Merry Merry Quite Contrary

On the first day of cancer, my chemo gave to me, a focus on mortality.

On the second day of cancer, my chemo gave to me, two rubber gloves, and a focus on mortality.

On the third day of cancer, my chemo gave to me, three scars to mend, two rubber gloves, and a focus on mortality.

On the fourth day of cancer, my chemo gave to me, four funky turds, three scars to mend, two rubber gloves, and a focus on mortality.

On the fifth day of cancer, my chemo gave to me, FIVE BROKEN DREAMS. Four funky turds, three scars to mend, two rubber gloves, and a focus on mortality.

On the sixth day of cancer, my chemo gave to me, six insurers payin’, five broken dreams! Four funky turds, three scars to mend, two rubber gloves, and a focus on mortality.

On the seventh day of cancer, my chemo gave to me, seven kids a’staring, six insurers payin’, five broken dreams! Four funky turds, three scars to mend, two rubber gloves, and a focus on mortality.

On the eighth day of cancer, my chemo gave to me, eight blood counts sinkin’, seven kids a’staring, six insurers payin’, five broken dreams! Four funky turds, three scars to mend, two rubber gloves, and a focus on mortality.

On the ninth day of cancer, my chemo gave to me, nine shots a’smarting, eight blood counts sinkin’, seven kids a’staring, six insurers payin’, five broken dreams! Four funky turds, three scars to mend, two rubber gloves, and a focus on mortality.

On the tenth day of cancer, my chemo gave to me, ten hours sleeping, nine shots a’smarting, eight blood counts sinkin’, seven kids a’staring, six insurers payin’, five broken dreams! Four funky turds, three scars to mend, two rubber gloves, and a focus on mortality.

On the eleventh day of cancer, my chemo gave to me, eleven nurses nursing, ten hours sleeping, nine shots a’smarting, eight blood counts sinkin’, seven kids a’staring, six insurers payin’, five broken dreams! Four funky turds, three scars to mend, two rubber gloves, and a focus on mortality.

On the twelfth day of cancer, my chemo gave to me, twelve friends to sooth me, eleven nurses nursing, ten hours sleeping, nine shots a’smarting, eight blood counts sinkin’, seven kids a’staring, six insurers payin’, five broken dreams! Four funky turds, three scars to mend, two rubber gloves, and a focus on mortality.

barry and me

Major League Baseball can add me to their rolls.

Of steroid users that is. I have officially begun chemotherapy again after a five week hiatus. Although my body is already reacting more strongly this time around, it is good news that my infection-fighting white blood cells are battle-ready.

and away we go again...

Guam

so, my uncle bobby called me today. he was very kind but basically echoed what all my family says, that i should rest and not be going to school right now. he invited me to go to Guam, where he has a "lovely apartment" and just relax. he said it's just like Hawaii 30 years ago; calm, beautiful. now, offering that in the middle of finals is just not fair. so tempting... what would you do?

neutropenia

As many of you know, my chemotherapy treatment schedule is currently administered in three-week cycles. Due to levels of chemicals, how long they take to kick in, how long they take to flush out, how much rest I get plus various other issues, I would describe the schedule in the following way:

Week 1- Sucks.
Week 2- Extremely sucks.
Week 3- Somewhat sucks.

And then the cycle repeats.

This has been the story of my life health-wise for about 48 weeks now. When close friends and family call and say, "how are you?", I can say, "I feel like my usual Week 1" and they know what I'm saying.

So, given this long-standing routine, it is notable that my last Week 3 (or in hospital parlance, Day 15) in-hospital intra-venous treatment was Nov. 7, almost one month ago. This is the longest I've gone "off treatment" in almost two years. The reason my next cycle has been postponed three times so far rains on my toxin-free parade.

The first thing they do when I go in for treatment is take a series of blood samples from which they assess the robustness of my health to make sure my body can withstand the chemo that week. The past 3 weeks, the lab has reported white blood cell counts too low to withstand chemotherapy. Since chemo attacks infant cells as they try to grow and multiply, they can't fight the potential cancer cells without harming my already low white blood cell count. (WBCs fight infection and are muy importante.)

