Learning to Walk, Seven Times

Dear blog,

This shall be the last cancer blog, pending recurrence. I, naturally, grow weary of the topic.

I am tired. Exhausted, etiolated, sapped, cut-through, zonked. I'm frustrated, near tears, near tantrum with everything. It's all coming back too slowly. I fought to learn to walk after being bed-ridden every two weeks for the last two months. I vomited, ultimately, once, after eating too fast, because I was starving from not being able to eat for two days. I struggled to eat slowly after fasting every two weeks for the last two months. I'm just not interested any-more.

I am also triumphant! Horns blasting, timpani rumbling, electric guitar squeeling and ten thousand baritones screaming their best high G. A genetic mutation lead to rampant spread of caustic foreign death through an alarming portion of my body. The only treatment: to poison it and you, and hope you live longer than it...and I did. And I got a Mother Fucking 4.0 (completing my Master's requirements) while I did it. That's right: capital letters in foul language. Sometimes it's appropriate (probably not now). Anywhat.

"What's it like having a port?" -paraphrase. It's the question I'd rather answer, anyway. It's like the Borg. It's totally alien. It's unlike any natural process, hugging, talking, shaking hands, scrunching toes, pulling hair, eating squid, nothing. They knock you out and you wake up in discomfort with a small jagged scar and a visible sub-cutaneous implant (three cheers for spelling cutaneous first try!). Later, they stab you in the chest with a three quarter inch needle, which hurts like the dickens for a second, honest Abe. Then you watch saline solution pumped in the direction of your chest through a little tube and it disappears. Intellectually, you know where it went, but you can't really feel it. The vibration is too slight to activate the insensitive chest nerves. Later than that, you watch colored liquid go through the tube and disappear through the needle you cannot feel, and you know it's poison, and you sit still anyway.

If you're human that is. I refer to Dune, Frank Herbert. I am a human. I can be sure now.

I must not fear.
Fear is the mind-killer.
Fear is the little-death that brings total obliteration.
I will face my fear.
I will permit it to pass over me and through me.
And when it has gone past I will turn the inner eye to see its path.
Where the fear has gone there will be nothing.
Only I will remain.

I have to rebuild my body. I have gained twenty pounds of fat, while losing vast strength, endurance and some flexibility. I have become addicted to sleep aids. The chemo caused insomnia. I will face sleepless nights this week as I kick the drugs. I hope to counteract the withdrawal by exhausting myself daily with intellectual and physical tasks.

I have to deal with paper-work. The insurance was kind enough to stop paying bills at some point, which problem I put off til now to deal with.

I must, and I will, slowly, and carefully, and with all the tedium and frustration inherent, grind away at the junk that's wrong in my life as a result of this dice roll. And let it be an example to anyone who thinks anything might be unfair, or that any task be too boring or frustrating to tolerate. As always, this is what I hope to be my message here. Do your jobs folks, it could be worse. You could be paid less and have to work harder and be dying while it happens.

Your Obedient,
Ian Hogan M.S. B.S. A.A.

Apple Cider

Dear blog,

Obviously, I'm not writing very often these days. This is because I am very tired just about all the time. Earlier in the semester, I would experience, perhaps, four days each two weeks where I could not do very much. Now it is easily working in to the sixth day after chemo that I don't get much done and I never stop being tired. The only thing getting me through now is that the end is in sight.

I just got done getting my fourth to last infusion Thursday. I'm still just about incapacitated. In fact, the only reason this blog is being written is that Vivian has offered to take dictation. I have been exploring potential Ph.D. dissertation advisors at Ohio University and Kent State University. It is not ideal that I should be sick and studying while exploring this but there is no other option. I have narrowed down my possible fields of higher study to topologically driven dynamical systems and characters of finite group representations. The motivation for the latter is that characters of finite group representations have applications in chemistry, which I do not know enough about. The motivation for the former is that there is a large and active research group at the university on the subject.

If Joyce Stock is reading this, Vivian told me about a cake that you make made of layers of thin wafer with some sort of cream between the layers that softens the wafers. I would like this as a get well from cancer dessert. I plan to be in the Cleveland area in late December.

Regards,
Ian Hogan B.S. A.A. C.P.Lf.P.

Dear blog,

I am quite busy, so not blogging often. There is little to note. I do not feel well, with a cold, but no so unwell that I cannot get chemo tomorrow. I am due for chemo on Thanksgiving day. I must decide whether to go short or go long. Pros and cons to each. If I go long, the whole process will run longer as a result. If I go short, I miss the break. Same for finals week. That's the long and short of it.

