My Cancer Story

In the fall of 2016, I was diagnosed with Stage 3 rectal cancer. Below are the posts that I wrote through the diagnosis and treatment process.

While I would not wish this journey on anyone, it has been one of the very gifts of my life.

I hope that as you read the different parts of my cancer journey linked below it will be of value to you. If you have a friend who is going through their own health or other personal crisis, please feel free to share it with them in hopes it may help them as well.

1. A Messy Concoction of Uncertainty, Dread and Fear · 2. MRI Required · 3. Os-to-me… Ostomy · 4. The Diagnosis · 5. The Planning Fallacy · 6. What If · 7. A Decision Reached · 8. Getting To Yes · 9. Day 1 Treatment Review · 10. Not A 60% Guy · 11. A Heavy Heart · 12. Man Up · 13. Stage One Is Done · 14. Mid-January Update · 15. Becky’s Update from the Hospital · 16. Becky’s Weekend Update · 17. Home Again · 18. The Biopsy Results · 19. Breathtakingly Beautiful · 20. The Grind · 21. Enough · 22. Surgery, Part Two

1 A Messy Concoction of Uncertainty, Dread and Fear

September 23, 2016

The call came at around 12:50pm last Thursday. Dr Deabes announced himself and my heart started to beat fast.

“How are you feeling” was his first question.

I responded positively.

But that was not the intent of the call. I knew that.

“A couple of things,” he said. “The blood tests were unremarkable.” He went on to explain that nothing showed up in the lab to be concerned about.

“But…” he lingered on that word, almost like that word in a joke just before the punchline, “the biopsy on the mass we found is cancerous.”

It’s a weird moment when that “c” word shows up in your life about you. I tried to stay present with the doctor as he explained it more and what would happen next.

But when he told me that the 5 centimeter mass growing in my rectum found during my colonoscopy the previous day was cancerous, an emotional weight latched on to me that was a messy concoction of uncertainty, dread and fear.

Cutting through this new heaviness, I heard him clearly explain that my situation was the “best, worst news he could deliver” and felt a slight sense of relief. The CT Scan showed that the mass was contained in my rectum and was in a good place for the surgical procedure that would need to be done. The kidney, liver and other blood markers showed this was early detection. He already had me scheduled with the surgeon. This was all part of his “best” description.

I asked him some clarification questions, made sure I wrote it down so I could share it with Becky and then hung up.

I stood silently in my office as I tried to embrace this new reality I now live within. I was aware that everyone has cancer cells in their body. But, this is more than a few random cells. This is serious.

The last few days has allowed this new knowledge to settle in. It’s life. I don’t have a free pass on the ugly stuff life hands out just because I work hard to be healthy.

Granted, I’ve been extraordinarily lucky so far. The intravenous needle put in my arm last week for my colonoscopy was the first one I have ever had in my 51 years. Besides that, I am healthy. And I have the capacity, strength and resolve to do what I need to do.

I face this all with with incredible support. Becky is an amazing partner is so many ways I cannot describe. She is my rock.

I have a great medical team from Scripps who are experts in all of this. My family and intimate friends are delivering positive and prayerful energy as well as offers of every type of practical help. The team at Flourish Press and WebVitality are seasoned professionals who have already stepped up to give me the time and space I need for what I am already experiencing and what lays ahead.

But, other than the meeting with the surgeon this coming Thursday, I don’t know what comes next. The research I did this weekend has me more than freaked out about what this could all mean in terms of surgery, recovery time, complications and next steps.

While I do not know the timing of my treatment as of yet, Becky and I will keep you updated as best we can. I expect and will work towards a full and quick recovery.

Thanks for the support I know you will respond with. I am grateful for your presence in my life.

2 MRI Required

September 29, 2016

Just got home from the meeting with Surgeon.

We learned a lot about the most likely options and paths, but still more testing is required to know what specific stage of cancer it is.

Essentially, that means they need to determine how much, if any, it has spread within the rectum and lymph nodes. This requires an MRI as soon as we can get one scheduled. We hope to have that done in the next week or so. But much of the direction going forward will be determined by the MRI, specifically what treatment plan comes in which order.

The location of the tumor also means a more complex type of surgery then we originally anticipated. And, the big learning today was my specific situation is likely to require a much longer process than we had hoped for. So, there’s lots more things to figure out related to this.

You might be wondering how I feel after today’s meeting.

Initially, I’m impatient. I wanted a more clear path forward today. And, then, frankly a little discouraged. I hoped that the tests done already would have been more conclusive. But, at least I know the potential paths. So, that’s good.

Plus, I’m feeling fine. No pain. Just some discomfort.

We will keep you posted as we learn more. We don’t expect any new information for a few weeks, so in the meantime, “no news is good news.”

3 Os-to-me….. Ostomy

September 30, 2016

Mandy welcomed Becky and I into her small treatment room. We’d been told by the lady who checked us in that she was the “angel” in this department.

Becky sat on the treatment bed. I stood. The air seemed heavy and and the walls felt close.

After some initial hello’s we got right to the goal of the meeting – to learn about an ostomy, should I need one after surgery.

Having done no research on this very likely addition to my surgical recovery process, I went in feeling extremely ignorant about what it all entailed.

I had assumptions. I thought that they surgically created some sort of valve that then supported a collection bag. Turn it on and off as required. But, no such thing.

Depending on the doctors decision in surgery, and the pre-defined spot for the hole determined by Mandy, the small or large intestine is bent, folded and cut open in order to attach it to the hole in my skin. Sewn together actually. The intestine just meets the skin and forms the outlet for all the waste. It’s called a stoma.

