat surface for about 40 minutes was rough. The injection itself was normal. I didn't feel the meds going in or anything, which is always a plus.

I have this thing about needles. I didn't realize why until I broke my arm in junior high. The doctor wanted to give me a shot in the leg to get the pain meds in quicker and I freaked out. As soon as he said he'd do it in my arm, I calmed down. Later my mom told me that when I was an infant, a clumsy nurse, probably used to just giving shots to soldiers, gave me a shot in my leg and I squirmed and the needle broke off in my leg. I was too young to remember, of course, but it has to be why needles bother me so much.

Anyway, wasn't bad. I should get the results tomorrow when I see Dr. Woo again, I think to have my mask made. Basically a plastic mold so my head is in the same place every time.

A painting and some info

Figured I'd combine the two this time around.

Verge
5" x 7"
Acrylic on canvas

Like some of my pieces, this started out as something else. I just decided to stop early.



Next week will be a busy one. I have a PET scan coming up on Tuesday at 3:30pm. I'm guessing it's similar to a CAT scan, just not sure what the differences are. I just hope I don't have to have iodine injected into me again. That was just too creepy feeling and I hate needles.
Then I have a planning session with my radiation oncologist. I believe this is when I get "marked", Either with dots of ink or actual tattoo dots. This is to make sure the lining up of the beams is consistent. I also believe I will be fitted for a mask at this time too. Basically, a mold is taken of my face so a mask can be created. This will fit over my face and be bolted to the machine's table so I my head is in the exact same position every time and so I can't move my head during the procedure. Glad I'm not claustrophobic.

Newest Painting

About 5 hours work. Not sure I like the exaggerated colors or not.

Santan Sunset
8" x 10"
Acrylic on canvas

Night and Day

Met my radiation oncologist today. Dr Charles Woo. Very personable guy. Hard to say how old he is, but his salt and pepper hair suggest early 40s. As uncommunicative as Dr. Rothman is, Dr. Woo is almost too talkative. I can't say that because I like it, but it's shocking the difference. I can already tell he's not a soft touch. He was rough with that tongue depressor in my mouth, but he looked in there for a good 30 - 40 seconds. He noticed the tear I keep feeling as well. He seemed confident it would heal, I felt. He went over my pathology report.

Aside from the tonsil, I had 27 lymph nodes removed, 2 of which were "involved", aka cancerous. He said that was pretty good, considering. I have to agree that 2 out of 27 is pretty good, in cancer terms. He said they went in there deep and close to the border of the resection. Virtually every surgery has the chance of missing a few cancer cells and radiation is almost always recommended to get as much as possible. There will also be some mild chemo to help the radiation. Then he actually said that there were a couple of studies that showed that supplementing with chemo makes a difference, especially with high risk patients.

Being referred to as 'high risk' was a bit unnerving, even though I already knew that. Still just hard to hear. We talked about my teeth and the need to make sure they are healthy, because having to pull a tooth after the radiation is dangerous. He talked about side effects and I have to say I was a little relieved at what he had to say. I had read a journal the day I got diagnosed. I've mentioned it here before. www.cancerlynx.com - the problem with this seems to be simply that it was written in 1997. There was a lot of concern about losing your saliva glands permanently, or your sense of taste. According to Dr Woo, this isn't nearly as much of an issue right now. They've been able to pinpoint the electron beam to the point where they aren't damaging the nearby organs of tissue nearly as bad as 5 - 10 years ago. He said that I would likely have taste bud issues, but that it would be temporary and also said that my saliva output could be affected but it doesn't suffer serious or permanent damage like it used to. This is a huge relief for me as those were the two things I was concerned about most.

He also explained how the radiation causes burns to the skin, both outside and inside the throat, like a really bad sunburn in and out. I would also lose some facial hair where the beams penetrated, but the side effects of the radiation wouldn't be felt for the first two weeks. He said that sometimes, depending on the person, there could be some fibrosis, a stiffness in the tissue at the site. Sometimes the fibrosis can feel as hard as wood and sometimes nothing happens. Hopefully my good healing abilities will prevent that. I'm going to look up some lotions to apply each day.

