Geoff Fox: My Permanent Record

Today was an exciting day. I went on Facebook to announce I’d be back on Channel 8. More on that in a later post, though I will say the path to this day has been absolutely surreal!

Taking most of my attention today are three teeth removed from my infected gum this afternoon. It feels every bit as bad as you think.

I don’t like taking narcotics. Even after my Whipple they were used sparingly. I’ve made an exception here. Mouth pain is the worst. My dentist prescribed Norco, aka Vicodin.

This combination medication is used to relieve moderate to severe pain. It contains an opioid (narcotic) pain reliever (hydrocodone) and a non-opioid pain reliever (acetaminophen). Hydrocodone works in the brain to change how your body feels and responds to pain. Acetaminophen can also reduce a fever.

Stuff like that fascinates me. Norco doesn’t make you have less pain. It just allows you to give less of a damn about it.

Hopefully things will begin to turn around tomorrow. Maybe my mouth will allow the rest of me to enjoy what’s about to happen.

I am awake. Why not? I’ve been in bed mostly for the last 30 hours. Welcome to my final post-chemo weekend.

It actually hasn’t been too bad. Mostly fatigue. Mostly treated with bed rest.

My stomach acted up for a little bit, but a pill delivered by Nurse Helaine fixed that.

We really go at this in a much more organized and thoughtful way than when we first started. The idea is to keep me from dehydrating or having my blood sugar go too low. I’m already weak. Other problems can spiral quickly.

Tipped off by the sound of an upstairs flush, Helaine checked on me every few hours. I survived the weekend mostly on English Muffins with strawberry preserves and ice water in a red cup with a straw.

I’ve been up close to an hour now but my body is giving me the signs to pack it in. It’s not just my eyelids getting heavy — everything is! My arms and legs are a burden to move.

So far this weekend I’m down around 6 pounds.

I’m not going to miss chemo one little bit.

My dad is tough to buy for. He’s 91. Skiing lessons are out.

The past few Father’s Days we’d gotten him a high end shave and cut at a place not far from his apartment¹. He liked the attention.

This year we went for hardware. The family bought my father a 15″ digital picture frame. We liked it because of some special features.

His “Pix-Star 15 Inch Wi-Fi Cloud Digital Photo Frame FotoConnect XD with Email, Online Providers, iPhone & Android app, DLNA and Motion Sensor (Black)” is equipped with WiFi. Once the frame is on the Internet anyone with its email address (or an app) can place pictures without my dad lifting a finger.

Voila! New pictures appear as if by magic.

So far it seems to be a hit. Our family has no shortage of photos to share.

¹ My father’s apartment will most likely be found mistakenly one day by a heat seeking missile. He normally keeps it in the 80°s.

We were ready for my post-chemo weekend. Everything was all planned out.

It wasn’t as bad as anticipated. Maybe we scared most of the effects away?

Make no mistake, you don’t want to have a weekend like mine. Most of Saturday was spent in bed with sporadic trips downstairs. I would nap a few hours and be ready for more sleep in 20 minutes.

Beyond that was the full body fatigue I’ve tried to explain, probably not effectively, before. Sometimes just standing and sitting are tough to do. Each step is labored. Concentration or deep thought are not recommended. It’s more than just being tired. That’s the part I’m not sure I’m explaining.

It’s just past midnight Monday morning. I’m not near 100% yet, but enough pep has returned for me to be functional. The worst has passed.

Thursday is my last chemo treatment. It is followed by a Neulasta chaser the next day. That has not been a fun combo for me. We’ll be ready again next weekend come what may.

This weekend is Father’s Day. It’s a time to honor your father, sometimes with a gift.

Here’s our problem. My dad’s 91. What exactly could he use that he doesn’t already have?

I asked for help. The chosen suggestion comes from LaTonya who watches over my dad like a hawk… and won’t say anything.

Don’t say anything, LaTonya!

It’s on its way from his children, grandchildren and great grandchildren. It will arrive Thursday.

Knowing my father it will also be opened Thursday. An unopened package is irresistible.

Now what the hell do we do for 92?

I wouldn’t wish cancer on my worst enemy. Actually, I really don’t know what cancer feels like. What grief I’ve suffered is 100% a product of my treatment!

This weekend was particularly tough. We time my chemotherapy so the side effects don’t show up until Saturday. Helaine and I were prepared.