"...has this experienced changed you perspective on how you want to live your life? Has it affected your feelings about death or changed your opinions about anything like health ins. or capital punishment or anything like that?"

In short, no. I feel like I was living a fairly full life before the risk of truncation became more solid before my eyes. I have been impelled to read a few books I was meaning to read, but nothing other than that. So while many find God or realize they have wasted so much time or whatever, I did not find or realize anything to that effect.

And in regards to health insurance, my opinion has not changed. My personal opinion is that in an era of such abundance: that there should be produced each year enough grain to feed the world; that individuals exist who pay in property tax the net income of entire villages over generations; that even one adult has the liberty to choose to purchase a large house between his other two houses so that he need not stop at a hotel driving from one to the other; in this world, it is unthinkably immoral and corrupt of anyone to believe I should be bankrupt because I rolled unlucky at the cancer craps table. I think it unfathomably disgusting now, now that I am facing the cruel reality of sitting near people whose surplus of wealth would handily end every financial woe I possess, knowing that if I even mentioned the disparity to them that they would merely cough uncomfortably and attempt to part company. I thought it unfathomably disgusting that such pairings existed before I was in one.

Frankly, it's enough to make any upright citizen sick if they think about it long enough. So now, as then, I try not to think about it.

Regards,
Ian Hogan.

$\ iff$ X is compact

Dear blog,

Naturally the title is referring to the fact that ultra-filters converge in compact spaces. (Makes sense right? They're compact. There's no infinity to go to.)

Ok, so most of you aren't mathies. Most of you are interested, perhaps nominally, in my state of existence viz. how many pieces of bad news am I from death; perhaps aesthetically in some sort of well-structured (insofar as none of you realize I'm practically illiterate) prose. Clarification: early one morning I grunted at an old man who had said hello. He asked me if I was 'even alive yet', prolly referring to a lack of coffee. I think I said no, a clever response requiring coffee, but then pondered the question more deeply (while waiting for the pot to fill with coffee). In said meditation, I decided it was possible metrize state of alive-ness by how many pieces of bad news I am from death. The most alive is 3 I think.
1) You have cancer;
2) The treatment isn't working;
3) There's nothing we can do.
Given that I have recently received (1) I rated myself as 2 on the metric.

This is all pretty silly and I'm sure any of you with some thought would come up with far more elegant metrics. I encourage you to do so as an ice-breaker at parties. Anywhat, I think I may be back up to 3 as of today, depending how one reads the metric.

I have received a negative PET scan. (Technical language follows, please skim this bit of wikipedia) What does this mean? Roughly it means that what cancer remains is insufficiently active to make the screen light up. There is certainly still some cancer, potentially alive and weak or too small to register on the scan. Thus I must continue treatment until December as planned.

That's really all the cancer news that's important. On to more frivolous matters. Comments. I got a bunch. Splendid. Better though was that one of them had several questions. Questions are good. Answering questions is fun and easy. I will endeavor to answer at least 1 with each post. If more questions are posed, the rate of answering will increase.

"Like, what all goes on in the chemo room?" Remarkably little, though I suppose answering will end up burning a lot of space. "...the chemo room" is a little incorrect. There is an "oncology and infusion" wing or department or flat, whatever you like. It is attached the the general hospital (ER, crap like that) by way of a hall. It consists of a front desk and waiting room (for when they are full or haven't finished whatever state-mandated prep they have to do in the morning) which is shared with cardiology, and a devoted piece of building with a central, partly open, partly walled room with desks and faxes and the like where nurses sit while they do paper work and scheduling and so forth, some halls around that central room with a few private inspection rooms (or whatever, they have the padded table and that's where the doc feels you up), two private infusion rooms and at least the doctors private office if not a few more offices that I cannot look at because they might be around a corner I have no access to...and a big room with a bunch of chemo chairs and televisions. Certainly more than a kiosk, certainly less than a Sears.

