Autumn. Time for many creatures to prepare to meet their maker. Personally, I try to always be prepared to meet my maker. It’s easy because I’m usually pretty ticked off at him, her, or it and anxious to meet so we can sort a few things out. Like how and why an all-powerful being can stand aside while 10s of thousands of children around the world pass their nights alone, abused, cold, hungry or sick. I mean what the hell kind of deity has it in its power to prevent shit like that from happening and does not do so? What does that say about the morality and/or intellect of said deity? I know what it says to me. It leaves me pretty pissed off is what it says to me.
But that’s not why we’re here. At least not mostly. We’re here because this is now the…uh…second autumn since I was diagnosed and treated for cancer. An autumn I might easily not have survived to see. So I’m damned happy to be in attendance! Sure, we don’t have the sugar and Norway maples that give those gaudy reds to New England towns and hillsides, but the mid-Atlantic has its own, slightly more subdued, color palette. Oaks and hickories, sweetgum and tulip poplar, all give things a nice yellow-to-orange air for the season.
And I continue to slip toward “normalcy”. Voice still impaired, check. Swallowing still clumsy, check. Fitness still sucky, check. But. My voice is actually getting noticeably better. Last week I had several lengthy conversations with people I’d never met and who were at distant ends of teleconferences and who managed to understand me all the way through. Spent a couple days in the field in the deep, deep south with people who all understood me for the entire time. Ate real food, sort of, on the road.
Actually, the food was a little humorous. Stayed at a Marriott property in an old high rise building on the fringe of Baton Rouge. Had fabulous lacquered wood escalators, BTW. Didn’t really fit in with any of the other décor, but that dark wood with the thick lacquer shine was absolutely gorgeous. Anyway, I was tired. Ordered a room-service burger on the first night. It was delicious. Handmade, high-quality beef, plenty of good blue cheese, perfectly cooked. I managed to choke down a quarter of it before giving it up and calling for the room service guy to come retrieve the tray. 3 minutes later the food manager was on the phone, horrified that I’d eaten so little of the burger. He was terrified that there was something wrong with it. In fact it was one of the best hotel burgers I’ve ever had. I ordered another one the next night. Managed nearly a third of that one.
Gotten into a decent nutritional rhythm the past few weeks. I stick a frozen breakfast sausage biscuit in my brief case on the way out, eat it around lunch time with a weak and diluted mug of cold decaf instant coffee. Works pretty well. With that solid food going down every day, I feel ok about weakening and doing liquids for breakfast and sometimes supper. Seems to work pretty well.
Almost makes me feel like a normal human being. I know I’m not. My Arabic CD instruction is being impaired by my destroyed epiglottis. Means my glottal stop—a key phonemic function in Arabic—is sloppy, doesn’t stop quite suddenly enough. Makes me sound, I’m sure, intoxicated. Which is also against the rules of Islam.
Which takes us full circle to that “meet your maker” deal. In addition to the letting-children-go-to-bed-abused thing, I’m gonna have to discuss the fact that he, she or it invented high-quality whiskey and then made it a) physiologically destructive, and b) proscribed by certain religions. We live at the behest of a sick deity, my friends. Or at least one with a sour and none-too-funny sense of humor. But don’t worry. I’ll sort things out when, eventually, he, she or it and I meet up. Shouldn’t take long to sort things out pretty effectively. Maybe I’ll have that opportunity on the night of 21 December 2012, huh? I’ll try to be prepped. Send me any messages you want conveyed. I’ll carry them in for you. What the hell, if I’m askin’ questions and takin’ names, I might as well take some for you! Love you all, my friends. Holidays about to kickoff. Thanksgiving invitation is out in via email, the driving CD goes to the US Postal Service this week. Walking into another one. Who woulda thunk it?!?!?!
It Might Get Messy
When I was a kid, there was an oddball theme park somewhere in the Greater New York/New Jersey Metropolitan Area called “Freedomland”. I don’t recall too much about it. I do seem to remember a sort of set-piece sequence to the attractions. First you road a “paddle wheel steamer” down “the Big River”, along which were such animatronic arcana as a settler’s log cabin, a bear, a native American, a fox….you get the idea. Disembarking from your paddle wheeler, you proceeded through a succession of exhibits such as craftspeople hammering horseshoes, some penned-up bison, a petting zoo, etc. Somewhere between the blacksmith hut and the electrically-lighted wigwam, we would park it on a bench and eat lunch, invariably egg salad on white, ham and cheese on rye, and pasta salad made with elbow macaroni, and a half-gallon “guj” as my parents insisted, of Kool-Aid or lemonade.
