Persistent Postoperative Changes? What the 5FU Does That Mean?

From: The Astonishing FartMan
Sent: Tuesday, May 24, 2011 9:07 PM
To: ZoomberGirl
Subject: Re: I Started a Blog

Hey ZoomberGirl,

You are such a good sport for so graciously and for so long tolerating the all the nonsense I had posted in the comments section of your blog. I guess I needed an outlet, but me and my alter ego doing our own blog probably makes more sense (or more nonsense), doncha think?

I will hoist a large glass when they disconnect you permanently from that port-o-pump.

I’m doing okay (thanks for asking) and hope you are, too. Got myself CT Scanned Friday, and this morning my onc (who is not my uncle) sent me a vague email describing the results. Man, I thought we lawyers were the ones who were supposed to be purposefully vague, but when it comes to conjuring up a dark cloud of disconcerting obscurity, my onc’s email surpassed anything I could ever achieve. In case you don’t believe me, here’s the reply, verbatim, he emailed me when I asked him what was in my CT scan report:

From: Dr. B___________
Sent: Tuesday, May 24, 2011 8:08 AM
To: The Astonishing FartMan
Cc: M__________

The CT looks pretty good. There are some (what looks like) persistent postoperative changes around the liver and some tiny, stable, indeterminate lung nodules. Nothing else to do to evaluate these. We should check another CEA and CT in 3 months. Please call [my assistant] M____ to schedule these.

M____: can you please order a CBC, CMP, CEA, and CT C/A/P for Mr. W____ to be done at the end of August, with an appt with me the Monday after these tests?

Dr. B_________

Pretty good???? Persistent postoperative changes???? Indeterminate lung nodules???? What the 5FU am I supposed to make of that?!?!?!

So I spent several hours this morning frantically googling “persistent post-operative changes” and “stable, indeterminate lung nodules.” Finally, I gave up and emailed my onc (who is not my uncle) a list of stupid layman questions, the first of which was: “Based on what’s in the CT scan, does it look like there is 'probably' or 'certainly' cancer still in me? Or does it look like there is 'probably not' or 'certainly not' cancer still in me?”

Three email exchanges later, the good Dr. B______ finally got around to writing, in a rather offhand manner, there is “no evidence of cancer by CT” scan. Geez, doc, couldn’t you please have just told me that three heart attacks ago!?!?!

If you are curious, my first reply to my onc's email is reproduced below my signature. As you might surmise from the slightly snarky tone of that reply, I’m sometimes a difficult patient, but at least I keep it interesting, which is good, I guess, because, as you well know, cancer can be awfully boring . . . unless you happen to have it yourself.

BTW: You had mentioned on your blog something about getting your port-o-cath removed once you are done with chemo. My onc (who is not my uncle) told me today that he wants me and my alter ego to leave ours in for at least a year, in case we have a recurrence. The thing is, now that I’m off chemo, I’d like to feel normal for at least a little while, but can’t feel normal with that dern port bulging under my collarbone. I might have them take it out anyway, ‘cause I don’t want no more chemo!

To avoid closing on a sour note, let me tell you that I’m really enjoying your blog. I think you are cutting deeper and deeper every day, and I know how that can hurt . . . but it’s worth it.

And to close on a humorous, obnoxious, and inapposite note, here’s a picture of a binfull of Teddy Bears, which my alter ego shot with his phone cam when he and his wife and daughter and I were at a super kitschy souvenir shop in Las Vegas last summer. (Please note the silly, clever, obnoxious, and perfect title I’ve given it.)

From the smiles on all their faces, it sure looks like they’re having a good time. (I am soooooo bad!)

You Go ZoomberGirl!

Yours truly,
The Astonishing FartMan

P.S. Here's my email replying to my onc's vague report about my CT Scan. Doncha like the snarky tone?

From: The Astonishing FartMan
Sent: Tuesday, May 24, 2011 12:17 PM
To: Dr. B______
Cc: M_____
Subject: Re: What Is the Plan for W_____ Going Forward?

Dear Dr. B______,

Could you ask M___ to please post the CT Scan report in my online records so I can read it for myself?

As a lawyer (fond of equivocating parentheticals), I appreciate the vagueness of the words “(what looks like) persistent post-operative changes” and “some tiny, stable, inderterminate lung nodules.”

But as an ordinary human being, I’m stymied.

And I would rather not wait until the end of August to understand all this better.

While I can accept uncertainties so far as they really are uncertain, and can understand that no further evaluation is possible right now, can’t someone explain better what is meant by “persistent post-operative changes around the liver” and “indeterminate lung nodules?” (I hope you know that I want to know the boundaries of the uncertainties as well as all the facts.)

Some questions, ranked in order of stupidity, with my stupidest question first:

1. Based on what’s in the scan, does it look like there is “probably” or" “certainly” cancer still in me? Or does it look like there is “probably not” or “certainly not” cancer still in me? (I know this is a stupid question, but if I could get you on the witness stand under oath, I would not let you go until you answered “probably,” “certainly,” “probably not,” or “certainly not.”)

2. What kind of “persistent post-operative changes?” My smarty-pants wife is wondering aloud whether you might be leaving open even the possibility that a tiny fairyland giraffe has grown up and established its permanent residence around my liver? When we say “persistent post-operative changes,” are we talking about cancer, or something else? I can telll you that, four months after the liver surgery and two weeks after my last-scheduled chemo, the area around the liver still hurts most of the time, and I still tire very, very easily. Are those symptoms, perhaps, probably, or certainly, the result of “persistent postoperative changes,” such that I will have to learn to live with persistent pain and the fatigue? Should I be doing something (diet, exercise?) to ameliorate the “persistent postoperative changes,” whatever the heck they are?

3. What about the lung nodules? Were they discernable in previous scans or are they something new in this scan? If the nodules were apparent in previous scans (as seems to be the case from what is reported in those older scan reports), why had you not mentioned them before, or is there something different now that makes you mention them now?

4. Is it reasonable for me to get my port removed now? If not, why not?

5. Should we explore taking me off the blood-pressure meds (Amlodipine 5 mg) now that I’m not on the Avastin?

Thanks, Dr. B____, for taking such good care of me these many months. I think you are a very fine doctor, and otherwise a very good man. Sorry for being such a PitA, and sorry for the stupid questions, but those are the only kind I know how to ask.

