cancer

Caffeine Therapy – Update #1

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So…I may have been talking tongue in cheek for much of my Caffeine Therapy article, but I was serious as a heart attack, and we all know how serious those Widow Makers are, when talking about the positive impact that caffeine has had on my mental state of mind. Before I started drinking coffee I never knew where I was going to be mood-wise. Some days I would wake up Dr. Jekyll, some days Mr. Hyde. It was very stressful. After I started drinking coffee again, or, more specifically, after I added caffeine to my diet again, life was much more normal, predictable, and pleasant for me…and the rest of the family. While I still get stressed out and tense relatively easily, even while caffeinated up, it isn’t nearly has bad as it would get while I was caffeine-free.

Consequently, when I visited the doctor for a checkup from the neck up…and down…this past Thursday, I was looking forward to finding out how adding caffeine to my diet has impacted my liver, since that is where it’s metabolized.

Well, the lab results showed that my liver component counts were pretty high. Here are the numbers (Read: Component, Low Range, High Range, Range Units, My Lab Results):

DIRECT BILIRUBIN, 0.0, 0.4, mg/dl, 0.3

ALKALINE PHOSPHATASE, 30, 120, U/L, 173

ASPARTATE AMINO TRAN, 0, 37, U/L, 100

ALANINE AMINO TRANS, 0, 40, U/L, 263

Now, I have no idea what all of these different components are, but I do know the docs look at them to determine how my liver is doing. I asked my oncologist if he thought I should stop drinking coffee because the counts are so high and he said no. He wasn’t worried about the impact of caffeine on the liver. In fact, he agreed with my assessment that it is probably the caffeine that is positively stimulating me mentally while suppressing the negative psychological impact of all the other drugs and stress from my inflictions.

He was, however, worried that the high counts indicated that Graft Versus Host Disease was flaring up in my liver. After examination, he also assessed that it was flaring up again in my skin and eyes. He wanted to take some “preemptive measures” (his words) by either raising my steroid dosage or by trying another drug called Cyclosporin. But the way things work with my care and treatment, it wasn’t his call. All decisions relating to my care that involve GVHD are made by a different oncologist, one who also is a nationally renowned GVHD specialist and he was not quite as concerned about the elevated numbers as the other oncologists on Team Kurt. In fact, the wife and I had lobbied the GVHD specialist to raise my steroid dosage the last time we saw him over a month ago. I could tell even then by the way that I had been feeling and how my skin had looked that the GVHD was flaring up. But the specialist’s primary concern is with the GVHD in my lungs and not so much with the GVHD anywhere else. According to him, the other areas are relatively minor concerns compared to the lungs and were no cause for alarm or any additional action. A month later he apparently still feels the same.

I’m guessing the GVHD doc wants me to focus on my upcoming week-long visit in April to the National Institute of Health where I will participate in a study to get FDA approval for a new Lung GVHD treatment.

Still, the other oncologist wants me and the wife back next Thursday so we all, to include the GVHD specialist, can get together and further discuss this GVHD flare up in the liver and elsewhere.

Until then.

Denial

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Even now, nearly a year and a half later, it still seems that my whole experience with leukemia isn’t real, that it just could not have possibly have happened to me.

Something of this magnitude only happens to other people.

I know what I am experiencing is real, but it is just so hard to accept because the consequences are so big, so out of this world. My mind just cannot get itself all the way around it.

How I feel about it is how I imagine one would feel during an out-of-body experience.

And I feel the same way about my lung disease, perhaps even more so because the data is so sobering.

And I feel exactly the same way about the disaster in Japan.

If you have spent any time at all on this blog, you know that Japan is just as much a part of me as is my arm, or kneecap, or heart, or any other part of me.

Just as with the leukemia and the lung disease, or as it would if I were for some reason to lose an arm, my mind is just not accepting the fact that so much tragedy has fallen on Japan.

The horror that I am witnessing on the television and the internet cannot possibly be happening to the country I know so well and love so much.

Something of this magnitude only happens to other countries.