So, 36 treatments over 7 weeks. One treatment a day, five days a week. I've learned when a Dr. says it will be rough, I'm sure it will be, but as long as it's not worse than the surgery, I can deal. Not like I wouldn't have to deal either way... just what I'm hoping for.

The End of the Hunt

The End of the Hunt

12" x 24"
Acrylic on canvas

The Gila River Indian Reservation viewed from Hunt Highway.
About 6 hours work before I made myself stop. I feel like I didn't quite get the image I wanted, though I'm happy with the painting in general.








Link to the painting in my Etsy shop:
http://www.etsy.com/listing/75603218/the-end-of-the-hunt

New piece in progress

The End of the Hunt
Work in progress. Not bad for about 2-3 hours work. Need to add the birds and touch up the details in the foreground, smooth out the sky. Maybe deepen the blue a touch.

Amber No 1

Finished, for the most part. I'll probably keep messing with it, but overall I'm happy with the results. Especially considering I only put about 10 hours into it.

The Neverending Sutures

I would have thought these would have dissolved by not, but apparently not. They pretty much cut through my lip and chin (among other things) and around the base of my tongue and up and around to my uvula. You can also see the gap where they removed a tooth. Some bummer news: the titanium plate they tied my chin back together with doesn't set off the airport metal detector.
I don't know why I'm telling y'all this, except I took a picture and didn't want to waste it?

The Perils of Percocet

Ah it is as it has been foretold. Pain medication tends to give one confidence to do more, sometimes too much. Yes, my back is killing me. I am all but finished with a painting I started Saturday night at around 1:30am. I worked about 4 hours on it that night and about 4 hours today. I am happy enough with it that it's hanging on the wall. I'll touch it up for a couple of weeks before I'll think it's done, which isn't really true since I never feel like they're done. I just have to force myself to call it done.

I thought it would be interesting to show a work in progress. The pictures were taken about every 60 minutes. I tend not to like to show the process, since for 90% of that process the painting looks, well...awful. Still, for the curious:

Progress

My day nurse, Wanda, just left after her daily visits to monitor my progress. I've never been a morning person and having to get up at 8 in the morning would normally have been a major annoying pain in the booteh, but the combination of minor pain, the realization that every minute is one I should be aware of rather than sleep through and Wanda's pleasant, calming personality make facing the mornings a bit easier. As always I'm hoping my body will get the message and rework it's inner clock so that I do indeed become a morning person. Of course, this ain't gonna happen, but I'm not going to dwell on it. Just glad to be up and relatively pain-free (thank you percocet).

Narcotic or not, possible dependence on said narcotic be damned, I am so much happier, so much more comfortable, so much less brittle in my emotions just from the one pill that I can't help being both thankful and bitter about the whole pain-management thing.

Anyway, no one wants to hear about this anymore. It's been said already, I just can't get over what a difference its made. For example; I painted last night. I'd been fiddling with the idea, even putting some minimal slashes of color on a canvas.











These are just work in progress (WIP) shots and are by no means at all how the final piece will look, which is why I tend to not put up wip images. I had an image in my head and worked it up using some reference, but the concept was to take that image, which had a vague feeling of freedom and defiance coupled with the flying hair, and meld it with other symbolist images like the owl in flight. I'm waffling between keeping the owl face on the woman and overlapping it further to add more layers to her "personality". Snakes, goddesses, angelic wings and demonic scales. We'll see. I suspect what you see here will be all but obliterated in the process, whcih is the other reason I take pics of them.

All this even led as far as re-working an older painting I wasn't pleased with and adding an oil glaze to another to warm it up.










The nude needs some more work, but basically I had to give her a breast reduction, as the ones she had previously were too large and had no 'feel' to them. They drew too much attention away from the rest of the image and were also feeling rather light and frivolous as opposed to the overall darkness of the image.

The profile portrait was originally over a flat grey background and that uncommitted, emotionless color was holding the image back. Now its a bit warmer and feels less dead. I'll probably add a few more glazes to it for the depth it needs to make her rise above the flatness of that background.