Yours truly,
The Astonishing FartMan

So, do you think my onc (who is not my uncle) is gonna wanna ditch me?

Later,
T.A. FartMan

Our Favorite Household Appliance

A comment The Astonishing FartMan recently posted to ZoomberGirl's cancer blog:

TheAstonishingFartman wrote:

Hey ZoomberGirl,

I hope you are doing okay, and have not gotten yourself into a fistfight with Mickey or Goofy during your visit to Disneyland, as I recollect in some earlier post you said something about regretting never having had the experience of being in a good fistfight. Well, I can tell you, in my misspent youth I participated in a few good fistfights, even one that took place in the street outside a bar and another one that, until the police showed up, required fervent tussling in the dirt with an ex-wife's naked boyfriend for possession of a serrated kitchen knife. Athough the physical interaction can be invigorating, I think such entertainment is best left to the youngsters, who are more likely to recover from the effects of stray bullets.

Apropos of nothing particular, but perhaps useful to give your blog readers some further insight into the tres chic chemo lifestyle, reproduced below is another typically maudlin schmaltzy email my alter ego, W___, sent today to his chemo clinic "next door neighbor," one of those nice bald ladies who, with her husband T____ at her side, sits in a LAY-Z-BOY next to him in the "Confusion Center":

Hi S___ and T____,

Well, FINALLY I found that piece of paper with y'alls' email address on it!

Every time I went through all the mass of disorganized papers in my man-purse, my chemo brain couldn’t spot the one with y’alls’ email address, and I was afraid to throw away anything before finding the one with your address.

I sure hope S____ had a “good” week. Of course, for someone getting dosed weekly with chemo cocktails as brutal as hers, “good” is a relative term and usually means “not as bad as it could be” or “not as bad as last time.” I don’t think there are any really “good” weeks on chemo. My regimen is a walk in the park compared to hers, so I think that S____ is one tough cookie, tougher than me, to put up with that stuff she gets every week for 18 straight weeks.

I also hope today was a tolerable day at the clinic for S____. It has been a real pleasure for me having you two as my infusion center “next door neighbors” these last few weeks. It made my time in the confusion center, oops, I mean the infusion center fly by. I hope all my yakking and goofing around wasn’t too annoying. We could blame it on the dexamethasone, but the truth is, I probably talk too much even when not being poisoned!

Speaking of the effects of being carefully poisoned, my week was a little rougher than normal. I guess after 12 cycles the cumulative effects of the chemo have finally caught up with me a little, because fatigue has been a problem lately. Even today, on Day 8 of my last cycle, I’ve slept away most of the day, propped up in my “nest” of pillows on the love seat. Yes, the fatigue and the constant, worsening peripheral neuropathy are no fun, as S____ can surely testify, but I’m not going to complain too much because lots of people are going through things a whole lot worse.

And, lucky me, I’m done with chemo for now, and if I’m really, really, really, really, really lucky, maybe I’m done with chemo forever. (Of course, the “odds” say I’ve got something like an 80 percent chance of recurrence, so I’m not going to get too cocky.) I declined the infusion center ceremony to “ring the bell” signifying my “last” dose, because it might not really be my last dose, and I don’t want to tempt fate or to risk that noisy bell awakening some evil spirit that might have had it in for me! (You know, I'm Native American, so perhaps that's why I'm a little nervous about thumbing my nose at any evil spirit that might have had a grudge against me.) Instead of ringing the bell, I just gave our infusion nurse, M_______, a big hug and slipped out that side door as quietly and humbly as possible. I gotta tell you though, it was pretty emotional. I had to give M______ an extra-long hug to gain time to choke back some tears before anyone could see a tough guy like me getting all mushy.

I just googled T___, found your family web page, and looked at some of the pictures and videos of your family and your celebrations and travel adventures. What a good and happy family, especially those sweet grand kiddies! (If you google me, you won’t find much, and I will have to deny all knowledge of and responsibility for anything that might be associated with my name!) Just so you’ll know what my dear sweet wife looks like, I'm sending this picture of us taken just last New Year’s Eve.

You’ll note that we are posing in front of our favorite household appliance—the refrigerator—as is appropriate. But please resist the temptation to make any clever, funny, rude observations about what my left hand might be doing. (I think the smile on my wife's face tells all!)

Even with this dern cancer, we are happy and feel blessed. I can’t hardly imagine how happy we’d be if we didn’t have this stupid cancer messing with our lives! But I do worry about how we’ll deal with the more difficult times that might be headed our way before long. I suppose, when it comes to coping with cancer, we all do what we have to do—mostly because we don’t have that much choice about it.

When you have the time, please keep me posted on how things are going with you two.

Sending love, hope, and prayers!
W_____

Just between you and me, ZoomberGirl , I think my alter ego, W____, is spending way too much time hanging out with the bald ladies, and I would welcome your suggestions for finding him a more stylish social circle. Please let me know what you think. Meanwhile, I remain . . .

Your Loyal and Still Astonishing FartMan

A Dubious, Shifty, and Complicated Provenance

A comment T.A. FartMan recently posted to ZoomberGirl's cancer blog:

Hey ZoomberGirl,

Okay, I admit it.

I lie.

A lot.

But sometimes, halfway by accident, I happen to tell the truth. The trick is to figure out which is which. But don't fret too much about it, 'cause it's all in good fun.

So anyway, ZoomberGirl, you should be informed that your cancer blog posts have often been the initial inspiration for philosophical musings shared with my dearest friends.

For example, reproduced below is an email, lately sent to some of those dear friends (the ones too simple-minded to figure out how to set their email to block my messages), thanking them in my strange way for indulging me so kindly during our mini-reunion to see Lucinda Williams perform in Austin last weekend, and forwarding, in the middle thereof, a comment, much revised to the point of being ersatz, that I had posted in its original form to your blog around that same time.

(The dubious, shifty, and complicated provenance of the writing below seems especially fitting, since this whole stupid cancer business is dubious, shifty, and complicated.)