A chemo chair is a well padded chair that reclines quite a lot for comfort with an IV stand next to it. The main room has 6 chairs and two televisions which typically air soaps. A person sitting in one of those chairs is first given a nominal evaluation, blood pressure, temperature and heart rate and is asked if they're feeling alright. If all that is a go, they typically proceed to put some fluids in you by some means for some purpose. Those means are limited (a stick in the arm or a stick in a port), but the purposes and fluids are many and varied. Most of them are blood (supplements to those whose counts are low) and drugs (either to treat cancer to to mitigate the effects of the ones treating the cancer). The IV stand is on wheels because you will have to pee. Not might, will. They not only encourage you to show up as loaded as possible to make it easy to find veins and so forth, but most of the drugs come blended in water which your body decides it doesn't need immediately after sifting it from the drugs.

Anyway, like I said, once whatever treatment is a go you do whatever it is you do to avoid eye-contact with the other ill people with needles leading eerily to tubes and pouches of poison and strangers' blood and such for several hours until you feel like crap and they let you go home. I personally wear ear-plugs to blot out the damn TV and try to study until the chemo turns off my brain (at which point I will continue to be as studious as a gold-finch for 100 hours approx.). The IV machines (they don't drip, they force) beep quite often and nurses bustle out to see why they're beeping. Half the time the machine is claiming "air in line" when there isn't any and the other half they're claiming they're done with the pouch and to please hang up a new pouch. Maybe half of those times they're actually done, the other half the nurse tells it to keep going.

I think that's about it. Until next time,
-Ian Hogan.

"...brown gobbets up I throw."

Dear blog,

Another chemo session over, and I feel quite ill. My blood count is low again, so I will have to go get more Neulasta tomorrow. It's time for me to get a PET scan. The lymph nodes in my neck are fairly staunchly present, contrary to expected progress of the treatment. However, the other surface-accessible nodes under my arms could not be found by the doctor. Thus, there is hope that the nodes in my neck are necrotic and things are progressing normally or that treatment is simply progressing in an uneven fashion. I am fairly anxious about all this.

Given that everything is pretty routine and some other factors there may be fewer or less frequent updates in the future. One contributing factor to this is the lack of commenting of late. At least two people have indicated that they do read but this is always of short reassurance and comments would drive up post rate.

Respectfully submitted, your obedient, in the fullness of time,
-I.

Three or Two or One

Dear blog,

Today I got infused for the third time. By the way I had been counting, I am on my third cycle. However, this is technically incorrect. A cycle is two infusions, so I have just started my second cycle. Then again, there is a chance that this treatment will not be effective, and I will have to do a different treatment. By that counting, I am on my first treatment, hence the title.

Last blog, I mentioned that I would get a port consult the next day, which was about 2 weeks ago. The consultation went fine, and I was scheduled for port placement last Friday. After the consult, I got the Neulasta injection to boost my white blood cell count. My white blood cell count had been 1.7 on a 0 to 10 scale (I have met people with AIDS with higher blood cell counts). Neulasta burns, but it must be effective, because this time my count was 8.2.

The port placement went as planned. I was very sore afterwards. They prescribed Percocet. Since they could not be sure in which side of my chest they would place the port, they shaved my whole chest. So, I shaved the rest of my torso because it looked silly. Then I had my wife shave my back, because it still looked silly. Don't worry, there are pictures.

This infusion, so far, has made me feel much sicker, much faster. Already today, I have taken a nap, which I did not on the same day of previous infusions. Also, I am between my third and fourth sittings attempting to eat some chicken ramen soup because I feel sick after only a few bites, which I did not experience on this day of previous infusions. I did, however, bike to and from the infusion.

The PET scan showed some areas of bone marrow disease. This means I am, in fact, stage 4B. This mostly just means that I am at higher risk of recurrence than otherwise.

Funny story: I'm a member of an online fitness tracking website called Fitocracy. I have been using it to advertise my cancer exercise tale. On that site, I am a member of a group called Bearded Barbell Club. One can imagine there are a wide variety of highly fit, burly men in this group, however, there are also some total wussies. Here is how I know: On the 17th, I joined a group challenge to see who in the group (who also joined the challenge (some 29 members)) could log the most points in the 2nd half of July. At the onset, I had anticipated coming in last given that I have fatigue-inducing cancer, fatigue- and nausea-inducing chemotherapy and a surgery scheduled during the challenge period. Yet, I am so far ranked 22 out of 29. I have a hefty margin over the member currently ranked 23rd, so I anticipate maintaining my rank through tomorrow (today being the 30th and second to last day of July).

Bwahahahahaha, wussies!! I tell you say, "Y'all losin' to a guy with cancer."