Mandy showed us the diagram and picture of what it would look like. Becky sighed and lay back on the treatment bed, and I started controlled dancing anxiously between both feet. I was experiencing that distinct pre-faint feeling. I kept moving and breathed deeply. It looked really weird. A red colored skin attached to the white colored skin.

“So no valve?”

“No” said Mandy. “It’s just the stoma. There are no controls. It just comes out as the intestine pushes it.”

She then went on show us the ostomy bag that gets stuck to the skin surrounding the stoma using cutting edge adhesives. She explained the process of filling the bag and to frequency and method to empty the bag. She explored the options and the possible issues that might come with it.

Becky asked about gas. With a bit of a chuckle, Mandy responded, “Yes, that too. It all comes out.”

“Is there a charcoal filter?” I wondered aloud.

With confidence, Mandy pointed to the tiny charcoal filter on the bag and described how it worked.

“Yes, here it is. So there is no smell”

“Normally, with the way it is now I can control it. If you have to fart, you hold it or excuse yourself. But you’re saying there is not control when gas happens? What do you do?” I asked awkwardly.

“You just muffle it with both arms.” She demonstrated the position and continued. “No one will know.”

We laughed together, but it struck me in that moment how I much want this process to be simple. But it is not. I want the easy surgery without the need for 2/3rds of my rectum to be removed. I want to avoid the ostomy. I don’t want to deal with all this right now. It’s almost surreal. I’m healthy. I feel fine. And, I am likely going to need to wear one anyways.

I’m brought back to focus as Mandy reminds us that thousands of people live their lives with an ostomy bag. And she confirms that the technology has improved over the years.

With no more questions we exit her room. While I believe her colleagues admiration, and respect her knowledge and expertise, I secretly hope I won’t have to meet her again.

But now I am ready, just in case I do.

4 The Diagnosis

October 8, 2016

After a full week of scans, testing and meetings with doctors, the verdict, though still inconclusive, suggests that I have Stage 3 rectal cancer, with possible spread to lymph nodes.

It’s Stage 3 because the cancerous mass is, in fact, through the wall of the rectum. It is not contained as originally indicated in earlier testing. The MRI showed enlarged lymph nodes in the immediate area. As best they can tell, there is no indication of any spread of the cancer to any other parts of my body.

The treatment plan uniformly recommended by my medical team includes 5.5 weeks of chemotherapy and radiation Monday through Friday. The goal is to shrink the tumor and kill the cancer cells, pre-surgery. Then after a period of recovery from the treatment, I’ll need to have laparoscopic surgery to remove the tumor and related lymph nodes for assessment. This process will also remove most of my rectum. If all goes to expectation, that should do what is necessary to eliminate the cancerous activity. Though, if they find any remaining after they test the cells, there might be extended chemotherapy.

The reality of this diagnosis and treatment plan is starting to sink in. I’ve rummaged through the stages of grief with all of this all week and found connections to all of them.

Shock catches me as I’ve sat and waited for a test or appointment with the doctor. There are times when complete and utter disbelief overtake me.

“How and why is this cancer happening to me?” lurks in the background then shows up with regularity.

Then, I catch myself in complete denial.

“It is not happening. It can’t be.”

Anger, fear, uncertainty and numbness. They all absorb me and grab me for a time.

“What did I do to cause this?” holds my attention longer than most.

In late night hours of sleeplessness and the moments when concentration on the task at hand is lost, I’ve catalogued in my mind all the causes of this disease for which I might be personally responsible.

Was it my love of Coca Cola in my twenty-something years? Or the extreme stress I lived under during my thirties? Did my time as a frequent flyer and the road-warrior diet that accompanied it cause this? Or, is it the amount of sitting I have done at my office desk trying to build a business over the last 13 years? The list of self-induced causes seems particularly easy to document. The coffee? The sugar? The Scotch whisky? The cell phone? The multiple computer screens? The list grows if I let it.

It’s easy for me to think that life is the absence of the crappy and difficult things that show up. Thus, the goal is to get rid of them as soon as possible.

I’ve looked at my Athletic Greens powder, Vitamin C, and other supplements and conspired to have them work with me to destroy the cancer before the chemo and radiation begins. “I’ll just double the dosage.” seems appropriate I think.

But then, in the stillness of my morning mediation, or the times when my foundation feels solid from the support I have received from so many, I know the plan. I accept my fate in it and am ready to face that which lies ahead of me.

I have rectal cancer. I will have chemotherapy and radiation. I will have surgery and all that comes with it.

A Zen Proverb reminds me, “The obstacle is the path.”

This newly discovered cancer, its treatment and its effects are life. My life. They are my path.

There is a greater meaning to this. It’s my task to find it. There is a purpose for this new reality in my journey.

So, I will find it, try and learn it, and if I do, I will share it with you.

Becky continues to shoulder this new reality with me. There is no one you would ever want more in your corner than her. She’s single-handedly managing a complex healthcare system, insurance and all the details that come with that. And that’s after all the amazing things she does already to make our lives, our family and business work. I am the luckiest man in the world to be her husband.

Thanks for your support and concern, your prayers, your energy and your love.

I am a blessed man to have you in my life.

5 The Planning Fallacy

October 14, 2016

There is a phenomenon in business and life called a “planning fallacy” in which predictions about a future project or task display an optimism bias and underestimate the time, expense or resources needed to complete it. And, while I am pretty good at spotting the planning fallacy in my role as a business owner or executive coach, the phenomenon showed up in my world this week.

