Friday, August 22, 2008

Barbara's Post

I am supposed to write about my father here; this is not easy, how do I explain such a man. My sisters gave me a plaque that says “For those who know me, no explanation is necessary. For those who don’t, no explanation is possible”. I think that explains my family well.
My father is an extraordinarily interesting man and was incredibly fun to grow up with; although, I am not sure , he has ever stopped enjoying his child within. Dad is an adventurer. He loves to learn, to challenge himself, to travel, to experience life. We took wonderful vacations, with many “adopted” family members along for the trip. My father is comfortable in the company of women; having grown up the youngest with 4 older sisters and then marrying my very independent mother and having 4 daughters with her. I can’t really discus my father without my including my mother, although they are often at odds, they love each other completely and intensely. They taught us many lessons, some of which seem so simple in this age, but they were teaching my sisters and me these lessons in the late 60’s and early 70’s, when these views weren’t always popular.
1. There is no one in the world more important than your spouse. You will spend your life with this person, much more time than you will with your family or your children. When it is just the two of you, this is the person who you will spend your life with. My parents have a tumultuous but incredibly strong relationship.
2. Your family, especially your sisters, are the second most important people in your world. Your sisters are, and always will be your best friends. No one can ever understand and know you like your sister, she has loved you all of your life. Don’t get me wrong, friends are irreplaceable, but I cannot believe how supportive of each other my sister’s and I have become over the years.
3. You can be anything you want to be. All you have to do is set your mind to something, learn as much as possible about it, and you can make it happen.
4. You must always be your best when you make a commitment, whether it is a relationship or some sort of task, or especially a job. You must be loyal, reliable and willing to do whatever it takes to make your efforts productive and smooth. My sisters and I thought they were tough about this (we all went to work at Applecrest at about 12), but my parents stood firm. We all grew up to be hard working, responsible people.
5. Sometimes you have to follow orders, but sometimes you have to just follow your heart. My father took me out of school to fly in a plane that he piloted, to go skiing, to go to the mountains, to just have unexpected fun once in a while. Remember, he is a Marine, duty and orders come first (except with those he loves.), but it was a lesson he was determined to teach.
6. Make somebody’s day, every day! Compliment someone. Tell someone they look great, they are doing a terrific job, that they made your day more pleasant, that they made your life easier. Tell someone you love them and that they make your life more enjoyable. You would be surprised how much pleasure, somebody else’s pleasure can bring you.
7. You are smart and you are beautiful. Never doubt yourself.
8. Probably most important of all - Life is a lot of fun! Enjoy yourself, be adventurous, travel to different places or bette yet,live in a strange place. In other words, experience at much as you can, don’t have regrets. (My father will tell you it would be better to live in, rather than travel to these places!).
9. The new lesson we have learned, is don’t be afraid of fate. My father has been diagnosed as a terminal patient. He sees this as a new adventure. Who knows what is beyond what we know or see. He has made it much easier for us to see it this way. The things I know for sure about this new adventure – if there is a way, he will let us know that he has never really left us; enjoy every minute you have! Have fun with your life, let the people you love know how much they mean to you (which you really should be doing all along), never give into despair and in the true Marine spirit, never give up!
I know this does not cover everything I want or need to say, but this is being posted on a blog, and I don’t want to take too much of your time.
I thank you for being a friend to my Dad and my Mom. I thank you for being a friend to my family and having fun with us. I thank you for praying for him and for our family.
Love, Barbara

Please Excuse Me

I haven't posted anything since May 25th. I keep getting up, or perhaps more properly getting awake, and meaning to write something and for one reason or another something always gets in the way. Tomorrow is a Family Reunion which was concieved as my going away party last April with perhaps one hundred and fifty family and friends attending. The idea was that I would have the opportunity to drink beer at my own wake without scaring people off with my impending death. Since April I am almost seven months into my alloted year, plus or minus two months, given in February. Well, I now expect to exceed that allotment so I may have to give the party next summer. If you can make the party I will be really pleased to see you. If you can't keep trying this site and I'll get you caught up by Labor Day. Meanwhile I have posted an entry that my daughter Barbara wrote for me to post.

Sunday, May 25, 2008

This Years Experiences Are Far More Interesting and Varied Than Last Year’s

I haven’t written anything for the last several weeks because events have moved very quickly in a wide variety of directions. The lessons this time are very diverse and a great deal of the time far more intense. That said; let’s pick up where I left off in my last posting.

On arrival at the ER on Sunday morning I was examined by the duty ER doctor, x-rayed and CT scanned and pronounced, in preliminary diagnosis, with a broken hip. On Monday more images and tests were carried out and it was confirmed that the “neck of my femur” was fractured. This is part of the bone which contains the ball which fits into the hip socket and connects the hip to the knee. Just below the ball the bone reduces to rather small diameter. A cancerous lesion had formed in this area which had escaped detection by the PET scan. It had weakened the bone to a point that the small amount of stress caused by my limited movements and finally by moving my right foot laterally about six inches caused the femur to fracture.

I was referred to an orthopedic surgeon Dr. Bob Bear to repair the damage and was operated on Tuesday April 1st. A plate was attached to the neck of the femur and a pin was inserted into the ball. This stabilized the femur. I spent the next five days in the hospital and was transferred to rehab the following Sunday. After a week in rehab I was getting along well on crutches and discharged to home on April 13th. Home felt really good even though my stay in the hospital had been made as pleasant as possible by the fine people who attended me. I continued to make good progress working with my Visiting Nurse Physical Therapist and became so mobile that I was looking forward to getting back to walking with a cane by the beginning of May.

On April 17th I had my first session with chemo. Here I encountered a very interesting, although not altogether pleasant, experience. The injection of the chemo chemicals is an all day process in which you sit comfortably in a lounge chair and take the chemo mixture through an IV inserted into the arm. This is a painless and not unpleasant experience. The evening after the initial injection and the following day I felt fine. The second evening I had a very real dream which, in my mind, sums up the chemo experience.

First, let me say that nothing prepared me for chemo. I had an orientation session and a booklet, put out by NIH that told me that I might have any, or none of, about a dozen side effects but these were spectacularly non specific. In my dream I, some how, came across an alpha test of a computer simulation in which you could choose a disease and experience the symptoms, select a treatment and experience the side effects of the treatment. Obviously I chose lung cancer and since I had no direct experience with the form of treatment I chose chemo. You must understand going into this that my personality always demands a plan, perhaps a back up plan, benchmarks on which to gage progress and signs of direction in things that I do.

