Saturday, May 24, 2008

holding pattern

After a week of tests and trips to various hospitals and doctors, the news appears to be no news. Jiffy came with me on Wednesday to see my oncologist and discuss next steps. We talked about surgery and she agreed that it was a likely option, especially if we could get Professor Pafko, Havel’s three-time lung surgeon, to perform the operation. The PET scan would be the deciding factor.

Turns out I only have four tumors, as opposed to the previously-reported seven – my CZK 80K a cycle oncologist at Karlák must have been seeing double back in February.

So it was off to my PET at Homolka, where they quizzed me for as long as they could about my identity – not too long, as they only had my name and birthday to go on. They informed me that I couldn’t be around small children, pregnant or nursing mothers for a day, as I would be radioactive. “What about my cat?” I asked.

“How old is she?”
“Ah, no problem then.”

They didn’t tell me any of this last time, or at least I don’t remember. The doctor/technician was a bit of a wise-ass, and very funny in a very deadpan, straight(wo)man sort of way. I imagined the comedy team we could make as I faded in and out of sleep during the fifty-minute exam.

I saw Dr.? Wang on Thursday, who, when I told him the lung tumor had grown, barked at me for not having drunk all of my foul-tasting tea since my last visit. I had seven pins this time and bought more tea.

Jiffy and I went back to Motol yesterday to see my oncologist and get the official comparison between the February and May CT and PET scans. Doctors and hospitals generally don’t trust each other’s diagnoses in the Czech Republic - I’ve come across this a few times before. According to the radiologist at Motol, the lung tumor is ‘stable’ (no change in size) and the three lymphatic tumors may have actually decreased slightly in size. The PET revealed no further metastasis.

So my oncologist recommends more chemo – to begin on Wednesday: same cocktail, unspecified number of cycles, followed by or concurrent with radiation treatments. She sent me to Dermatology to have two spots/moles (one of which is the possible site of the primary tumor), excised and biopsied.

“The patient, who lives with his mother, is 39, and still lives with his mother.” has been replaced with “Melanoma of the lip.” which has dogged me for months now. “You don’t have melanoma of the lip!” they inevitably say, “I know,” I always reply. The dermatologist checked me over thoroughly, even checking a suspicious lesion on Jiffy’s foot, all the while babbling to us in Latin along with encouraging head gestures.

She scheduled the two excisions for June 12th and, out of the blue, asked me if I spoke French. “Mais, oui,” I replied. Then began twenty minutes of us blathering on in French, Spanish, Czech, Slovak, English, German and even a little Hungarian – most of which she speaks very well AND has a medical degree to boot. We hit it off.

I’m not looking forward to next week’s chemo or the 7AM Tuesday blood tests. I just want to get this crap out of my body as soon as possible and, scary as it is, would prefer to have the operations. Apparently, the lung tumor is too close to an important vein and the surgery would be very risky. But I guess no news is good news and I’m already well-past the median survival time for Stage IV metastatic melanoma. So, “Steady as she goes, Mr. Sulu.” The party continues: going to see Dinosaur Jr. at Akropolis tonight.

I wish Paquito a very speedy recovery from his knee operation last Thursday. Todo va a salir bien. Un abrazo.

Tuesday, May 20, 2008

good news? bad news? no news?

Mary came over around 11 yesterday for coffee, snacks and to take me to my oncology appointment. After an hour wait, we got in to see my oncologist, who didn’t have Friday’s CT results ‘in the system’. My ‘birth number’ was changed when I got insurance and had caused some sort of compu-bureaucratic snafu.

While we waited for the results, she checked out my lymph nodes. After quite a lot of digging, poking and prodding, she said that she could no longer feel anything tumor-wise under my armpits.

Both she and Mary were very excited about the prospect that my tumors had completely and magically disappeared since I began my treatment. I, however, took it all in with a raised eyebrow, hardened and skeptical from so many recent disappointments. She saw another patient while we waited outside.

The results, but not the scan itself, came and we went back in. Not having the original CT scan from February with me, we had nothing to compare it to. She sent me home to look for it and I was to drop it off the following day.

I finally found it at home and checked it out myself. Not the best of news: lung tumor went from 26x20x22mm to 38x30x33mm. I SMSed my oncologist to let her know (that I needed a day off) and we agreed that I should come in tomorrow before my PET scan at Homolka to compare and contrast and discuss further treatment options.

"Hey! Where’s the good news?" You ask. Well, there’s been no further metastasis: liver, pancreas, kidneys, etc. are clear, but that won’t be confirmed until after the PET scan tomorrow.

I also have an enlarged prostate and a gall stone! = the least of my worries. Stay tuned.

Saturday, May 17, 2008


Mary came over yesterday at 6:30 in the morning to take me to Motol for my CT scan. Our first and last stop was the Foreigner’s [sic] Office, where I dropped the bomb (replete with crescendo whistle-sound, followed by large explosion sound effect) of my spanking new (as of Wednesday) state health insurance card. Kuba’s eyebrows went up past his hairline, his mouth agape.

“How the hell did you get this?” he asked.
“I have a good lawyer,” I said.

They all congratulated me and Mary and I went off to the CT scan scot-free (well not Mary really, who is of Scottish origin). We had to wait an hour, as I was supposed to drink a liter of contrast solution before the exam. The woman before me came out of the exam with four bandages, shrugging her shoulders, and saying, “I have bad veins.” I have terrible veins, especially after more than 300 holes put into them over the last four months and imagined that I would come out with at least ten misplaced injections.