As theme parks went, it was fairly lame (of course, I’m no reliable judge, having raised 3 kids and never gone to a theme park!). But the routine was comforting. You knew, when the adults were hauling you to Freedomland, how long it was going to take, what you were going to, when you had to ooh and ahh, when you could be tired and bitchy.
The process of dealing with cancer has turned out to be rather similar to a summer-day visit to Freedomland. A settled sequence of events, tolerable, even comfortable in their own weird way, familiarity yielding calm, not contempt.
Which means, not much to report on the cancer front this week. That alone, of course, feels pretty damned good. Oh, there’s the usual litany of what are presumably permanent complaints. Room service here at the Marriott in Baton Rouge, Louisiana just retrieved my tray and the poor food and beverage manager called after noticing the hamburger was barely eaten and wanted to know if everything was ok. I assured him it was delicious (and in fact I must say it was, handmade, well flavored Angus beef, plenty of good blue cheese, a nice crisp pickle which I’m finding is something of a Marriott trademark, at least in the south). But I can only get so much solid food past those shards of my epiglottis before it rebels and makes it clear that it’s not going to put up with any more pointy, sticky, or dry stuff and it’s time to switch to those thick shakes or give it up. Given that my weight has reached the high 220s, or higher than I want it, the shakes are going in favor of iced decaf coffees and low-fat mochas.
So I got my ongoing discomforted throat. I realized the other day while dealing with some technical difficulties with my crossbow (it may be getting close to time to switch to a recurve version without compounding cams to complicate things) that my left arm is still partially paralyzed. I want to get an inexpensive traditional recurve and get that old fire-at-will feeling back. But I may not be able to do it very well. On the other hand, it may be just the exercise I need to rebuild some of my left arm function.
Finally, I gotta get my annual drug and alcohol screen so I can work for a particular client. And I’m looking at the handful of meds I take every evening and thinking that one or more those must bleed a detector output spike somewhere near something illicit. But I got the scrips and I clearly have the need, so I guess we’ll find out.
This is what passes for adventure in my life these days, BTW. Sigh. Catch ya’ll next week. Later in the week there’ll be a new professional blog up at http:\\aehsfoundation.org\, it’ll go up later this week because it made it up late last week and I like to leave ‘em up for around a week for proper aging. Similarly, I’ve got some decent autumn photos, I’ll start getting those up over at http:\\docviper.livejournal.com\ later in the week, shoving the Thanksgiving invitation down to a deeper date. I’m expecting Thanksgiving to be just awesome this year, coming as it does a few weeks shy of the Mayan long count calendar end of the world. We ain’t lettin’ the universe end without a fight!
It Might Get Messy
Have drugs saved the world? There’s little doubt that they will, someday, maybe someday soon. The emergence and host transference of hemorrhagic fevers like Lassa and Ebola, highly evolved immune system nightmares like HIV, and the reservoirs of Yersinia pestis, cause of black or bubonic plague, all argue for the near-future probability of some massive contagion requiring heroic pharmaceutical intervention (see, among most recent examples, epidemic epic and Laurence Fishburne vehicle “Contagion”). Hell, there’s apparently still enough smallpox on ice in Russia, the U.S., and Ukraine to trigger such an event via a power outage and some careless cleanup of some messy old freezers.
But I’m thinking of this another way. One place I’m amazed drugs didn’t alter the world for the worse was the brain of Charles Darwin. On the Beagle as a young man, probably somewhere in South America, Darwin contracted a persistent tropical infection. He was plagued, so to speak, for the rest of his life by abdominal pains and other complaints. He was treated with increasingly frequent and massive doses of mercury-based medicines. Mercury, therapeutically useless, is in fact a powerful nerve toxin, and impairment of brain and other nervous system functions inevitable outcomes of chronic dosing. Yet Darwin created, thought through, and finished his most brilliant and prolific work in the throes of mercury poisoning. Of course, he was very slow to get the Origin of Species into print, and he actually meant for it to be the abstract or précis of a much larger and more seriously scholarly work. Maybe some of that was an outcome of his mercury intoxication. But if so, on the scale of the lives of us normal human schleps, you’d be hard-pressed to clearly label that a negative impact.