After signing up and being given the same NIH booklet to read I was launched into full scale realistic simulation of chemo treatment for lung cancer. I had no information on which to base a plan, no benchmarks were discernable nor was there a back up plan or any signs indicating direction or progress. I was also isolated from others participating so I was on my own in uncharted waters, confused, very sick and scared. I found the test director and asked for the manual. He told me “We picked you guys to alpha test this simulation because we thought you were pretty smart. There is no manual or any other information available to you. You figure it out.” The dream then turned into a confused night mare in which I struggled through sickness, pain and degradation. I woke shaken and confused and spent the next forty-eight hours in more or less the same condition. Someone once described chemo as “riding a rollercoaster, seated backward and blindfolded”. In my experience, this is a pretty apt description.

After about five days the effects of the chemo were done with me and I sat back to enjoy the next ten days before I took my next treatment. This was not to be as I shall tell you in my next installment.

Here, I should tell you the lesson that I learned in this phase. I have had wonderful care and caring from hospital staff, doctors, family and friends. I have learned how wonderful those who care for you either on a professional basis or a personal one can truly be and how much love is shown toward me by people who are total strangers as well as those whom I thought I knew very well. I am blessed.

Friday, May 2, 2008

Well, It's Back

Early in January I began to feel some pain in my lower back. This pain radiated down into my right hip and my right leg. Since my usual cure for that problem was a visit to my old and dear friend Dr. Harold Edelstein who may very well be the worlds best Chiropractor my first thought was to consult him. Harold looked me over, reminded me that I was a lung cancer survivor and suggested that I go to Exeter Hospital for a series of x-rays before we began treatment. I did, and soon had an extensive series of pictures examined by the hospital staff radiologist who was aware of my history and was pronounced clean of any detectable sign of cancer in the area. With that assurance Harold began treatment on me. After two weeks we agreed that we were making little or no progress and stopped treatment. I had a routine check up appointment with my oncologist Dr. Danny Sims very close to that date so we decided to see what he had to say.

I met with Danny Sims on Monday January 31st and on examining me and hearing my complaints he immediately ordered a CT scan. The scan showed some signs of positive results so a PET scan was ordered and that scan lit up cancerous areas in my lower spine and perhaps a small spot on my liver. Danny ordered a needle biopsy of my liver to verify the spot which turned out to be positive. Joan, my daughters Linda, Erica, Kristen and I met with Danny and he told me that my lung cancer had spread to my spine and liver, not a particularly encouraging diagnosis.

I wasn’t terribly surprised because the reading I had done on lung cancer survival had indicated that it was among the most deadly of cancers and subject to spreading throughout the body. I also didn’t feel any particular pain or depression in the news. It’s still, as it was last time, a lesson in the series of lessons that have made up my life, and if this one is followed by the final exam that’s all right and in the proper order of things.

Danny believed that the pain in my right hip and leg was the result of pressure being put on nerves by the tumor in my lower spine, so he recommended ten radiation treatments to shrink the tumor to reduce this pressure. The treatment was set up and I was remanded to the radio oncologist to perform the work. This consisted of ten sessions one each day of the week with weekends off. For my first visit I walked into the office with some small discomfort. By the third I was using a cane, by the seventh I needed crutches, and for my last two I arrived from my car in a wheel chair with some pain and a lot of effort. This was apparently due to the fast pace of the tumor’s growth. The radiation didn’t seem to help much but I was told that the radiation continued to work for about two weeks and I should see improvement soon.

My radiation treatment ended on Wednesday March 26th and I continued to have an increasing amount of pain at home. On Saturday evening Joan and I went to bed after dinner to watch “No Country for Old Men”. At the end of the movie I moved my right foot about six inches across the bed and felt, perhaps, the worst of pain I had ever experienced in my hip and groin. Something was very wrong. Having experienced emergency rooms on Saturday nights I took a handful of pain meds and decided to wait until early morning before calling the EMTs.

About 5:00 AM on Sunday morning Joan called the 911 and the Stratham EMTs responded. I was very afraid of being moved at all because any movement of my right leg brought agony. The EMTs were great they handled me with the greatest of care and delivered me into the hands of the Exeter Hospital ER.

I am going to stop at this point before I go on forever. Stay tuned and we’ll get to the next part of this adventure.

Sunday, December 9, 2007

The Final Post

The first thing I want to tell you is that I am well, very well. I had a CT Scan about a month ago and a visit to my surgeon about three weeks ago who pronounced me, to the best degree of assurance that medical science could offer,free of cancer. My experience with cancer was so easy compared to the experiences of others who have had cancer I do not consider myself a cancer survivor. Now I have to explain to you why I have left you without word since May 10th, my last blog post.

When I began this blog on February 18th I had just had a preliminary diagnosis of lung cancer. I went home from the hospital, clicked on lung cancer on the internet, and discovered that the survival rate for the average lung cancer diagnosis was six months. At that point I had no idea of where my life was headed or even if I had a life to live. So I decided to share whatever was to come as widely as I could, thence the blog. I told you that I was taking this as another lesson in my life long learning assignment and asked you to come along with me to see what this lesson contained and to share it with me. I also asked, if you were so inclined, to pray for me or to think positive thoughts about me if that was something that you found preferable. I invited you to bring others if you thought that they might be interested. A lot of you came and an astounding number prayed or contributed positive energy. Over five hundred people viewed my profile. I have no idea how many viewed the blog text but I believe that it was many more. I got a lot of e-mails from family, people that were close friends, business associates and many form people that I didn’t know at all who were interested in following my lesson and helping to make the experience a positive one. I believe that I had several thousand people praying for me because many who wrote me told me that I was included in their church’s prayer list and there were a lot of churches mentioned. I have always considered myself to be a very lucky person but this outpouring of concern over my comfort and welfare made me realize just how magically lucky I really am.

It’s a long way from May 10th to December 10th and since this is the first blog entry in that long period of time it poses the question, why did I not post more frequently after promising to bring you along on my journey? The simple answer is that the process slowed to a point that it didn’t present much, of what I felt to be, very interesting content. The warning, diagnosis, operation, post op, etc were well defined, dramatic events which were easy to write about in clear descriptions. The longer process of getting totally back to normal was a much slower, less well defined process that had a lot less drama and to my mind, interest, to those not experiencing it. So a brief chronology of what happened between the last post and this one below.