Sayonara Marrowish

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[notice]Because I am no longer going to blog at my Marrowish website, I just imported all of its articles, pages, and comments into this site. The following Marrowish article discusses my reasons behind the change.[/notice]

I’ve been thinking about doing this for a while now and now is as good as time as any: I am going to suspend blogging here at Marrowish and blog only at my other site BOJIKI.

I’m doing this for a couple of reasons:

The primary reason is that things have radically changed for me since starting Marrowish back in December 2009: now that the cancer is gone and I have this Lung GVHD/Bronchiolitis Obliteran thingy, things just don’t feel the same for me around here–I feel differently about my relationship with the Lung GVHD than I did with the leukemia for some reason, which maybe I’ll try to explore and write about later at my other site; also, I’ve changed a lot since starting this blog, both physically (I certainly don’t look much like that guy anymore in the banner photo) and mentally–I’m ready to move on.

Sayonara Marrowish

Another reason I’m doing this is because I’m lazy–I’m tired of managing two sites. I don’t intend on taking this site down, so everything written to date will stay up indefinitely, or at least until the evil Prednisone overlord who resides in my head forces me to take it down. And I will still write about Marrowish-type issues–I will just be doing it at BOJIKI instead (look for the “Marrowish” tag in the Tag Cloud or articles filed in the “Health” Category).

In addition to this site, I am also going to suspend tweeting at my Marrowish twitter account. If you want to follow my health updates, along with any of the other BS I tweet about, like updates about my books and other writings, as well as my musings about current events, you’ll need to follow me at twitter.com/kurtbrindley.

This place, and especially all of you who stopped by here to offer your support, prayers, and encouragement, really helped me cope with some crazy stuff this past year or so and I am very, very grateful for it.

I look forward to seeing you all over at BOJIKI.

OK. That’s it. Sayonara.

Stimulating News

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Ever since mid-December 2010, I have been getting light headed whenever I stand or lean over. A couple of times I have come pretty close to passing out. The last checkup I had the doc took my blood pressure lying down and it was 135 over 70 something. He then had me stand up and took it again. It was 110 over 60 something. A pretty significant drop.

One of the many side effects of prednisone, the steroid I take to try to stop the deterioration of my lungs, is that it causes sodium retention. Because of this, the wife and I have really been cautious about my sodium intake, trying to keep it as low as possible. The doc thought that my low sodium intake was causing the light headedness so he recommended that I up my sodium intake a bit to see if that helps. I didn’t think it was the sodium and I let him know, but I said I would give it a try anyway since that meant I could eat more pickles.

After having a couple of days to reflect, the doc decided he wanted me to take a Cortisol Stimulation Test, or Stim Test as it’s referred to in the business. Basically, all the test consists of is drawing my blood, testing my cortisol levels, then injecting me with something that stimulates my adrenal glands, and then at the 30 minute and 60 minute periods after the stimulation, drawing my blood and testing the cortisone levels again. Because the adrenal glands were stimulated, the level of cortisone should be higher.

I just received an email from my doc that says: Your Cortisol stim test was normal response. There is sufficient amount of Cortisol, according to the test, to protect you against orthostatic hypotension [dizziness].

That’s good news. However, even after increasing my sodium intake, I still getting dizzy when standing. Any of you smart people out there have any ideas what may be causing this? My gut is telling me it’s just a reaction to the cocktail of medicines I take every day but if you have any other ideas, please let me know.

Wishful Thinking

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There have been many o’ mornings throughout my life that I have laid in bed, fighting with the snooze button on the alarm clock, wishing that something would happen in my life that would make work go away forever.

We all know the old saw: Be careful what you wish for because you just might get it.

Well, I got my wish.

I just didn’t expect it to be answered in the form of a debilitating lung disease.

I was hoping more for…oh, I don’t…newfound riches…being elected king for life on a small tropical island…alien abduction…just about anything other than what I actually got.

But as the new saw goes: It is what it is.

So now what?

