The Struggle Has Ended

Greg Hewlett passed away on January 17th after nearly eight years of battling colon cancer. While we grieve his loss, we are comforted to know that he is with his Lord.

If you would like to leave your thoughts on Greg, please see this thread.

If you would like to make a charitable donation in Greg's honor, please see this thread.

Friday, February 20, 2004

My birthday

I turned 36 yesterday. When we talk about someone having a "good" birthday, we usually mean something like a day of fun or a particularly good day at work, or a day with a fun event with one's family. Yesterday was indeed a "good birthday", but not in the usual sense of the term.

I spent most of the day by myself at MD Anderson meeting with doctors, nurses, and genetic research interviewers. Then I made the 250-mile drive up I-45 back to Dallas alone. This is the same dull drive I have made countless times, especially during my college years. The visual highlights of this stretch of Texas highway are limited to a few scenic oak groves, some billboards for Bubba's Bar-B-Q of Ennis ("serious barbeque"), Huntsville State Penitentiary, and a ridiculously huge (even by Texas standards) white statue of Sam Houston overlooking the roadway. Incidentally, in my mind, this jolly monstrosity does little justice to that great man because the statue looks too much like the giant Pillsbury Dough Boy from Ghostbusters.

In any case, I had a delightful day. I had some CDs and a book-on-tape but found myself opting instead to sit in silence. Among other things, I contemplated 36. I kept recalling a small private thought I had in the early days after diagnosis last summer. During those dark days, when looking at data showing a median life expectancy of something like seven months, I wondered if I would see 36. And here I was, driving down this same ol' road on that very day. 36 had indeed come. The tumors were gone. The doctors were more optimistic than usual, and overall, I didn't feel too sick. (although the Sonic burger was still stubbornly resisting digestion -- Sonic is still the height of cuisine on I-45).

To be sure, the dough-boy statue was still ridiculous and the penitentiary still loomed. But the Bubba's signs were a bit more humorous. It also seemed like there were more oak groves. And they were more beautiful than I had noticed before. The air seemed fresher, as well. So if anyone asks... yes, I did have a good birthday.


Tuesday, February 17, 2004

Brenham bed & breakfast & dogs


Here are some pictures of our weekend get-away to Brenham, TX (1/31-2/2). We stayed there the final few days for a break after surgery recovery and before I began this last round of chemotherapy.

Christine, of course, will remember it for the many dogs...

This fella, who was in charge of the bulding next door, wanted to come out to meet us.
Christine especially liked the Cocker Spaniels, who lived in a kennel on the property. They woke us every morning barking (nothing like the sound of a dozen Cockers at 7am), but she didn't mind - dogs are always given grace in our world.



Monday, February 16, 2004

Finished round six

This morning I took the last of my Xeloda chemo for this round, completing round six. I'm not what you would call productive these days, so I consider completion of a round of drugs to be a major accomplishment.

I am now at a point of only being mildly sick and my strength from surgery is still steadily gaining. I will be in Houston meeting with Dr. Hoff and Dr. Rodriguez-Bigas on Thursday. There will be some minor tests, but this should be an uneventful trip. The next round of chemo will begin next Monday, assuming all goes well during my evaluation Thursday.

Christine continues to struggle with a bad season of migraines, so she will remain home.

Sunday, February 15, 2004

Fallen Snow

Backyard.jpgDolce.jpgWe awoke yesterday to a pleasant surprise. I extend apologies to my friends of the Northeast, where I hear snow and ice has been an unrelenting challenge this season. Down here, we delight in it and take our mandatory out-the-window photos, as if to prove to ourselves it wasn't a dream. After all, as was the case yesterday, it is usually mostly gone by the end of the day.

We cancer patients are understandably drawn to read Job. Here are some words from Job 37 that yesterday brought to mind...
God's voice thunders in marvelous ways; he does great things beyond our understanding. He says to the snow, 'Fall on the earth,' and to the rain shower, 'Be a mighty downpour.' So that all men he has made may know his work, he stops every man from his labor. - Job 37:5-7

Thursday, February 12, 2004

Tuesday, February 10, 2004

Thank you Dr. Heiderberger

In 1957, Dr. Charles Heiderberger discovered 5-flourouracil, otherwise known as "5-FU", at the University of Wisconsin. This drug remains today as the most effective chemotherapy for use against colorectal cancer. Xeloda, which I am taking now, is the oral form of 5-fu. The poem below reflects some of my own thoughts about 5-fu, which I use here to represent all chemo I have had to take. (Because I am now only taking Xeloda, I am expecting the full force of the symptoms below will not appear. But this still reflects how I feel about chemo)


Having met Sir C-name,
I'll never be the same.
For he forced me into a battle
I call the chemo game.