During the remainder of May I spent my time in an experiment with drugs trying to achieve a balance between some degree of comfort allowing sleep and ability to move my bowels. Pain was not a major problem, I could handle it, except when it came to the ability to sleep for more than an hour or less at a time. The lack of sleep was a discomfort but the inability to have normal bowel function was even more discomforting, so a lot of things were tried before I found, what I thought was, a solution. After several weeks of trying a number of pain and sleep aids as well as laxatives of various kinds my daughter, Kristen, gave me a an Ambian CR pill. This drug is a hypnotic, not a narcotic, so works differently on the body. I took it and found that it numbed my left side to a point that allowed me to sleep and had sleeping medication properties as well. I had minimal hangover in the morning and felt a lot better during the day. Happily it didn’t interfere with my bowels. I called my surgeon and asked him to write a prescription for me which he did, telling me to be a little careful because he had heard some strange stories about it’s effects on other people using the drug. For the first week one 6mg dose let me sleep comfortably nearly all night every night and didn’t interfere with my bowel movements. Then it stopped working. So I took two of the capsules a dose of 12mg which was also available in the form of one dose so I reasoned that that it was alright to do. That worked for a little over a week and then, it too, started to fail. I went back to not sleeping so after a few days I took two of the 12mg pills and slept very well again. After a few days I began to get very weak and winded just going up a flight to stairs, I got dizzy spells when I rose from a sitting position and finally I began to have some very strange thoughts. One morning, after waking and checking my blog, I found an anonymous comment that said -

“Everything happens for a reason and as such I see that you have much still to do. Your job is not done here; though you may not even truly know what it is. The pain reminds you of what was; now until it subsides focus on the grand adventures you have yet to experience. What do you want to do with the gift you have been given?”

In my altered mental state I took this as a message directly from God and panicked. I called several close friends and they were caring and sensible enough to suggest that it was a conventional, supportive, post to my blog and not God speaking to me and to suggest that I might take a hard look at whatever drug I was taking. The fatigue and dizziness was worse as well so I called my surgeon again who had me readmitted to the hospital and got me off the drug. In a day I was back to normal. At that point I decided that pain and sleep in drugs were not for me and stopped taking them.

So one of the lessons I’d like to pass along is be careful with self medication; in fact be very careful with medication even if it is prescribed for you. I wonder how many people die needlessly trying to balance, with or without the help of the medical community, one resultant problem of their illness against the medications prescibed?

By Memorial Day I went to my first social event. The engagement announcement of a mid life couple of friends of ours. It was wonderful and inspiring to see these two friends, in their fifties, find love and happiness together.

In early June I was able to drive my car and began to visit the office for short periods. I had been working several hours a day from home on my computer.

By the forth of July I was back on my bike riding around the neighborhood and have ridden over three hundred miles since that time.

By August I began to make longer trips by car and visited my family in Rhode Island.

In early September I was able to make a long auto trip to Ithaca, NY to visit a potential customer, Cornell University.

In late September I made a week’s trip to Quebec City with Joan and our friends Elizabeth Winship and Mary Larson. I had a great time with these three charming ladies.

Since then I have been full time at work and very busy.

Now to lessons –

I was shown that every day is a good day to feel alive and to do whatever needs to be done to give meaning and joy to being on this earth. I believe that this consists of minding the lessons I was shown below.

I was shown how much my wife and children loved me.

I was shown that I have more, a lot more, friends and people who love me than I ever could have imagined.

I was shown that there are people who are willing to love you and pray for your benefit even if they have never met you.

I was shown that there is something that intervenes on your behalf to help you along the way in your learning and life’s mission.

I was shown that there seems to be a plan and you are presented with lessons to be learned. I have been aware of this for some time but the experience with cancer made me far more certain.

I was shown that life is truly worthwhile, fulfilling and that in this life my mission is to be useful and to learn everything that I can from my experiences during my time here.
was made to realize that I am an extremely blessed person because I have been privileged to have been shown that all of the above is true.
Additionally it was confirmed to me that something that I learned as a nineteen years old Marine is true; death is one of the two universal experiences in life. Everyone gets born and everyone dies. Death is not to be feared. Death should be regarded as a wonderful entry into the next phase of your existence in the universe. Passing from this life is not a sad event unless you have ignored the ways that you should live in order to fulfill your perceived mission and not acquired or acknowledged the knowledge contained in the lessons presented to you.

I don’t know what will come next but I do know that I believe I am ready for it whatever comes my way. When and if the next major instructive event takes place I’ll ask you to come along again and I hope that you will find it in yourself to be as supportive and loving as you were in this phase. I hope you will find in your lives a path to follow that will be as instructive and joyful as I have.

All my love to all of you.


Thursday, May 10, 2007

Getting My Head Straight

I went to see my oncologist, Dr. Danny Simms, on Monday who pronounced me, with the concurrence of Dr. Rod McKee, Dr. John Riedle and various labs who examined my blood and tissue, to be free and clear of cancer as far as the present state of medical science is concerned. This means that I have no further course of treatment recommended at this time. No radiation and no chemo. Great news!!

So why has it taken me a couple of days to write this in my blog? Because I still hurt a lot and I had to come to terms of the why and how of that and where it fit in the scheme of things to do with this experience. Over the past week I have had a substantial amount of pain which I didn’t have during the first two weeks after the operation. How come later rather than sooner?

There are a couple of answers. The first one I knew, but didn’t fully acknowledge. The anesthesiologist gave me an epidural anesthesia which controlled my pain and even allowed me to fine tune, for relative comfort, during the first three days after the operation. Even though I knew this to be expected it was easy to say, “I’m a tough guy and this is a piece of cake”. When the epidural was removed a piece of foresight on the part of my surgeon took over, something called a cryo-block, which happily for me in the first week and a half after the epidural anesthesia was removed also eased my pain in the area effected by surgery. Even when it was explained to me I didn’t tumble to what it was or what it was doing until after it wore off last week. It was too tempting to think of myself as a tough old Marine who could take pain with the proverbial stiff upper lip and grim smile.

Well, the cryo-block wore off and my stiff upper lip softened and my grim smile faded quickly. I began to take oxycodone, the prescription pain drug, more seriously. This prescription worked well. The pain pills however had a serious side effect; the oxycodone turned the contents of my intestinal tract into solid concrete, a problem that I have yet to completely solve. All of those things kept me from getting very much sleep which is yet another form of discomfort and a hindrance to healing.