What this means is two things. One, I am very tired, because it takes the body a lot of energy to produce these fighter cells. Think of yourself with a cold or the flu. Two, I need to be very careful about exposure to bacteria. That means avoiding a lot of things I'm already supposed to avoid such as crowded subways, sick/contagious people, raw foods- but actually doing it. But also, I'm not supposed to floss, to shave, or do anything that could lacerate the skin and let in those icky germs that would have a free-for-all while the immune system is out of town.

How and why is this happening? At first, the doctors shrugged and said without concern: "oh, this just happens sometimes when someone has been on chemotherapy for such a long time." The second week, when my counts actually continued to fall instead of rebounding as expected, the doctors began to integrate a second theory: Around the end of October, I, in a week-two-druggy-haze, accidentally loaded my pill cases incorrectly, dosing myself with twice the amount of 6MP per day than my weight allows. I felt terrible all that week, but didn't discover the mistake until Jaci figured it out. This was initially dismissed by the docs as rather inconsequential, but is now figuring more heavily into their hypotheses for my current neutropenia. [One doctor told me, "you know, this medicine is toxic stuff!". Well, NO SHIT, I wanted to say, who do you think you're telling that to? Have I not been questioning whether the treatment actually causes more harm than the disease since this whole disaster commenced?] When the 3rd week of low counts rolled around, it was decided that, if my counts did not display improvement by the following visit (this Wed, Dec.5), they would conduct a bone marrow biopsy to check for some other more serious malignancy.

I reeeeally don't want my bones drilled into this week. I've got finals coming up. I just don't have time for cancer (or whatever else my body is brewing) right now.

love, through time and space

Gna-boo died yesterday. She went to sleep for an afternoon nap and never woke up. While the whole family struggles with grief and the inevitable confusion death brings, there are few alive today who could hope for a better life or a better death than Madeline Kwok's.

Some highlights (hopefully correct and not those fuzzy guesses that over the years become fact in grandchildren's minds):

-Madeline lived 89 years, although she has been saying she's 90 for the past 2-3 years (because age garners respect and admiration? because she was just rounding up? because in Chinese custom, age begins 9 months prior to birth?)

-She was born in Shanghai in 1918, moved to Hong Kong in 1949, and to San Francisco in 1974.

-She was the matriarch of our family: 5 children, 9 grandchildren, and 6 great-grandchildren-- but all with personalities and partners that make the family seem so much BIGger.

-The day she got her driver's license (in HK), she got in a fender bender and was too scared to get behind the wheel ever again.

-I don't think she worked (for money outside the home) a day in her life.

-She believed in enjoying life, particularly food. She was known to say that you can't eat dollar bills, so money paid for good dining was always money well spent. Of course she loved good Chinese food, but had a special affinity for a fine slice of prime rib too.

-She was a devout Catholic, who in her later years would watch the Mass on TV on Sundays when it became difficult to get to church.

-She loved nature videos, particularly oceanographic explorations.

-She had a weekly mahjong game with other "boo-boos" in her building.

-She always wanted to please others. Even in her last days, she would mumble gratitude to those who came to visit her, eat only to make her caretakers happy, and in general try to ease the sadness and burden her deterioration was causing her children.

I asked Gna-boo about a year ago about her late husband, my namesake, Eric. With the exception of some time in the 1940s when such associations became prohibited, he worked as a distributor for American entertainment companies, such as United Artists. He was a charming, dynamic business man, at ease mingling with movie stars, a global player before the word globalization even existed. He died around 1971, almost 40 years ago. I asked my grandma if she missed him and she did not hesitate, "Yes, very much", she said.

My grandpa Eric died on November 15, 1971. His wife, my Gna-boo, died this year, 2007, also on November 15.

Funeral arrangements will be finalized today. Thank you for all of your messages of comfort and gentleness.