The first injection turned out to be the charm, so I was relieved - I still hate needles even after all of this. They made three passes of my upper body (shoulders and chest, midriff and gut, abdomen and private bits) and I was on my way back to Kuba to pay the remaining CZK 126 left on my account, have a tear-jerking goodbye and make promises to see each other socially - he came to mikeFEST! after all.

I get the results at 1PM on Monday when I meet with my oncologist (and Mary again) back at Motol. This will decide (somehow) if I have another cycle of chemo (which I expect I will). I have a PET scan on Wednesday at Homolka, which will determine whether or not I’ve had any further metastasis. So it all comes down next week.

Now that I have insurance, I can spend more money on complimentary therapies, vitamins, crazy teas, faith healers, herbs and the like, not covered by the system. In between coverage (February 21st to May 14th), I’ve shelled out around CZK 50 000 ($3125) for my treatment, which included: three cycles of chemo, an MRI, blood tests, consultations and prescriptions. Not too bad, considering.

I’ll try to update the much-neglected mikeFEST! blog tomorrow and post my CT results and conclusions on Monday evening, depending how I feel. Until then, wish me luck...

Tuesday, May 13, 2008

east and west

I went to see Dr. Wang yesterday, who listened to my story and stuck pins in my face and hands for ten minutes before doling out large packs of herbs and roots that have to be slowly cooked together for half an hour each day, strained, chilled and drunk. I have to go back in ten days for more pins and some eye of newt.

On the bus to Homolka this morning, I sat next to a couple of strapping, Campbell soup Utah Mormons who interrupted my reading of The Amber Spyglass (atheist children’s lit) with their spiel in Czech. I told them that I’d heard it all before, thanks, and was more interested in my book, thanks. But then I felt bad.

I’ve seen these guys in every country I’ve lived in and they always speak the local language at a surprisingly high level, are incredibly polite and friendly, clean (almost shiny), well-dressed and inevitably look like a rosy-cheeked Norman Rockwell tableau. They are the only people (except for tourists) who actually smile on public transportation.

Compared with the rest of the trash we get here, the Mormons are the cream of the crop. If I’m willing to give the stinking-drunk british stag party directions to the nearest brothel, there’s no reason why I shouldn’t be polite to these misguided cherubs. So I gave them the aforementioned compliments, but told them I still wasn’t interested in their ‘message’.

Unfortunately, the bus ride is far too long for just small talk, so the conversation eventually turned to cancer. “I can’t possibly know how you feel,” said Elder Something, “but there’s one guy who can! – Jesus Christ.” I replied: “No. You can’t possibly know how I feel; but there are millions who do and are more easily accessible. I’m more concerned with living right now than with afterlife preparations, thanks.” They were nice, I wished them luck and we parted on the best of terms.

My appointment with Dr. Klener went very well. He agreed with my interpretation of the MRI and added, “If you didn’t know where and what to look for, you couldn’t tell you had an operation.” I’ll be starting med school in the fall.

Although there was no further brain metastasis, the MRI apparently showed some sinusitis that I wasn’t aware I had. No follow-up visit scheduled, but I have a PET scan (the nuclear moment of truth) there next Wednesday.

My friends, Sonya, Liz and Henny, are coming to Prague this week and when the four of us get together, you’d better look out! I’m exhausted after mikeFEST™, but it looks like no rest for the wicked. I should have listened to the Mormons...

Friday, May 9, 2008

of MRIs and blood counts

I was up at 6:30 this morning for blood tests at Motol. The results, which I just got over the phone, are as follows: white blood cells 6.3; red blood cells 4.44; hemoglobin 14.0; and platelets 199. So all my numbers are back up and well within the healthy ranges.

I had an MRI of my head at Homolka on Wednesday. This is the worst slide of over a hundred, so comparable to the others already posted:

This is one of very few slides where you (or any other untrained eye, like myself) can even tell that I ever had an operation. Of course, I’ll have to wait until my consultation with Dr. Klener on Tuesday for the official analysis, but it looks good to me: no obvious baseballs, grapefruit or watermelon in any of the slides and the swelling has unswollen.

I’m meeting a Chinese doctor who practices Chinese medicine, of all things, on Monday afternoon. We’ll see what he has to say. I have a CT scan of my chest next Friday (the 16th), which should reveal any progress or regress of my remaining seven tumors. This will decide whether or not I will have a fourth chemo cycle, although I have no idea what the deciding criteria are.

On the whole, I’m feeling very well despite the time-consuming responsibilities and obligations of mikeFEST!™ (already in progress). I had a great week with Christine and am really glad she made it out. Between chemo, entertaining a house guest, and running a 12-day festival, I haven’t had much time to write. Thanks again for your comments, advice, and most of all your presents... uh, I mean presence ;-) Here's a picture of Christine in the hospital:

Friday, May 2, 2008

happy mikeFEST!™

Christine arrived on Saturday to a spectacular lesbian wedding in my courtyard and (eventually) some four-hour, four-cheese fondue that I spent most of the day slaving over (mostly just stirring).

My blood results from Monday were a little disappointing. My white blood cell count is down to 5.2 (low end of healthy), while platelets are up to 177, so I guess I can shave now. Everything else has remained steady. Here I am as the spitting image of Michael Moore:

Christine came with me to the hospital for all three days of chemo and seemed to enjoy herself sleeping on the communal table. The third cycle wasn’t so great. It really burned this time and I found myself writhing in pain often. I threw up five times on Wednesday, but am feeling a bit better now. I’m really glad it’s over and hope that I don’t need another cycle. My expensive, state-of-the-art tests are all this month, so I should know where I stand before June.

But it’s mikeFEST!™ already and I’ve got a very busy schedule lined up. Please visit: click on the poster, and check out the blog. I’m keeping them separate ‘cause cancer ain't got no place in mikeFEST!™