Saturday, August 29, 2009

Norco Haze

  This past week has gone by in a  haze of norco, benedryl, and morphine.  I spent much of my time sleeping.  I was barely waking long enough to read a few short pages before I would doze off again.  I developed a sore throat on Tuesday and it raged all week.  I think that today I am finally on the other side of this episode.  I am getting a lot of transfusions.  This week I was given four units of red cells and three units of platelets.  
 Yesterday I had another bone marrow biopsy.  I won't know the results until Monday.  A good result would be no detectable cancer in my marrow.  
  I was able to write an article for Dog and Driver Magazine.  I compare training dogs using a scooter and a bike.  I prefer the scooter.   I am trying to get ISDRA to only sanction one rig for the one and two dog classes. Right now the classes are broken up into bikejoring and scootering.  The scooter field is profoundly diluted.  Most competitors are bikejoring.  I have done a lot of bikejoring and I know it is a much more dangerous way to run dogs.  The problem is that most people already own a bike.  It is going to be tough to get all my competitors to buy a scooter.  
  Universal Sports is streaming  the entire Vuelta de Espana live.  This will help make my next three weeks a lot more interesting.   Today is the prologue.  There are two American teams in this years Vuelta.  For some reason the race is starting in Holland.  This race marks the return of Alexander Vinokourov who is coming off a 2 year suspension for blood doping.  He just started to a deafening silence. 
  This past week I have been following the news of Jaycee Lee Dugan.  I remember when she was kidnapped in 1991.  The cold case has haunted the Lake Tahoe communities for all these years.  Reading all the comments about the articles I am shocked about how many people are ready to torture and kill the perps.  I think the death penalty just brings the people and the state down to the level of the perps.  I am ashamed that my country still sanctions the death penalty.  We are down there with Iran, Malaysia, Saudi Arabia and a bunch of other great countries like that.  

Monday, August 24, 2009

Day 1

Taking Deni's advice, I entered the emergency room at Tahoe Forest Hospital in Truckee CA  at o700 AM,  Monday July 27th.  I was the first patient of the day and I didn't have to wait long.  A doctor came in to check me out.  He looked at the ugly sore that was rotting away the roof of my mouth.  He asked a few questions and left.  A lab tech came in and drew some blood.  A little while later another physician accompanied by the first one looked in my mouth.  
  My primary care physician showed up at about 0900 AM and asked me a few questions.  He then dropped the bomb.  He said he thought I had Leukemia.  My blood was 90% worthless cancer cells.   By this time my Sister Marti was with me and she was reciting the blood numbers to Deni back in Anchorage.  "That can't be true!" Deni said. "Read them to me again."
  It all made sense to me now. I was out of breath with the slightest exertion because I had no oxygen carrying red blood cells.  My white cell count was low and that is why I kept getting infections that were not going away.  I was also out of platelets and that explained why the slightest insult was bruising me.  I hardly ever bruised before.  
  Cancer was the farthest thing from my mind.  I thought I just had an infection that a few antibiotics would take care of.  I had no clue as to why I was feeling so tired and out of breath.  Normally I am a strong, healthy adult male.  I should have known that I was not normal.  It is amazing how deep a person can go with denial.  
 I owe my life to Deni.  I might have dropped dead the next day if she didn't tell me I needed to go to the emergency room.  I wouldn't have gone to the emergency room myself because I felt that what I had was not any kind of emergency.  
  I was admitted to the hospital and I was immediately given a blood transfusion.  Dr Lombard my primary care physician worked hard to find me a place in Sutter General Hospital in Sacramento.  I knew I had a long way to go and I was alive.  