Before the lung disease, I was messing around with that leukemia thingy for the past year and it had kept me and my family plenty busy. I was back and forth to the hospital so much and feeling so crappy I didn’t have the time or effort to do much more than sit around, take my meds, and feel sorry for myself.

But just when I was starting to feel somewhat like what I used to feel like before all that leukemia thingy…just when I was beginning to ponder what it was going to be like returning to a normal life (normal meaning back to the daily morning battles with the alarm clock, the cursed commutes, and, of course, work)…just then…without any warning…BOOM…the doctor dropped the bomb on me.

Lung disease.

A lifetime with the constant feeling of slow suffocation.

A lifetime of high, daily doses of steroids.

A lifetime with the constant threat of diabetes and of osteoporosis.

A lifetime with a degraded immune system.

And, by the way, a lifetime of no more work.

I didn’t see that coming.

So much for my dream of helping to build a small company into a megarich, international conglomerated corporation and becoming rich enough to buy a professional sports franchise.

I guess I’ll just have to stash that dream away with my other unrealized dream of becoming an international rock star.

It all still hasn’t really sunk in yet.

I’m only forty-five years old. Regardless of my disease, I plan on hanging around for a very long time.

What the heck is a guy who has reluctantly been holding some form of drudgery…er, I mean, a job…since he first started delivering newspapers sometime around the time our nation celebrated its bicentennial birthday supposed to do with all of his newly “free” time?

What the heck am I supposed to do with myself for the next however many years I have left on this rock?

Well, I do have other yet unrealized dreams.

One of them is to write.

Not just bloggery writing like I am doing right now.

I mean to really write.

To write books.

And not just to write them.

To have them published.

And not just to publish them but to write them in a way that people want to read them.

I want to write in such a way that enables me to be able to proudly call myself a writer…An Author!…and not feel like a creepy, amateurish dork when I do.

So that’s what I’m doing.

I’m writing.

I’ve written.

I’ve written a novel called THE SEA TRIALS OF AN UNFORTUNATE SAILOR.

I’ve written a collection of poetry called POEMS FROM THE RIVER.

They will be available via e-book and pdf on (fingers crossed) February 19, 2011.

You can read a synopsis and first chapter of the book at bojiki.com/book.

But you know what? I wrote most of the novel and the poetry collection before I had all this free time that I now have. I wrote them slowly, sporadically, painfully, over a fifteen-year or so period when I was a working class stiff.

Now that I can fully devote myself to writing I should be able to blissfully write for hour after hour every day, right?

I should be able to crank out a novel every six months, or so, right?

Well, maybe…but, I have quickly discovered that writing fulltime is hard.

I am finding it hard to be disciplined enough to write every day.

It’s hard to sit down with laptop in hand…er, I mean on lap…and to think of stuff that other people might want to read.

I am finding that writing is like…

work!

Back when I was writing while I was still working out in the real world, writing was more like a hobby. I didn’t have to do it. I did it because it was fun…or at least cathartic.

It was fun writing crappy poems and crappy short stories and a crappy novel because I didn’t have to worry about feeding my children from the proceeds of their sales. I could pretend I was a writer without actually having to make the commitment of calling myself a writer.

Sure it stung a bit every time I received a rejection slip from publishers, but who cared. I still had a day job.

But now I have no cover. I have found that writing full time is hard work and I have no fallback position.

Well, I’m on disability so I guess I could always fall back onto the position of doing nothing. Do nothing but sit around, collect my monthly payments, and…

wait…

for…

something…

to…

happen.

Zzzz…

Who the hell wants to do nothing for the rest of your life when you have a once-in-a-lifetime opportunity to recreate yourself into whatever you want to be (provided that whatever you want to be can mostly be accomplished within the confines of your home…and the internet)?

I have declared that I want to be a writer.

And I find that’s it’s hard work.

And now I feel a little exposed.

And a little vulnerable.

And a lot like a creepy, amateurish dork.

But I don’t wish for it to be any other way.

Because we all know to be careful of what we wish for, right?