From: TheAstonishingFartMan

Sent: Tuesday, May 10, 2011

To: Undisclosed Recipients

Subject: What a Great Attitude You Have, Grandma!

Hey fellas and fellows,

            For your continuing edification, entertainment, irritation, or ignorement (whichever you please), reproduced and forwarded below is a comment (now heavily edited and revised) I wrote yesterday in response to an unsuspecting cancer blogger's post about her chemo experience.

            My comment was posted to ZoomberGirl's blog under my most pompous Stage IV colon cancer chemo week pseudonym ever, The Astonishing FartMan (“able to leap tall buildings with a single poot”), written in a style emulating the ethereal effusions of that one and only Melodious and Malodorous Super Hero, and stunk up with past-participle passive voice. (Passive-aggressive that is: So you don’t wanna slog through this impenetrable prose? Well, too bad for you, ‘cause I can guilt-smack you into reading it.)

            And it doesn’t really matter whether you’ve read half this shtick eleven times already. My shtick is just like chemo. You gotta sit through it again and again and again and again, week after week after week after week, to absorb fully its salutary effects.

            So it seems that ZoomberGirl, the cancer blogger, and I, the blog-squatter/commenter known as The Astonishing FartMan, are getting the same colon cancer chemo regimen every other Monday, the very same Mondays. But I'm one cycle ahead of ZoomberGirl in that sublimely educational process. (She's on cycle 11 of 12, and I'm on cycle 12 of 12.) Our common travail seemed to authorize me to report to her my own chemo clinic adventures. Thus, my comment below, posted to ZoomberGirl's inspiring blog, begins modestly enough, with esoteric details of our très chic alternative chemo lifestyle, and then crescendoes into a cosmic comic dialectical masterwork.

            So, dear friends, suck it up and read it through, but you don't have to read it all at once, 'cause I know how hard it is for you healthy people to cope with cancer.

On 5/9/2011 at 3:39 PM  [or thereabouts], TheAstonishingFartMan wrote [approximately]:

            You go, ZoomberGirl!

            But you can't catch up to me because I'm one cycle ahead of you and right at the finish line. Yes, I'm ahead of you by one whole go-round, getting my last-scheduled infusion (cycle 12 of 12) right this very minute.

            Through my port-a-cath (a medical device, surgically implanted below my left collar bone, and connecting my circulatory system to the outside world via my superior vena cava), I've already gotten today’s dose of the helper drug levoleucovorin. And I've also already gotten my dose of the steroid, dexamethasone, AKA decadron, which will help prevent some bad allergic reactions, but, like bad speed, will also keep me pumped up for a couple of days and stop me from sleeping much at all today—thus this tome. But then the decadron will crash me down hard into the pavement Wednesday or Thursday. I used to get 12 mg of the decadron, but it wired me up too much, so I talked to my onc (who is NOT my uncle) about cutting the dex dose to 6 mg, which doesn't launch me so high and, therefore, doesn’t end in such a brutal crash landing when it wears off. Right at this moment I'm getting infused with my palonosetron, the "pre-drug" to control nausea. But no oxaliplatin or Avastin for me this round because the peripheral neuropathy and those two drugs’ other side effects had gotten too bad to justify continued use.

            So now all that remains to complete today's in-clinic devil juice cocktail is my “bolus” of the strong stuff, the 5FU (technically called fluorouracil, but medically abbreviated as 5FU, presumably to indicate the number of times it can F-U-up during a typical treatment cycle).  Even as we speak, my infusion nurse, the charming and beautiful M____, has begun shooting me up with my bolus of 5FU (pardonnez moi le francais).

            After shooting me up in clinic with that bolus of 5FU (pardonnez moi le francais encore), the charming and beautiful M____ will hook me up to a stylish "ass-bag," oops, I mean "butt-bag," ooops, I mean "fanny-pack," oooooops, I mean "personal portable chemotherapy pump transportation device” (insurance code number 584938-954394-938434) full of another dose of 5FU (pardonnez moi le francais encore), with its accompanying semi-silent portable pump. ("Grish, grish, grish" is the eerie spooky sound that pump makes every few minutes.) Then the charming and beautiful M____ will send me home to enjoy privately my next 46 hours of "continuous infusion."

            (Note to self: Have a chat soon with psychotherapist about this weird nurse-torture-mistress fetish I seem lately to be acquiring. Might be fun, but the outfits could get expensive and probably aren't covered by health plan.)

            Grish  . . .  grish  . . .  grish . . .  grish . . .  grish . . .  grish . . .  grish . . .  grish . . .  grish . . .  grish.

            Every five minutes.

            For 46 hours.

            And people wonder why I act bat crap crazy?

            But then when the pump runs out of devil juice, it starts beeping and blinking non-stop, like a kitschy terrorist bomb in some over-budget Bruce Willis flick. A few cycles ago, when my empty pump went to bleep, bleep, bleeping, blinking in a crowded elevator, I felt a mighty temptation to yell a few "Allahu Akbars" to see if any poor fools would gang-tackle the sweaty pudgy brown-skinned guy strapped to the bleeping, blinking, beeping butt-bag with tubes poking out. (I'm still here, so you can probably assume I was able to repress my natural inclinations just that one time.)

            So it’s 12 of 12, and after I come back to the clinic on Wednesday to get untethered from the port-o-pump, I will be done, done, done, done, done, 5FU done with chemo, at least for a while, and with lots of luck, maybe FOREVER!

            But for now I'm still sitting here in the "Infusion Center," which I call the "Confusion Center," trying to keep everybody laughing, and not letting anyone get any rest.

            Funny as I am--and I am painfully funny--the nice bald lady sprawled in the high-tech LAY-Z-BOY next to mine has me beat hands down today when it comes to black humor. She and I were laughing together a little while ago about how silly it is that healthy people can almost unfailingly be counted upon to say the following two things, the first thing being what they almost always say the moment they encounter us, and the second thing being what they almost always say when they are trying desperately to extricate themselves from our discomfiting company:

First: "You really look good."

Second: "You have a really great attitude."