It is with a heavy and saddened heart to tell you all that Gna Boo/Grandma is fast declining. She has not eaten in 3-4 days with only a few drops of water as intake. She is very weak. She moans and flails her arms a lot and we are sedating her with morphine as well as atavin to sooth and ease her pain and discomfort. She hasn't spoken in days and barely nods or shakes her head. She seems to hear and understand when we speak to her but often there is no response. Once in a while, we get a faint nod. She frowns sometimes and seems to be displeased about something but we don't know what.
This morning when I sat with her, held her hand and kept talking to her, she seems to understand and hear me. When Willy came into her room and spoke to her, she opened her eys and smiled ever so faintly...what does that tell you, eh? We gave her a few drops of water and she took that.
The nurse is coming again today at 1:30pm and we will see what she has to say after she gives her another examination. When she came her yesterday, Gna Boo had a slight elevated temperature so we are giving her liquid tylenol every 4 hours. She can barely swollow but she tries.
Please continue to pray for her. She is a brave lady and despite her frailty and discomfort, she is doing her utmost to ensure we are all okay as well. When we talk to her, we keep assuring her that we are all here and okay.
Jimmy just called me and said he has been with her for the last 20 mins and she is quite out of it and really does not know that he was there.
Will keep you all updated...
Peace and Love
Auntie Judy

Gna-Boo Report

From my Mom:

Today is Sunday 10/14/07...
Willy called me at 6am this morning and related that Mother is doing very well this morning. As usual, first thing when she wakes up is that she is hungry - a good sign. She had her oatmeal which is what she asked for. When Willy declined the nurse who came in to give her IV, she immediately piped up and said she needed it as she is not eating enough. So, you see, she knows what is going on and what is needed to give her more energy and strength. She is trying harder to eat but she does have difficulty swallowing.
Willy again spent the night with her and Lillian relieved him at 9am. Jimmy just called from the airport that he has been to see Mom and she is looking a lot better, more lucid and smiled when he told her he is leaving for a few days. Bobby is back from Las Vegas last night as did Lil from Chicago. I will relieve Lil at noon. So we are taking shifts so as not to bombard her with too many people at one time. Cousins Annie (who has been there almost daily), Lily and Dorothy also came to see her yesterday and Lily fed her almost half a bowl of Soy milk that she likes. Adelaide and white son Tim also came by last evening with flowers and biscotti. Mom is totally aware of everything and when she is tired, she just closes her eyes, tunes out and rests.
The plan remains that tomorrow hospice will send all the equipment to her place and will set up so that when she goes home, probably either in the afternoon or Tues morning, depending on how well things are finalized at home for her. She seems pleased that she will be going home where she will be more comfortable, being within her familiar surroundings. Her regular maid, Annie, whom she also likes and relates well, will initially be there to take care of her during the day. So, we will see how things go and go from there on a day to day basis.
Will keep you guys all informed. Thank you Jason and Erica for wanting to return to SF immediately to see Grandma but at this point, its best that you guys stay put and we'll keep you abreast of the situation. Robby and JJ both have been to see Grandma when she was in ICU. Even though she was groggy and sleepy then, she was aware who came and smiled.
Peace...
Judy

when it rains...

i sit in my curtained cubicle in the hospital feeling fuzzy-headed and lost. how did i arrive at my appointment four and one half hours late?

my gna-boo is in a curtained cubicle in a hospital right now too in San Francisco. she is my one grandparent left and she is in intensive care, speaking little, eating nothing. Congestive heart failure, kidney disfunction, levels of this and that and falling down and a stroke (or two!) and doing better, no doing worse, no you shouldn't come, she's gonna weather this one through, no she doesn't want anything invasive, why weren't the ICU nurses watching her, bleeding bump on the back of her head, smiled at news of great and grand-children, lucid, silent.

i feel depressed and impotent. it started before news of my grandma but that sent me into a state of avoidance- of classes, responsibilities, engagements. have i overloaded my schedule, am i moping, self-indulgent? have a recent lowering of medicines been premature? i have had pneumonia for the past month or so, but antibiotics seem to have quelled the chest pains and cold symptoms. this progress, reinforced by specific blood tests and CT scans, seem to confirm that the pneumonia was/is bacterial and not fungal- a good thing. body-sick no. heart-sick.

Madeline Kwok. all of my friends who've met her agree that everyone needs a gna-boo. the sweetest little old lady ever. i'm so scared i'm not going to get to say good bye.

Any Given Wednesday III

The final installment of this three part series is the simplest. Every time I go to the hospital, before anything else can be done, they must send blood samples to the lab to make sure my levels of white, red, and purple blood cells, magnesium, potassium, myassium, protein, preteen, calcium, ABC, XYZ, CRS, etc are all either good or "expected under the circumstances". This photo flipbook show them accessing my portacath, taking blood and then administering the intravenous chemotherapy into the same port.