Sunday, August 23, 2009

The Easy Keeper

  In the fringe subculture of dog mushing there is a term we often use to refer to this or that dog as an "easy keeper".  An easy keeper is a dog that inhales his food, maintains a good weight, rarely gets sick, is a hard worker, is happy all the time and gets along with the rest of the team.  
   One of my objectives while staying at this hospital is to be an easy keeper for the staff that cares for me every day.  I have been here for 27 days now. It would be easy to become a professional patient, barking orders from my bed and complaining about every little thing.  In the back of my mind though I know that I am building a relationship with the staff here and when I am too sick to move I will need them more than ever to care for me. 
    One of the first days I was here, my regular doctor said I really didn't have to thank them so much for every little thing they do for me.  I replied that I couldn't help it and she should blame my mother.  
    I see the results of my careful cultivation of relationships.  I have become the easy keeper in the oncology wing.  Instead of getting  a continuous rotation of nurses that I was getting earlier I have just a few nurses that probably request me for their shifts.  They can trust me to do whatever I can on my own without calling them on the intercom for every trivial thing.  I know the routine by now.  Like my dogs that lift their leg to help me to put on their harnesses I lift my arm for the blood pressure cuff,  offer my finger for the oxygen reader and lean over  to breath deep at the right time so they can hear my lungs with the stethoscope.  Every morning at 0400 AM I present my arm that has the PIC line for the daily blood draw.  
  I can be a pain if I have to.  Today I had the substitute doctor come in for a visit.  The day before I refused to shake his hand when he presented it because I had no idea where his hand had been before he entered my room.  He had not sanitized his hands like everyone else did after entering my room.  He said, "I will have to examine you anyway" and I gave in and let him handle me.  I even presented my hand and he shook it.  
  When he appeared today he did the same thing.  He walked right up and was about to touch me but I stopped him.  I asked him to sanitize his hands please.  He replied, "I did wash them earlier".  I had no idea what "earlier" meant and how many patients he had handled before me.  Billie was sitting there and she said he put his hand on the door handle and then the door before he walked up to me.  He then said that that sanitizing foam was too greasy and he didn't like it.  I replied, "Hey, it's my life not yours".  He relented and went over to the foam dispenser and did what I requested. 
   I have to say that it was Deni,  my friendly nurse in Anchorage married to my brother Kit that warned me,  "You have to watch the doctors.  They are the worst".   I was forewarned to scrutinize and Deni was right.  The doctors are the top of the pecking order in a hospital and if you want to keep your job, you let them do what they want.   Being a patient, I was not in danger of losing my job.   I had the license to open my mouth and let him have it.  He was a little shocked I could tell.  I was not going to be some complacent gomer and let him get away with the disrespecting this patient.  

Friday, August 21, 2009

My Artificial Immune System

   All of us hear every day from Jamie Lee Curtis and thousands of other sources about the immune system.  This or that remedy or potion will "boost" your immune system.  Everybody is aware that we have an immune system.  It is the buzzword of the decade.  We have become deadened to the concept and we think we know all about it now.  Move on to the next Oprah episode. 
   Actually most people do not understand the immune system.  There are whole fields of science dedicated to the immune system and millions of physicians publishing papers every day about new studies.  We still have a lot to learn about our immune systems.  It may just be a buzzword to the public but in the real world of real science it is serious business.  
  Right now my immune system is tethered to me.  My IV pole has a cocktail of antibiotics and an assortment of other drugs.  I take anti virals, anti fungals and and several other drugs that are designed to kill any hostile organism that can potentially be lethal. The common cold could kill me in the condition I am in.  If I didn't walk into the emergency room the day I did I probably would have died the next day.  I had what they called "bled out".  I had almost no more blood left .  My bloodstream was full of cancer cells
 Right now my white blood cell count that is there for me to fight disease is about 40 times lower than the level I need for a minimum to be discharged from the hospital.  My red cells are so low that I need transfusions about every four days.  I also need regular platelet transfusions to help me clot in case I start bleeding from the most minor insult.  
  It is important that everyone understand this because for the next few weeks I could die easily from the slightest insult.  In a few weeks after more chemotherapy my blood numbers should start climbing.  That time I may be able to take visitors.  In the meantime I will have to only allow siblings and Billie to visit me.  
  I am used to living alone and I am not the type of personality that knows what boredom is.  I have this laptop with plenty to write about and an infinite amount of research to do with the help of the internet. I have Billie visiting me every day twice a day and that is the best situation there is at this moment in time.
   Right now we are just trying to be cautious.  In a little while I will be able to see you all.  I am getting the best of care.  I love all my family and friends but you are all also vectors that could deliver the lethal dose of some opportunistic disease.  I am driving this point home because it is so important.  It is all about the choice between death and survival.  I want survival. This disease is cancer in one of it's most ugly manifestations.  My doctor told me today that Lance Armstrong had a pretty easy row to hoe compared to what I will have to go through. Keep your hopes up and I will do all I can to insure that I make it through this episode in our lives

Tour of Denial, Stage 4. The Crash

   After the Tour of Nevada Classic I resumed my life going to work 40 hours a week as a carpenter and running my dog team on weekends.  Billie, my wife usually comes to Tahoe in the summer from our other home in Sacramento.  My work is at the Lake .  Because I am a carpenter I can get higher paying work at  Lake Tahoe.  The Tahoe economy is a little more immune to the outside world.  Billie works for IBM and has to work in Sacramento.  We traveled 2 hours to see each other when we were dating and when we married we continued to do the same.  So far we haven't been able to break from this scenario and live together. 