            The nice bald lady and I laughingly agreed that, even when these two statements are demonstrably false, healthy people can still be relied upon confidently to assert them, presumably as their attempt to contribute a much-needed variety to our cancer-filled day. And, honestly, in my case, both statements always are demonstrably false, because:             

First off, I have never looked good a single day in my entire life. Until I got cancer, NOBODY had EVER told me I look good—EXCEPT my wife just that one time several light years ago when she was pass-out-horny-drunk and the pool guy was on vacation. (And I somehow doubt that the cancer or the chemo has improved my appearance.)


Second off, I have always tried to fulfill my constitutional duty to preserve, protect, and defend my obnoxious attitude, extant by nature, perfected by training, and allowing no wobbly exception for this stupid cancer thing.

               Me and the nice bald lady at the chemo clinic further commiserated that the second cliché is the more ticklesome, as it suggests that a spiffy attitude is going to cure our cancer, and inversely suggests that, if we do die of cancer, it must needs will have been because we didn't have a good enough attitude. (Please note with admiration the new verb tense invented in that last sentence. I shall call it the future conditional obligative tense, a very intense tense, and one with which I hope to addle your brain throughout the remainder of this comment.) By that implied logic, if I croak out from cancer, it's gonna be my silly fault because I didn't think positive enough????? To quote the immortal dialectical philosopher, Desiderio Alberto Arnaz y de Acha the Third:

"E dun thin so, Lucy."

Nope. I ain't worried about dying of a bad attitude, because if a bad attitude were ever fatal, I wouda been outahere a long time ago. But I will confess to being a leetle teeny tiny itsy bitsy eentsy teensy itty bitty smidgen worried about dying of cancer.

             To be fully honest about it, the whole attitude-enforcement phenomenon pisses me off, and not only with regard to a cancer patient’s mens rea mental state, but also about all sorts of unrelated subject matters, the specifics of which I will leave you to guess for yourself. (Suffice it to say that I think the implicit requirement that a cancer patient must maintain a “positive” mental attitude should qualify as a Federal Hate Crime.)

            So anyway, like I said, the very nice bald lady—the one who sits in the LAY-Z-BOY next to mine in the Confusion Center, oops, I mean the Infusion Center, the lady who has a damn aggressive ovarian cancer that has spread to her omentum, and spread here and there and elsewhere all around her peritoneum, and is inoperable—she has me topped when it comes to fine upper class gallows humor.

            With a happy mischievous-innocent grin on her face and a beautiful light in her eyes, she explained to me that, when healthy people say to her, as they all apparently must do, "You have such a great attitude," she replies, monotone, deadpan, "Yeah, I'm what they call an incurable optimist."

            Now that IS funny. AND sadly true.

            Funny, sad, and true.

            So me and the bald lady, we laughed our little donkeys off. Then we smudged the tears from our respective cheeky cheeks, and blew some big holy globs of bloody snot right out of our respective noses. (Yes, our chemo regimens do make the snot bloody.)

            After all that, the nice bald lady and I sadly conceded that, over the heads of our intended victims, our deadliest discharges of flat black humor fly unobserved, mostly harmless, and certainly without leaving any lasting detrimental impression. Healthy people just can’t snap to a good cancer joke, unless we esplangs it to ‘em, Lucy. And even the ones who might sorta “get it” usually won't have the balls to laugh. Bet you didn’t realize that, metaphorically speaking, one needs large balls to laugh at this stuff. Well, mine, the metaphorical ones, are HUGE, especially when the decadron  swells them up to twice their normal volume.

Laughing balls. Giggling balls! How they jiggle!

Even healthy people, lucky fools that they are, would have to admit that the thought of laughing balls is pretty dern funny.

            So tell me, ZoomberGirl, doncha think people who don't have cancer can be soooooooooo boooor-rrrrriiiiing and predictable?

            In some such way, so ended my comment today on the site of the inspiring yet unsuspecting cancer-blogger whom I call ZoomberGirl.

            And to complete this nonsense, the next time any of you, my dear friends, happens to see me (if I live that long!), you are instructed to greet me with a wet sloppy bolus-kiss of oral adulation: "Man, you look really great!" And you are further instructed to win your extrication with a continuous infusion of portable flattery: "You sure do have a  great attitude! Man, I just wanna tell you what a great attitude you have. With your great attitude, you are sure to beat this stuff!"

            Maybe so, maybe no. But I will deal with either, come what may, and that’s no joke.

Meanwhile, I remain . . .


Your Melodious, Malodorous, Ever Faithful Super Hero,
The Astonishing FartMan

P.S. to M___y and L____, D____, C___ and M____, K____, et al: All kidding aside, but not to get too mushy about it, the Austin Lucinda get-together thingy, with all its associated imbibementations, gustamentations, visitations, peripatetications, boogiefications, and dialecticalations, kinda made my day, or week, or year. (Okay, either I lost my thesaurus, or I need to lose my thesaurus, or I love to show off my fat-assed vocabulary, or maybe I’m just totally full of it, or maybe the decadron is majorly messing with my head. Whichever it is, thank you, dear friends, for indulging me so well and kindly last weekend, today, and always!)

P.P.S. especially to C____ and M____: Sorry you two had to leave the Lucinda Williams concert early to meet those bothersome in-laws. You probably missed the amusing sideshow of me being unceremoniously bounced and booted from the special reserved handi-crapped section, on the pretext of my purportedly over-emphatic dancing, but probably to free up space for some straw-sucking wheelchair guy. What?!?!? After bowel surgery, liver surgery for mets, and 11 rounds of chemo, all in the last eight months, we cancer-disabled people aren’t allowed to dance our butts off? Anybody who has made it through that gauntlet oughta be dancing his butt off. And we’ll see all about that, ‘cause I’ve got my ADA lawsuit drawn up and ready to file against the nightclub, as soon as I can figure out which ones of you guys to sue as co-defendants.

So, ZoomberGirl, that's how it went, more or less.

Rooting for you, ZoomberGirl, I remain . . .

Your Loyal Melodious and Malodorous Super Hero,
The Astonishing FartMan

Some Crazy People

From: The Astonishing FartMan
To: B______
Subject: Crazy People at Lucinda Concert
Date: Sun, 8 May 2011 10:54 PM

Hey B_______,

To start with, here’s a picture of some crazy people at a Lucinda concert.  In the background, above M____y’s left ear, you can see a very, very small image of Lucinda, performing. In the foreground, below M____y’s right ear, you can see a very, very large image of a tongue, performing:

S____ and I just got back from Austin a couple of hours ago and have only just now received your email.

