To accomplish great things, we must not only
act, but also dream, not only plan, but also believe. 
~Anatole France
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I Have Cancer, Part 4

1/30/2014

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I had my vitals and blood taken yesterday - I was there 45 minutes before my appointment time and was admitted another hour after that - so, I think they're always busy.  After the wait, I was in and out relatively quickly - I spoke to a nurse practioner about my anesthesia.  Of course, when they drew my blood, I asked about what gauge needles they were using (21) in order to compare with what we bleed the rhinos (23).

Today was my lymphoscintigraphy - a process by which the lymphatic system is mapped through use of a radioactive isotope that was injected into my neck/jawline in four areas proximal to the melanoma.  The needles here were 25 gauge.  After several minutes passed - letting the isotope spread through my lymphatic system - a few five minute scans were taken using a SCENT CT (google failed me on that one) in order to find the sentinel lymph nodes (lymph nodes closest to the site of the melanoma and if my cancer has spread, the most likely to indicate as such).  I will not know if the cancer has spread (or not!) until the tissue and lymph nodes are removed during surgery and tested (I've been told results will take a week).  The technologist marked the two sentinel lymph nodes with blue paint (as shown below).  I then had a 20 minute 3D full body scan - during which I fell asleep...hehe.  This gives a much clearer image...blah blah blah.  I asked questions, but it was a lot of information.
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Surgery is tomorrow at 7:15 am.  We have to be there at 5:15.  Yay!  My parents flew in just before my appointment today and we had a great dinner at Gino's.  I'm very glad they will be there tomorrow.  Time to pick out some cute underwear for tomorrow in case a nurse gets curious.  ;)  Who knows?  Maybe I'll meet the love of my life.

I'll post another update as soon as I'm home.
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The T-Shirts Are Here!

1/30/2014

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I have finally finalized the design!  They are ordered and on their way.

If you would like to donate $20 (or more!), e-mail Sean@RunningForRhinos.com (or go to Facebook) with your preferred size.  I will then give you instructions on how to pay and when you can expect your shirt.

I have pledged a certain amount of money to Save the Rhino International - if I am unable to raise that much money, I must cover the difference myself.  Thus, proceeds from the shirts will go to Save the Rhino International in the event that I do not have enough donors through my Donate page.  Got it?  Good.  :)  Ipso facto, if I do raise enough money through donations, the proceeds from the shirts will go to paying for my $1,000 flight to London.
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I Have Cancer, Part 3

1/25/2014

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I suppose the alternative title for this post could be "I Had Cancer, Part 1," but that remains to be seen.  My surgery has been scheduled - it will be Friday 1/31 at 7:15 am.  My parents should be getting here on Thursday.  I have two pre-operative appointments this week - one on Wednesday for bloodwork and normal pre-op tests, and one on Thursday for lymphoscintigraphy - a procedure involving radioactive staining of my lymph nodes, so the surgeon can detect those closet to the melanoma site.  It appears to involve multiple stinging injections, so that sounds fun!  In any case, I'm glad I was scheduled so soon and hopefully all goes well and they do not find anything in the removed lymph nodes (though that apparently does not mean it hasn't spread...going to have to ask about this).

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I Have Cancer, Part 2

1/22/2014

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Well, it’s not bad news!

I had my first appointment with my oncologist – Dr. Wayne Cruse – this morning at “9am.”  Sara, my friend and co-rhino keeper, picked me up at 8am.  I showed her my newly painted apartment wall and we headed to get some breakfast.  There was a little traffic, but we hit up Panera and headed to the  Moffitt Cancer Center – just a few miles down the road from my apartment.  They have valet parking – invaluable, as the place is enormous and busy.  It felt like we were on the streets of Boston's medical district.  I will bring a camera next time – it’s really quite beautiful.  But, we were slightly late – supposed to be there 30 minutes before the appointment - so as soon as we entered the front door, I asked the receptionist where the cutaneous unit was.  We had an escort show us the way there –though he didn’t quite give us the right directions, we were close.  I signed in, filled out the paperwork 30 minutes later and was finally called to go in just before 10am.  I guess it was a busy day.
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So…down to the details.

He told me that my skin cancer is a nodular melanoma and it is 1.95mm deep – an “intermediate depth, not great news, but not the worst news.”  I will be receiving a call from the surgery scheduler in the next few days to schedule my procedure.  He will surgically remove the skin and underlying/surrounding tissue – about 1-2 cm in diameter – and also the sentinel lymph nodes (10-20 nodes).  There will be a significant scar, but he is also a plastic surgeon, so that’s something.  It’s kind of ironic that I got the mole removed because I didn’t like how it looked and now I may have a worse-looking scar – but I believe not having cancer is the better of those two evils.  The removed
lymph nodes will be sent off for cancer screening.  There is a 10-20% chance that they will have cancerous cells (i.e. the cancer has spread) and further surgery (remove all my lymph nodes) and treatment (TBD) will be needed.  This also means that there is an 80-90% chance that the lymph nodes are clear and I will need no further treatment.  For those of you that are like “What the hell are lymph nodes?” – I googled it for you and found this on Wikipedia.