This is a Port-a-Cath or as we lovingly call it, a port. There is one just like it implanted in my chest as I type. It grosses me out still sometimes to think about its plastic invasiveness, but it's really quite a convenient little gadget. There are two pin-cushion pads where a special needle has lots of room for error. We all have our horror stories about difficulty finding veins in our arms and hands to access for blood collection/donation, right? Well, when my veins were just about to walk out of the factory in protest, the union renegotiated their contracts and got them vacation time. Technology was brought in via a surgical procedure last spring to implant this mechanism. The tube winds around my collar bone giving it special access to all that fresh blood pumping out of mi corazon- and front row seats to deliver all the poison throughout the body as well.


This is Kecia removing the bandage I had put on at home. When I remember, I put a topical anesthetic cream on the port one hour before show time. Everybody's different, but this seems to help me avoid a good deal of the pain.


I think I've blogged about nature's gift of outward perspective before, but it applies to my port as well as to my general looks over the past year and a half. It's really such a great feature of being human that we can't look at ourselves, save by aid of mirror. Therefore, my self-consciousness about being bald, enfeebled or even having strange lumpy protrusions in my chest has been limited. There are some fashions I will not sport (strapless tops shout: Stare at my weird pectoral tumor!) but mostly the summer found me donning tank-tops and bikinis just like everybody else. Few people mention the port and so I forget about it.


She's using alcohol to clean the site.


That's the fancy needle. Considering it's length, it's remarkable that the pain is insubstantial and the success rate of first-time access nearly 100%.


My nurse verifies a blood return, or, makes sure that the port is functioning well both in and out. She'll take several vials of blood, flush the tubes inward with saline and heparin (an anti-coagulant), and then pinch the tubes shut while we wait for my results from the lab. This waiting period is usually the bulk of the time I spend at the hospital each week- approximately two hours. During this time, I usually eat something from either the hospital cafeteria or the food court. I always plan to study or work, but rarely actually do. Hospital time gets sucked into the black hole of all wasted hours plotted with the best intentions.


I think there has only been one time when I was too sick to get my weekly chemo and it hasn't happened for a looooong time, thank goodness. So, next, the nurse will suit up in a thick protective gown and pull on special heavy-duty gloves. Can you imagine? The crap that they inject INTO MY HEART is so toxic and terrible that those who administer it must dress for a walk on the moon lest it splatter or drip a drop on their skin. I love that.


Another saline and heparin on the rocks, bartender.


The nifty needle has a spring-loaded release mechanism to immediately self-sheath the point upon removal.


By the way, these pictures were taken in July, so your eyes aren't playing tricks on you- my skin does look terrible. One of the things they are always telling me is that my skin on chemo is very sensitive to the sun, but I would scoff and insist that they didn't know MY skin. MY skin rarely burns and always tans. Well, score another one for the medical establishment. In Costa Rica, I got very burned and some of these pictures show the healing process. Still today, the remnants of the sunburn are faintly visible on my legs. Oops.


Et voila! All of that blood, water, and chemical exchange and all I get to show for it is an unnecessary band-aid. They should at least give out suckers. Or toothbrushes.

Signing off Sunday.
T minus 3 days until this is repeated.
And twenty-eight more times after that.

TV X'S 2

1. A feature on TV last nighton young adults with cancer, including following some around Dana Farber Cancer Institute, my home away from home.

2. A documentary on The Learning Channel. Said Carr, the creator, "People often ask me why I named the film Crazy Sexy Cancer. The answer is simple: to challenge the perceptions, to poke fun and bring humanity to a disease that is still so misperceived and feared. No matter what happened, I refused to be saddled with the isolating stigma associated with cancer. Just because it had changed my life forever, didn't mean that I had changed."
Word.

what a mess

quoted from a hand-painted sheet on the side of a rural Vermont farmhouse:

Nobody died, when Clinton lied.

the kingdumb

Dear Mr. Obama,

I just received your campaign's "Iraq" e-mail. As another person who opposed the war in 2003, I respect that you can boast the same. However, I wanted to let you know that I found the e-mail's simplification in saying "the people who attacked us on 9/11 were in Afghanistan, not Iraq" to blatantly neglect the paramountcy of Saudi Arabia's role. Going after the physical perpetrators of terror may be cathartic and important, but going after the money (whether that means through economic, political, or physical means) is the better way to be proactive about terrorism and not reactive. I do hope that future communications to your constituency will better reflect an acute awareness of this reality. Thank you.

