Thanks & see you in six months

There is no predicting when or if Enrique's cancer will come back. So I don't think we're ever going to end this blog for good.

But I am going to take a break from blogging for the next six months or so, until we get the results of his next scan.

So, if you want to follow along, mark your calendar for March.

See you then.

Six Months

Enrique's next doctor's appointment is in six months, when they'll do a full body scan and tell us the ultimate result of his radiation therapy.

Last year, the same six months seemed like a long wait to find out if he would be healthy.

This time, it seems like a long time without any treatment or visits to the hospital: a good thing.

"Very optimistic"

Enrique went to his endocrinologist a couple of days ago to get the first level of results from his radioactive treatment. The news was good. The body absorbed the radiation in the right place - in his neck where he has some small remaining tumors.

Also, there was no sign of distant tumors in weird places. Apparently, sometimes people will have some cancerous thyroid tissue in their leg or abdomen or somewhere other than their neck. But, Enrique was clear on that front.

The only other place were they found traces of radiation from the iodine was in his liver - but that it also a good sign. Once the radiation starts killing cancers cells they are processed in the liver. So that means the treatment is already killing his cancer.

We won't know for another six months what the final result of this treament will be, but the endocrinologist said he was very optimistic.

Back at Work

Enrique just finished his first week back at work. Physically it's been a little bit of a challenge, but not a problem. He doesn't have 100% of his energy, but he does have enough to get through the day.

Overall, he is very happy to be back at work and appreciative of working for a company and with colleagues who were very kind and understanding during this difficult year.

Help and Food From Friends

Enrique was able to go off his diet about five days after taking the radio-iodine treatment. Until then he had a bunch of specially prepared meals that my mother and I had made for him.

We did a pretty good job of cooking, I think, but at the end of his three week diet, he was ready for a cheeseburger. He also got to enjoy a basket of food delivered by some kind-hearted colleagues and several bouquets of flowers.

During our week apart, I stayed with a very generous friend. And Enrique got a constant stream of cards, calls and emails to keep him company. Lots of folks also called me.

I am not a very sentimental person, but I was surprised at what a big difference it made for both of us to be remembered by so many people. Thank you.

Radioactive Dates

Enrique's radiation therapy went well, much better than last year.

He asked for anti-nausea medication and it worked well. During his week alone, the worst he suffered through was extreme fatigue and loss of appetite. Neither are fun, but they don't compare at all to nausea. (It makes you wonder why the doctors never offered the anti-nausea medication - but at least we learned to ask.)

The first few times I came to visit we had to be on opposite sides of the room. In the early days, so long as we were at least three feet apart, for no more than a few minutes, I was safe.

One time a friend came with me and I found myself saying, "He's safe, so long as you don't get too close."

After a couple of days, his level of radiation was low enough to allow me to visit for up to an hour. So we had a series of radioactive dates.

For us this was new. We never really dated. Enrique moved in, de facto, within a day or two after we met.

The "dates" -- mostly in our living room -- consisted of watching a little TV or going for a ten minute walk if he was feeling well enough.

Five days into his treatment it was safe enough to enjoy a quick hug.

Call

Starting Friday Enrique will be alone and radioactive.

He probably won't feel ill until Saturday. The worst should be over by Tuesday. And sometime between Wednesday and Friday I'll be able to come home and rejoin him.

During this period, please give him a call (or two or three) and let him know you are thinking of him. If he isn't feeling well, he might not pick up, but your message will lift his spirits.

Thank you.

Radiation Treament

After being postponed for a month, Enrique's radiation treatment was again postponed, but just for a day. It will be on Friday.

He's nervous. This will be a higher dose than it was last year. But, they are giving him anti-nausea medication this time. (Only because we asked - I'm not sure why they don't just offer it.)

We don't know the time of the radiation treatment yet. It will involve a short trip to the hospital where he'll be given a radioactive pill. Afterwards I'll drop him off at home and take him back home. Then we'll say good bye for a 5-7 days because it will be unsafe for me to be around him.

My mother, with help from my father, have been cooking up a storm. Our refrigerator is stocked with food for him to eat during that time.

Right now he is a on a low-iodine diet which will encourage his body to absorb the radioactive iodine. All the food they (and I) have prepared has had to adhere to this diet.

Back at Work

I haven't been much of a blogger lately.

Enrique went back to work about two weeks ago. The postponement of his radiation treatment created a window where he was well enough to be at his office.

He was nervous the night before his first day back. It reminded me of the first day of school for a kid. But he came home beaming - looking happier than I had seen him in months. He got a lot of support and good wishes. Plus he has found working and being busy satisfying.

That said, there have been days when he has come home exhausted, when I am reminded that he isn't at 100% - however healthy he may look.

Today was his last day at work for a couple of weeks.

Radiation Postponed

Enrique's endocrinologist postponed his radiation treatment by about one month. He wants Enrique to heal more before he undergoes the treatment.

Right now it is scheduled for August 23rd - but last time there were a lot of delays, so it's tough to say for certain.

Enrique will need to be on a low iodine diet for about one week before and after the treatment - to starve any remaining thyroid tissue of iodine. Then we he gets the radioactive iodine, it will be sucked up by cells that are hungry for it.

Among other items, the diet prohibits dairy, seafood and iodized salt. The salt part is the trickiest because it essentially means that everything needs to be homemade. You can't have much meat and you have to avoid many nuts and beans.

One Year Anniversary

A year ago today, Enrique's doctor discovered the lump in his neck that turned out to be cancer.

Coincidentally, he had an appointment with the same doctor today.