A lymph node or lymph gland is an oval-shaped organ of the lymphatic system, distributed widely throughout the body including the armpit and stomach and linked by lymphatic vessels. Lymph nodes are garrisons of B, T, and other immunity cells. Lymph nodes act as filters or traps for foreign particles and are important in the proper functioning of the immune system. They are packed tightly with the white blood cells called lymphocytes and macrophages.

Lymph nodes also have clinical significance. They become inflamed or enlarged in various infections and diseases which may range from trivial, such as a throat infection, to life-threatening such as cancers. In the latter, the condition of lymph nodes is so significant that it is used for cancer staging, which decides the treatment to be employed, and for determining the prognosis. When swollen, inflamed or enlarged, lymph nodes can be hard, firm or tender.

Lymph nodes are not part of the body's system for handling illnesses stemming, for example, from environmental toxicity or personal injury— those tasks are handled by the liver and kidneys in the former and the muscular-skeletal system in the latter. The lymphatic system is structured to address biological infection by other organisms as well as biological breakdowns/ errors within the same body (i.e., cancer). 
 
So….not sure how they’d remove all of them since they are throughout the body - that doesn't seem pleasant.  It is also odd to find that lymph nodes help combat infections like cancer…but are also possible hosts for my cancerous cells.  But, I don't write this stuff, so...?  I’m not sure what would happen to my immune system if my lymph nodes were removed, but I can cross that bridge if I get there.

There are still a few “What if…”s, but on the whole, it is relatively good news.  I will post an update when I have surgery scheduled.  It should be just day surgery– in and out – and my parents are coming down for it.  I had sinus surgery in 2011 (my 5th one) and they did not come down for that – mistake on my part (I told them they didn’t have to).  I had to wait so long to go in for surgery – I had too much time to think about possible bad outcomes and my parents getting a terrible phone call.   Long story slightly longer…I had a mini-breakdown though I was also drugged at the time, in a state of hyper-emotionality and hitting on the male nurses via the female nurses, so there’s that.  I do think I look good in a hospital gown (pretty much like the image below - I'm in the next bed over) and those little socks they give you are wonderful.
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Piano Man

1/17/2014

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1/18/14 - 12:06am - Just got back from the Billy Joel concert at the Tampa Bay Times Forum.  I had a great time with my friend, Morgan.  More information and photos to come!  I have to go to bed - 10 mile run in the morning.
1/19/14 - 8:18 pm - Finally have a few minutes to RAVE about Billy Joel.  I saw him once before with Elton John in Houston in 2009 and he did not disappoint.  He is definitely the best showman I've ever seen.  I've included the set list below, as well as a few videos.
Above - "Pressure," from 1982's The Nylon Curtain - one of my favorite Billy Joel songs, an early memory from childhood as well - I remember my Mom going to see Billy Joel with her friend Carol in the early 90s and telling me about the crazy lights used during this song.

Below - Billy talks about his opening act (still trying to find his name), who played "Tiny Dancer" earlier, and joked that they'll keep him around since he's "cheaper than the other guy."  He also made a slight dig at Madonaa, but I won't hold it against him.
Set List
*Miami 2017 (Seen the Lights Go Out on Broadway)
*Pressure
*Sleeping with the Television On
*Vienna
My Life
*All for Leyna
Movin’ Out (Anthony’s Song)
Zanzibar
*And So It Goes
Allentown
*New York State of Mind
*The Entertainer
Don’t Ask Me Why
River of Dreams
Scenes from an Italian Restaurant
Piano Man

Encore
 *Big Shot
It’s Still Rock and Roll to Me
You May Be Right
*Only the Good Die Young

* = songs I had not seen performed previously
Above - "And So It Goes" from 1990's Storm Front - one of my favorites, album and song.
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I Have Cancer

1/5/2014

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Written on 12/30/13, a few hours after finding out :

I'm not sure if I'll ever post this, but I've heard it's helpful to write one's thoughts down.  It is quite possible that this is the beginning of a long journey - really, it's the middle of my running journey, but now, it's the beginning of my cancer journey - and so this becomes the first document in what will hopefully be a large collection of thoughts on the subject - it is equally as possible that the journey will be a short one, and it is with this fear in my heart that I write.