Sincerely,

Erica Murray

***

Dear Erica,

I have spoken out against the war in Iraq since before it began.Today, I outlined a plan to turn the page in Iraq and end the war.Sign on to the plan today:my.barackobama.com/iraqplan

The saddest thing about the Bush administration's surge of public relations in favor of the war in Iraq this week is how predictable it has become for them to make their case for war around the anniversary of 9/11.

Five years ago today -- September 12, 2002 -- President Bush made his case for war at the United Nations.

He was wrong. The people who attacked us on 9/11 were in Afghanistan, not Iraq, and his case was built on exaggerated fears and empty evidence.

But conventional thinking in Washington lined up for war. Too many politicians feared looking weak and failed to ask hard questions. Too many took the President at his word instead of reading the intelligence for themselves. Congress gave the President the authority to go to war, and our only opportunity to stop the war was lost.

I made a different judgment. I opposed this war from the beginning. I opposed the war in 2002. I opposed it in 2003. I opposed it in 2004. I opposed it in 2005. I opposed it in 2006. And I introduced a plan this January to remove all of our combat brigades by March 2008.
The time to end this war is now.

My plan for turning the page in Iraq is clear:
remove our combat troops from Iraq's civil war by the end of 2008
take a new approach to press for reconciliation within Iraq
escalate our diplomacy with all of Iraq's neighbors and the United Nations
confront the human costs of this war directly with increased humanitarian aid

Sign on to support the plan now and join the voices calling for an end to this war:
http://my.barackobama.com/iraqplan

Our troops have performed brilliantly, but let me be clear: there is no military solution in Iraq, and there never was.

The best way to protect our security and to pressure Iraq's leaders to resolve their civil war is to begin to remove our combat troops immediately.
Not in six months or a year -- now.

We must get out strategically and carefully, but our drawdown should proceed at a steady pace of one or two brigades each month. If we start now, all of our combat brigades should be out of Iraq by the end of next year.

Show your support for the immediate drawdown of our combat forces:
http://my.barackobama.com/iraqplan

While we change the dynamic within Iraq, we must surge our diplomacy in the region.
We need to launch the most aggressive diplomatic effort in recent history to reach a new compact in the region. This compact must secure Iraq's borders, keep neighbors from meddling, isolate al Qaeda, and support Iraq's unity.

Conventional thinking in Washington says Presidents cannot lead this diplomacy. But I think the American people know better. Not talking doesn't make us look tough -- it makes us look arrogant. And it doesn't get results.

Strong Presidents tell their adversaries where they stand, and that's what I would do. Now is the time for tough and sustained diplomacy backed by real pressure. It's time to rally the region and the world to our side.
Support new diplomatic leadership and my plan to end the war:
http://my.barackobama.com/iraqplan

The final part of my plan is a major international initiative to address Iraq's humanitarian crisis.
There's no military solution that can reunite a family or resettle an orphaned child. It's time to form an international working group with the countries in the region, our European and Asian friends, and the United Nations.

We should increase our support for displaced Iraqis and expand access to social services for refugees in neighboring countries.

It's also time to go to our friends and allies -- and all the members of our original coalition in Iraq -- to find homes for the many Iraqis who are in desperate need of asylum.
As Americans, we must keep faith with Iraqis who kept faith with us and take responsibility for our own actions:
http://my.barackobama.com/iraqplan

I welcome all of the folks who have changed their position on the war over these last months and years. We need more of those votes to change if we're going to change the direction of this war. But if we've learned one thing from Iraq, it's that the judgment that matters most is the judgment that's made first.

I opposed this war from the beginning, and I want to bring this country together to end this war now. The American people have the right instincts on Iraq. It's time to heed their judgment.
We have the power to do this -- not as Republicans or Democrats, but as Americans. We don't have to wait until George Bush is gone from office -- we can begin to end this war today, right now.

It's time reclaim our foreign policy. It's time to reclaim our politics. It's time to lead this country -- and this world -- to a new dawn of peace and unity.
Thank you,
Barack Obama

Any Given Wednesday II: Bone Marrow Biopsy

The bone marrow biopsy is performed on me every 3-4 months. It is done to check to make sure there are not cancer cells in my bone marrow. And, just in case you're wondering, I remain in remission with a big fat ZERO leukemic cells. 18 months and not even a blip on the cancer radar screen.