The weekend was a blast! We’re exhausted, but happy.

I think everyone had a good time, but it would have been way better if you had been there with us.

D_____ and M___y and C____ and K____ are all still crazy. M____y’s good wife, L____, was the only halfway sane person in the group.

Lucinda was good. She played a long set and two encores, mostly older stuff (even sang “Sylvia” and “I Lost It”). She did a few acoustic songs, and then rocked everything out for the rest of the night. (I danced for the first time since my big liver surgery! And it felt good!)

We were too busy having fun to take many pics, but I think we have just a couple more and will try to get them to you with a later email.

S____ sends love, and so do I.

The Astonishing FartMan

A Hapless Tragi-Comic Fiasco of a Farce

Posted recently as a comment on ZoomberGirl's cancer blog.

TheAstonishingFartMan) wrote:

Hey ZoomberGirl,

I used to think that when the chemo side effects were wreaking havoc on my body, it meant the chemo was really working. But I've learned that "the studies show" that there's no correlation between how well the chemo is working and how badly it makes us feel.

So you really are a lucky one to be dancing and b-balling your way through this stuff without too much of the usual chemo misery. I'm jealous.

But now that I have listened to you brag about how impervious you are to the devil juice known as FOLFOX, to earn my absolution you will have to indulge me as I philosophize a little in my silly ever-so-grandiloquent way:

We smart lawyers recollect the schoolboy’s quintessential syllogism, with its major premise, minor premise, and conclusion:

“All men are mortal. Socrates is a man. Therefore, Socrates is mortal.”

But now I want to plead with fate: Is it really necessary that, into that bone dry logic, I must someday , perhaps someday soon, substitute my very own dear self to take the place of Socrates?

“All men are mortal. I am a man. Therefore, I am mortal.”

The dry logic is irrefutable, but I don’t have to accept it, do I?

Well, yes, I do have to accept it. We all have to accept it, whether we like it or not. We are human, and that means we are mortal—by definition.

But, notwithstanding the power of that inexorable piece of logic, perhaps we should think about these things just as “poetically” and “spiritually,” as we do “logically.”

Whatever might be our preferred thinking process, whether poetical or logical, I think the effort of trying to live as fully as possible (whatever that means) while at the same time trying to accept that universal human characteristic—our mortality—is something we all, both the sick and the supposedly healthy, should spend some good time thinking about.

Yet, unless we are one of the few who are fortunate enough to be looking the wrong way while crossing the street in front of a dump truck, I expect that however much we might try, emotionally and otherwise, to prepare ourselves in advance, when our time seems near (whenever that might be), we each will probably find that there are still plenty of emotional, spiritual, and simply mundane practical matters to deal with, many, many, things that we just cannot anticipate or understand until we are facing the actual hard-pressing reality.

Isn’t that just the way life is? That we can’t quite know precisely in advance what any experience will be like until we actually have that experience. Although at times I had thought about what things must be like for someone with a life-threatening illness, I surely had no idea what living with a serious illness was like until I actually had to live with this serious illness, this Stage IV Colon Cancer with Liver Mets.

So now, with my serious illness, I want to try to find a way to live each day as fully, yet normally, as possible for as long as that seems to be possible. But then I also have to expect, and try to accept, that even near the end of my days, whenever that might be, the rest of the world will not pause long to favor me with the full-time white glove concierge treatment I deserve. Even at the end of my days, I will probably have to muddle and struggle through some difficult, confusing, or frustrating, but mundane, issues (money issues, scheduling issues, insurance issues, medical bureaucracy issues, transportation issues, nutrition issues, crazy brother-in-law issues, bathroom issues) that will sometimes transform my bold attempt to “live each day fully” into a hapless tragi-comic fiasco of a farce.

So I expect it to be the usual business, the business of trying clumsily or gracefully, gratefully or grudgingly, to gather from the tangled vines of the painful, the banal, and the mundane, into the spindly wicker-basket of my soul, a little harvest of the beautiful, the sublime, and the meaningful, or if not that, at least a modest serving of the humorous, the hilarious, and the downright silly.

For us puny humans, if you see things the way I do, all of life seems to be pretty much a hapless fiasco of a farce. Yet it is, according to my ridiculous poetical beliefs, a fiasco of a farce that is every moment presenting possibilities of love and beauty and goodness that are oftentimes right there in front of us, free for the taking, and even better, free for the giving.

For us humans, so fragile and finite in this earthly form, it seems there’s nothing ever perfect, neither a perfect life nor a perfect death. Still we should give ourselves good credit, because we deserve good credit, for trying to do the best we can.

Created to Create

FartMan recently posted the following comment on ZoomberGirl's cancer-fighting blog.

TheAstonishingFartMan (unregistered) wrote:

Hey ZoomberGirl,

By way of apology and reparation for my last, perhaps disconcerting, comment, of which not all might appreciate the humor, may I gently philosophize? (And who's gonna try to stop grumpy little ol' me?)

One of my silly theories is that human activity can generally be divided into two categories: creating and acquiring, giving and taking, producing and consuming.

As I began, or rather I should say, as I begin, to acknowledge my own mortality, which is something we all must do sooner or later whether or not we happen to have cancer (as I do, Stage IV Colon Cancer with Liver Mets), as part of that process of wrestling with my mortality, I discovered within myself an impulse, a compulsion, a yearning, to create.

I'm no artist, but suddenly I wanted to make art. I'm no cook, but suddenly I wanted to fix dinner for all my friends. (And now I understand better why my dear mother-in-law would slave for hours every Sunday to make a meal that we gluttons would consume in less than thirty minutes.) I'm no musician, but suddenly I could not stop myself whistling with the birds during my walks around the neighborhood. I'm no carpenter, but suddenly I found myself spending way too much time in my garage making strange little pieces of furniture or other odd wood objects.

Hmmm?!?!?!

Is that desire to create merely a vain wish to "leave something behind that they will remember me by"?

Yes, to some extent, that rather selfish motive cannot be denied.