Becky and I have been deluged with a torrent of information from meetings with the team of doctors, and the results of the many tests initiated by my recent cancer diagnosis. It’s compounded by the additional Doctor Google monsoon unleashed by our own research on everything related to rectal cancer, the treatment side effects, chemotherapy drugs, radiation therapy and more. This information overload left me full of data, but in a somewhat delusional state, despite my best efforts to know everything about what would transpire over the course of this cancer eradication project.

Last week Becky and I scheduled a follow-up visit with Dr. W, my surgeon, as a way to make sure we could clarify our concerns and finalize any questions we had before my treatment began.

Earlier this week we were ushered into the treatment room. I was asked to get on the awkward exam table/chair contraption and Becky sat in the regular chair. The nurse took my vitals and declared I was “where I needed to be.” I felt like a little kid sitting there as my legs hung off the table, not long enough to reach the ground.

Becky and I had a plan for this meeting. I had two pages of questions. I would ask the questions, Becky would document the answers. If something didn’t make sense, we both agreed to stop Dr W. and try to make sense of it.

Dr W arrived, closed the door, logged into the computer and then leaned back against the door. It seemed this was not her first inquisition by extremely “prepared” patients. I started with the first question on my list. And the discussion proceeded.

I felt much more present at this meeting than I did the first one. Dr W didn’t seem to be talking so fast. We understood more of the terms she used during this meeting than we did in the first one. Our “deer in the cancer headlights” shock was no longer present, so we were taking it all in as best we could. We were moving into my second page of questions, when it happened – I realized I’d fallen victim to the planning fallacy.

I had employed my own optimism bias around the complexity and implications of my treatment. I’d also under-estimated the timelines associated with it. As Dr W answered our questions and gave additional information to support her answers, it became very clear that I needed to get real and drop the assumptions. I had to get out of my planning fallacy. So, I made sure Becky and I understood as much as we could, not only about our questions, but also any other things I might be missing.

As a result, this is the most likely treatment plan I’m anticipating, along with the explanation, order and expected timing.

Meet Dr X, my Oncologist. This happens next Wednesday. We’ll officially decide on the chemotherapy treatment plan.
Book a time to do the intake for radiation treatment. This means I need to get measured for the radiation treatment. As best I understand it, this is where they line up the “lasers” to zap you with radiation. I then wait approximately a week while the radiation doctors and physicists program the “lasers” for my radiation treatment.
Start the combined chemotherapy and radiation treatments. It’s an oral chemotherapy which means I take all the pills at breakfast and dinner. This happens on the same day I get radiation, which is every weekday for 5 1/2 weeks. Saturday and Sunday are off as a break. The radiation sessions last about 15-20 minutes each day. Thankfully, the radiation center is about 15 minutes from both our home and office. Each week I will also have blood tests and scan to monitor my situation.
At the end of combined treatment period, there is a 6-8 week recovery period. During this time I rebuild my strength to get ready for surgery. At the three week mark in this recovery period, I’ll be scheduled for another scan with the radiologist to help them know the results of their work. If all goes as planned, we should be into the Christmas season by now. One month after I’m done chemo and radiation, Dr W schedules the surgery, which we anticipate will happen in late January or early February.
A day or two before surgery, we go back to meet with Mandy, the ostomy specialist. She figures out where on my body the stoma will be placed for best fit and comfort of the ostomy bag and tattoos my skin so Dr W will know where to connect it.
Then, the surgery. I’ve learned it is a pretty significant operation. Dr W plans on doing it laparoscopically, using the robots if they are available. The surgery includes the removal of most of my rectum, along with the fat and lymph nodes surrounding it. Lymph nodes and other substances removed will be biopsied for any remaining cancer. My colon then is attached to the remaining parts of the rectum and sewn together. The stoma is also added that links the small intestine to my stomach skin in order to add the ostomy bag. This bag will be my companion for anywhere from 3-6 months. There are 5-7 days of hospital recovery from surgery. Â Once I am released from hospital, Dr W suggested that my recovery from surgery will last anywhere from 3 to 5 weeks.
Depending on the biopsy from surgery, there is also the possibility that I will start more chemotherapy in anything is still cancerous. This will most likely be the more intense drip IV or pump version of the treatment. This usually lasts anywhere from 5-6 months.
At the end of this period – either 3 months of recovery or 6 months if the additional chemo is needed – there is still another surgery to go, the removal of the ostomy and stoma. This is also a much bigger surgery than I was expecting. Hospital recovery lasts another 4-6 days. Then more recovery time at home as my digestive track learns to operate again.
Finally, there are ongoing tests, exams, blood work and scans to monitor and watch my ongoing condition. All of this is subject to things going as well as they can. Complications are part of the risk. But, now I know what to expect, as best I possibly can, without the planning fallacy. I hope this helps you as well, if you were in any way stuck in the thinking with me.

There’s something calming about knowing the reality. Yes, it’s not always pleasant, but at least I know what I am up against. And I am ready to get on with it.

Thanks for your unquenchable support.

PS. If you’ve ever watched the movie, The Princess Bride, you might see the connection. As we were chatting with Dr. W, and I had that realization of my planning fallacy, the words of Vizzini came to mind.

“You just fell victim to one of the classic blunders, the most famous of which is ‘Never get involved in a land war in Asia.’ ”

This was just after they had all scaled the Cliffs of Insanity and Vizzini and Westley were engaged in the battle of wits to save the princess. Here is the small replay for your enjoyment.

https://youtu.be/RWW6aDpUvbQ

6 What If

October 18, 2016

Scared of what lies ahead for me, I’m often caught in a cycle of worry, fear and uncertainty. I hate the fact that this cancer has shown up. I’m angry at it and what I need to do to fix it.