    In the spring and fall I spend more time in Sacramento.  I love riding the American River bike Trail.  I use my old Colnago that I bought in 1979.  The trail is flat so I can ride with an intimidating tight gear ratio.  I often get a lot of compliments about my old bike.  Of course like any self respecting road cyclist I wouldn't show up anywhere without my bike being sparkling clean and oiled.  Sacramento has a bike subculture going strong and the bike trail has a lot to do with keeping it thriving.  I can ride 50 miles without encountering a car.  I am accompanied only by other cyclists and a few joggers that usually behave by running off the pavement.  This past spring I hadn't been making much time for riding the bike trail.  My legs were still hairy and I didn't feel like my old self.  

  At my work I started to notice that I was slowing down and starting to get out of breath when carrying weight or climbing stairs.  I just ignored it and kept on working.  I had a cold that wasn't going away.  Usually a cold lasts about a week and then I'm fine.  This was weird.  I came down with some painful canker sores in my mouth.  This was unusual because I hadn't had a canker sore since I was a child.  The sores went away after about ten days but then I got another sore soon after.  

  About this time we had visitors to our Tahoe house and Billie and I played host to two old friends.  On Sunday we all decided to go on a short hike at Tahoe Meadows.  There is a beautiful trail at 9000' elevation with a sparkling creek and a wide open mountain meadow teaming with song birds and wildflowers.    We ended up hiking about 2 miles and I found myself hardly keeping up with our two 60 year old friends.  I didn't say anything. The canker sore in my mouth had grown into something much worse.  It was growing fast and opening a huge crater in the roof of my mouth. 

   That next week I tried to get an appointment with my primary care physician but it had been so long that my records were somewhere else.  I was told that I might be able to get an appointment sometime the next month.  I worked a full forty hours that week in the hot high altitude sun.  My appetite was fading.  I did not feel like eating much.  Food didn't taste good.  I was out of breath climbing stairs in my house.  

  When Billie arrived for the weekend she was alarmed.  We made an appointment the next day at a doc in a box that was in our medical plan.  That morning we were at the Urgent Care Clinic in Carson City NV first thing in the morning.  The doc there looked at my urine which looked normal and peeked at the sore in my mouth.  "That could be cancer" he said. He gave me a few numbers to call of a few local ENT specialists and sent me on my way.

  That night my sister Marti and her husband David arrived to spend a few days in our Tahoe house.  Billie suggested I call my sister in law in Anchorage who was a nurse for a little medical advice.  She said,  "You need to go to the emergency room!".   I knew that the emergency room at the local hospital was a zoo on Sunday night filled with mountain bikers with broken elbows.  I decided to go there first thing Monday morning. 

  Early Monday morning  I told Marti and David that I could drive myself and I would probably be back in a few hours with a prescription for antibiotics..  That was the last time I saw my house at the Lake.

Thursday, August 20, 2009

Tour of Denial, Stage 3

  Mid to late spring is one of my favorite times to get out and ride.  The creeks are full and the mountain flora is just starting to awaken and bloom.  There is not a lot of dust on the trail so the traction is better than normal.  I should have been going up to speed by now but instead I was losing my enthusiasm.  Everything seemed to take so much more effort.  I would still take the time to clean my bike after every ride and bring it inside.  My bike began to spend more and more time inside as I rode less and less. 
   I could still run my dog team using the scooter.  As the days got warmer I was only able to run the team on weekends and in the early morning.  By now I had bought a new helmet camera for recording my dog runs.  Running the dogs did not take a lot of energy on my part.  I was getting that sensation of speed vicariously through my dogs.  It was one of the few sources of adrenaline type fun that I still had.  
   In mid June on Fathers Day I went to Nevada City to watch the Tour of Nevada City Classic.   Lance Armstrong would be there with his team mates and it was promising to be a pretty good show.  An old friend Grant Boswell, had a son in the junior race and that also added interest for the day.  I had met his son last as a young child and now he was a strapping sinewy roady just like his dad.  My old friends Mike and Marsha were also there and their daughter was in the woman's race. It was a great day for the next generation of cyclists in my small world.   I often meet up with old friends in Nevada City and we catch up. One thing I couldn't do was suggest we go on a ride.  I was ashamed that I was so out of shape at this time of year and I didn't talk about it.  I walked a lot that day in the hilly little town.  I was not in very good walking shape either.  I was starting to get out of breath without much exertion.  
   Something was going wrong but I didn't have a clue.  I just thought I was lazy. When I looked in the mirror, I had the bread face of an out of shape cyclist.  I was sure my friends could see it too.  My legs were hairy.  As an old roady I looked forward in the spring to the time I felt good enough to shave my legs and don the garb of the roady.  I didn't feel worthy to shave yet.  I really missed that day with clean shaven legs, a sparkling road bike and  in full lycra, spinning an easy 100 rpms down the road.  That day didn't come this year.