But the impulse to create is not essentially selfish. Quite the opposite, the desire to create is essentially generous. It is a desire to give of oneself. But along with that, more than that, the desire to create is a yearning to follow The Divine Example, to participate in and join with The Eternal and Divine, through the God-like act of creation.

I think this creative yearning is one of the many meanings we can find for that glorious, generative, and comforting tidbit of Biblical information that tells us we are all created in the image of God. We are created in the image of The Creator! Thus, we are created to create, which means we are created to give and to share, most especially of ourselves.

Your paintings, into which you pour your heart and soul, will eventually turn to dust or ash. They cannot last. Michelangelo's dome cannot last. Our bodies cannot last. Yet I do believe eternal the creative giving acts that brought these things into being.

A Tale of Two Whiners: 5FU You, Too!

A comment The Astonishing FartMan recently posted to ZoomberGirl's cancer blog:

TheAstonishingFartMan (unregistered) wrote:

Hey ZoomberGirl,

Here's a funny thing—well, not ha-ha-funny, but curious funny: We seem to be on the same chemo schedule.

That's right, even as I write this, I'm stumbling around with my ultra-fashionable butt-bag full of devil juice just like you are. (Did they tell you why our main chemo drug, fluorouracil, is abbreviated as "5FU"? It's a reference to the average number of times fluorouracil will majorly "F U up" during a typical treatment cycle.)

My big surgery, a right hepatectomy--removing 3/4 of my liver along with a couple of nice-sized mets—was a few weeks before your HIPEC procedure. Since you are younger than me, I guess they let me have a head start. And man-o-man, I am so impressed with the way you are sailing through your recuperation from the HIPEC, which, if I had to face something that big, would have scared the holy beans out of me.

(Speaking of holy beans, I now refer to myself as "The Astonishing FartMan," which is kinda like that other super hero, "The Amazing SpiderMan," except that SpiderMan's special super power, induced by radiation exposure, involves arachnid gossamer, while my special super power, induced by a repeated fortnightly exposure to chemo drugs, is of an even more ethereal, silent, and deadly composition.)

Another funny thing: Like you, I happen also to be a lawyer at a big fancy firm, which shall remain nameless, lest something I write hereinabove or hereinbelow (lawyer talk) reveal a career-ending political-incorrectness. And yet another funny thing, and this is actually ha-ha-funny from my point of view: My one and only major victory as a courtroom litigator, a form of practice I have happily renounced, came at the expense of an O'Melveny lawyer almost twenty years ago. Okay, maybe I shouldn't brag because I had better facts, better law, and a prettier client, so even I couldn't 5FU it.

So anyway, we are almost like blood-brother and sister, except whereas you are of the cheerier and spunkier type of cancer patient, I am of the grumpy and obnoxious variety. Cancer is a boon for grumpy people like me. You would not believe all the obnoxious behavior I can get away with now, behavior that heretofore would have gotten me disowned, arrested, fired, ostracized, or sent off for remedial sensitivity training. But now people think, "Gotta cut him lots of slack, 'cause the poor guy has got Stage IV cancer." Yes, cancer is the ultimate trump card, and I'm milking it for all it's worth. (It even gets me off the hook for mixing my cliched metaphors.)

The way I see it, ZoomberGirl, I have had a classically bad attitude since the day that mean bully kid told me there wasn't really a Santa Clause, and my bad attitude hasn't killed me yet, so I'm gonna stick with it. I ain't the least bit worried about dying of a bad attitude; but I am just a little worried about dying of cancer!

I do so enjoy my obnoxious attitude. I specialize in black humor, and savor a delicious guilty pleasure in watching healthy people squirm, when they can't tell whether they're supposed to laugh or cry when I quip out some especially cutting gallows humor. When they tell me--as they all invariably do--how good I look, I tell them to "just be patient." The sad fact is, I never looked good a day in my life, and I rather doubt having cancer has improved my appearance. Silly me, I prefer compliments directed my way to be colorably believable.

Yes, ZoomberGirl, all the stupid healthy people mean well, but meaning well is an excuse just one notch above the dog ate my homework. Really, sometimes I get the feeling that certain healthy people think it is my duty to make sure they aren't the least discomfited by the happy fact that Yours Truly, if you believe the stats, is highly likely to croak out in a decidedly unpleasant manner sometime in the next three or four years, give or take a half-dozen months of "chemo-enhanced" additional survivability. So I guess my cancer "trump card" doesn''t work all that well with certain people, and here's an interesting example:

I have a certain "friend" who complains constantly--every waking hour to anyone who will pretend to listen--about all her numberless unbearable troubles, a dodgy new cellphone and some mishandled dry-cleaning being two of the most recently insurmountable difficulties in her life, utter catastrophes that supplied her with material for six days of non-stop bitching. When I had the insensitivity to interrupt her latest gripe-a-palooza to mention that, "Hey, everybody's got problems and so do I," this "friend" got indignant and said I was "always throwing my cancer up in her face." She further informed me that I, The Astonishing FartMan who has taken an oath always to fight the good fight, am an evil person who doesn't care about anyone's problems except my own. Having put me in my place, with her nose upturned she stormed out of my house (where she had been living rent free for the last several weeks due to her ongoing "employment problems" that just might be related to her incessant grumbling about trivial matters), taking only the most necessary of her personal effects, but vowing to return at her convenience to remove the remainder from the guest room closet they presently completely fill. But, really, how can my "friend" be expected to cope with hearing me talk about my cancer when she can't get decent tech support for her four hundred dollar cellphone, her laundry is a spotty, and her new job is slave work?!?!

Yes, some people seem to think it's my obligation to help them forget I have cancer. Forgive me please, but that work is not billable, and I don't do pro bono.  (But I can refer them to you, ZoomberGirl, if you want to take on the (mis)representation.)

And when it comes to doctors, don't get me started. Most of them these days have less bedside manner than a cheap digital alarm clock. Excuse me, doc, you are supposed to be caring for me, but you seem to think you are supposed to be caring for my disease. So, doc, let's get this straight:

I am your patient.

The cancer is not your patient.

The latest battery of lab tests is not your patient.

My MRI Scan is not your patient.

My body is not your patient.

I, The One and Only Astonishing FartMan, I am your patient.