It's been a long year.

But I'm so glad he spent that year getting treated, rather than letting the cancer continue to grow, undetected.

If you haven't had a physical in over a year, schedule one today.

One Thing He Doesn't Need to Worry About

A lot of people have asked how Enrique's work has treated him during this time. They've been fantastic.

Individually and as a whole, they've been very supportive and encouraged him to focus on getting better rather than worrying about work.

Also, his health insurance, which they provide, has been surprisingly good.

Radiation Treatment

Enrique's radiation treatment was postponed for a week because his doctor had a family emergency.

On Thursday we should know the basic schedule for the treatment. It begins with a course of injections that will cause any remaining thyroid tissue to become thirsty for iodine. Then they'll give him a big dose of radioactive iodine, which the thyroid tissues will absord. Hopefully the radiation will cause the tissue to die.

He'll need to be alone in our house for 4-7 days. I'll stay with a friend to avoid the radiation.

The whole process should take 2-4 weeks.

Ups and Downs

Enrique's thyroid medication has been adjusted again and that creates a fair amount of disruption in his mood and body.

Mostly, however, he is doing well and feeling good.

That said, he does get regular hot flashes and fatigue. He often moody and down. Once the new, higher levels of hormones stabilize, he should be feeling better.

A Quick Trip Home

Enrique had a brief window between doctors appointments and was able to take a quick, restorative trip home to Mexico.

I've had the chance to eat some of his mother's food and I know it's healing power. I'm not joking.

It was the first time he's seen his parents in more than a year and half that didn't involve a trip to the hospital.

He came back more relaxed than I've seen him since before his diagnosis.

Scar 3.0

Enrique's bandage fell off a couple nights ago.

The scar looked awful. Bigger than before and red and swollen.

"It looks like a caterpillar crawled into my neck and died."

It really did look like something out of a B-movie. We were both pretty disturbed.

I was really pissed off that no one mentioned that the scar would be bigger.

A couple days later, the swelling and redness are much reduced. Also, I think it's actually the same size that it was before.

In fact, the scar looks thinner and straighter than the previous scar - which Enrique's surgeon told us to expect.

(She cut out the old scar and pulled the skin together.)

Once it has healed, it shouldn't be that visible.

The Worst Part Isn't Bad

This surgery went the way the first surgery was supposed to go: one night at the hospital and minimal pain.

Enrique is eating a normal diet, is off his pain meds, and isn't taking anything except his hormones and his calcium supplement.

He's a little moody and still tires easily, but he's beginning to take short walks around the neighborhood and do a little housework. (Hooray!)

The part of his recovery that he hates the most is his bandage. He doesn't mind that everyone can see it. He minds that it is so ratty and dirty and bloody.

"It makes me look homeless."

It is pretty ugly. But it should be gone in a few days. It will either fall off or the surgeon will remove it at his next appointment.

His scar should actually be less visible than it was before. The surgeon reopened (but didn't enlarge) his previous scar.

Apparently, this time she closed it up in a way that makes it appear thinner.

A Stronger Radiation

The tumor the doctors removed on Friday was a bit bigger than 3 centimeters.

The smaller one they left in is about half that size. Enrique's surgeon also mentioned that there are two tiny ones about a half a centimeter in his neck. I hadn't heard that before.

All of those tumors - and any leftover microscopic cancer - will be treated with radiation therapy, in about three-to-four weeks.

They're going to give him a stronger dose of radiation than they did before.

I assume that means more nausea. But hopefully, it will do the trick.

A Persistant Cancer

I wrote in an earlier post that Enrique has an aggressive case of cancer.

That's probably a little too strong.

His disease is very unlikely to kill him or even shorten his life.

But it does seem to be a persistent cancer - one that he'll need to watch for the rest of his life. That's unusual for this type of thyroid cancer.

We met with his surgeon a couple of days ago and she suggested that he'll probably need another surgery at some point in his life. It's likely that it will be years or even decades from now.

Nevertheless, that was hard to hear.

She said her hope was that this round of treatment would mark the end of aggressive treatment -- for good -- and that any future treatment would be more moderate.

Since his case is atypical it sounds like it's tough for anyone to make predictions.

Home

We just arrived home five minutes ago. It feels great.

For Enrique, the best part of coming home is being able to take a shower - so that's his first stop.

I think I may take a nap.

Enrique just came by and asked, "Would you help me with a little ritual? I need you to cut the hospital's security tag off of my wrist."

It's the fourth time I've done it (three surgeries plus one surgery cancelled in the O.R.). Hopefully, it will be the last.

Competence not Privacy

The ward Enrique is in is totally different from the others he stayed in.

There are no rooms (just curtain dividers). But that means the nurses are
always within earshot.

Also, the patients around him seem to be much sicker.

Nothing makes you want a private room like overhearing a discussion of
bloody vomit during breakfast.

The other main difference is that all the staffers have been really
competent and the whole place feels very well run.

In some of the other units, after 24 hours, I was better able to find
supplies and make things happen than some of the nursing assistants.

A low-fat grande

Last night the doctors lifted the restriction on solid foods. Enrique was
hungry and tore into the food I had brought from home.

He slept just ok. They had to wake him up every two hours to measure his
neck for swelling (which has been minimal).

He is still tired, but he has have very little pain and no nausea -- a huge
difference from his previous surgeries.

He isn't taking any pain meds at all right now.

He ate a big breakfast, partly what I had brought from home and partly
hospital food, plus a latte from the starbucks across the street.

It looks like he will be released to go home today. We are waiting for the
doctor to come by.