I have had a red mole (I've tried to google image search and can't really find something similar) on my right jawline for about three years (as far as I can tell from past photos).  It has only been recently with an uptick in my dating life that I became self-conscious about it.  I also - for the first time since moving to Tampa - visited the doctor because of my upcoming marathon - and he mentioned working outside means I should "...see a dermatologist, they're on the 6th floor of this building, make an appointment."  The subsequent week, I did; the mole was removed in seconds; and sent off for a biopsy.  A few weeks later, I'm back in FL for two days having spent Christmas home in MA when I get a call saying I need to come in for my biopsy results.  ???  I did not feel good right away - despite friends' attempts to assuage my worries, I still felt it was bad news.  And it was.  It remains to be seen how bad, but I am still at DEFCON 1.

I have malignant melanoma - aka skin cancer.  From the biopsy, they can tell the depth of the melanoma and it is Level 4 - "deep" - it is almost through the dermis.  I was told that a doctor would be calling me to schedule an appointment and then surgery - they are removing the tissue beneath and around where the mole was and also probably taking a biopsy of the nearest lymph nodes to see if it has spread.  I have done some online research (need to cut that out) and they do this because the presence of cancer cells in the nearest lymph nodes is indicative that it has spread to other parts of the body.  The absence of them does not disprove the spread of them (it can give a false negative in terms of metastasis).  So, waiting is fun.

I am a worrier.  I am an overanalyzer.  My mind is at a mile a minute right now.

My first thought when I heard was of my grandmother.  She was an amazing woman, having battled four types of cancer throughout her life, but did not make it through the second bout of lung cancer.  My second thought was denial - I couldn't believe it.  I have cancer.  Shit. 

And then I thought of having to tell my parents, and I cried.  The PA was very nice, but I had a hard time concentrating.  I asked her to repeat things several times, a few questions...but I really won't know much more until I see the oncologist.  I keep thinking...and that is a problem...is it Stage 4? - there are no treatment options - how much time do I have? - I have treatment options - clinical trials - my life is an episode of Grey's Anatomy - losing my hair - sterility? - will I have kids? - how will I find someone with whom to spend the rest of my life? - is there even a point in looking? - will I run this marathon? - I need to write a Will - I need to plan my funeral - who will take care of my cats? - should I renew my Disney pass? - should I stop going out in the sun? - I need new work clothes to stay out of the sun - how do I tell everyone? - is it too late? - why is this happening to me?

I've seen the stories on CNN, on Ellen, through facebook - kids with cancer, BatKid, teenagers, college athletes - and I thought, "That must be fucking terrible.  I have it easy."  My life is cake.  Boyfriend breaks up with me, wah.  No hot water in the shower, wah.  That asshole cut me off in traffic, wah.  I complain all the time, but I also realize constantly how amazing my life is.  How lucky I am.  How privileged a life I have just being an American - a white male, for that matter - electricity, clean water, plumbing, police, paramedics, pharmacies, hospitals, roads, grocery stores.  And now I feel as if every moment I spent complaining was a complete waste of time.  And yet I still complain - about cancer worries (am I entitled? this is confusing) - and I still feel guilty complaining, because there are people dealing with worse.  Worse happens every minute.  One of my best friends died three months before we were to graduate high school - I have lived twelve years since then!  Almost 5,000 days!  I have been to Australia and Italy; I've seen Brad Pitt in person; I've run half marathons; I've cuddled with baby anteaters, giraffes, okapi; I take care of rhinoceros for a living!  I wish I could do it all again - I'd do more, spend more, talk more, dance more, laugh more.  Every moment is precious - I shouldn't have wasted a single one.  Why didn't I wear more sunscreen?  Damn it.

I would gladly re-live the worst day of my life over and over than have terminal cancer.  There's just no describing this feeling.  It's surreal.

Update, written right now!:

Well, I have since re-aligned my way of thinking to its more positive state.  It's no surprise - part defense mechanism, part who I am.  I have talked to a few people at work, and their stories about dealing with skin cancer were reassuring.  I'm fairly sure it was caught it time - a little part of me is still worried, but I can't do much about the past.  Cancer is a scary word, and I was scared.  I've had time to adjust to the thought of it, and I really don't feel much different.  All that is changed is that I know, and that is a good thing.  I also have realized that skin cancer (while still sometimes terminal) is not the most serious (by far) cancer I could have, and I'm thankful for that.  I am focused on January 22nd - that is the date of my first appointment with the oncologist at Moffitt Cancer Center here in Tampa.  Fingers crossed - I will post as soon as I know more.

P.S. I'm still raising money for rhino conservation!  :oP  That is this site's main purpose.  ;o)
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