So, all you doctors, you can start by paying some attention to me, and can begin that process by contemplating the strange possibility that I might be able to give you some useful information about what's going on both inside and outside my body!

And all the other healthcare providers and health care bureaucrats are not much better than the doctors, although there are some happy exceptions (my infusion nurse, M______). But I excuse most of them because they, like me, are victims trapped in the medical bureaucracy: If filling out forms were therapeutic, I'd have been cured on the second day after my diagnosis. One time, ZoomberGirl, I kid you not, I filled out a three page form that asked for my home address nine separate times! I suppose it is possible--because I am, after all,  the One and Only Astonishing FartMan--that I could have relocated my entire household during the seventeen seconds that have elapsed since I last answered that question on your stupid form.

I would not mind so much filling out the dern forms, if somebody actually bothered to read them. But they don't hardly read them at all, except for the section with the toll free number of my health insurance company.

Whiz. Moan. Whine.
Whiz. Moan. Whine.
Whiz. Moan. Whine.

There! I got that out of my system, and boy do I feel better!

Speaking seriously (well, as serious as I can be), ZoomberGirl, if you ever do feel really down in the dumps, and need someone equally bleak and blue to commiserate with, you can count on me, assuming of course that I am actually still haunting this earth. Yes, a messy commiseration, slathered with tear-snot, is not something a tough gal like you ordinarily wants to partake and is somewhat contrary to the job you've taken on as cancerland's most exuberant exponent of positivity. But in case you ever feel that your dedication to that good and noble duty limits your freedom to interact with other people in crude reality (a reality that can be "positively" brutal sometimes), please, please, feel free to email me any time at astonishing-at-att-dot-net.

I hear it sometimes makes people feel better to learn that someone else is more miserable than they are, so you can always rely on me to fill that role. And if I'm not available, you can always call my "friend's" broken cellphone number. (That's a joke, in case you were wondering. )

But don't feel obliged to email me, now or ever, as I am sure you have more than enough admirers to contend with already.

I do apologize for this overlong comment. If I wanted to rattle on forever, I should probably start my own blog instead of monopolizing yours. And maybe I will start my own blog someday, and include this comment as an entry. (I could title it "ATale of Two Whiners.") But if I did have my own blog, some idiot would probably want me to turn it into some kind of cancer-diary book. Just more work. Like I don't have enough crapola to do already.

Amaryllis Finis

From: W______
Sent: Tuesday, April 19, 2011 1:38 PM
To: V_______
Subject: Amaryllis Finis

Dear V______,

I hope you’re doing okay. Write if you feel like it.

I just wrote you a poem about a picture I just took for you.

It all happened very quickly.

Here’s the silly poem:






Amaryllis Finis

The amaryllis
Is almost finis    

And here’s the picture that inspired the poem, exactly what my eyes, with a slight upward glance, would look upon this very moment as I write this:

(Please don't let FartMan see a copy of my stupid poem. Even though it's only two lines, he would tear it into a thousand pieces.)

Thinking of you!

W_____

I Hope This Doesn't Cheer You Up

From: W_____
Sent: Tuesday, April 19, 2011 6:40 PM
To: Undisclosed Recipients
Subject: Fwd: I Sure Hope This Doesn't Cheer You Up

Fellas and Fellows,

Forwarded below is a troublesome message T. A. FartMan sent to our online cancer support forum today.

He thinks it's hilarious.

But I think it's totally inappropriate for him to be sending this kind of purposefully confusing message to a support group for us cancer patients who are desperate for clarity and certainty in our sadly discombobulated lives.

If FartMan doesn't stop posting this kind of stuff, I'm afraid he's going to get us banned from the group. He acts like he's some kind of super anti-hero who can fly above it all, looking down contemptuously at all the mushy online kisses, hugs, and handholding. FartMan really does think he's above it all, but I think he feels that way only because he has never really accepted the fact that we have Stage IV colon cancer. And that's fine if denial allows him to cope. Whatever works. But interaction with the support group is important to me, and I don't want him to ruin it for the both of us.

The truth is, I think FartMan spends way too much time sitting in his Throne Room, feeling superior, and writing this kind of crapola, while fumigating his brain with his own percolating gases.

Anyway, FartMan has been avoiding me all day, because he knows I'm seriously pissed, so if any of you happen to see him out farting around town, I would appreciate it if you would tell him to cool it with the confusing contrarian messages he keeps sending to our support group.

But I want you to judge for yourself, and that's why I'm sending along FartMan's latest obnoxious message which you will find below my signature. Chuckle at your own risk.

W________


From: The Astonishing FartMan
Sent: Tuesday, April 19, 2011 4:20 PM
To: Online Cancer Support Group
Subject: I Sure Hope This Doesn't Cheer You Up

I think all these so-called "studies" about how attitude affects health and life expectancy are just plain silly.

But it sure can be a lot of fun to pretend to take them seriously.

So if you would join in my child's game of pretend, you might imagine how I—being crotchety both by nature and by training—could not subdue the warm uplifting feeling suffusing body, mind, and spirit as I read about a recent study confirming (exactly as I have always believed) that "Cheery people die sooner."

Yes, that's a direct quote from the headline of a media report you can read at the following link:http://today.msnbc.msn.com/id/42577652/ns/today-today_health/

The suggestion that ornery old cranks like me might outlive all those impossibly annoying cheerful people, especially the young ones, well that thought positively cheered me up, to an extent that some might consider shamefully schadenfreudeish-- . . . . . . until I realized that by allowing the study to cheer me up, I had thereby forfeited the expectancy of several precious years of my formerly purely and uncorruptedly crabby life.

But then the prospect of this loss of life expectancy restored my native emotional dispostion--angry and depressed--and, thereby, one hopes, also restored to me the expectable years I feared were lost to my one careless lapse into cheeriness.

And now I hesitate to permit myself to contemplate my emotional reaction to that reprieve, lest a feeling of the mere mildest complacency again subtract numberless years of expectancy from my sourpuss life and render its remainder a Permanent Catch-22 maze befuddling even Mr. Heller.

Needless to say, these rapid psychological reverses, re-reverses, and re-re-reverses have left me ridiculously confused, not knowing whether to feel happy or feel sad, most particularly about whether I will live forever or drop dead before I finish writing this sentence.