No, I’m going the other way with this line of inquiry. Consider. Through the 1930s, Adolph Hitler was smart, rigorous, and systematic. He manipulated first the Germans, then the Europeans and Britons, then the Soviets, in succession until he’d taken the European continent on a pretty casual basis. If he’d retained that systematic rigor through the 1940s, there’s no telling what the hell the world would be like today. Let’s say Hitler retained the peace treaty with the Soviets (who were nowhere near ready to defend themselves) and gone ahead and taken Britain instead. Oh, that wouldn’t have been easy. But it would have been doable. Then, without a hostile pipeline for American wrath at his back, he could have turned his sole attention to the Soviets. Given how fine a line there was between success and failure at Moscow, Leningrad, Stalingrad, and in the resource-rich southern Ukraine, it seems like the Germans might have made a real run at it. And we know from recently discovered research documents that German engineers were already thinking ahead to the Western Hemisphere. Ambitious weapon systems like 8 engine intercontinental bombers, huge transport submarines, and nuclear fission weaponry were all on people’s drawing boards.
What we have to thank for the way things actually worked out is a string of oddly piss-poor decisions made personally by Hitler himself. He insisted the Messerschmidt 262, a stunningly advanced jet fighter that could have be in production by the early 1940s, be configured inappropriately as a bomber. He discounted jet and rocket technology and strategic bombing following the tactical success of continental blitzkrieg. He gave up on invading Britain after a long hard year of strictly aerial combat. He halted the units that were moving in to capture the allied forces the heroic Britons pulled off the beaches at Dunkirk. He signed on with Italy, putting a political and military albatross squarely on his chest. He insisted on mistreating Ukrainian and other non-Russian Soviets who initially treated the Germans as liberators. And most stupidly, he opened the second front with the Soviets, and in the process of dividing his limited resources shitcanned a succession of competent and professional military leaders and appointed himself, amateurish, petulant, irresponsible, and, basically, clueless, as top commander.
And what might account for Hitler’s transition from unlikely but disciplined and successful political leadership to incompetent and untenable insanity? Well, historians generally do NOT blame his physicians [1]. But as the 30s became the 40s, Hitler met a mystical, semi-competent, marginally ethical doctor named Theodor Morell. As a fellow wack-job, Morell and Hitler hit it off right away. Especially since Morell immediately began administering cocaine eyedrops, amphetamine breakfast injects, morphine bedtime injections, a weird patent-medicine supplement product that contained a considerable concentration of nicotine, and other, even odder substances (possibly none quite as toxic as the nicotine, though). And he Morell gave him this stuff in increasing frequency and quantity right through to Hitler’s suicide in the Berlin bunker in the late spring of 1945. I think it’s likely that Hitler crossed that fine line between evil genius and evil idiot as a result of Morell’s ministrations. Morell—and his drugs—may well have saved the world.
And why do I bring up this rant of historic esoterica in the context of a cancer recovery diary? Because I have my own drug problems. As I’ve told you several times in the past couple of years, I’ve had to wean myself off of addiction to powerful sedative Xanax (actually the generic equivalent Alprazolam). Like quitting daily alcohol when my cancer was diagnosed, I don’t seem to have a lot of trouble attenuating then breaking the inevitable addiction to the sedative. It’s just odd to go through it repeatedly. Last time I saw my GP, he loaded me up with blood pressure and anti-depressant meds, and started to renew the scrip for Xanax. I told him not to bother—that with the cancer over, I was sleeping just fine and didn’t need it. Two days later, we found that scary tumor-looking blob on my throat. I faxed a note back to Dr. K, explaining that I had been too cocky, that I’d probably need that sedative to sleep effectively for a while. He renewed, no problem. As you can see here:
Xanax generic equivalent ready for use.
So I’ve been sleeping well on a milligram, milligram-and-a-half of Xanax. Got a couple more weeks of that, then the scrip will start to run down and I’ll wean myself back off it. I apparently inherited my father’s awesome control over his physiology. Dad was a serious alcoholic for decades, not having a night in maybe 30 years that he didn’t go to be at least pleasantly drunk and often further into it than that. Then his doctor told him alcohol was poisoning him and his liver and heart were going to fail very soon if he kept it up. That night he stopped drinking. No problems, no physiological issues. I read somewhere that you can’t die from heroine withdrawal, but you can die from alcohol withdrawal. I wonder about Xanax?
