Statement from Dave's family

As many of you know, Dave Ludwig died yesterday almost 4 weeks to the day that he entered the hospice center. He had no pain and his breathing was comfortable before he quietly passed away. After all of the bad things that happened to him these past 4 years, it is a relief to know, as a wonderful friend said to me, that nothing bad can happen to him again. He is at peace now.

True to the way he lived his life, Dave wanted to contribute to science and learning even after his death. As he wished, his body was donated to be used for teaching or research. There will be no funeral but we will be having a celebration of his life at a later date, not yet determined. Dave has left us a list of the music to play at his party and we will be sure to toast him with his favorite cocktail – a negroni. Luckily, he taught our  youngest son, at the age of 8, to make negronis. (To his mother’s great relief, Colin did not have to write a “what I learned over the summer” essay when he  returned to school that fall.)

Dave did not have a lot of energy to spend as much time as he would have liked to travel to the shore or mountains for snake hunting and bird watching in the last couple of years. However, there was a wonderful natural area not too far from our home where he could take walks on those days when he would feel well enough to get out of the house. He would head over to it and spend time taking pictures and turning over logs and rocks looking for snakes. Many of the photographs of flowers that he added to his blog were taken on these walks. We request that if anyone wants to make a donation to honor Dave, please make it either to a charity of your choice or to the Middle Patuxent Environmental Area, Robinson Nature Center, 6692 Cedar Lane, Columbia, MD 21044. The check should be made out to MPEA and write his name on the memo line of the check or attach a note saying it is to honor David Ludwig.

These past four years have been challenging for Dave and us and it would have been unbearable except for the love and caring that you all have shown us. Whatever form your thoughts for us took, we drew strength from them and we want to thank you with all of our hearts.

Love,

Cathy, Molly, Jesse, and Colin

Well, it has been 2 weeks since Dave was transferred from the hospital to the hospice center and each day has brought new challenges. There have been days when he slept all day and most of the night. Lately, there have been days when he hasn't slept at all. It has become increasingly difficult for him to communicate through writing, especially when he has gone without sleep. The doctor thinks the cancer has spread to his brain. Some days he is clear headed but there are many during which he is confused. He is compelled to write on his pad constantly but it is usually, though not always, incomprehensible. It will be a jumble of letters, often repeated, or he will start a sentence but he will lose focus and not be able to complete it. He knows what he wants to say so he gets very frustrated and angry that he cannot translate it onto paper. He certainly recognizes all of us and anyone who comes to visit him. He is no longer able to read. We have been able to get him outside a little bit in the small courtyard here. He is really weak so we put him in a wheelchair and push him around.

The staff here are wonderful. They are so caring and attentive, especially to keeping Dave comfortable, but also to us. Dave's family are all here and spend most of the day with him. Molly has taken off from work and does all of the grocery shopping and cooking, bringing dinner here where we 'party' every evening. Copious quantities of alcohol are consumed and we fill the room with laughter, often playing Scrabble, and suffering while we watch the Orioles.

We are taking it all day by day. The doctor has not given us a timeline for what is going to happen but we are pretty sure it will not be a whole lot longer- whatever that means.

As you have probably been able to tell from the long absence, Dave isn't doing so well. He's in hospice surrounded by his famiy.

Apology Foreword

I open with a note of apology. For the ongoing and multiple years battle with cancer, I have set this blog at a high priority for getting into print by Sunday (at the latest. Many of the entries make it by Saturday night). For its entire life, except for a few times when the blog has been overridden by a perfect storm of “facts on the ground,” it’s been Priority One, challenging whatever fog of medicines, treatments, ongoing pain and discomfort, new pains and discomforts, inability to hike and general crankiness that go with terminal illness. 

Besides, I figured, it was an easy way for people to know I’m Not Dead Yet. A quick look at the blog, and whatever gibberish may be there (we’ll return to that point in a few minutes), at least you know enough shards of me exist to get stuff blurted into an MS Word file. 

I’ve maintained this procedure through 2 full rounds of radiation and chemo. Last week, in a stealth move, the doctors had me in the hospital for a variety of minor physical tune up items. Before they could finish up and get me back on the road, they went ahead and pumped me full of chemotherapy toxins. I barely recall it happening. The nurse hooked me up at around 2 a.m. By dawn, my brain was re-scrambled and the physical impacts of the treatment were starting to manifest. Having the chemo done as an inpatient had innumerable benefits. The docs could monitor and respond to pain, dehydration, nutrient imbalances, vomiting and nausea. The chemo still beat the shit out of me. In fact, today is the first day I can say that I’m back to a “normal” level of pain and discomfort, and able to sit and write. Obviously blowing the whole theory of the regular-like-clockwork blog indicating I’m alive. So I’ve screwed up royally here. But honestly, I forgot (or suppressed) how savage the chemo was. 