These things are still going on and I have been feeling pretty sorry for myself, but today I took a look in the mirror and said “Self, as a guy who just came out of an illness clean in which the survival rate is less then ten percent, what in the hell is your little problem? Get over it! All of this small stuff you are undergoing right now is nothing compared to what might have been or what so many survivors and, unfortunately, non-survivors go through with less than a one in ten chance of seeing next New Years Eve.” Based on everything that I have seen or heard during the past three months I can hardly call myself a cancer survivor at all; just one lucky, and up till today, ungrateful SOB. So now that I am in the unaccustomed position of being humble and my head is somewhat closer to being in perspective I can sit down and write this addition to my blog feeling gratitude to everything and everyone who helped me get through this experience, which could easily have been my last, instead of fault pride and ego.

In fact, when you come right down to it someone or something chose to give me a very early, very pointed, warning. I was guided to great medical team at a great hospital; I had, thanks to all your prayers and positive thoughts, a great spiritual support team working with me to get the heavens and the universe on my side. In short, I am much blessed. There is no way I can face the world this evening with anything short of wonder and gratitude at the experience and a broad smile on my face.

Stay tuned. I started this and asked you to come with me to see, among other things, if we could learn some lessons. If you have found some answers or good questions please share them with us. Let’s see what a little perspective offers.

Wednesday, May 2, 2007

A Thank You Lettter

Note to Readers: I was so impressed by the staff of Exeter Hospital in Exeter, NH that I felt compelled to write a letter to the President of the institution. I also felt that the hospital deserved wider publicity so the following post of a copy of the letter.

April 26, 2007

Mr. Kevin Callahan
Exeter Health Resources.
5 Alumni Dr
Exeter, NH 03833

Subject: My Recent Stay At Exeter Hospital

Dear Mr. Callahan:

I write to praise my treatment by your staff during my stay in your facility from April 19th to April 24th. I am very impressed by the ethic of care and helpfulness shown by, not just a few but, by all of your staff that interacted with me. During that stay I was met only by the utmost helpfulness, kindness and consideration by everyone with whom I came in contact. I know that the personality of a group tends to reflect the ethic and the direction of the leader of the group and I want to thank you for providing that leadership.

My experience began with an unexpected call from my surgeon, Dr. Rod McKee, around five o’clock on the evening before I was to have surgery. The anesthesiologist, doing careful checking of my medical records, questioned the ability of my heart to withstand the rigors of the surgery that was proposed for 11:00 AM the following day and wanted a stress test to confirm my fitness to undergo the procedure. I was given three choices; first delay the operation, second to move the site of the operation to a facility that could accommodate open heart surgery in case my heart became an issue, third attempt to emergency schedule a test early the following morning at the hospital. I chose the third option and Dr. McKee confirmed, within a half hour, that space had been arranged to accommodate a test at 9:00AM the following morning. Dr. McKee’s caring actions that evening saved me from a possible long period of anxiety and worry and those of the anesthesiologist showed a care and prudence that I found comforting.

On arriving at registration the following morning I found that due to the late scheduling changes of the evening before, correct physician authorization had not taken place. Claudia, the wonderful lady working with me in registration and a very dedicated blonde nurse from the stress test facility worked hard tot obtain the necessary signatures and codes from my primary care physician Dr. John Riedel clearing me for the test in time to make my surgical appointment. The surgery went well and I proceeded through recovery to the ICU where I was handled with the utmost care and kindness. Everyone who worked in the unit was first rate but I would particularly commend Nurse John Viray and LNA Stacey Mitchell.

On Sunday I was transferred to Surgical Unit of Wing 4 and found that the same high standards of helpfulness, care and courteously that I had found in other parts of the hospital were demonstrated again in this unit.

All in all your staff worked hard and well to make a potentially difficult experience a good and memorable one for me. I would like to thank you for having such a great group of people instilled with such a great ethic of work and service.


Nels Tyring

The Good News Is, There Is No Bad News!

The good news this week is that there is no bad news! Our team met cancer on the battle field and, apparently, delivered a smashing defeat. One of the problems with the enemy cancer is that his choice of battlefield is always the body and the collateral damage caused by the fight to defeat him has consequence for that body. During the operation a horizontal incision about a foot long was made, one of my ribs broken to allow room for the operation to proceed and about half of my left lung removed. The lung, the rib and the flesh and muscle involved has seen considerable trauma and is now involved in healing which provides some discomfort that, my surgeon, Dr. Rod McKee tells me will go on for some time. The upshot of this is that I don’t get a lot of sleep because I have only a very limited sleeping position, This position is on my right side and in which I am lying on some parts of my body not effected by the surgery. Since this position cannot be changed without infringing on a part of the body that was affected it is very limiting. So I get very cramped after about an hour and have to get up for a while to allow myself to un-kink. This however is but a very small price to pay for the elimination of cancer from my body and also gives me a lot of time to write at some strange hours of the night and early morning.

Late yesterday morning I went, with second daughter Barbara Smith up from Florida for a week to take care of dad and Nurse Joan, to visit Rod who proclaimed that I was healing nicely, that I had a bit too much fluid in my left lung cavity and, most importantly for all who were there, that no trace of expansion or migration of the cancer was found in the materials that had been removed during the operation. The tumor, itself, which measured five centimeters, was completely removed along with the entire upper lobe of my left lung. Other tissues and lymph nodes were removed as well and sent to a lab to be checked for signs of cancer. No indications were found. The fluid will be reduced by a strong diuretic starting tomorrow morning and keeping me close to home and john for the next couple of days.

The next step is to revisit my oncologist Dr. Danny Simms to find out if there is a need to pursue any additional course of action such as chemo or radiation. I have an appointment next Monday the 7th for this consultation. More on this in my next blog post.

In speaking with the many cancer survivors who I have come in contact with over the past couple of months I have been cautioned that cancer is a very clever and devious foe that has the ability to disappear and later pop up at unexpected times in unexpected places. So my team and I must be vigilant to guard against missing the early signs of it's return in case that does happen. You, my readers, were a strong part of the team that worked hard at the spiritual aspect of the battle and whose efforts proved to be, I am convinced, one of the deciding factors in our fight. I want you to understand how much I owe you for that help and how much I appreciate your prayers, thoughts and presence. Please stay with us in case there is a next round. The other part of the team were the great people at Exeter Hospital. I have never met a more consistently wonderful group of people and I am extremely thankful for their treatment, care and kindness and proud to have been among them. We may or may not be finished, but for now, it looks like the team decisively won this battle!

