Saturday Confessions

  I was raised in a Catholic country, and attended a Catholic primary school in Mexico City.  Although my mother was not a practicing Catholic – she was a vague Christian at the time – she sort of went along with the Catholic thing, and did not object to my sister and me learning catechism and making a First Communion.

  The pretty white dresses and shoes were a major part of First Communion, and we had a good time finding the right  white dresses and the little party we had.  But there was another part of First Communion and becoming a “child of the Church” and that was learning to make confession, learning the Act of Contrition, and going to Confession on Saturday afternoon so that we would truly be in a state of grace if an errant Mexico City bus hit us on the way out of Church on Sunday.   In keeping with the Saturday Confession tradition, I would like to make a Confession to you, my dear Politicook friends.

Last summer, I started feeling really bad.  I had started work with the urgent care clinic chain I work with now, and instead of working in a civilized private practice setting where I had a degree of control over the hours I spent at work, now I was working ten and twelve-hour shifts with no breaks.  I was exhausted by the time I came home, and I took naps whenever I could find a free hour.  My appetite went away, and I was dropping weight gradually.

  The onset of my illness was so gradual that I did not really notice much at first.  My gut had never acted normally, so the upset I was experiencing was nothing out of the ordinary at first.  I had some vague abdominal pain, but not much else.  I just knew I was old and tired.

  But one day, my dear friend Mary saw me and politely told me, “Chelo, you look like shit!”.  My clothes were sort of baggy on me, and apparently my pallor shocked her.  By then I was noticing that I was a little tired at the end of a weight training session at the gym, and that I was not able to lift as much, and I was getting short of breath walking to the car at the end of 45 minutes of working out.  Again, denial kicked in, I attributed my fatigue to the long hours I was working, until the awful gut upset started.  By that time, I knew something was terribly wrong with me.

  I waited a couple more weeks until my health insurance “kicked in” and since I did not have a primary care doctor to go to, and the doctor at the clinic where I worked told me I had diverticulitis (I still don’t trust that doctor), I packed myself a little bag and went to the emergency room of the big hospital close to where I live.  The nurse there took a look at me, sent me to a room in the ER, and the ER doctor got a CT scan that showed a large mass in my pelvis, involving the lower colon and rectum, and found that my hemoglobin level (the red blood cells) was about half of what it should be.

  In short, I found out I had advanced rectal cancer.  They scanned me, gave me two units of blood, and consulted all my old colleagues in the medical oncology bidness, and the next thing I knew, I was signed up for a combination of oral chemotherapy (Xeloda – $3000/month!) and radiation to the pelvis.  That is what I did last summer.

  Following the radiation and chemotherapy, in November of ’07,  I had a resection of the tumor with the creation of a colostomy, removal of the uterus and ovaries.  Three weeks after surgery, I was hospitalized again for a post-op bowel obstruction that resolved without surgery.  In late January, I went back to work, and also started on a sixteen-week course of intravenous chemotherapy.

  The IV chemo was a bitch.  I did not have much nausea and vomiting, but the drugs messed up the sensory nerves in my hands and feet, making them extremely sensitive to cold.  Cold temperatures would send pins and needles shooting up my hands and feet, so much so that I had gloves stashed all over the house, especially on the refrigerator and the kitchen sink.  I lost a bunch more weight, down to 93 pounds…I felt like shit.  But I was able to keep working in the weeks in between chemo infusion, and that helped keep me sane, as well as paying the 10% that Humana did not pay for – that added up to over $2800/month.  That torture finished in May, and everything was good.

  Until July.  Then I started having left hip pain, and I bitched and moaned so much that my oncologist agreed to getting a CT scan in August instead of waiting until December.  Right before Labor Day, they found the 3 cm mass in the lymph nodes in the abdomen that had not been there in May.  Shit.

  I have recurrent cancer.  This is not a curable situation.

  But, no other areas of cancer showed up on the PET scan, so there is an outside chance for what the Experts call “durable remission”, whatever that means.  So I’m going for broke, going for the Full Court Press, the “A” Team, the Big Enchilada – the Clinical Trial.

  On October 6th, I will have surgery to remove the lymph node mass.  The doctors will then take the tumor mass, nourish the cancer cells with special growth fractors, and then mess around with the genetics of the cancer cells to make my very own personal anti-tumor vaccine.  After surgery and radiation, they will give me this vaccine, just like a flu shot, as part of this trial.

  It is no guarantee of cure.  All we know so far is that this procedure is safe.  The side effects are the same as for any vaccination – pain and tenderness at the injection site.  The hope is that the genetically modified cancer cells will interact with my own immune system, and create cell-mediated as well as “B” cell immunity against my cancer, and control it.

  No chemotherapy side effects.  No profound fatigue, no painfully numb hands and feet.  No suppressed appetite.  Just shots.

   I’m scared, but I’ve decided that my mantra of “deal with it” is a good one in this situation.  An opportunity to participate in a clinical trial, the best current treatment for a situation like mine (surgery and radiation to the tumor bed), and the outside chance that this vaccine might work.  I’m keeping hope in that little part of my soul, and trying to deal with the rest as best I can.

  So I’ll be AWOL after the first week of October, and I needed to make this confession to you all.  Please keep good thoughts going for me, as I may need them.  I’m blessed that my dear brother and sister-in-law will be coming down from Oregon to stay with me and the dogs while I’m in the hospital, so that is a huge load off my mind, as will the fact that the folks I work for will want me back to work when I recover from surgery.

  In the meantime, and after surgery, you’ll have to put up with me!

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