Thus, it’s taken me until now to get this into print. My deepest apologies to all!

Back to Normal-ish Blog Update

The pot of contagion in the human ecosystem is stirring itself into existence. The slow cooker of pathogenic microbes (from viruses through bacteria to protozoans), plus a big-ass bucket of multicellular organism that we (“we” in this case stands for old and cranky parasitologists) used to lump together as “worms”. Some of the latter are the weirdest damn things your imagination could conjure. Don’t think for an instant that the creatures of the “Aliens” cinematic franchise are anywhere near as extreme as the living yield of the evolutionary dance between hosts and parasites right here in River City, on earth, right the hell in front of us. Where we got two drinking bars, and that starts with B and that sounds like T and that stands for trouble. 

Now, in addition to diseases and parasite loads, an emergent property of modern ecosystems is the redistribution of human beings across the biosphere. Some of you may recall that I’ve been bitching about this in publications and presentations for decades. The issue is simple, and represents a logical inevitability. Having visited impoverished communities in the tropics and near-tropics of Asia, the Middle East, the Americas, and Europe, one factor overrides all others—information. Take a walk through a couple of the larger, older souks any city in the Muslim world, or, now, some of the outer ethnic suburbs of the enormous megacities of Europe, Asia, and the Americas.  When you get back to your hotel, sit at the bar with an iced fresh mango juice (everywhere) or a Negroni or Mojito (in countries allowing visitors to consume alcohol) and think quietly for an hour or so about what you’ve seen.

What you’ve observed is this. Everybody, from those living in extreme poverty, to those stressed but hanging on to a difficult middle class have access to English and local language Al Jazeera, CNN, networks (parent holding companies) news and opinion broadcasts, etc. In short, the more than TWO BILLION people living at or below the U.N. and World Bank poverty threshold, see perfectly clearly on the screen at the neighborhood waterpipe emporium that pretty much everybody north of the tropic lives in relatively clean, dry, safe-ish conditions with opportunities to rise economically at least theoretically achievable. And they don’t.

My vaguely alarmist theory foresaw millions of environmental refugees pouring north. Because if your choice is to watch CNN in a damp mud-floored hut where malaria (or worse. See, for example, River Blindness) is endemic, emergent diseases jump from wild and feral animals to humans and back again (see hemorrhagic virus for a scary glance into that world), potable water doesn’t exist, economic opportunities are somebody else’s…and the list goes on. Live in shit and watch your kids explode their lives in work, illness, and a 24/7 search for food and water? Or consider the possibility of raising them in London, Paris, Copenhagen, Hamburg?

Well, duh. Time to wrap the last couple of cut down paint cans used for cooking pots, pay off the smuggler, and get on the overcrowded boat to Sicily. Maybe we make it in. Maybe we don’t. At least we have something to focus on besides mud, malaria, and finding sufficient twigs to boil water to drink for one more night.

Ah. We already live in the clean northern world. And it’s a good thing, because Your Obedient Servant (that would be me) has been stricken with a particularly complex and dangerous illness. The kind of thing where, if I didn’t have health insurance, or lived in a country lacking high-powered medical talent wielding high-powered medical tools, I would have been dead years ago.

Next up is a continuation for 5 more infusions of the chemotherapy drugs. The impacts of the drugs themselves on my physiology are extreme and difficult to tolerate. Having been in the hospital (by chance) for the first application in this series, I can see a lot of advantages in being treated as an in-patient. As doctors point out, insurance won’t pay for such in-patient treatment. This despite the fact that every other chemo infusion I’ve had through 2 full courses has put me in the hospital, usually via the Emergency Room. I see no reason to anticipate that this round is going to be any different. Likely we’ll follow the same path as before. A couple of nasty, painful, disgusting days immediately following treatment, a determination that I’m dehydrated and cursed with intractable vomiting, a trip to the ER, admission to hospital for several days to get physiological wreckage back on track. 

We do have an advantage this time, and it’s something that worked pretty well getting me through the last round of chemo. With the assistance of a home-visit nurse, Cathy has been trained to administer intravenous fluids and even i.v. treatment drugs. This certainly has the potential to ease our way into this round of chemotherapy. 

OK, sports fans. My deepest apologies to all for being so late with this report. I am indeed alive. Difficult as I find it to say this, we’ve already stepped onto the treadmill for a 3rd round of chemotherapy. We’ll just have to let this one play out. It’s a fair bet it won’t be pretty. But, translated into an uncensored weekly weblog, it can it least be entertaining. Be here next week everybody—I will not be late with next week’s entry, unless something untoward (correct idiom?) occurs. In such an event, I or one of my children will get a quick note up to get information out. So rock and roll. And use ‘em while you got ‘em. Remember, your drummer could spontaneously combust at any time (cross-reference Spinal Tap. Frequently. Along with a couple liters of really good beer. My love to everyone!!!