As a result, all sorts of “what ifs” pass through my thoughts on a daily basis. They hover like a gnat attracted by some ripening bananas.

What if I don’t do well with the chemo treatment? What if I get some of the side effects of radiation? What if it the surgery goes poorly? What if they find more lymph nodes or cancer during surgery? What if the colostomy bag doesn’t work? What if I need more chemo?

What if… what if… what if…

I try to swat them away, but they return with annoying frequency, buzzing around my brain. They seem attracted to my fear.

But, in those times when I stop, quiet myself and connect to this moment I’m in right now, another thought whispers within me.

Life is not happening to me, it is happening for me.

And, from that perspective, new, more powerful “what ifs” emerge.

What if this diagnosis is for my good?

What if this cancerous growth in me is a gift?

What if this sickness will save me?

What if the lessons that come in this process are part of a bigger, more valuable gift I have to give the world? Is there a greater good being birthed in this rectal cancer reality?

In these new “what if” questions, and the others that appear along with them, a bigger, more courageous part of me emerges.

From them, at least most of the time, I feel confident and ready for what is ahead.

7 A Decision Reached

October 26, 2016

Last Wednesday Dr. X, my new Oncologist, was straight with me in response to my many questions about the side effects of chemotherapy.

“Listen, this treatment will be hard. And, yes, there will be side effects. There will be discomfort and maybe a number of other things will show up as well. You’ll be fatigued and quite likely get diarrhea, nausea and even vomiting. Your skin, especially on your hands and feet will likely get really sore. But it’s only for five and a half weeks. We’re saving your life here. You’ll get through it; I need you to Buck up!”

As tough as it was to hear, it was a trust building statement. Many of the other answers Becky and I got from Dr. X confirmed that she was a great choice. She listened and responded to all our concerns. And I left feeling like I was in good hands.

Earlier in the day, I received a very detailed document from the MD Anderson Cancer Center, who I had contacted about a second opinion. It laid out their complete treatment approach to Stage 3 rectal cancer. Their standard treatment aligned almost exactly with what my doctors were recommending for my specific diagnosis.

With my emerging trust in the recommended treatment process, the medical team that supports me, and all the love, thoughts and prayers made on my behalf, I’ve decided to officially move forward with treatment.

This afternoon I have my “laser” mapping appointment for radiation treatment, which means they’ll figure out precisely where on my body the radiation will target. The chemo drugs are on order at the speciality pharmacy. Chemotherapy and radiation treatment will likely begin in the next week.

Internally, I’ve resisted making a final decision on this treatment because it leads me into my deep fears. Fear of the unknown. Fear of the side effects. Fear of the long term effects. Fear of surgeries. Fear of my own mortality.

“Courage is not the absence of fear, but rather the judgement that something else is far more important that fear.” says James Neil Hollingsworth.

Oh, fear is there all right. In full force. But, it is time to proceed. Something is more important right now.

John Wayne reminds me. “Courage is being scared to death, and saddling up anyways.”

I’m saddling up. Reluctantly courageous.

I’ll keep you posted as my treatment proceeds.

8 Getting To Yes

October 31, 2016

The radiation technician directed me to lie face down, arms above my head, on a almost-hard, molded body holder that positioned me from my head to my upper thighs on the platform of the CT Scanning machine. She then covered me with a warm, blanket-like sheet.

I was here for the set up and staging for my radiation treatments. I felt like I was awkwardly positioned to look like I was about to dive into the circular portal of the CT machine.

After a few minutes of moving me around and adjusting the mold on the platform, she and her colleague called out some numbers to each other. She then moved up my left side, put her head close to my left ear and let me know that “25” was my position number and that I would likely hear that number a lot.

As she moved away, she informed me she was about to lower the sheet covering me and touch my back. While her touch on my bare skin was expected, I still flinched as her finger landed just above my exposed tailbone. She commented that I must be ticklish. I wanted to explain that I wasn’t and why I had the reaction I did, but it seemed pointless. She was already on to something else.

Here’s the thing. As she lowered the sheet, I was expecting a needle.

And I absolutely HATE needles.

Even with all the ones I’ve endured in the last month, I’m still not used to them. When I know they are coming, something inside me revolts. I tense up. I can’t look when they draw blood or add an IV tube to my arm.

But I knew what was coming today in this situation.

A tattoo.

A tattoo was NOT on my to do list. Not today. Not ever. I had no plans to ink myself.

My resistance to a tattoo is not so much the unique marking itself, but due to the fact that it requires a needle as the delivery mechanism for the ink.

Thankfully, at this point in the procedure, she explained that she was only marking me with a pen to get the positioning right. I relaxed a little.

She pulled the sheet back up covering me up and informed me they needed to do a number of scans. After confirming I was still doing okay, she asked me to lay very still for the next few minutes as the scans took place.

As she left the room, the machine roared to life. The platform began to move and I pulled my arms in tight above my head knowing how small the opening was in the machine. I noticed the extreme tension I was holding in my stomach, shoulders and legs.

The body mold seemed to harden around me, especially at my forehead and cheeks. I wondered if I was lined up correctly. I desperately wanted to move and adjust, but I couldn’t. I had to lie still. So I brought my attention back to my breathing and quieted myself.

And in those moments, as I was shuttled in and out of the CT machine, a realization occurred to me. Maybe I need to come at this whole experience in a different way.