Bone marrow is the spongy stuff found in the center of most of our bigger bones. For these biopsies, they usually take from the hip. They alternate between my left and right hip each time. For this procedure, I lie flat on my stomach.

Ready? Me neither.

Injecting the lidocaine actually creates a pocket of liquid under the skin (seen here). It burns a lot but obviously I can't imagine this procedure without it. They usually use a few syringes of it.

They insert anesthetic as deeply as possible. I can usually only feel the needle tap-tap-tapping on my pelvic bone as they numb the area.

Here, Adriana (my wonderful 7-months-preggers physician's assistant) is cutting a small slit into my skin. Apparently, this is her special trick to allow easier entry of the big needles. It also seems to allow the area to heal faster.

She leans her weight on this, twisting back and forth, and just bores down into the bone. This part hurts a bit; there is intense pressure.

Next is the worst part- they insert a needle within the "drill" and suck up an aspirate sample. There is this horrific jolt of sensation down my leg when this is done. Honestly, pain is so much easier to take than deep strange nerve reactions.

The marrow of me.

The drill just chillin' in me. I guess they all went for a coffee break or something.

Then, they do the actual biopsy, which is basically sucking up more marrow and bone, but it's done with a different needle. Where her thumb is pressing is the new needle going into the core.

This is the bits of marrow and bone from the 2nd needle.

Andres used to sing that Diana Ross song- "I'm coming out! I want the world to know, Got to let it show..." when he was done with a spinal tap or a bone marrow biopsy. The relief that the needle was coming out and it was over combined with his singing The Supremes in an Argentine accent usually had me laughing by the finish.

All done.

By the way, I've noticed bone marrow biopsies on House, Grey's Anatomy, and Scrubs and would like to dispel a little of the fear of pain they seem to exaggerate. This is not something I'd choose to do in my spare time or for kicks, but when this procedure could save the life of a bone marrow match, there's no question that it would be worth it. And you'd only have to get this done AFTER you'd already tested as a match for someone-- testing is a pain-free mouth swab. Have you been tested yet?

Any Given Wednesday

Since the day when I find myself most prostrate before god, the day I contemplate my mortality and pray most fervently is a different day than most Americans, I thought I'd invite you my sabbath. The reasons why Wednesdays find me feeling most small in the scheme of the cosmos and the fates is that I spend three to six hours every Hump Day in the cancer ward getting various treatments, usually simply liquid chemotherapy injected into my chest portal.

What kind of visuals does that meager description conjure for you? If I didn't know what it looked and felt like, I think I'd find it rather hard to imagine. So, for both your entertainment and education, I have, with the help of a few friends, photographed three of the procedures I may experience on any given Wednesday. Some people find me very strange and not a little morbid to be intrigued by needles entering my own body, but, personally, it makes me feel a little more in control. Also, if I leave it to my imagination, I've found that my idea of what must be causing that crazy pain is often scarier than the truth. The 3 photo "flip books" will be of 1) a lumbar puncture or spinal tap, 2) a bone marrow biopsy, and 3) a run-of-the-mill CBC and chemo injection. Here's numero uno:

Lumbar Puncture or Spinal Tap
August 22, 2007

These are the vials into which my cerebral spinal fluid will be collected. CSF is a clear fluid that circulates in the space surrounding the spinal cord and brain. It protects the brain and spinal cord from injury by acting like a liquid cushion.
I get spinal taps in order to both test my CSF and to put chemo medicine into my CSF. I used to get them very frequently, but my schedule for LPs now are every four months. These days, I rarely see results from my various tests and procedures to tell you the truth. Instead of celebrating every cancer-free test result, we just consider no news to be good news.

I sit on the side of a patient bed with my legs dangling and drape my body over a small adjustable table. I suppose the rounding of my lumbar region makes the vertebrae easier to delineate. After thoroughly cleaning the area, the doctor or physician's assistant will use their hands to feel deeply between my vertebrae, aligning with my waist, etc. A special plastic sheet is stuck to my back, I believe to prevent the various fluids involved from getting on my clothes. After a site is selected, they inject lots of lidocaine, the "pinch and burn" of which is really quite excruciating.