I Want To Know

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There has been much news lately about how the Transportation Security Authority’s new screening procedures are upsetting the traveling public and, to be honest, all of the whining is getting on my nerves. On the one hand, we demand our government guarantee us a safe, bomb-free air travel experience, yet we don’t want to utilize the advanced technology to help secure this guarantee because of our own fears and insecurities.

What are we afraid of? That some TSA screener is going to get to see us bare and blemished? Come on. Haven’t we all undergone a doctor’s examination? Haven’t we already had to overcome our pretensions and shyness to strip bare in his or her office to receive a truly hands-on, prodding and poking screening in attempt to guarantee our health security? At the airport all we have to worry about is having a remote image of ourselves being seen by an anonymous government employee who has the unenviable task of actually having to look closely at and examine our scanned image in all its glory. Have you taken a good look at us lately? I certainly wouldn’t want that job. So lets get over it. Lets get scanned. Lets get screened. And lets do it with as little delay and complaint as possible so we all can get through the line and to our destination as quickly and stress-free as possible.

Or is it not our insecurities of public nudity so much as it is our fear of the doses of radiation that the body scanner supposedly emits that forces us out of the body scanning line and into the alternate, hands-on, I-love-you-short-time screening line? Come on. Electromagnetic radiations are emanating at us from everywhere and we know it. We are basically being slow cooked regardless of where we are. Heck, we even carry around portable brain cookers in our pockets and purses–they are called mobile phones. What are the odds that getting an occasional body scan at the airport is going to cause us harm? What do we think is going to happen, that we’re going to get…cancer?

Well, maybe we will.

Maybe we won’t.

Who knows, right? I sure don’t. I have no idea how that airport body scan, or the x-ray from our annual checkup, or our microwave oven, or our mobile phone, or our televisions and computer screens, or the power terminal that we used to play around when we were kids, or all of the other many environmental and life hazards like pollution, in all its forms, and stress, in all its forms, will impact our health.

I don’t know…but I wish I did. I wish I knew how all of the radiation and pollution and stress impacted my health over the years. Does any of it have to do with how or why I became inflicted with leukemia? I want to know.

My not knowing is not from not asking, that’s for sure. When I first was diagnosed with leukemia, I asked just about every oncologist who came within grabbing distance of my long reach what exactly caused my disease. Their pedantic responses, often laced with undertones of condescension and self-serving gravitas, sounded more like a jargon-laden abstract of an article published in an exclusive, onocologists’s-eyes-only medical journal than a clear and thoughtful response based soundly upon their careful study of all of my specific lab results compared against my very singular and personal condition and lifestyle. I soon tired of their tedious and inconclusive answers and stopped asking them.

Perhaps I am being too hard on my oncologists. I have come to learn this past year that one would be hard-pressed to get a definite answer to just about any question asked to them regarding cause or diagnosis to any infliction, whether its concerning my leukemia in general or any of the multitude of subsequent ailments I have experienced as a result of my treatment. It seems that every response is heavily guarded by caveats and suppositions. Maybe they have become so conditioned by fear of litigation.

So I began my own quest for conclusiveness. I cruised up and down the internet so many times in search for answers that I felt like a cross between Sam Spade and Clu. I searched through all of the search engines. I searched through WebMD. I searched through NIH. I searched through CDC. I searched through WHO. I even went retro and searched through my hard copy series of Encyclopedia Britannica and, in the end, the only real answer I came up with to how or why I became inflicted with leukemia is…it depends…which is essentially the short version of the long-winded blather my oncologists gave me.

It depends. Such a disheartening answer to such a profound question.

But there it is so I guess I have to let my oncologists, and the entire medical community for that matter, off the hook for not being able to provide me with a definite answer.