Instead of saying “no” to the needles, the tattoos and the treatment in front of me, it might make a lot more sense to take a different approach. My “no’s” caused me to tense up, fight what was happening. I was internally resisting the very treatment I was agreeing to. And, that likely wasn’t going to work very well.

I decided that instead of “no” as my default response, I would start to say “Yes” instead.

“Yes” to the needles and IV’s that were to come. “Yes” to the tattoo. “Yes” to the chemotherapy and the radiation. “Yes” to the blood tests, the scans, the rigid molds and the occasional wait times. “Yes” to this treatment path in front of me and all that I might encounter along the way.

And, in that CT Machine, another more powerful thought emerged. It was time to say “Yes” to this Stage 3 cancer diagnosis. “Yes” to this tumor in my rectum. “Yes” to what was happening to me and in me.

I decided to accept what is. Not because I love it or want it in my life. But because it is my reality.

As the scans completed, the radiation technician once again joined me. This time to give me the official permanent markings that will be used to line me up and position me on the radiation machine for my ongoing treatment.

As she described what she would be doing, in my head and in my body I silently affirmed my new “yes” to what was about to happen. And despite her warnings to the contrary, I barely felt a thing as she tattooed me.

Moments later, I got off the machine with not one, but four new tattoo’s. Four, really cool small dots on my body. One on each side of my hips and two additional dots a few inches apart on my lower back.

They are my “yes” dots.

Wednesday, November 2nd at 11am Pacific time is my first radiation treatment.

After breakfast that morning and after dinner that evening I will swallow the first sets of my chemotherapy treatment.

Yes! I am ready.

Thanks for your continued care and support.

9 Day 1 Treatment Review

November 3, 2016

The prescription bottle of chemotherapy tablets stood beside me through breakfast. I had already removed the first three 500mg tablets and placed them in the overturned prescription bottle cap.

Doctor X. and the pharmacist both stressed the need to take them after food was in my stomach. So I finished breakfast and waited a little bit. After 12 minutes, I tentatively reached for them. But, something caused me to pull back. Almost as if there was a force field blocking me from them.

I looked to Becky for support. But, I knew what I really wanted was the acknowledgement that my, or more accurately, our treatment was about to begin. We’re doing this together.

We knew, without saying it, that we had to mark this moment. We needed to engage a ritual that celebrated the beginning of this treatment process. Maybe that’s why I hadn’t swallowed the tablets yet.

Through breaking tears, aware of our shared uncertainty, but offset with lots of underlying hope, we looked at each other as I raised the three light orange tablets in my right hand.

“Trust the healing power,” Becky affirmed.

I took in her words and struggled for my own.

A simple “yes” emerged in my thoughts and released from my lips. It’s the only thing that came to mind. And behind this yes was a belief that this substance I was about to swallow would do its work in my body.

Eyes still locked, Becky and I fist bumped. Yes! We actually fist bumped.

We are not fist bumpers by nature. I’m not quite sure if we’ve ever fist bumped before. But sitting at our kitchen bar, in our impromptu ritual, that’s what happened between us.

I lifted up my cup, half full of cold Earl Grey tea, threw the three pills in my mouth and washed them down. Treatment was officially started.

11am Wednesday morning was the start time for my initial radiation appointment.

I checked in using my barcode wristband on the scanner at the side of the front desk. When the scan gets recognized, my name loads on the screen and then disappears. That lets them know I am here and loads my treatment data into the system.

I enter the changing suite and choose my private change room. It’s more like a spa than a hospital. In the change room is a single cupboard with two doors. The top door is shelves with gowns and robes. Bottom door is already worn gowns and robes – the dirty pile. I made a mental note not to mix them up.

It takes me a bit to remember the order of dressing. The gown opens to the back and goes on first. The robe opens to the front and goes on over the gown. I strip down and don the radiation wardrobe. I lock my clothes and and other items in the locker outside the change room and proceed to the waiting room.

Filtered water, magazines and a large screen TV are the included amenities along with the 20 or so chairs.

Instinctively, I go to the water dispenser and pour water into a small Dixie cup. I scan the room while I do. There are others waiting there, most wearing my same outfit. But we don’t make eye contact. I look just past them. I find my chair and sit strategically. My back is to the wall opposite the TV and entrance from the change rooms. I am also seated between the only other doors. One to the radiation area and one to the examination rooms.

As I look around to the others seated here, I know we’re all here for radiation which means we’re all at some stage of the cancer treatment journey. But in this brief waiting time before we get called through either door, we sit in silence. I want to talk and ask, but I stop.

I’m the youngest gown and robe wearing person in the room. The others all seem to be veterans. I know I’m the rookie today. Some people don’t even wear the external robe. I catch myself wondering how they walk so confidently into the room with the open back exposed. I’m a little afraid to look and see if anything actually is exposed. I expect they are in a different type of treatment and refrain from pondering any more.

I wonder what these others are thinking. Are they afraid? Are they freaked out? Are they alone in this journey or do they have the incredible type of support I’m blessed to have? I know I’m apprehensive and a lot nervous. Yes, I was shown everything last week, but this is different. This is the real thing. It’s not just the set up. It’s actually happening today.

A few people come and some go. I wait about 10 minutes before the door opens and I am called by Bethany. She wears a long white lab coat and funky glasses. As I walk through the door she shakes my hand and leads me directly into the radiation room. A man joins us who introduces himself as Gerry. As I get to the door, another lady is walking behind me.

“Hi, I’m Kristi and I’m taking up the rear!” she says with a grin. “Oops, that’s awkward.”

I laugh, relieved at my broken tension.