Needle is inserted into spinal column. This part can take several tries as they search for a good extraction place. When these occurred every few days or so during the initial induction phase in the hospital, I would have to get this done under fluoroscopy, to obtain real-time images of the internal structures.
This "hunt and stab" routine is my LEAST favorite part of all my treatments because sometimes the needle hits weird nerves or other places which cause jolts down my legs or shocks up my back. Everything in my body tells me that I should NOT be playing around with this vulnerable space, but what can I do?

After a juicy spot is found, the "plug" needle within the needle is removed to allow fluid to flow outward.

Collecting the precious nectar. Drip, drip, drip.

While they're there, chemotherapy is injected. You know, two birds with one stone.

Finished!

O Canada!

For those of you who have been following Jim and Jesse's incredible journey hiking from Mexico to Canada this summer, they have finally arrived! Here is their final update, including the total money raised for the Dana Farber Cancer Institute and the Cammy Lee Leukemia Foundation.

***

Our final post! (To see pictures associated with this post, please visit our blog: http://www.marrowtrek.org/blog.php.)

Hike Vitals
Miles hiked to date: 3000
Miles to go: 0
Days since hike started: 116
Location: Waterton Lakes, Alberta, Canada
Showers: 14

Fundraising Update
We raised nearly $35,000 from more than 200 people -- it was a moving display of support from our family, friends, and some whom we have never met. Thank you to all for the donations, care packages, and letters of suport we have received during our trek. We are very honored.

NOTE: For those that are supporting our charities through a per-mile pledge, we will be emailing you in the next few days with instructions on how to complete your donation.

Trek Update
We reached the 49th parallel marking the Canadian border on August 13th, 116 days and 3000 miles after leaving Mexico. We couldn't have scripted a better ending to our trip. Our week-long victory lap through Glacier National Park was some of the most majestic scenery either one of us had ever seen.

Our trek through Montana (and Idaho) did not begin with such promise. The first 500 miles of trail strictly (and often ridiculously) adhered to the divide, following jeep roads and ATV tracks as they meandered up and down (and up and down and up and down) the dry, rolling hills (labeled by another hiker as "PUDs", for "pointless ups and downs"). Thick haze from the summer's many fires often obscured views, and the lack of diversion and dimension caused the days to pass slowly.

Then we reached the Anaconda-Pintler wilderness, and we left behind the staid hills for more rugged terrain, rivers and lakes of alpine country. We continued to move quickly, weary of the rapidly growing fires in the north. Our fears proved well founded: By the time we reached our second to last resupply in Lincoln, fires had closed more than 100 miles of the remaining trail.

We settled on a route that preserved our long sought wilderness experience by tiptoeing around more minor fires on the western edges of the Bob Marshall Wildernes. During lunch one day, we sat on a high ridge and watched the dark, billowing smoke of trees bursting into flames a mile away.

Our detour extended into the southwestern corner of Glacier National Park where we left the fires behind (though not the smoke) and entered a glacially carved landscape of dramatic peaks, deep lakes, and beautiful tree-line passes. It was the type of scenery we had dreamed of on the CDT, but which had proven somewhat elusive. We swam in deep pools beneath towering waterfalls, ate trailside thimble berries, and took long lunchtime siestas. Mike Payne, our good friend from San Francisco, joined us for the last 50 miles, providing new perspectives and fodder for our daily trail banter. Jim's mom and her husband met us at trails end with food, comfortable beds and a welcomed ride home.

We are now spending our days working off our hard-won fitness as quickly as we can with a regimented diet of milkshakes, steaks, soft beds, and golf. Jesse will soon wake up to the imminent responsibilities of his September wedding, and Jim will face the challenges of finding a job and a place to live. But right now, it is time for another nap.

recalibrated, illustrated

Artineh's Bachelorette Party at Malibu Wines

I'm on a self-imposed mildly-unsuccessful non-drinking phase.

What a hard worker! (Jamie on her work cell while in Catalina.)

Newlyweds: Anai y Roberto

Anai, Uma, me, Marie, Erik (newly and happily divorced: uma y erik)

The Empire State Building.

Mom, Jaci, Andres y me at Katie's company (Rosenblum's) event.

Uncle Jimmy y me with Palace of Fine Arts & the bay behind.
(This is the actual view from their balcony!)