It Might Get Messy

Commander Cody got lost in the ozone…repeatedly. Eric Clapton could hammer the shit out of a Stratocaster, but never could figure out a mature and satisfactory approach to sexual relationships. Kurt Cobain was a lost-cause genius from the drop of the flags, as much as Einstein was an eternal genius who will be with us until we are no longer us. And me? I spend a lot of time in the hospital for various reasons ranging from the mundane to the truly quirky.

This week I’m here for several reasons. My breathing declined rapidly earlier, as fluid built up in the chest cavity around the lungs. For immediate relief, the fluid needed to be drained (simple process), but the source of the fluid, increased cancer growth in the lungs, had to be dealt with. Simultaneously, the feeding tube apparatus in my gut finally gave up its functional ghost and had to be removed and replaced—not a simple operation under any circumstances. And, as long as I was hangin’ at the hospital, the good doc figured we might as well go ahead and get me started on a new round of cancer-suppressing chemotherapy, on the theory that the last round bought me some nice months of comfortable and happy time with my family and friends, and another round could do the same. Particularly if we took the clues regarding drug cocktail contents in an attempt to reduce ugly side effects associated with the chemo infusion.

So. Here I am. Again. Probably well north of a dozen admissions in. Yesterday they undertook the painful effort to yank the golf-ball-sized feeding apparatus from the tiny hole in my gut, and replaced it with an easier-fitting alternative. Late last night (around 2 a.m.) they started the chemotherapy infusion. An hour later and I was pretty well zonkered. Stayed that way until nearly 10 this morning, at which point the nurse kicked me into gear and got me medicated, liquidated, and fed, and the technical assistant held me down for a thorough sponge bath and change of bedding. 

So, assuming my health doesn’t collapse any from here and I remain free of ugly impacts of the chemotherapy, I should be able to go home tomorrow to hang with my guitars and drum pads in the corner of the room. If I continue to feel this good, I might be able to rebuild some strength between every-three-week doses of chemo drugs. If the chemo drugs don’t pound my health (Dr. T made a substantial cut in the amount of the suspected culprit causing the repeated nausea in prior applications), this could be a real nice success story in the history of my cancer process.

We’ll see. For the moment, I’m alive, cogent, able to keep you somewhat up-to-date. You have my love and gratitude. Use ‘em while you got ‘em, everybody. Clearly they are not forever. But they’re all you get. Talk to you next week!

It Might Get Messier

And it certainly will at some point. The question is, are we at that point? And the short answer is—I have no frickin’ idea. The past few days, I’ve been feeling really crappy. But in a kind of generic, nonspecific, can’t really pinpoint particular symptoms, kind of way. Which, oddly, makes the prospect of ill health more frightening than if there was something identifiable and specific to trigger concern. That’s because I have so many areas of cancer loci in my lungs and chest cavity that I’m not going to die from one or two high-powered tumors. Rather, at some point, the entire malignant mess will get its collective shit together and start robbing my physiology of important components of life.

I saw the oncologist yesterday, and we put together a package of diagnostics to try to get  handle on what the hell is going on. Friday I’ll get blood drawn, Monday have a CT scan, and a couple days later meet with the oncologist to discuss the radiologist’s report. If I continue to feel generally icky without particular things getting specifically worse, the conclusion may be ugly. Although as oncologist Dr. T points out, it’s been 6 months since my last chemotherapy infusion, which in theory means it should be as effective if applied again. Of course, it hammered the shit out of me itself and left me repeatedly hospitalized. But it did indeed knock back the cancer. So things aren’t necessarily totally dark even under worst-case conditions.

But we’ll just have to see. For this week and next, I’m just going to update this weblog with brief notes and progress reports. After we get through the radiology, I’ll go back to the more illuminating and interesting presentation format. For the moment, I thank you all for being here with me. With a little luck, I may be with you for at least a while longer!

It Might Get Messy

As some of you have no doubt deduced, all is not well in Cancer Land (trade mark, copyright) this week. There seems to be a general buildup of unattractive and dangerous goop affecting important components of my physiological infrastructure. At this point, I have no idea what is happening, why, and what the implications are.

I’m heading for the oncologist’s office now. She’ll probably adjust the meds, but has no new diagnostic data to help her figure our what the disease is doing. So I’m basically expecting to get a date established for a PET/CT scan. Which  means if I continue to be uncomfortable, by next week, we should have a handle regarding what’s going on. And what, if anything, can be done about it. Check in next week for a detailed exposition of what goes down and how bad it is. Otherwise, keep on rockin’  everybody. Important for people our age!










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