Based upon what I now know, the cause of leukemia may depend on so many different variables—one of which is NOT hereditary, surprisingly—that it really is impossible to pinpoint the exact cause of why someone becomes inflicted with it. But, there are environmental and lifestyles conditions that may increase one’s chances. With this knowledge, I have narrowed the cause for my infliction down to the following few possibilities:

  • Pollution. I have no idea how much pollution I have consumed in my life; but I do know of times when, because of the work I did in the navy early on in my career, I had to breath in large amounts of ash and dust for up to eight hours a time on many occasions. I would cough up and blow out black gook for days after each occasion.
  • Asbestos. I have no idea if or how much asbestos I have consumed in my life; maybe none at all; or, maybe enough of the tiny particle stuff drifted down from the insulated pipes in the old school and office buildings I used to labor in to impact my health. There was a time in the navy, however, when I may have been exposed to trace amounts of it when I was involved with a team conducting a thorough inventory of my ship’s supplies. The team, including me, was immediately sent to medical for an occupational health asbestos screening.
  • Radiation. There are many ways to be radiated and there are many types of radiation. Types of radiation can be broadly categorized as being either ionizing radiation (xray, gamma) which are known to cause cancer, and non-ionizing radiation (microwave, radio wave), which is disputed within the medical and scientific communities as to whether this type causes cancer or not. I have no idea how radiated I have become in my life; but, as a telecommunications specialist in the navy, I was constantly working around transmitters (I know, non-ionizing) and many other sorts of electronic equipment for most of my career.
  • Lyme Disease. I’ll be honest, I have found nothing that links Lyme disease with leukemia; but, I contracted it in 2005 and, before the leukemia, it was the most horrible thing medically that ever happened to me so I really, really would like to be able to blame it for my leukemia.

Unfortunately, neither I nor anyone else can say with any degree of certainty if one or all or none of these conditions caused my infliction. But here is to hoping and praying that someday a test will be developed that will. For once there is a way to determine the cause of leukemia, it seems to me that, in addition to providing a balm of understanding and a level of closure to the inflicted, it may also help facilitate the discovery of a means for preventing and eventually eliminating the disease all together. Until then we will just have to hope, pray, wonder, and wait.

But there is one thing I am certain of—if I am ever standing behind you in a security line at the airport and you start making a scene about not wanting to go through the body scanner for whatever reason and it has a negative impact on my travel experience, you will know that the sharp smack you receive to the back of your head and its resultant pain was definitely caused by me.

A Bone Marrow Biopsy

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If you’re like me, you’ve probably never witnessed a bone marrow biopsy procedure before. That’s right, even though I’ve had more procedures done to me than I care to remember, I have never actually seen the procedure being performed on me. This is because, 1. I always have to lie on my stomach, and 2. I’ve always been too scared to try and look.

But during today’s procedure, I mustered up the courage and asked my herculean wife to take pictures of it so I could finally see what it was all about. I call my wife herculean because she’s been exceptionally strong and courageous for me throughout my entire cancer experience; and after I saw the pictures, it amazes me even more how strong and courageous she really is. I know for certain that if the roles were reversed and I had to be there to support her during one of these procedures, especially during the first time, I would pass out. For real.

I also asked my wife to take the pictures so I could share them with others who may be interested in learning and seeing what a bone marrow biopsy is all about. But please be warned, these pictures may be disturbing for some people. If you’re still interested, please click the more link.

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Hair

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Warning: This is potentially a TMI post. Read at your own risk!

Kurt with hair
Kurt with hair
Before my cancer and all the chemo, I saw myself similar to how Ricky Bobby saw himself in the movie Talladega Nights: I’m just a big hairy American winning machine, you know. That was me. I was confident, happy, had a wonderful family, a great job, felt strong and in okay shape, and I had a thick mane of hair on my head and a decent coat of fur all over my body. I was no back shaver, mind you (not that there is anything wrong with those of my friends who feel the need to shave the back…you gotta do what you gotta do) but I definitely had some hair to be proud of. But all of that, especially the confidence, the being in shape, and the hair, changed after the chemo.

Now I know some of you are wondering—I know I was before I started getting the chemo, so I asked my nurse—does one lose ALL their hair from the chemo treatments? The answer I got was that it depends. It depends on the person, the type of chemo, and the amount of chemo received. I would just have to wait and see.