Thursday, April 26, 2007

We Won The First Battle!!

I am at home, out of the hospital on the 23rd, and this is proving to be a far more interesting experience than I thought it would be. The good news is that the first battle is over and we won. The possible bad news is that we don’t know if we destroyed our enemy or if cancer still has reserves that have been dispersed and hidden to enable him to regroup and attack again from a different place in the present organ or a whole new area of the body. Some specimens were taken and sent for analysis which will be returned late this week or early next week to help determine if we are to know if these reserves exist and where they might be hiding. I have an appointment with my surgeon Rod McKee on Friday May 4th to hear about the results and am making an appointment with my oncologist Dan Simms for a visit right after that to talk about the need for future strategies and tactics and, if required, what these might be.

Meanwhile here is what took place. Apparently, late on the 18th my anesthesiologist, looking at my medical records, became uneasy with my apparent risk of a heart attack due to the stents in my heart. He wanted a stress test. One was hurriedly arranged for 9:00 AM on the 19th, the morning I was schedule for surgery at 11:00 AM. I arrived, took the test and apparently blew past it with flying colors. I went to pre op as scheduled at eleven and, after getting in suited up or perhaps down for the event is a better description, I met with the anesthesiologist to discuss and select a type of anesthesia, I selected the epidural type in which I could self control pain after the operation, he approved, and from that point on things get foggy. After, what I have been told was, about three hours and a half hours in the operating room I woke in the recovery room to meet my wife Joan and daughters Linda, Erica and Kristen. I was then delivered to the Intensive Care Unit. In the ICU I was hooked to a lot of instrumentation and receptacles for bodily fluids and closely monitored by a team of very nice and caring nurses and nursing assistants. I spent three quite comfortable days there due to the fact that the epidural drip effectively numbed the areas of my body that had been involved in the surgery on my demand. I ran a slightly high fever and was given antibiotics.

Sunday afternoon, Dr. McKee determined that one of the two drains connected to my chest, the catheter connected to my bladder and the feed to the epidural system could be discontinued and that I be moved to a bed in the surgical wing of the general area of the hospital. At that point I began to experience some pain and was given, initially, percocet and later morphine to ease it. I was told that I might go home on Monday but my fever returned and I was given another day's stay and more antibiotics. The last drain was removed on Monday afternoon and at noon on Tuesday I was released to the care of Nurse Joan and home. I was given a prescription for a supply of the antibiotic drug and one of oxycodone to continue the antibiotic course and to ease my healing pain. It is now Wednesday the 25th’s evening and I am in good enough shape to write my first post op entry to you, my blog readers. I have a lot more to say about the experience so I am going to write another entry over the next couple of days.

Meanwhile God bless all of you who have kept me in you mind and prayers and please continue to do so. We won this round, I am certain that your kind help and support were a large factor in our victory. We need to be ready for the next attack, should cancer be foolish enough to continue to challenge the strong combat force that we have built through Exeter Hospital and it’s fine and dedicated people, medical technology, a great medical team and your strong support and demonstration of faith and trust in God, the Universe and the sheer power of prayer and massed positive thought.

Saturday, April 21, 2007

Linda's Post

"My father is fighting cancer." Nope. Sounds too much like a back alley brawl, and this is a much bigger deal than that. "My father is battling cancer." Closer to how he, the Marine, looks at this. Given the great chunks of medical machinery being brought to bear on his illness, "battle" does seem more descriptive than "fight". So, my father has become a foot soldier in humanity's on-going war with cancer, the one in the trenches, dealing with the crap rations, the foot rot, and the deafening machines of war. We, Mom and my sisters (but mostly our Mom) and you, his many extended family and friends, are a close and motivated troop; his support staff, providing love and support, and eagerly and nervously awaiting news from the front.

While speaking of his support staff, I’d also like to mention both Dr. Simms (the oncologist) and Dr. McKee (the surgeon), his doctors with great bedside manner. I’ve watched them communicate with my parents and me and explain what was wrong, what we might do about it. They inspire confidence and hope, which is a very important part of the Dr./patient and family relationship — to convey a sense of, 'I'm here on your behalf to try to make things better' — and are both very approachable people. I imagine that's one of the challenges of medicine, especially when you're caring for patients with terrible diseases. In my experience, some doctors are more naturally empathetic, and others are more distant. I would guess that there is also the protective mechanism, a tendency to sometimes keep a distance from the patient because it's emotionally difficult to have so many patients die. A cancer diagnosis is a real defining moment in people's lives. Most of us don't think about our mortality, but when diagnosed with cancer, you are thinking about it. When you think about it, you meet your oncologist and surgeon for the first time, talk with each for maybe a half hour to an hour, undergo some tests, and then agree to go through an operation that is life threatening. That is a remarkable trust the patient and family puts in a doctor. In a profession that many of us feel is eroding, with medicine turning increasingly into a business enterprise, consisting of insurance plans and profit margins and that often times is advertised like a car dealership, with signs advertising liposuction, breast implants and other optional treatment, they are both attributes to the medical profession. We have respect for these men.

So now, to the moment you’ve all been waiting for…..Nels’ surgery Thursday went very well. Took about 3 hours, he went into recovery without the need for oxygen, and within 1-2 hrs was in ICU, hooked up to a lot of monitoring equipment, but quite alert and doing well. While in surgery to remove the growth, they took lymph node samplings around the lung area, which will be tested to determine whether radiation and/or chemotherapy will be required in the future. These results should be known sometime later next week. I visited him again late Friday afternoon, still in ICU, and he was sitting in a recliner telling many stories to his very attentive primary nurse Kristin. So, he’s doing well, and asking for his Blackberry.

Thanks to all for your support, I imagine Nels will be posting again soon!