The massive radiation machine is dwarfed by the size of the room I enter. Under and in front of the machine sits a platform with some sheets on it covering the body mold.

Bethany re-scans my barcode, asks my full name and birthdate and then asks me to explain the condition I have that needs this treatment. After she confirms my identity, Gerry asks me to remove my robe and lie on the platform. He helps me get situated in the mold, and then begins to move and adjust the settings. My “Yes” tattoos help them align me to the green lasers lines coming from the walls and celing. Once they have me in my final position, they ask me to lie very still.

Bethany explains that they are going to take a number of X-rays and match them to the CT Scans done in my mapping session. This session will take a lot longer today than through the rest of treatment. She informs me that Doctor L. will take a look at the settings, the alignment and confirm everything is good to go. She checks to ensure I am okay and then leaves the room.

I slow down my breath, lie as still as I can and feel the room around me. I can’t see anything as my head is wedged into the hard body mold. The machine makes a lot of different noises. I wonder if I am moving or if it’s just the machine moving around me. Then I hear beeps and clicks and more sounds coming from both the machine and devices around the room. My senses are fully alert.

Either Bethany or Kristi enters the room again. I’m not sure who, as I can’t see who it is. She tells me she is going to mark my skin with the pattern of the radiation beam. She draws on both hips and my lower back. Then she takes pictures of each drawing on my skin.

I ask if she is a papparazzi. She gives an awkward laugh and says “No, your pictures won’t be on eBay.”

“I bet she hears that a lot. Why did I say that?” I question my dorky statement. At the same time I wonder why I never knew that you could buy celebrity paparrazi photos on eBay.

She finishes her photos and tells me the treatment is about to begin and it’ll be done soon. She informs me the sounds will just go a little longer than I heard earlier.

“Lie still” she reminds me and exits the room again.

I lie still and hear the machine make all sorts of new sounds and it seems to move around me. Then, it’s silent and still for a moment and I wonder if I am being radiated yet. But then, head munched into the sheets covering the hard mold, I hear a sound that reminds me of an old welding machine power supply and I sense more light in the room. I know this is it. I silently whisper, “yes” and try to remember what Becky said in our ritual after breakfast this morning. I cannot remember it.

I try to feel what is happening, but I feel nothing other than the discomfort of my head pressing against the hard mold, and the sense of some intense light in the room around me.

After 30-45 seconds, the sound stops and it feels like things on the machine are moving again. Then the sound comes back a second time. Then more movement and noises, and then a third time.

And then after a few moments of silence I hear someone say, “You’re all done!”

I start to lift myself off the mold and platform, but she tells me to lie still. “You’re way off the ground. Wait until we lower it back to the floor before I help you get off.” I peek and see that I am 4-5 feet in the air. It’s not long before she says it’s okay to get up. I lift myself up, and Bethany helps me to move off the platfom.

My first radiation treatment is complete.

As the afternoon wears on, I hover near nausea. Not quite there, but close. My body feels different and weird. I keep drinking water as directed. I can only imagine that my body is trying to figure out what the heck just hit it today.

My second dose of chemotherapy is consumed after dinner, during the World Series Final. As the Indians tie up the game in the bottom of the 8th, I’m not sure if the weird feeling in the pit of my stomach is related to the emotion of the game or the effects of the chemo. It’s probably a little of both.

Day 1 of treatment is done. Just 27 more to go.

I’ll keep you posted. Thanks for your amazing support.

10 Not A 60% Guy

November 8, 2016

Becky asked Dr. L, the Integrative Medicine cancer specialist, directly, “What are the odds that Tom will get the side effects from his treatment given his age and good health?”

Dr. L didn’t hesitate. “100%” He then paused for a few moments before adding, “We just don’t know which ones will show up and when they will happen.”

I mentally reviewed the list I’d been studying the last few weeks as he continued. Fatigue, nausea, diarrhea, vomiting, hand and foot syndrome, skin rash, numbness or tingling in hands and feet. I tried to recall the rest of the assorted side effects stored in my mind, but they seemed to elude me. In that moment, the list and his proclamation of 100% weighed heavy. No one else had been that direct with us.

During the first three days of treatment my most evident side effect was fatigue. I had no reserves in the tank to do much more than what I needed to do. Sleep, managing my energy expenditures and rest seemed to be the best solution to the empty tank.

But Dr. L had a different prescription.

“Walk. You should have a daily practice of walking for at least 30 minutes. And if you can, do it a second time.”

He supported his directive by explaining that the very best response to fatigue was to do the thing that seemed completely counterintuitive-expend energy. He suggested that despite not knowing why it worked, there’s plenty of evidence to show that walking reduces fatigue, and as an added bonus, it’s shown to support more effective treatment.

I took that one in easily. It went on my daily to-do list. I would certainly walk. In fact, I would walk twice a day if at all possible. And I would do more. I’d do my stretches and also the new kettle bell exercises I’d been working on. I’d fight the fatigue. I thanked him for making it so clear.

And then Dr. L made an even more sobering disclosure. “Expect to only be able to do 60% of what you think you can accomplish each day.”

His statement hit me hard in the gut. I’ve had a lifetime of boundless capacity. I’ve always been able to do more than expected. There’s invariably more fuel in my tank. In fact, it’s been one of the underlying beliefs I’ve held about myself for most of my life.

In school I was never the smartest, most athletic or most talented. But, I was the one who worked the hardest and did more. I hustled and was rewarded as captain of my athletic teams, leader of the band and student council. It’s been my M.O. since then.