Full of fried chicken,
-Ian Hogan

Return of the Poison

Dear blog,

I biked to my second chemo session today. I had been feeling about 80-90% of normal for the last 5 days about of the first two week period. I could do sedentary activities without any symptoms, and walk without symptoms, but more serious exercise had a cap well below my usual ability.

My white blood count is low. I will have to take neulasta, an injection to stimulate production, tomorrow. I will get it after my port consultation at 2:15 PM. I decided to get a port after two of my veins failed to make a good IV site despite what appeared to be perfectly expert administration by the nurses. Let's be honest; setting IVs is their business, and if they had that much trouble after one cycle, I'll go ahead and do the surgery.

And I biked home. I'm pretty fatigued. The doctor said fatigue would tend to build. That makes sense. If I started the last treatment at 90 and I start this one at 80, then I'm bound to bottom out lower this cycle than last. I'm going to see if avoiding the anti-nausea at night helps me not lose sleep later in the cycle. I guess I didn't blog that bit. After the big sleeps died off, I actually had a lot of insomnia, which I blame on withdrawal from the drowsiness inducing anti-nausea.

So I have my protein shakes and iced-cream all ready, and turkey and mayo so I can make bland high protein sandwiches when I have limited appetite and potentially mouth pain later this week. If you're a turkey and mayo kind of person, I insist that you are bland. Bland bland bland.

With great piquance, if only in spirit,
Ian Hogan.

Chemo Days 4 and 5

Dear blog,

Day 4 (or third day after treatment) was the worst for me. I had mouth pain develop on day 3 that made me dread even taking a drink of water. It got worse on day 4 and is still present now. I treated it with the ten pound box o' packets' "salt water rinse" and "absurdly frequent tooth brushing". I mean, these guys were talking 'after every meal'! Anywhat, the salt water, while disgusting, had some soothing effect after eating or drinking, but that didn't change the fact that it was so hard to start. The worst pain is in the first few bites or sips, when salivation is activated. I found that this is common in forums online. For some folks, the symptoms only lasted days or a few cycles. I really hope the same is true for me.

I managed to get out of the apartment only once yesterday, to go to an arranged study session. I was able to think clearly, realize why the math made sense, but it wore me out extremely fast. In about 45 minutes I was feeling very sick and didn't get much done after that. I took a long nap and then watched TV for the rest of the day, until reading time.

Today I feel less fatigued and nauseous, though I actually took an anti-nausea early in the morning today, which might have been a good move yesterday. I was able to get down some Arby's chicken sandwiches which I had a coupon for and do normal stuff without great difficulty. I still took a 2 hour nap after getting some fun mail. 4 pieces of mail from the insurance.
The Good News: They processed my claims and they're not denying them!
The Bad News: I have copays and they are no longer an ethereal, in-the-future thing. 16 separate claims with 'student balances' running from 10 to 1500 dollars. That's after more than 80% was paid on each claim. I didn't manage to do a total before I decided sleep was a better idea, and now I'm writing this.

I would like to say, I don't feel better. I feel less bad. Something about a cold and feeling better, you expect a total cessation of symptoms in the near future when you feel better. I expect the symptoms to get slightly less until they get seriously worse again, and so on, for six months. Then, I will feel better.

5 down, 79 to go,
Ian Hogan.

Day 3 of Chemo

Dear blog,

Another day rolls by and the nausea remains tolerable, but. I need to be eating more and I am, in fact, eating less. The morning is easiest, but as the day goes, when I would usually be getting in the bigger meals, the nausea is actually getting worse. I'm down 3 pounds in as many days.

So I'm taking some advice on getting food down from the ten pound box o' booklets they gave us on the first day. I got some lactose free ice-cream and Fortify Plus, kroger brand "ton o' calories in a bottle". 350 calories to the fortify plus bottle, 13g protein and a vitamin pill's worth of ground up nutrients. My thinking is that I will eat as much solid food as I can, then fill in the remaining calories with this junk to keep from dropping weight so fast.

I slept for 11 hours last night and took a 1 hour nap this afternoon. I swam in the morning, but not particularly far. Hopefully day 3 is the worst day, because I feel pretty lousy at this point.

Rolling along,
Ian Hogan.

Vlog Zwei

Dear blog,


-Ian Hogan

Blog With A Vee

Dear blog,

Vlog

Addendum

Sincerely,
Ian Hogan.