A conspiring of radiology with cohort oncology
And - who knows - microbiology
Employing a well-intentioned dimented psychology
Turned loose a rabid shrew
I never before knew
My body was attacked by 5-fu.

"For my own good" everyone else understood.
The mean lifetime increases a year or two
If I'd be a good boy
And take my 5-fu.

Hamburger tastes like a rotting yak
Intestinal revolt
Gastronomic attack.
Developing a gut-wrenching gurgling lump
The posture curling into a slump
Schlop and glop from the rump
(I'm sorry to use the terms I do
But I'm left with no choice by 5-fu)
Gagging, cringing. What's a good boy to do?
Paste on a smile and take more 5-fu.

I do not want it in a box.
I do not want it with a fox.
I do not, do not in a tree.
Not in a car, you let me be!
Not with a pig or kangaroo
I do not want my 5-fu.

Tumor retractibility? 5-fu.
Metastatic possibility? 5-fu.
Microscopic activity? 5-fu.
Perhaps curability? 5-fu.
Even longevity? 5-fu.

He who works under, behind and through
Ordinary means like 5-fu
Is free
O so free.
Dimly I yet see
The author of life and of 5-fu
Guarantor of peace making all things new
And ridding the world of 5-fu.

Wednesday, February 4, 2004

Brain MRI result

scarecrow.bmp I would while away the hours
Conferin' with the flowers
Consultin' with the rain
And my head I'd be scratchin'
While my thoughts were busy hatchin'
If I only had a brain.

Some very good news... I got the call today from my doctor's assistant about the MRI result. She said, "Yes, they did find a brain... and yes, it is clear." It's good to know both! Thus, the recent headaches are not due to any cancer, which was my and the doctor's concern. As you might imagine, I was quite concerned about this, and am so relieved and thankful. joy.

Tuesday, February 3, 2004

In Dallas, facing new decision

We arrived yesterday back in Dallas after a terrific weekend at a remote bed & breakfast near Brenham. This was a refreshing break for both of us. No telephone (or internet) connection kept us confortably secluded. We especially enjoyed the many ranch dogs, who kept things under control on the property.

Back on the medical front, we are facing a difficult decision for future treatment. Because there aren't any studies on what to do at this point (Dr. Hoff says any plan now is sort of a shot in the dark), no decision is easy. The desire is to avoid recurrence, which is not uncommon with my type of cancer. He recommends that I continue taking the Xeloda oral chemotherapy for three to four months. I started it yesterday (and accordingly have begun once again updating my home page chemo tracker). This stuff isn't as bad as the irinotecan I took intravenously with Xeloda in the past. The irinotecan is only effective for shrinking tumors (not avoiding recurrence), so I won't be taking that.

The question then, is whether to take a relatively new drug, oxalyplatin, alongside the Xeloda. There are several reasons why I should not. (1) It is proved to be only marginally effective (around 4% higher survival rate) for people who have earlier stages of this cancer (not yet reaching the liver). In my case, it is not even known if it would have the same advantage. (2) It is nasty stuff, likely causing worse side effects than any of the drugs I have taken in my current treatment, and my body has been through a lot. Some of the side effects, like losing touch sensation at the fingertips, could be permanent. (3) The drug is related to cisplatin, to which I had a moderate allergic reaction back when I had bone cancer as a child. Since oxalyplatin tends to cause more frequent and severe allergic reactions in patients than cisplatin, there is risk of a dangerous allergic reaction. (4) I would have to take reduced amounts of it at least initially because of my liver, which is not at full power.

In my mind, weighing against all of this is the philosophy to do everything possible to insure the cancer will not come back.

For this first round, I am only taking Xeloda, bacause I am weak and I wouldn't be able to take much oxalyplatin anyway until my liver comes back to full strength. Dr. Hoff thinks this is the way to go. As for whether I will take the oxalyplatin in the future, right now I am seeking the advice of my various doctors and am joining with Christine in asking for wisdom from the Lord. Asking for wisdom is part of the process of Christian perseverance, (for which I am in deep need), as illustrated by this passage from James:

Consider it pure joy, my brothers, whenever you face trials of many kinds, because you know that the testing of your faith develops perseverance. Perseverance must finish its work so that you may be mature and complete, not lacking anything. If any of you lacks wisdom, he should ask God, who gives generously to all without finding fault, and it will be given to him. But when he asks, he must believe and not doubt, because he who doubts is like a wave of the sea, blown and tossed by the wind. That man should not think he will receive anything from the Lord. James 1:2-7

Finally, I did have a brain MRI last Thursday to rule out metastatic activity as the cause of my recent headaches. It takes a couple days to get the radiology report and I have not yet heard the result.