It turned out that during the first phase, things moved slowly hair loss-wise. It took several weeks before any hair on my head started falling out and a couple more weeks before my beard began thinning out. I never noticed the loss of any body hair. I will say, it was very unsettling when the hair on my head began falling out in earnest and I would wake up in the morning to see big piles of it all over my pillow and bed. Once that started happening, I went directly to the barber and had my head shaved.

Shaved head
Shaved head
It’s not as easy as you think to get your head shaved. When I went, my regular barber was crowded so, not wanting to have to sit around and explain to the regulars about my cancer, I went to another barber that I had only been to once before. It was empty so I went in. The barber was a female and after I sat down and explained that I wanted my head shaved, she almost seemed offended, but in a cheesy, middle-aged flirty kind of way. She gave me the third degree and wanted to know why I wanted my head shaved. Still in no mood to discuss my cancer, I just said something rather curt about me being sick of having such thick hair to mess with. She reluctantly began shaving it off, but as she did, she went on the whole time about how a guy should never shave off such a nice head of hair. (I have another story about my hair and my youngest son’s ill-fated attempt at trying to shave if off…but that’s for another time.)

I had a couple of weeks off between phase one and phase two treatments. During the time off, the hair on my head and face started growing back in rather quickly. But again, after a few weeks of the phase two chemo treatments, both head and facial hair began thinning out. Again, I did not notice the loss of any body hair. This time, because the hair on my head was so short, I was able to shave it off myself.

Before the transplant
Before the transplant
During the first two phases, while I did lose a lot of hair, I never lost all of it on either my head or face. But all that changed after I received the large doses of chemo in preparation for my bone marrow transplant. About two weeks after the treatment, hair everywhere began falling out. And by everywhere, I mean everywhere. After about a month, the only hair I had left on my body was my eyebrows and my eyelashes. My body was smooth as a newborn baby. I won’t go too much into details, but I will say, things feel a lot different without hair in the places where you’ve been used to having it. I was left feeling very incomplete and somewhat insecure. I didn’t like it at all.

But now, finally, it’s all coming back and I’m beginning to feel much more like my old self. And by old, I mean much older. As you can see, even though I looked older than my age before, this whole cancer ordeal has aged me even more. And even though I’ll still be completely gray on top, I’ll be glad to have it back and I promise not to complain when it once again gets too long and too thick and too hot on my head. And I won’t, in frustration, ask my son to shave it off (again, we’ll leave that story for another day).

Coming back!
Coming back!

Chemo

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Chemotherapy Nurse
Kurt's nurse suited up and prepared to administer his chemotherapy

It seems to me that the word “chemotherapy” is one of those rare words that can instantly conjure up fear and images of pain and suffering, similar to words like “Holocaust” and “September Eleventh.” Perhaps those comparisons are not exactly appropriate (and bordering on bad taste), but my point is, just hearing the word chemotherapy tends to scares us.

And for good reason, too. Chances are, we know someone close to us, maybe a loved one or a friend, who got cancer and who had to receive rounds of chemotherapy. And from them, we heard firsthand how tough it was on the body. We heard about the nausea and vomiting, we heard about how it attacks the intestinal tracks and causes mucositis, we heard about their inability to eat and the loss of weight, we heard about the lightheadedness and dizzy spells, and we heard about the hair loss.

But chances also are, even though we know the word and are familiar with all of the effects associated with it, we really don’t know what it is. Now, I’m not about to try to cover the many different forms of chemotherapy treatments that are available, you can do a quick search and find out all about them if you’re really interested, but I do think it’s interesting that one word can have such an impact on our collective psyche without us really knowing much about it.