Absolutely Maybe

Dear blog,

I met with the O'bleness oncologist, Dr. Sarwar, today (the close one). He had received none of the staging information from Dr. Jain (the far one) which was supposed to be ready 'late last week'. But, regardless of all that information, the treatment is the same. ABVD, 6 months.

That's two months of warm up, two months sustained heat and two months cool down, for my fit readers. Some absolute maybes there. It may work. I will absolutely be able to tell if it is working. Around the time hair starts dropping out lymph nodes which I can feel are supposed to reduce in size. If that's not what happens, we absolutely know what kind of even more caustic drugs they will drip into me then. I'll let that go until we see how things are progressing in a few weeks.

I will certainly get a port. When my good insurance kicks in. That's 4-6 weeks from 1-2 weeks ago. Y'all are smart, you can figure that out.

I start Monday, 8:30 for five hours. My guess is about an hour for each of the A,B,V and D drugs they need to drip. Y'all have google. Go nuts. Poison is set for a biweekly schedule thereafter. I didn't ask if six months is generally 24 or 26 weeks. I guess I'll find out around Christmas.

Cordially,
Ian Hogan.

P.S. I got a call shortly after posting. There is no cancer in my bone marrow. Stage 3B.

Beyond Good and Evil

Dear blog,

This is not about updates. This is about emotional hippy dippy. Some folks have related concern.

There are some things in my worldview that need to be considered before one may understand how my emotional hippy dippy works with regards to cancer. I present a quote from a film, My Dinner with André:

WALLY: Yeah, but I mean, I would never give up my electric blanket, André. I mean, because New York is cold in the winter, I mean, our apartment is cold. It's a difficult environment! I mean, our lives are tough enough as it is, I'm not looking for ways to get rid of the few things that provide relief and comfort, I mean, on the contrary! I'm looking for more comfort, because the world is very abrasive, I mean, I'm trying to protect myself, because really there are these abrasive beatings to be avoided everywhere you look.

End quote. I recommend reading the entire transcript or watching the film for those who are not familiar. Here is another quote:

And the ocean itself turns out to be one enormous engine of decay. Seawater corrodes vessels with amazing speed-rusts them, exfoliates paint, strips varnish, dulls shine, coats ships' hulls with barnacles and kelp and a vague and ubiquitous nautical snot that seems like death incarnate.

End quote. That was from David Foster Wallace, the essay which title I used for the previous post. The astute reader may note a theme through the two quotes. This theme runs through my view of the world and how I deal with it.

The world is a cruel, cold, 'abrasive' 'engine of decay' if you will. This is the functional aspect of the world, anyway. You all should know that the world is also a glorious morass of hilarity and gorgeous landscape; taradiddles and forays and adventure; love &c. But that's not a functional view. Functionally, the world, with no particular consistent speed, annihilates absolutely everything. Set something down and sooner or later it will be gone. Animals will have sapped all of the nutrients, plants will have upended it with their roots and cracked it into many parts and solar radiation will chip at its chemical bonds until rain and wind and meteors ultimately render it to cosmic dust.

The world is also in no shape or form fair. I have had some great luck in my life. For instance, I was not born into an impoverished and disease ridden town with a life expectancy in the twenties. I was not consumed by fevers or pirates as a youth. Other such things all included. I have also been ejected from a program as a result of politics. I have been poorly advised before I knew to question the advice of advisers. I have been lied to to prevent me from getting jobs. I have had my car acquire more repair costs than its value at my poorest time at only 100k miles.

How did I deal with these things? The same way that one must, in my view, deal with the perpetual death machine that is the universe. By moving, thoughtfully, rapidly, and without rest. When an army is outmatched, its only option is to move, at all times, thoughtfully, rapidly. It must outmaneuver and be absolutely relentless to have even the barest chance. When I was ejected for unfair reasons without recourse, on a Friday, by Monday I was 100 miles away, signing up for a temporary position and contacting people for a room to rent in that area. It was the closest work, the most guaranteed work. I thought about it and I hustled on what I determined to be an effective plan. If I had waited a week to get my bearings, I would have missed that opportunity.

Cancer is just one of life's neatest tricks for me. It may be on a greater scale than ice followed by snow that is nigh impossible to chip from a walk, but it's the same style. The carelessness of the universe at the inconvenience of the human, best fought by well reasoned and relentless attack. It is this same mentality, I wish to add, which is very necessary to get by in a graduate program. Even with passion, if there is no ability to work without rest for hours, days, weeks, months, years, then failure is guaranteed.