We did the best we could in a shitty situation. I was fatigued in a way difficult to explain. Any motion meant great effort.

Helaine kept me hydrated and with enough food in my belly to keep my blood sugar up. I can’t imagine doing this solo.

It’s Monday now. I’m mostly recovered, certainly enough to be functional and working.

Two more of these to go. They won’t be easier.

All through my journey I’ve claimed I’m doing nothing special. It’s nothing more than following doctors orders, right?

This weekend I traded emails with my of the folks shepherding my care. “Aren’t I the norm,” I asked?

No, it’s not what everyone does at all!! Unfortunately, many people don’t go through this with your attitude or outlook, no matter how excellent or poor their prognosis is. Don’t get me wrong, I meet a lot of inspiring and courageous people here everyday, but, attitudes and outlooks like yours are not plentiful. I agree you are doing yourself a huge benefit by choosing to be positive, I wish everyone could find that within themselves, it’s invaluable during these trying times.

Total surprise. I had no clue.

Some of you reading this are in a similar situation to me. Having the right attitude will help you get through it easier. Make the commitment.

The treatments are still going to suck, but it’s Monday and I don’t remember much of what transpired (mostly sleeping or laying in bed). And after nearly a year the end is in sight.

Make no mistake, I can handle this. Anyone can.

There is nothing on Earth as complex as the atmosphere. I’ve said that many times, but it’s probably meaningless words to most. Here’s where time lapse video (below) makes the difficult easier to see!

The atmosphere and humans run on different time scales. We don’t notice the atmospheric changes constantly taking place.

A few things to note. The low clouds that dominate the beginning of the video are associated with the marine layer.

A marine layer is an air mass which develops over the surface of a large body of water such as the ocean or large lake in the presence of a temperature inversion. The inversion itself is usually initiated by the cooling effect of the water on the surface layer of an otherwise warm air mass – Wikipedia

This is a very dynamic layer. Clouds are forming and fading constantly.

Usually the marine layer leaves my part of Orange County around noon, which is what happens in the video. As the low clouds fizzle they expose a high deck of cirrus clouds, formed mainly of ice crystals.

This higher layer looks much more stable. All the atmospheric physics that produced the clouds happened upstream. We’re just seeing transport as the clouds are propelled by light upper air winds.

It’s very cool to see this laid out before us.

It’s Sunday evening around 5:00 PM as I begin to regain my bearings. It’s another post-chemo weekend.

Everyone is different. For some people chemo is associated with nausea and more. Not me. This is 100% fatigue. It’s weakness beyond anything I’ve felt before.

Nearly all yesterday was spent sleeping. It’s difficult to get an exact number, but I can’t remember being awake more than an hour at a time. Even when I was awake my steps were short, my brain a little fuzzy.

None of this is permanent. As the drugs get absorbed by my system I’m popping back, but its frustrating to feel you’re really not in control.

Just three more of these chemo treatments and I’m done.

Having cancer teaches you about cancer. You have no choice.

When I began, I had no idea what ‘cancer’ actually meant. Here’s what Wikipedia says:

Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body.

I like that explanation. Cancer isn’t a disease as much as different diseases that share a single deadly trait. When healthy cells split, if they reach another cell, they stop. Not so with cancer. Cancer cells keep dividing, taking space normally reserved for vital bodily organs and functions.

That’s why every cancer needs a different cure and why different cancers act differently.

Some cancers are more easily detected through tests or exams. Some like my pancreatic cancer are seldom found until it’s too late.

Lots of cancers are treated with chemotherapy. Usually, not always, that’s a liquid dripped directly into the bloodstream. I’ve taken chemo pills too.

From the National Cancer Institute:

Chemotherapy: Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing.

Different cancers need different chemo drugs. The goal, stop the cancerous cells from spreading. Sounds easy enough. Turns out it’s really hard.

Chemo is targeted, but this is not precision bombing. Chemotherapy takes out good cells with the bad. It’s poison with a therapeutic purpose.

After chemo my blood sugar is up, my white and red counts and blood platelets are down. Because I’m prone to infection I take another drug, Neulasta, after chemo.

There are steroids in my body tonight. As they wear off I’ll wear out and spend a good part of the weekend sleeping while my body feverishly works at replacing the good cells that got zapped. This is a priority set by my body. I have no say in it.