Saturday, April 14, 2007

And Now Like The Soldier Prepared For Battle, I Sit And Wait

Thinking about my experience with cancer so far I keep dropping in to a military analogy, perhaps because I see the cancer within me as the enemy that has attacked me and that I must now participate in a counter attack to bring my self to victory. Just as in the military one goes through training, tests and orientation; all in preparation for action against the enemy, I have done those things in the past two months to be prepared by my team to meet cancer and defeat it. I have been oriented to the enemy’s precise position and possible dispositions and strategies, I have been trained in what the enemy might do to confound our plan, what my team will do and what I must do to meet the enemy, I have been tested and tested again so that the ground my team has to cover has been reconnoitered as well as humanly possible. Now like a soldier awaiting the order to attack, all preparations made, I wait until the hour of action, Thursday morning.

Like a soldier, I look forward to the attack in a strange way. At least I will be doing something even if it may be an uncomfortable and dangerous time. I remember, as a Marine, the wait before engagement. Wondering what it will be like and if I will have the courage to live up to my part. I believe I am ready and I believe I am in the best of hands, I know I have a great many people praying for me, but still the wait is long.

From what I have been told I don’t think I will be able to report first hand on my operation next weekend, so I am going to ask my daughter Linda to post next weekend’s entry in my blog. God willing I will be back on my keyboard by the weekend of the 28th.

Meanwhile, thank you for all the communication, best wishes, kind thoughts and prayers from family, friends and wonderful people that I have never met and will very likely never meet. I believe that these things are as important to me and my well being as my medical team.

On Thursday we go forward!

Wednesday, April 4, 2007

We Have A Strategy, We Have A Tactic, We Have A Tactician, We Have A Time and Place; In Short, We Are Ready To Go

First an Important Note to Readers
Comments mean a lot to me and I suspect my readers as well. I want to hear from you about what your reading, doing and thinking. Several of you have told me that you would liked to have left a comment on one or more of the blog posts but were stopped for lack of a password. The reference to password only refers to those who have a Google account. Below the text box that appears when you click on comments there are three choices Google/Blogger, Other and Anonymous. If you want to leave a comment, and I hope you will, click on the Other or the Anonymous choice. Using these there is no need for a password. If this continues to be a problem for you get back to me by e-mail or phone and I’ll try to walk you though it.

Yesterday Joan, Linda and I met with the recommended surgeon, Dr. Roderick McKee. He is a very tall, very thin fellow somewhere, I would guess, in his forties. He comes very highly recommended by several of my “cancer club” members as does Dr. Sims, the oncologist who sent me to McKee. He did an physical examination and took us into his office to look at the PET Scan and MRI shots of the tumor. He spent some time explaining them and how an operation would be preformed and what it’s objectives would be. His verdict is that; it looks like it is in early stage, hasn’t obviously spread and that I am a very good candidate for surgery. He was very nice, very open and all of us agreed that we liked him a lot.

I need to have a couple of more checks before the operation such as getting a pulmonary test, which he uses as a base line to compare results and a check of my heart condition by my primary care doctor John Reidel. I see Reidel on Friday at 11:30 AM and the pulmonary test at 10:15 AM on Monday the 9th. I am scheduled for surgery on Thursday the 19th.

The scenario that McKee outlined was very much the same as that which Simms told of. Incision between my ribs, removal of the top lobe of the left lung, examination of the area for signs of spread of the cancer, close back up with some drains installed, a week in the hospital to allow healing and drainage, six weeks or so of recovery and perhaps additional treatment if indicated by what is observed during surgery and subsequent testing to be determined by Sims. So it looks like I may be back in stride by my birthday on June 11th if things go well.

Excuse the italicized “notice” above. I have heard from several people that they wanted to comment but were stopped by a request for a password. I hope the instructions above help and that you will make comments frequently because I value them a great deal.

Right now, that’s all the news from Stratham, NH. Thanks to all of you for your continued support an prayers.

Friday, March 30, 2007

The High Ground Seems To Be Confirmed

Last Wednesday I met again with my oncologist, Dr. Danny Simms. He walked in smiling and said “It looks like we have some good news”. Joan and Linda were with me and that put a smile on their faces as well as mine. He said that the PET scan that I had had last week showed no spread of the cancer from the tumor on my left lung. He showed me the picture and the tumor looked like a flash bulb going off but all seemed well around it. He stated that he felt that operating on a cancer that had spread was not good practice but I seemed to be a very good candidate for surgery. He would not guarantee that the surgeon would not find signs in my pleura, Joan, ever the nurse, tells me that the term means the outside covering of the lung, or in my lymph nodes near the lung but indications from the tests and physical examination do not seem to show that any involvement exists in any other area. So Simms advises that I see a surgeon and recommended a Doctor McKee who also practices in Exeter. He made an appointment for me for Tuesday April 3rd.

McKee seems to have taken the position of my tactician while Simms remains my strategist. I asked Simms what to expect and he told me that McKee would recommend if, who, how, when and where the operation would take place but he expected it would be Exeter Hospital. Asked what would happen, he told me that it would very likely be as follows – an incision would be made between my ribs on my left side close to the tumor, my ribs would be spread and the upper lobe of my lung would be removed. The area would be carefully examined for any sign of the cancer spreading to other organs and I would be closed back up and then enjoy a weeks stay in the hospital, then home for six or so weeks of recovery. After which I would very likely be returned to Simms for a course of chemo therapy. All of this to be confirmed by McKee after my visit on the 3rd.

So, all in all, I believe that my guardian angel has, once again, given me an early warning that may have saved me from something much worse. I know I was saved a heart attack by a pain in my butt which caused me to see a vascular surgeon who found that I had a far worse problem, two blockages in my heart, which had produced no symptoms but which could, if left much longer undiscovered, have caused a fatal heart attack. This time a pain in my chest, which could have been a heart attack, caused the early discovery of a tumor on my lung. In my reading on the subject, the high death rate in lung cancer cases is largely due to the fact that there is seldom any warning of a lung tumor until you find yourself in stage four with a cancer widely spread, from which recovery is difficult if not impossible.

So I believe that we are holding “the high ground” and from that great defensive position, with the support of all of you who have prayed, thought positive thoughts and kept me in you minds, we have, along with a good strategist and a well recommend tactician, a force that can withstand the assault by the disease and now mount a overwhelming counter attack on our enemy cancer. So off we march to war. Please march with us.

Saturday, March 24, 2007

A True Story About The Power Of Prayer

First let me say there is very little news this week other then the fact that on Wednesday I had a PET scan on my body and an MRI scan of my brain. These are standard and definitive tests that determine a course of treatment. I have an appointment with Dr. Sims, my oncologist, next Wednesday and should have an idea of what is going to be recommended as a course of treatment by the end of next week.