This year I have studied. I have expanded and condensed. I derived, integrated, extrapolated and inferred. I supposed and concluded. I contradicted and implied, computed, researched and proved. I revised and edited and inquired. I reviewed, memorized, copied and regurgitated. I can prove the statement of any theorem in An Introduction to Analysis by Kirkwood. I can use a strange intuition to tackle any exercise in Algebra by Gallien. I can search JSTOR for an Arhangelskii essay which hints at the answer to a topology problem, just to know what I'm trying to prove. I have spent 60 hours on a single problem. I never solved it. Life isn't fair.

For three years previous to graduate school I lost >100 pounds. I ran, walked, biked, swam, lifted, stretched, calisthenicized, yogaed, climbed, clamboured, pilatesed, fought and wrangled, all the time for years to accomplish the goal. I have been fighting the natural tendency towards decay for a while now and I'm damn good at it. So if I don't seem too put out about the cancer thing, that's why.

Wanna wrestle? We can wrestle.
Ian Hogan.

A Supposedly Fun Thing I'll Never Do Again

Dear blog,

The title is a rip-off from David Foster Wallace, an exposé on Cruises. It's not the best choice. Cancer isn't supposedly fun. However, I was reminded of the title by today's oncology experience.

I got a bone marrow biopsy today. Location: pelvis; right, rear entry. They numbed the skin and deep tissue with lidocaine, but there is no way to numb a bone. The doctor's description was that there would be pulling that would feel like pain for a minute that is not actually pain. A supposedly painless procedure. It's pain. Don't let them snow you. It felt like he was tapping a big part of my pelvis with a chisel. It was, however, a minute, and not more.

Bone marrow biopsy, while conscious, is on the list of things I never want to do again. It's a short list, getting longer with the new experiences I'm coming into with the cancer thing.

(1) I never want to do something I did, that hurt, and don't feel like sharing right now. It was a long time ago.

(2) I never want to be significantly overweight again. Ever. I'd become a drug addict before I ate to excess.

(3) I never want a doctor to stick 5 needles in my neck while conscious again. That was 1 lidocaine, 2 fine needle aspiration biopsy and 2 fine needle for flow test. The fact that none of them were diagnostic doesn't really add great positivity to my view here.

(3 1/2) (Cheers to Tychonov, I literally thought of this after writing (4)) I never want to get a bill that should be sent to insurance, call billing, call insurance, call billing, be told it's ok, get a second notice on the bill two weeks later and call billing, again. Tough luck on that, It'll probably be next month at the latest for that funzy game.

(4) I never want a bone marrow biopsy while conscious again. They said I wouldn't need one in conjunction with this cancer again. However, I know I'm at greater risk of getting this and other cancers later in life as a result of the ravages of treatment. I will probably ask to be put under if they start talking about needles in bones again.

The CT scan I got last Thursday is back. My spleen is enlarged and suspicious. The largest diameter of lymph nodes is 5.8 cm. Over 10 is what they call, if I'm not recalling incorrectly, "clumpy", and of different concern. So none of that. No nodes appeared in the pelvic scan. Some nodes in the chest were discovered, not surprising, and in the abdomen, also not very surprising. The easiest blood test in the world also came back; sedimentation rate. My rate is 97%. Bad is over 50%, some say 30%. This is not surprising given my fevers and night sweats-> indications of systemic involvement. This information taken into account, I am at least stage:
3B. If the marrow is infected (affected, I dunno), it'll be 4B, the latest and greatest.

I got straight A's though. If I pull that off on chemo this fall, I go to whatever PhD program I want. At least, I think I should be able to. I might get a port put in. That's a large vein temporary access port. That needs to be discussed more.

That's all for now. Bye bye,
Ian Hogan.

Tests Tests Tests

Dear blog,

Hurray, hurray, hurray, we got all kinds of tests. Not one blood sample but 4 blood samples! That's 20 ml (just 1 vein!). It's total madness. Two scans for the price of 2. We're checking marrow and heart and lungs. Does your body contain a specific organ or fluid of some kind? WE WILL EVALUATE!!!

Anyway, staging evidently involves many tests. I got CT, PET, blood work, ecg (simultaneous lung function test), bone marrow and semen analysis all scheduled or being scheduled for this and next week. Doc said this process should be fast. I asked him to define fast.