So now I think we need a double-blind randomized study to determine whether confused people live longer than people who aren't confused.

I would vote for the confused, and, while we wait for the rollcall, will remain . . . .

Your Melodious and Malodorous
Super Pooper Hero,
The Astonishing FartMan

Clomping and Slobbering All Over Each Other

From: W______
To: Undisclosed Recipients
Subject: For Your Continuing Entertainment and Edification
Date: Fri, 15 Apr 2011 12:25:11 -0500

Fellas and Fellows,

For your further edification and entertainment, and by way of catching you up on my own saga, and in a foolish and vainglorious attempt to wrench the beautiful and the sublime from the morbid and the mundane, forwarded below is a message, slightly edited, from me this morning to one of the pals I met on my online cancer support group.

I should warn you right off the bat that this stuff is probably pretty hard to read and even harder to think about, but does supply, even for me, an enlightening instance of the old cliché that there’s always someone worse off, so we should all learn to be thankful for just how good we have it.

My support group addressee, V________, is a single woman around my age, apparently pretty much all alone, whose situation just breaks my heart. She’s been coping with colon cancer for five years now, during which time she has had three or four big operations and many rounds of nasty chemo. Recently things took a bad turn, when during a surgery and related procedures to remove new tumors from her bladder, the doctors found additional tumors on her uterus. To make things worse, her bladder surgery incision has become infected with staph, and requires all sorts of constant gross attention, such as draining and packing the surgical wound. When she recovers enough from the bladder surgery, V____ is going back on chemo to try to shrink the tumors.

Now you would think that in her present condition V_______ would be completely bed-ridden, but actually she is up and about, going from doctor to pharmacist to clinic, helping her visitingg nurse with her own wound care, and looking after herself, as I said, pretty much all by herself. V___ is, I think, the bravest person I've ever known, but she won't even let me tell her how courageous she is. In our email exchanges, V______ and I have joked a few times about our misspent youth during the 70’s, so in her message to me this morning, which covered a number of topics of mutual commiseration, she asked me to tell her "something good (old from from the 70's)."

My reply to her is reproduced below, and it sort of involves a few of you.


W_______

From: W_____
To: V_________
Sent: Friday, April 15, 2011 9:26 AM
Subject: Re: Arrgghhh !!!! Part 2

Dear V_______,

They say misery loves company, so if you are suffering now, you might enjoy mine. (But I should tell you, there are happier words further below, something about good times in the 70’s, so don’t stop reading.)

Yesterday and last night were in some ways my worst since I got diagnosed. For no apparent reason, my liver and the incisions from my liver resection (which was three months ago) began to hurt like heck, and I began to feel really, really, really puny. I spent all day yesterday in bed, mostly sleeping, and then slept through the night. Yesterday was day four of my 4th post-liver-resection chemo cycle (unhooked from the pump on Wednesday; only 2 cycles more to go), and the 4th day is usually the worst so that might explain my symptoms. Doesn’t help that the peripheral neuropathy from the oxaliplatin is raging worse every day, too. I haven’t been given oxali since Nov 1, but the neuropathy continues to get worse. My feet are two bags of tingling rocks! Hands not much better.

Whiz. Piss. Moan. Whine. Whiz. Piss. Moan. Whine. Whiz. Piss. Moan. Whine. There! I got that out of my system!

And this morning I seem to be better, the liver hurts less and I don’t feel so tired as yesterday.

You said you want me to tell you something good from the 70’s? Hmmm. My old joke is, when it comes to the 70s, I can’t tell the difference between a memory and a flashback. Yes, I can barely remember the 70’s, but I will try to tell you something good from then. So here goes.

I remember back in, I guess it was summer of 1979, but it might have been 1980, I had just moved to Houston and made a lot of new friends. There were at least twenty of us in a group who hung out together all the time, going to clubs to hear folk music, going together on camping trips in the Austin Hill Country, going to music festivals, going on road trips, having big dinners at each other’s places, philosophizing naively about life, staying up all night listening to music together and dancing.

We made a happy fun party wherever we were and wherever we went. Lucinda Williams was a big part of our musical scene, as she was friends with some members of our group and lived for a while in our Montrose neighborhood in Houston.

It was all so happy and innocent. As time passed, our group did produce several marriages (of various persistence), but at the beginning, during our beautiful happy innocent summer of 79, the group wasn’t really paired off into couples. It was just a bunch of silly kids hanging out together. Imagine a pile of fresh 20-year-olds lolling through the days in a platonic scrum of young bodies and you will get the idea. We were like a big litter of puppies, eyes barely open, clomping and slobbering all over each other, and suckling endless joy at mother nature’s seemingly ever-overflowing, seemingly infinitely-numbered, teats.

A memory, or flashback, of the group of us on a baking summer day eating ice cream at a street fair in Austin sticks in my mind. It was one of those rare moments when you realize with serene clarity, “I am happy right now,” and you know you will carry that memory to the grave. (Okay, I guess my life has been pretty boring if eating ice cream on the street on a hot day is one of my most precious memories.)

Yes, we absorbed a few mind-altering substances and drank a bit of alcohol, and I suppose there was some good-spirited, well-meant, clumsy sex going on—which I seem to have missed out on, dern it—but really the experience was being together and sharing our lives in complete good will toward each and every one. . . . . . . . . . . . .

Of course, it couldn’t last.

Within a year or two, life's realities began to separate us, for various reasons, jobs in other towns, personality conflicts, married life; the necessities of maturity can be avoided only so long. But although some of us now only intermittently weave through each other’s lives, most of us have managed to stay in touch. Even today, several of our dearest friends are from that silly group of kids. I’ve managed to stay in especially good touch with one member of the group, my wife of twenty-seven years. On May 7th, we are maybe going to have a little mini-reunion at a Lucinda gig in Austin. It will be fun to see who all shows up.

So that’s my good 70’s story.

By the way, my amaryllis on the back patio have opened and are gorgeous. They’re about three feet tall, the blooms are about eight inches across, and I exaggerate only a little. As promised, here’s a picture, taken just this morning especially for you, V_______.

Thinking of you!

W_________