Now to the subject indicated in the title. This is a rather long story so bear with me. It starts in the mid eighties with a visit by an irascible old SOB (not meant to be construed as standing for Son Of Bob) and good friend named Charlie to Portsmouth.

Charlie Bergman was Vice President of Marketing for Bailey Controls, a large industrial controls company at the time. Charlie had contracted cancer, taken medical retirement and moved from Ohio, where Bailey was headquartered, to Wrightsville Beach, North Carolina. Once there, he continued treatments until his cancer went into remission. Charlie, an active guy, looked around for something to do. During his last few years with Bailey, Charlie had noticed a growing number of a new kind of service providers who put together, the then relatively new, electronic industrial controls into functioning systems. These were most frequently one and two man companies, but some had gotten quite large. They all operated quite differently, they frequently started up, grew for a while and then went out of business. This phenomenon interested Charlie; he began to study it by getting in touch with some of the owners of these businesses, to interview them at first, then to collect and consolidate marketing data. This he began to publish in a monthly newsletter to a few of us. One of the things that Charlie noted was that no standards existed in this developing industry. Because of the lack of standards those practicing in it frequently got into technical, financial, personnel or business troubles that
resulted in either the work they preformed being unsatisfactory, going out of business or both.

Charlie arrived in Portsmouth to talk to me about these problems as we had dinner at the Oar House on the Portsmouth waterfront. During the evening Charlie and I devised a unique name for the fledgling industry that of “Control Systems Integrators” to differentiate us from the people who integrated data systems. Charlie, after getting into a beef with a waitress over getting him a pack of cigarettes, got us thrown out of the Oar House with a strong request by the management that we never return. Charlie went on to call a group of integrators to a meeting in Wrightsville Beach later on that year and form our trade association, the Control Systems Integrators Association. I was off on something else at that point in time but a few of years later I joined. When I got around to joining I told the Executive Director that it was a shame that Charlie hadn’t lived to see the Association come into being. He told me he had spoken to Charlie that morning. I was surprised because I had heard that Charlie had died several years before. The Executive Director gave me Charlie’s phone number and I called to ask why he wasn’t dead.

Charlie then told me the following story. Three years before his doctor had told Charlie that that he had only six weeks to two months to live because there was nothing more the medical profession could do for him. Charlie sought the opinion of other doctors, internet sites and a variety of other possible sources but kept getting the same discouraging opinion. He then turned to the only remaining possibility of help that he could think of; that of a higher power. Charlie was not a religious man, didn’t have much by way of belief but he didn’t know where else to turn. He had made a friend in the Navy during World War Two of man who became a Catholic priest in Chicago. This friend, who was by then retired, was asked by Charlie if he would do some ‘consulting’ for him in the area of prayer because he didn’t know how or where to start. His friend came to Wrightsville Beach, moved into Charlie’s guest room and he and Charlie began work on to prayer. At the end of six months Charlie was well enough for his friend to return to Chicago and for Charlie to take his wife for a long weekend trip to Washington.

On the plane coming back to North Carolina Charlie struck up a conversation with his seat mate and told the man his story. The man had a sister in Nashville who had received the same fatal opinion that Charlie had been given six months before that very week. The man asked if Charlie could call here and council her. Charlie, always looking for a new challenge did so and so became the center of a growing group who were pronounced beyond hope and had come to rely on prayer. At the time I spoke with Charlie he had worked with seventeen people over a period of three years and had lost only two. The remainder were praying and urging anyone who was interested to pray with them. If the people they asked didn’t believe in prayer, then to think positive thoughts. Charlie finally died about eighteen months later having lived nearly five years after his doctors had given up any hope of his living past a couple of months.

At the time I heard the story I was impressed and thought it wonderful and inspiring but it had no immediate relevance to me. In the passed few weeks it has come the forcefully to the front of my consciousness. Perhaps a little more on this subject in a later post.

Saturday, March 17, 2007

Perhaps We Have Some High Ground Available

A short note before we begin: I have set up an e-mail address for responses to this blog for those who want to use direct messages rather then the comment areas indicated below. It is

On Wednesday I visited a recommended oncologist at Exeter Hospital. His name is Doctor Danny Sims, a fellow who appears to be in his forties who is very tall and very thin. Since Joan was in transit from her visit with her old friend Mary Larson in Little Rock, Linda went with me.

Before we get into the meat of the visit perhaps it will help if you know a bit of what I have learned about lung cancer. I have been doing some online research on cancer and, to bring you up to where I am, here is a brief summary of the results.

There are two broad types of lung cancer – small cell and non-small cell. Small cell accounts for about 25% of lung cancers and non-small cell the remainder. If you are going to have one, non-small cell is preferable because it is slower to develop and slower to spread to other areas of the body.

There are four broad stages of lung cancer. They are - Stage I is a cancer confined to the lung. Stage II is a cancer that has spread to lymph nodes near the tumor and within the lung. Stage III cancer is confined to the chest, but it has spread more widely through the tissues in the chest. Stage IV cancer has spread to other parts of the body, such as the brain, liver or bones.
There are standard tools of evaluation used to determine stage and course of treatment. They are - A chest X-ray is the first step in evaluating lung cancer. Normal X-ray procedures give a good picture of the chest cavity, but a CT scan (an advanced X-ray system) is usually done to show the lung mass, lymph nodes and the rest of the chest cavity in much greater detail. These X-rays may help evaluate the extent of a lung mass and suggest the likelihood of cancer. A diagnosis of lung cancer, however, requires a biopsy.
An MRI (magnetic resonance imaging) may be part of the evaluation for a lung mass. It is especially useful in evaluating the brain and bones, but it does not visualize the lung well.
A PET scan is a relatively new nuclear medicine technique that may be very helpful in evaluating and identifying the stage of a lung mass. If a lung mass "lights up" on the PET scan, it is a lung cancer most of the time. If the mass does not light up on the PET scan, it is not likely to be a cancer. The test also evaluates the entire body to search for any evidence that the tumor has spread to lymph nodes or other areas of the body.
During my stay in the ER I had the X-ray and CT (CAT) scan procedures as well as a biopsy. So the doctor had some information to work with during our visit.