The aftermath of chemo sucks, but it’s not so bad I can’t deal with it. Nothing I’ve been through has been more than I can take. Not even close. And I’m not special in the ‘suck it up’ department. Anyone can do this if you have the right attitude.

Look at cancer treatment in the aggregate and it looks horrible. But you don’t live it that way. You live it in real time and that’s much easier. Think bite size chunks.

Pancreatic cancer will soon be cured. Lots of other cancers too. It will be amazing. It will be expensive.

How much is living worth? To me it’s priceless.

I saw my oncologist’s physician’s assistant, Nicole, today. It’s a regularly scheduled appointment, part of the regimented protocol my treatment follows. This is also the first appointment since my last blood tests.

It’s good news all around. Though there’s no specific test for pancreatic cancer there are a few blood markers which can be helpful.

The carcinoembryonic antigen (CEA) test measures the amount of this protein that may appear in the blood of some people who have certain kinds of cancers, especially cancer of the large intestine (colon and rectal cancer). It may also be present in people with cancer of the pancreas, breast, ovary, or lung.

Negative.

Cancer antigen 19-9 (CA 19-9) is used to help differentiate between cancer of the pancreas and other conditions, as well as to monitor treatment response and recurrence.

Negative again.

A physician looking at my blood numbers and not knowing my details would see I’m anemic. We’re on that. Chemo brings those numbers down and Neulasta helps bring them back up (a little). So anemic, but under control.

I am five weeks away from the end of my treatment. Four more chemo sessions to take. No one looks forward to chemo. Certainly not me.

Cancer has shown me I’m strong… or maybe it’s made me strong. Chemo sucks, but I can do five more weeks.

I do a little gardening. Not much. My room for growing is small. Of course this being SoCal most plants don’t quite understand the limited space concept.

That’s what happened to a few bushes planted when we got here. Over time as they flourished their top shaded their bottom. Low growth stopped. The bushes became leggy. It’s not a good look.

Cutting back is a great leap of faith, because you’re left with what’s in this picture from three weeks ago. Seriously sad.

Today my bushes are on the comeback trail and their leaves are a whole lot closer to the ground. Because the original roots weren’t cut back they’re growing like crazy.

It always hurts to cut, but it’s never failed me. Every plant I’ve ever cut has come back stronger.

There’s a lesson in there somewhere.

Blogger’s note: The first paragraph refers to the sexual harassment charges and settlements paid on Ailes’ behalf by Fox News. I should have made that more clear from the get-go. Sorry for any confusion.

You shouldn’t speak ill of the dead, but Roger Ailes was a vile man. We’ll get that out of-the-way first. NewsCorp/21st Century Fox should be forever ashamed for what they allowed to transpire.

Ailes was incredibly impactful as a broadcaster. Fox News Channel changed the face of cable news.

Before FNC, CNN was ‘just a news channel.’ It was straight news delivered by straight news anchors. Sometimes they lightened it up a little (I always enjoyed Beverly Williams and Patrick Emery, the “Moonlighting” of TV news), but mostly it was news of-the-day from around-the-world.

Ailes brought personalities to Fox. It was much less expensive to have screaming hosts than reporters and bureaus. And it worked better!

It was under Ailes that Fox News became the first modern network with a political attitude. Saying “Fair and Balanced” couldn’t hide its right-of-center slant. I don’t think they really wanted to hide it anyway.

And it worked.

Fox News Channel was/is fabulously profitable. The dollars involved are mind boggling. This is a few years old, but you’ll get the idea.

Fox led in revenue in 2015; the network was projected to increase by 14% to $2.3 billion. CNN was projected to grow by 6% to $1.2 billion, while MSNBC was projected to grow by 3% to $518 million.

In a half-decade that saw moderate decline in the number of foreign bureaus, CNN continued to lead in the number of domestic and international bureaus. – Mediatite

Fox’s secret was to make its audience part of a cause and then keep them angry. I’m not saying others don’t do this now, just Fox was first and had a huge head start.

Here’s where it all goes off the rails. When there is no reason for its audience to be up-in-arms, Fox will find and promote a story to rebuild the anger.

They did it with the “War on Christmas” and recently with an awful story about the shooting of a DNC employee. Fox connected the murdered man to Wikileaks, as it turns out falsely.