Fast is pretty quick, it seems.
-Ian Hogan.

(After Having Written: Nodes I thought I felt aren't worrisome. Nodes I couldn't find were found. I'll call it even.)

Medicine is Borke

Dear blog,

I have some updates, but you get the griping with them. Gripe:

So here's how medical doctors do most things, it seems to me. Well, perhaps we'll do the "not most" or "some things" part because that's the cool part. Not most of the time, they remove things from you what ought not be there and cure you. Yay medical doctors. Most of the time, they recognize that something ought not be there and prescribe a treatment. Exit medical doctor, enter nurse, nurses, pharmacist or combination thereof.

Logical conclusion: You see a doctor anywhere, and get treated anywhere. Right? Wrong. The hospital won't treat you until you see THEIR doctor.

"Oh, when is YOUR doctor available to prescribe the same textbook treatment as MY doctor?"

Answer: a month an a half. I'm shocked, and that does not happen often. Well, say I, I have a fast moving cancer. None of that non-Hodgkins watchful waiting, prostate cancer what takes more than 10 years to kill you. Nay, I got happening, shaking up the dance floor Hodgkin's Lymphoma. Now when is YOUR doctor available?

A month and a week. They'll pull some strings to knock off a week. The actual update without gripe (maybe). I got an appointment for Monday (that I said last blues time, last blues hour), with an oncologist at Holzer. Holzer does not treat. Holzer's oncologist's patients get treated in Lancaster and Gallipolis. My home is roughly equidistant from each, 100 kilometers approximately. I would like to get treatment in Athens, at O'bleness Hospital (a mere 4.5 miles from my abode (a distance I hope to be able to bike even while being treated)), but they, as I griped, will not give me poison until their doctor sees fit that they do.

The plan: I will see the oncologist in Holzer on Monday. He will still be able to get the ball rolling on getting me staged, which since it is a brief process, I will be willing to go to Gallipolis to do it (I've been to Lancaster three times to try to get biopsies of my lymph nodes with no success before skipping one more out to Columbus. They say I'm young and should see the world. Hence, Gallipolis for the staging). I will see the Fancy Shmancy O'bleness oncologist three weeks later and bring diagnosis, staging and prescribed treatment from the Holzer oncologist and try to get him to say "Yea" so that I can be treated at O'bleness (the close one).

Constituent to the plan: (Does constituent mean what I think it means?...yes. Moving on.) I have scheduled an appointment to have my constituent part of any potential offspring analyzed up in Cleveland for the week after finals when I will be free to go up there. Cleveland clinic is the closest cryo facility to me, and the folks live there 'bouts and so on. Since Hodgkin's is a sterilizing disease, I need to get it analysed before paying my mother's hard earned dollars freezing it. No point freezing empty samples. Yeah?

Nigh identical constituent to the plan. I have made sure that Lakewood Hospital (near Cleveland) is on my insurance's preferred provider list so that I do some of the staging stuff up there. I know hospitals will take referred CT scans without pulling the "our doc first" line from experience. Hopefully I can get blood work done down in Athens or up in Lakewood and not have to make any trips to Gallipolis at all. But I've never been there. See the world, you know?

I don't know. I guess I'll find out.
-Ian Hogan.

Cancer

Dear blog,

Today is Wednesday. Last Wednesday I was diagnosed with Hodgkin's lymphoma. I have had it for over a year.

People are curious about the changes involved, and some want to be updated about future changes that will happen in the future. After-all, the future is where we will all spend the rest of our lives. Many folks think they know best about these things and have informed me that I should create a website through such and such and take this and do that and blah blah. I will do what the oncologist says, with the possible exception of skipping the anti-nausea drugs if they make me lose focus. Otherwise, why create a new device for relating change when life is change and I already have such a vessel?

I will post changes here, where change is the status quo and those interested may follow. I have an appointment with an oncologist next Monday, June 4 at 9 A.M. at Holzer Clinic, at the end of the bike path in Athens, Ohio. He will likely schedule me for CT scans of roughly everything to determine the spread of the disease. After that he will probably prescribe combination radiation and chemotherapy.

I will spend the summer sick and tired, practicing Algebra, guitar, piano and German, to help prepare for spending the fall semester sick and tired; teaching 1.5 times as much as a result of the quarters to semesters switch; and taking Algebra, Analysis and Coding, 6000 levels all.

Til Birnam Wood,
-Ian Hogan.