Wednesday, August 19, 2009

Tour of Denial, Stage 2

  My riding was not improving much on my usual trails.  I know I should have cleaned several sections by now but I just thought it was because I had let go over the winter a little.  The snow was gone by now on much of the mountain in my backyard up to at least 8000'.  
  I came down with a real bad case of the flu.  At first I didn't know what I had.  I thought the flu was what I had during childhood .  I remember nausea,vomiting and diarrhea.  Most likely what I had as a child was rotavirus.  The flu was something new.  With the flu I had a very high fever with intense cold symptoms along with body aches and prostration.  It took me about eight days before I could go back to work.  I don't like missing work.  Being sick is something I seldom do.  
  Coming off the flu I was not improving my riding.  At this time of year I would have liked to visit my friends in Chico and ride the Wildflower Century.  I was there last year and did it in a leisurely 6 hours on my road bike.  There was no way I was ready to go this year.  My progress as a cyclist was going backwards.  
  Meanwhile all this time I was still running my dog team regularly.  The team was in top shape and I didn't have to go out of my way physically when training them.  I just stood on the scooter and they did all the work.  A few spots I might get off and run.  As the dog team progressed I had to run less and less up the hill.  That was fine with me.

Tuesday, August 18, 2009

Tour of Denial Stage 1

  The snow melts earliest on one of my favorite trails for mountain biking.  By then I am ready to hang up my XC skis.    This past winter I skied a lot less because I don't like to ski without dogs.  I wasn't skiing at night. I barely did any skiing on weekends.  Out of character for me, I had let myself go a little.  

   I can ride out my house and be on the singletrack  after one block of riding pavement.   It is my dream to ride that early in the spring at Lake Tahoe.   As usual I try to get on my bike at the first possible moment after the snow melts. 

  I was just a little out of line with my usual fitness goals for the early spring.  The first mountain bike ride was not that unusual.  I had to push over a few patches of snow.  I had to push up a steep pitch that I would be riding up in a few weeks because that was the way it always was in early spring.   I shed my ski legs and put on my riding legs.   

 In a few days all the snow had melted on my trail.   

  My three dog team languished a little towards the end of the ski season because of my diminished program training them.  Soon though, my team was up to top speed riding a fast four mile trail in the Martis Valley near Truckee.   The rig of preference is a scooter with 26 inch wheels and front suspension.   Three dogs was above the maximum I would allow my self to scooter behind.  I rotated my little team so that I always ran at least two dogs.  

  So far, my early riding and dog scootering season was progressing like any normal year.


Last winter I decided that after the first night skijor that my dog team was too strong for me to control. I was 56 years old and I didn't want to do it anymore. My oldest lead dog "Flash" was still alive at almost 16 years. I remember he was 11 years old when he told me he didn't feel like racing that day. He decided to stay in the car and I let him because he had never before refused to jump out of the vehicle and be instantly ready to go. I raced with only one dog that day.

Without daylight after work, I had every year until then trained my team using an extremely bright headlamp. I could see clearly every bump and rut in the seldom groomed trail while on skinny XC skis. Always with at least two of my dogs towing me on skis I could travel high speeds at night. Over the years since 1995 my team and I traveled countless miles over countless mountains over countless nights. I behaved like this while living at North Lake Tahoe. I was in Kings Beach to be more precise.
I only entered one skijor race last winter at Frog Lake near Mt Hood OR. Ellen Donoghue for the first time smoked the trail to win ahead of me her first time ever. Another local 24 year old also passed me the second day. For someone used to winning, I still had a great time. I went as fast as I could.


  Most everyone has heard the athletes axiom,  "No pain.  No gain."   The saying has always  befuddled  me at least as much as the concept of the Holy Trinity.   For me the saying should go,  "No gain.  No fun."  Whether running or cycling, the act of going fast, faster and ball's out, has always equaled fun, more fun and as fun as it gets.  Where is the pain?  I don't get it.  
  For this reason I resemble my lead dog Mojo and the rest of my dog team more than any human I know so far.  Mojo  also thinks that running is fun, more fun and more fun than eating. 
  Am I in denial?  I honestly don't think so.  Perhaps I am a hedonist.  I won't deny myself any fun. I can't explain it.  It may be explained perhaps by Oliver Sacks,  but I don't get it. 
   I might have inhaled too many lead (Pb) fumes as a child while watching my dad make the million or so bullets that he was always busy shooting. He liked to shoot and I loved to make lead toy soldiers and cannons with my own lead.  Could the Pb in me from 1959 explain why I have Acute Myeloid Leukemia?  I doubt it.   Might it explain why I am a Chico State graduate and not Berkeley material?   I don't know.