Partisan news outlets aren’t new. The last fifty years are the exception. Newspapers which dominated journalism until the sixties was heavily political. I remember when the New York Post was the liberal voice of labor — really.

Through Roger Ailes, FNC and the other outlets have traded news for adrenaline. This is his legacy. No one should consider it a gift.

I’ve written about this before. Once you enter the ‘life or death’ portion of the program EVERYTHING changes. Medicine becomes much more proactive and caring, even (especially) outside normal appointments.

This morning was a good example. I left a voicemail message for Nicole, my oncologist’s physician’s assistant.

If you’re sick you want Nicole on your team. I’ve told her as much more than once. I told her again today.

It started after 4:00 AM when my body woke me from a sound sleep. It was as if my bones had grown too large to fit.

It wasn’t painful. I didn’t start screaming. It was extremely uncomfortable. There was no position I could find which would allow my bones to calm down. Until things subsided there would be no sleep.

None for my partner in-bed either! She is a sainted woman.

I had a doctor’s appointment this morning with my cardiologist (all good, even cutting back on my statin), so as Helaine drove I called Nicole to see if she had any insight.

My suspicion was this was Neulasta related. It is known for its bone affecting side effects, but usually on Day +2, not Day +4.

Nicole’s return call came while my cardiologists was examining me. Their offices are on the same floor. I stopped by on my way out.

“Nasty stuff” is my takeaway from our conversation. My post-chemo Neulasta shot is nasty.

Having a moment to see Nicole and discuss this speed bump made all the difference in-the-world. So often in cancer treatment you’re in unexplored territory. Who knows why you feel a certain way at any given moment?

I’m not TV-boy here in SoCal. This is not special treatment for a celeb. It’s just the way it is.

Thank God. If you’re ever in this position you’ll see how valuable this level of medical care truly is.

I remember this routine. At the doctor’s office at 10:30. A quick exam then short drive later, chemo. I was on my way home around 1:00.

“But why chemo,” you may ask? Aren’t you cancer free? Aren’t you cured?

The problem with pancreatic cancer is there are no really good tests to find it. We know from my Whipple surgery all the identifiable cancer is gone. Blood markers often seen in those with pancreatic cancer are in the safe zone too.

Are there microcells in the process of forming? Who knows? That’s why there’s chemo and radiation. We are taking no chances. It must be effective because Blue Shield has approved every step in the process.

The problem with chemo is it’s an indiscriminate killer of cells. We’re zapping good along with bad. The assumption is the good will grow back.

The whole process is slow-motion stressful. I’ve slept as much as twenty hours on Saturday after a Thursday infusion. Until Saturday the chemo had no physical effect at all.

No part of my cancer treatment has been beyond my ability. It’s the cumulative effect of all the little pain, inconvenience and indignities that has begun to get to me.

This is the last scheduled treatment, six chemo sessions in eight weeks. Enough already.

I am alive today and will be alive going forward because I have great health insurance — Medicare with a (free in California) supplemental plan. Though Helaine and I saved up a significant nest egg over 30+ years it would have been wiped out in one fell swoop by my cancer.

Though I pay some money for drugs my medical treatments and visits have cost zero dollars! I’ve had a half dozen ‘procedures’ plus major surgery, spent six days in the hospital, gotten 28 radiation treatments plus eight weeks of chemo with eight more to come. Zero dollars!

My worries started one night after dinner. One of my spicy favorite meals uncontrollably began exiting my body. It was everything gross you can imagine. It followed a few months of low level stomach upset. That night I decided I’d see my doctor in the morning.

My cancer was found while looking for the reason my stomach was upset. It took thousand of dollars of tests to make the diagnosis. Would I have proceeded had the money been coming out of my pocket? Maybe not. Probably not.

Like I said, we’re lucky. We were able to put money away over time. Most people cannot.

Without insurance my cancer would have been a death sentence. It wouldn’t have been found until my symptoms were more classically those of pancreatic cancer. By then it would be too late.

All around the globe in every other “first world” nation healthcare is something you get, like an education or police protection. It is coordinated and often provided by the government. That’s one reason our healthcare system is so lacking and expensive. Your health is constantly being weighed against an insurance company’s profit.

Congressional Republicans are finding Americans scared of the “every man for himself” system they’ve been promising for years. It’s 2017. Medical care doesn’t seem like it should be optional anymore.