On my visit I was, first, interviewed by a lady who described herself as a social interactive who talked to us about the help services, both material and emotional, available through the hospital and associated organizations

A Nurse Practitioner who took a lot of general data was next and then Doctor Sims. He asked a number of questions about possible symptoms that I had experienced. These were limited to the one chest pain session that brought me to the ER and the preliminary diagnosis procedures, some weight loss and some unproductive coughing. He took me to an examining room and listened and felt the areas in my body where symptoms might be found.

On our return to the interview room Sims stated that the broad range of possibility at this point was within stages one through three but his thought at that point was perhaps stage 1b. He said that the radiologist had indicated some involvement inside the lung but outside the site of the tumor shown on the CAT scan but Sims said he had not be able to find it in his examination of the results of the test.

I had some blood drawn and made appointments for PET scan and an MRI brain scan for next Wednesday to determine if the cancer has spread to other parts of the body and a visit to review results and possible treatment options or second opinion possibilities on the following Wednesday March 28th.

Meanwhile I am encouraged by the preliminary diagnosis because it indicates that there is an indication that I am in an early stage and therefore in a position to put up a good defense. My reference to “high ground” is from my old Marine Corps training which teaches that one should hold high ground whenever possible because it gives you a strategic advantage over the enemy. Cancer is now my enemy and I need to develop, with my doctors, family and friends a strategy and the tactical tools to defeat that enemy. The defeat of that enemy along with the lessons of the experience is what I hope I will take away from this period of my life. In all combat situations there is risk but a well-prepared strategy and tactics make the overall risk less and the chances of victory increase. Stay tuned and we’ll see how it plays out.

Saturday, March 10, 2007

Getting Everyone On The Same Page

As it turned out Joan was scheduled to go to visit an old friend, Mary Larson, in Little Rock on Wednesday, so my first task was to insist that she go as planned. The second task was to tell my kids what had transpired, to tell them how I felt and to try to get them on the same page I was on. I had a chance to talk to Linda on Monday and I called each of the others that evening and asked them, except Barbara who is in Florida, to schedule some time with me so that we could have a talk. I had a project meeting in Amherst, MA the on Tuesday so I thought I’d begin to talk to them on Wednesday.

When I arrived home Tuesday evening I was surprised to find that Barbara had flown up from Florida and she and Kristen were waiting in our kitchen. We sat, had a glass of wine and I began to tell them the story that I would repeat a number of times during the week to family and close friends.

I said “ I have had a long and very happy life which has provided me with a very large and very extended family and group of close friends which I love, value and find great pleasure in. I have no complaints and consider myself a very lucky person. I am convinced that I have been here before, that I will be here again and that I was meant to be here to have some very specific experiences and to learn from them. I have, in my long life, had a lot of experiences. Some were good, some not so good, some looked bad but turned me in a direction that I found to be necessary and good for my life. I tried, and I think succeeded for the most part, to learn from those experiences. What I am beginning to undergo I regard as an another important experience and I will endeavor to learn from it. If it turns out to be the final exam I have no fear of death. A long time ago I had opportunity to watch death visit a great many of those I knew in a very short period of time. I think of death, when it comes, as the next great adventure.

I have two concerns. The first: is that the word cancer puts people in the position of being afraid of being with you or talking with you because they don’t know what to say. I do not want to be isolated because I have thrived on human contact all my life. Please communicate with me. The second: is that people will spend time, emotion and energy in needless worry about me. I am going to be fine no matter what happens. As I said above, I believe that this is a part of my life plan and I need to follow it and learn.

Lastly: I need to reserve the right to live and to die in a way of my choosing at a time of my choosing. If I find I am becoming a heavy burden on my family and friends I may elect to remove that burden at my discretion and without anyones permission. In no way should anyone construe this to mean that I have any immediate plan to do so.

I love you all more than you can know and more than I have, unfortunately, shown at times. Please understand what I have said and be a part of my team and perhaps we’ll have opportunity to learn some important things together”

In an example of my first concern, my granddaughter, Leilani, told her aunt Barbara on Wednesday that she “would like to see grandpa but didn’t know how to talk to him under the circumstances.” Barbara told her to come talk to me. That gave me the opportunity to deliver the message above after which, I believe, she went away feeling better. Barbara, Erica and I had a nice diner at a local, upscale, Italian restaurant and, I believe, Erica went away feeling better as well.

I had a chance to talk with my son in law Smitty, my grandchildren Natalia and Colin’s father and that went well.

During the rest of the week I called a few close friends, gave them the same information and asked them to get on the same page with me. All in all I think this week has gone well. I am sleeping as well, perhaps better then normal and feel good. Next week we’ll get some medical treatment detail and I’ll pass that along.

I suspect that in future there will be times when I will not show as much bravado, but we’ll deal with that when we get there. Hope you’ll stay with me through this and see what we can learn.

The Begining

Fact: I found out last Monday, five days ago, that I have a preliminary diagnosis of lung cancer. It’s been a very busy week. I guess that I should give you a little background.

On February 13th I awoke about 3:30 AM with a small pain on the left side of my chest. Over the course of the next two hours it grew to a point where ignoring it seemed not to be an option so I woke Joan and said I thought that we should call 911. Living in a small New England town with a volunteer fire department, which handles ambulance calls, a young policeman arrived first. He tried to rouse a local EMT response with no results so he finally called the neighboring Exeter Fire Department that employs full time EMTs and they arrived. I got an initial survey, EKG, blood pressure, glucose level, etc and was loaded onto a gurney and out into a very cold evening. I was transported to the Exeter Hospital Emergency Room and a round of testing for a heart problem began.

After about an hour and a half the attending ER doctor came to tell me that the good news was that I was not having a heart attack. He said we should check to see if it was a blood clot and sent me to x-ray for a picture. About an hour later he came to tell me that the good news was that I didn’t have a blood clot and perhaps the bad news was I didn’t have a blood clot because there was a suspicious shadow on my left lung in the area were the pain hard occurred. He ordered a CAT Scan to take a further look and came back to tell me that I should see my primary care physician, John Reidel, and schedule an appointment for a biopsy.

On Friday February 23rd I had a biopsy done and the following Tuesday I left for Houston to attend a long scheduled conference, returning home late Friday evening. On Monday morning I called John who said the biopsy had been positive for cancer and that I should see an oncologist as soon as possible. John asked if I wanted him to set it up and I said yes. He called back in about ten minutes and told me that I had an appointment with a doctor Sims at 2:15 PM on Wednesday March 14th.