As an entrepreneur and business owner, it’s been a trait I’ve considered my secret sauce. I’ve put in the long hours for years. I’ve crammed years into months and saw it as a badge of honor I’m the extra miles guy. I read more. I research more. I prepare more.

And, I’ve proven it again recently. In the last few months, I’ve felt a lot of pride for doing extreme amounts of research on my specific cancer diagnosis, treatment and everything else I could learn related to it. I felt good about myself for doing so much.

But with the statement about my capacity from Dr. L, a new side effect emerged for me a challenge to my identity and sense of myself.

I am not a 60% guy. In Dr. L’s office I inwardly fight the notion. “That won’t be me. I will give this 150%.”

But, over much of this last weekend, as I lay on the couch immobilized by the fatigue, it became evident that my belief about myself might not withstand this new reality. The value I’ve placed on my capacity to do “more” smacks into a wall of tiredness that I cannot climb over. I feel like I’m lucky hitting 50% right now and I’m struggling with what it means about me.

In my couch-time quietness some questions emerge that challenge my fragile ego. Is my value dependent on my ability to do more? More than what? More than who? If I can only live at 60% capacity, am I okay with that? What if I had zero capacity right now? What then?

And underneath these swirling questions, I am struck by the power of the beliefs I have carried about myself for so long. This pressure I have felt to “be more” and “give more” and “do more” has been a constant companion. It’s not lost on me that this 150% approach could have been a contributor to my current health diagnosis. I recognize how these beliefs and actions have served me till now, and that it may be time to update them.

So, I’m going to try the 60% approach. I’m going to walk 18 minutes a day. I’m going to arrive at the office at 8 and leave at 4:30. I’m not going to start or take on any new projects right now.

I’m going to… Dang, there I go again.

11 A Heavy Heart

November 15, 2016

She was crying in the change room next to me at the radiation treatment center. It was not a quiet weeping, but a heavy, infectious sobbing that crawled inside me.

I didn’t see her. I didn’t talk to her. But I imagined what she might be experiencing. Maybe she’d just learned of her diagnosis. Or, maybe the treatment was taking its toll on her. Possibly, she was lamenting the sudden life-altering changes that accompany cancer. I projected other fears and feelings I’ve experienced during these last few months to her situation as I leaned against the wall that divided us.

Standing there, I felt her heaviness. And in it, I felt mine.

Heaviness, not only at my situation, but with hers and those who share radiation treatment with the two of us every day. And as I paused before I exited the change room, I thought of so many others who are also carrying a burdensome load.

Last week an industry colleague I’ve known for many years passed. His advanced Stage 4 liver cancer was discovered just a few months ago. A terrible loss. But along with that, my heart hurts for his love, best friend and soulmate. I feel and sense her deep, overwhelming sadness.

I think of others I’ve talked with and emailed in the last few weeks, each struggling with what life has handed them. I envision the strain they face. And, it’s probable, outside of my awareness, that you too might be fighting a great battle.

As a result, my heart is heavy today.

In these situations my tendency is to switch my attention to things that make me feel better. I’ve got a repertoire of positive, motivational and inspirational messages that I can repeat to myself to quickly cover over the heaviness.

Or, I can get lost in my Facebook feed, my email inbox or other self-soothing distractions like Netflix, my never-ending to-do list or even reading to keep from really feeling these things. I’m adept at fending off the more difficult emotions that might show up in me.

My habitual reactions have served to deflect the pain, sadness or fear I feel. I prefer to avoid this suffering and even the thoughts of it. It just feels better that way.

But in these last few months, I’m discovering something that I never really understood before.

Instead of resisting or deflecting, I’m learning to sit with this terrible, no good, rotten stuff that’s happening, and give it permission to have a voice within me. I’m practicing intimacy with the difficulty and sadness. I’m allowing myself to engage and dialog with the pain and discomfort I feel. I’m holding space for all of it.

And when I do, I’m jarred out of my complacency and the casual beliefs of an untroubled life. I accept my fragility. I adopt the instability and uncertainty of this life.

And in that, somehow there’s no need to fix, solve or reverse this heavy heart.

It’s fine just as it is.

12 Man Up

December 5, 2016

Today I complete the 23rd of 28 days of my radiation and chemotherapy treatment. I’ll be more than 80% through this first part of my treatment program. And while I wish I could tell you things are getting easier, the fact is, they are getting harder. Chemotherapy and radiation are cumulative, so over time, the side-effects grow. I’ve been informed that the next couple of weeks will likely be the hardest of all.

Up until now, I’ve been introduced to just a few side effects. Along with the obvious plumbing issues, fatigue and persistent nausea are my regular visitors most days. I’ve learned to manage the nausea with regular doses of ginger tea and ginger ale as well as an ever present supply of Saltine crackers. As long as there is something in my stomach, I’m pretty stable. And I’m getting a lot of sleep at night to combat the fatigue. As for the plumbing issues, I’m accepting them as my new normal.

An emerging side effect is a painful feeling in the soles of my feet that’s not uncommon with my particular chemotherapy drug. I feel like my feet have been bruised and parched from the inside out. It started early last week, mainly in my heels, so I walked on the front part of my feet. But in the last few days, there’s now a persistent parched feeling, and the pain and tenderness extend throughout the soles of my feet.

As I instinctively react to the various side effects of my treatment, the words “Man Up” ring in my ear.

It was a direct challenge delivered by my Oncologist, Dr. X during our first meeting as we discussed the possible side effects I would experience from chemotherapy. Her point was to give me some perspective. As she and my medical team try to save my life, I need to accept and deal with the tough stuff that will show up.