Notes
[1] http://en.wikipedia.org/wiki/Theodor_Morell
[2] http://www.fpp.co.uk/books/Morell/Morell.pdf
When I was in school, bomb calorimetry was all the rage in ecological research. Since it’s an esoteric art and no longer fashionable, some of you may not remember what a bomb calorimeter looks like or how it was used. In both theory and practice, bomb calorimetry is about as simple a process as you can undertake and still get useful technical results. The idea is that if you burn something completely—breaking all its energy-containing chemical bonds—and measure the produced heat, you have measured the energy content of the something you burned.
Back when systems ecology was an actual field of scientific endeavor (that is, before bioengineering and molecular genetics sucked up all the research funds on earth), the energy content of things was useful information. It allowed one to build a picture of the food web(s) in which the something-you-burned is embedded. Knowing the energy content in something’s chemical structure tells you how much energy it can contribute to something else that eats it. It also allows you (along with some other relatively simply gathered information) to estimate how much energy the something needs to maintain itself as a functional (that is, living) organism (assuming it was one before you stuffed it into the calorimeter and fired it up).
In the old days, we liked to think that a bomb calorimeter was called that because the process was similar to that of a bomb going off. But really the instrument was named because it looks almost exactly like one of those spheres with fuses from Bugs Bunny and Yosemite Sam cartoons. More or less like the flip chart picture Binyamin Netanyahu used to describe Iranian nuclear technology to the U.N. General Assembly a few weeks ago. Here’s a picture of one slurped off the web.
Granted, most modern instruments are shaped like cylinders, not spheres, but you get the idea.
And why do I bring this up in the context of a cancer-recovery diary? Because one of the primary debilitating effects of radiation therapy is an increase in overall metabolic rate that makes it almost impossible to maintain weight. In my case, of course, this generic impact was enhanced by the tumors being in my throat, and probably by the twice-per-day administration of the doses of radiation. But the metabolic bump is a general and well-known artifact of radiotherapeutics.
Of course, the converse occurs. Once the radiation exposures are halted and the tumors are suppressed, the metabolism starts to recover. Slowly. My treatments ended in June of last year—2011. So a year and a few months ago. In the interim, keeping my weight up—in fact, raising my weight—has been among the recovery objectives the doctors and therapists charged me with. Given my funky throat (where the tumors formed, grew to very large size, and then died and sloughed away when treated), this was a particular problem. Which I solved by developing an addiction to a ridiculous species of “milk shake” made with full-fat milk and huge quantities of both Carnation Instant Breakfast powder (nominally fully nutritional) and Nestles Quick chocolate milk power (sweet and tasty). 4 or 5 liters of such drinks a day kept my weight up pretty well. When I lost access to shake components (mostly when traveling), my weight dropped.
I reached a low of around 180 pounds at the peak of my treatment discomfort. This was nearly 100 pounds less than my maximum, which was 276 (right before I got disgusted with myself and worked out a rational routine of diet and exercise that dropped me to 240. This actually fixed my Type 2 diabetes—blood sugar returned to normal. Didn’t reduce my blood pressure, though). My GP wanted me to get to 220. I just laughed, and told him that the last time I weighed 220 was in high school and that I would never be able to reach that low again.
Then came what I like to think of as “the cancer interval” in my life. Which is passing. One sign of that passage is my weight—spot-on 220 pounds now. Given that I remain weak and need exercise, this is a good weight for me. It’s a great place to start hardening up and cardiovascularizing.
The only problem? Those damn shakes. I’m so used to slurping 6 huge ones a day, I’m having trouble breaking myself down to a more rational diet. Workin’ on it. Back to huge iced coffees, with no sugar, and iced teas similar. I must admit, I like the shake in the morning for breakfast, and one in the evening with my meds. Which would be fine if a solid food lunch—a Subway 6 inch tuna with mayo and oil vinegar is just about perfect, I can get the whole thing down in about an hour with a couple of cans of diet A&W root beer—was all I ate for the rest of the day. But recently, I’ve started getting hungry in the afternoon by dinner time, and again at bedtime. Just like in the bad old days. But 276? I don’t think so. Even someone as weak-willed and undisciplined as I am has to be able to avoid THAT milestone!
Hey, I’m working my way back to fully functional writing. There’s a version of the Thanksgiving invitation (with pix) over at http://docviper.livejournal.com/ , and a new edition of my professional weblog at http://www.aehsfoundation.org . Check ‘em out. Talk to you next week!
