Saturday, December 23, 2017

The war ahead

Left picture shows the area of action. These are high-contrast MRIs.

Let me set the scene for you. We are floating over the flatlands of Florida. My enemy is perfectly clear about its goals: kill me. My enemy is cancer. plasmacytoma, to be precise. It’s been likened to leukemia in my spinal blood.

I , on the other hand, am not defenseless. As we float over the battlefield, I look down at the fighters I have arrayed on my side. They are formidable.
My primary general at this moment is my oncologist. She has the responsibility for marshalling her forces and bringing to bear some pretty incredible artillery. Dr. Mary Koshy didn’t show up on my radar until I had been sent to Dr. Tiesi, a spinal surgeon. I’d been referred to him after spending six months being is severe pain. I came to fear sneezing because it felt as though my entire ribcage would shatter from the pain that accompanied every sneeze.

He had ordered MRIs on my thoracic spine and didn’t like what the pictures showed - little hairlines of blood intertwined all through my spine. He also saw that an old back injury in my T-6 vertebrae had essentially collapsed.
Dr. Tiesi suggested I go under general anesthetic so he could two things: he had a way to build a superstructure to allow him to rebuild the T-6. And then, while poking around in there, he planned to pull out material from my T-10 that could be biopsied.

The worst part of all this, was the general anesthesia. I’ve long known that this is the closest we get to moment of death. This is where lives hang on a tiny golden thread. And this was pretty debilitating. I suffered with  nausea, along with a complete upset of my bowels and my urinary tract.

After ten days of radiation therapy in which the oncologist 's staff created a customized cradle for my body that locked my torso in place while the great orbiting guns twirl around me, finding the ultra-precise locations for their magic bullets. All I do is hang in my cradle, hopping I'll be able to bring down my arms from behind my head before they atrophy

Way over to the left, I have another key soldier. He will be in charge of my chemotherapy. I have yet to meet him but he will ultimately hold the nuclear attack codes and we bring him and his big guns out at the end. Dr. Koshy, my oncologist, explained his role pretty succinctly. "Think of my role with radiation as one in which I precisely aim my pistol and fire my weapon at individual cells in your body. I can hit targets and blast them back to the stone age. But the chemo doctor will be detonating nuclear bombs in your body. He's very important. He's debilitating. But we won't get through this without him."

My primary care physician is the gatekeeper to keep all these moving parks from grinding to a bureaucratic halt. Dr. Vishal Sharma interfaces with my insurance company and none of these specialists get past his door without his recommendation. He is my advocate and I'm glad he's on my side.

I have a band of angels and foot soldiers strategically positioned all over the world. They are you. I want to tally up those troops because they are so important in the fight. Of course we have a treasure trove of friends in the U.S. and Canada. But there are these special folk who touched my life as Jo and I circumnavigated the globe earlier in our retirement. They are Vietnamese, Laotian, Burmese, Pakistani, Indian, Sri Lankan, Nepalese, Bhutanese, German, Cambodian, Namibian.

My most important general - at the very top of the heap - is Jo. She is the rock where I can think through positions, test assumptions, question and second-guess this maelstrom in which I find myself. She looks at the field with me and sees where all the players are positioned, how we get to them. She manages nutrition and energy. She is a jewel beyond price.

I invite you to come along on this journey with me. I have no ideas if I'll come out the other side without fatal wounds. But I do not fear death for I have lived a spectacular life.