One thing I can tell you about chemotherapy, the stuff is toxic. Take a look at the picture of my nurse at the top of this post. She has to take special precautions to ensure that she doesn’t come in contact with the chemotherapy. She has to wear a mask, a disposable suit that wraps around and completely covers her clothing, and special gloves that go over the standard gloves she wears. What you don’t see in the picture is that the nurses also have a special hat that has a clear guard to protect their neck and face. It looks similar to what a spot welder would wear. And then, after she is completely protected, she pumps that toxic junk right into me.

From my experience, it seems that whenever chemotherapy is discussed, we tend to focus on all the negativity associated with it–just like I’ve been doing in this post–and barely focus at all on its most important quality: CHEMOTHERAPY SAVES LIVES! It saved my life. And, like a miracle, it’s saving countless of other lives every single day. We all should give thanks to God for it.

My Cancer Class, 2011

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At the beginning of any new journey, maybe it’s starting with a new company, going back to college, or signing up for fitness classes at the local gym, it seems that you can easily identify those who are just starting out. Like you, they are the ones who are just learning the ropes of the new system. They don’t know exactly what to do, where to go, or how to get there. Like you, they just look new. Over time, whether intended or not, a bond will form between you and the group of new travelers and you will begin to identify yourselves as a sort of class. Maybe you will become friends with some of the people from your class or maybe you won’t, but the chances are you will always feel a special kinship with those who traveled on your journey with you.

My cancer journey was no different. Practically from the moment of my diagnosis, I began to notice others who had also just begun on their cancer journey. New cancer patients are especially easy to identify: they are the ones who have a constant stunned look of disbelief on their faces; they are the ones who are irritable, stressed, and anxious, not just from recently having learned about their disease, but mostly from the side effects of the steroids and other new drugs they had just started taking; and they are the ones who still have their hair.

After diagnosis, I was immediately admitted to the hospital for the first two weeks to begin my initial phase of chemotherapy and medications. From time to time I would see other new cancer patients as either I or they walked laps around the ward; or, I would see them pass by my door on their way to the little kitchenette for the always available ice cream or cup of noodles. Sometimes we would wave or nod our masked heads at each other. Oftentimes, we would just simply shuffle by each other without any acknowledgement.

After I was discharged from the cancer ward, I was admitted to the Inpatient/Outpatient Clinic. At IPOP, new cancer patients usually have appointments every day. Every day, my wife—my caregiver, my inspiration, and my guiding light—would pack me up and drive me to the hospital. The drive could take anywhere from 45 minutes to an hour and a half, depending on Baltimore traffic. When I got to the hospital, I would reluctantly don my mask, reluctantly disinfect my hands, reluctantly enter the clinic, sit down, pull my ball cap down tight over my freshly shaved head, and glumly wait to be called by the nurse. Meanwhile, my wife, always positive, always cheerful, would sign in for me in the registry, make herself a cup of coffee, grab a magazine, and then sit beside me and try to cheer me up. Other familiar masked faces would also be there waiting with their caregivers.

Soon my wife became friends with several of the other caregivers and, through her reports, I would be able to track the progress of the other cancer patients from my class. It helped me to hear about them from my wife. Knowing that others are on a similar journey as yours, that others are just as confused, just as sick, just as scared as you are, provides a certain level of comfort and a sort of release. I was able to let go many of my fears and better accept my condition because I learned that nothing that I was going through was unique just to me.

Unfortunately, there are many, too many, cancer patients in my class. And even though I was familiar with all of them and drew strength from their silent encouragement and solidarity, I only came to personally know a few of them by name. And of those, I only know the current fate of two, which is too bad because I often think about all of those faces who I had come to know so well and wonder how they are doing now. I try not to wonder who didn’t make it.

Next year my cancer class will graduate. Sometime next year, we will meet with our oncologist and we will be released from his or her care. Our disability insurance will stop and we will hesitantly and apprehensively return to work. After graduation, we will be free and encouraged to begin other new and exciting journeys, which is why graduations are often called commencement ceremonies. And when our new journeys do commence, we will look around and see that there are others who are also just starting the journey, too. And, while we will hope that we never have to travel down the same road as we did on the journey we just ended, we will know that we will all be better travelers for it.