So, when things get rough, I’m challenged to not to feel sorry for myself or assume the role of a victim. I’m reminded to accept and live with the pain or discomfort of the situation. I acknowledge my sore feet and try to walk without complaint. I say “yes” to my treatment and all that comes with it.

I try my best to “Man Up.”

Earlier this week I started reading the book, Letters To A Young Poet by Rainer Marie Rilke. The following paragraph in the 8th Letter jumped off the page to support and enhance the challenge from Dr. X.

“We have no reason to harbor any mistrust against our world, for it is not against us. If it has terrors, they are our terrors; if it has abysses, these abysses belong to us; if there are dangers, we must try to love them. And if only we arrange our life in accordance with the principle which tells us that we must always trust in the difficult, then what now appears to us as the most alien will become our most intimate and trusted experience.

How could we forget those ancient myths that stand at the beginning of all races, the myths about dragons that at the last moment are transformed into princesses? Perhaps all the dragons in our lives are princesses who are only waiting to see us act, just once, with beauty and courage. Perhaps everything that frightens us is, in its deepest essence, something helpless that wants our love.”

I can easily identify the dragons in front of me. I acknowledge the fear and moments of terror I face about all the unknown that lies ahead. I anticipate the inherent danger that my diagnosis implies. It’s easy to find my mind stuck and rehearsing the different abysses I could fall into.

Rilke’s words urge me to trust this situation I’m in and its presence in my life. And with the scary things that I encounter along the way, to act with courage and beauty. I am reminded to accept and love the parts of me that feel frightened and helpless.

It’s almost like he suggests I “Man Up” as well. But it’s more than the macho bravado the term seems to imply.

It’s more elegant, mature and soulful.

As a result I am compelled to ask, “What does courage look like for me in the face of this diagnosis and treatment? What does it mean for me to act with beauty toward all this? How do I love the frightened, helpless parts that live within me?”

The answers are not obvious to me. These questions lead to even more questions.

But in the process, it’s my hope that in my desire to live the questions, some princesses will show up along the way.

13 Stage One Is Done

December 19, 2016

Last Friday officially marked the end of the first phase of my treatment plan. It ended with a blood test. The previous Monday I graduated from radiation and completed my final morning and evening oral chemotherapy treatment. The most difficult side effects are almost gone, while others continue to persist in lessening ways.

For the next six to eight weeks my goal is to get back to physical strength and health in order to be ready for stage two of my treatment plan: surgery.

Early in January I’ll enter the MRI tube to get an updated three-dimensional picture of the tumor. We’ll learn how effective the radiation and chemo treatments were in shrinking it to prepare for surgery.

While it may sound strange to hear, learning of my diagnosis and the resulting experience I’ve had during the last six weeks of treatment have provided me with some of the most profound and meaningful gifts of my life. The lessons and insights have been life altering in a way I could never have imagined.

And, while I would not wish this fate on you or anyone else, and as much as I’d rather not be faced with it at this point in my journey, I am most grateful for its presence and the related effects on me.

As I have pondered my experiences over the past few months, I’d like to share some of them with you. Rather than all at once, I’ll deliver them over next few days and weeks.

Here’s the first.

I thought I was invincible.

I’d never experienced any health related issues in my life besides a sprained ankle from high school football, some stitches above my eye while playing football in college and a bout of pneumonia in my thirties. I’ve had my share of dental visits, but that’s been the extent of it.

Along with that, I had a quiet belief that my eating habits, my lineage of long-lifers, my positive energy and life contribution granted me a free pass on the possibility of a major disease, at least this early in my life.

I was arrogant about my health.

And while I might have admitted that contracting a more significant disease or life threatening illness was a possibility, I lived as if it wasn’t.

A diagnosis of Stage 3 rectal cancer in late September crumbled my belief immediately.

Overnight I knew my fragility. I was not invincible. No longer could I assume I’d live to see 100. This tumor growing in my body could be the death of me.

Face to face with my fear of pain, the uncomfortable medical situations, and the sometimes-humiliating exams and needles, I had to accept my new reality. I was not exempt from disease or the difficult treatment and side effects that accompany it.

No longer the one on the outside looking in, or hearing about it from others, I’m an insider now. The myriad of scary things I’ve proudly avoided for over 50 years are now mine to bear.

But this arrogance extended beyond myself. It showed up in my inward impatience toward those who might be limping, walking too slowly or complaining about their health. I often struggled to make eye contact or personal connection with someone obviously suffering or infirmed in some way.

I realize now their situation touched my deep fear. If I couldn’t face the possibility of disease or physical suffering in me, I could hardly accept it in others.

Sure, I could listen to those who shared their health situation and try to sympathize with them. But, I never really understood it. I could not get into their moccasins. It was easier to run from it or avoid it.

Thankfully, these last few months have demanded a new perspective in me.

So many people live with pain and persistent physical hardship every day. And this takes it’s toll mentally and emotionally. There are those who show up every day fighting monumental battles I will never know.

I’ve met individuals in the last few months who are grizzled veterans of deep and prolonged suffering. It’s never easy for them. From the first step out of bed every morning to their last breath before falling to sleep, and often throughout the night, it’s a struggle.

I know because in my small way, I caught a glimpse into what they experience on a regular basis.

These people are my heroes. They are beautiful and real.

I’m reminded of the wonderful line from The Velveteen Rabbit book where Rabbit is talking to the Skin Horse about life in the nursery and what it means to be “real.”

“Generally, by the time you are Real, most of your hair has been loved off, and your eyes drop out and you get loose in the joints and very shabby. But these things don’t matter at all, because once you are Real you can’t be ugly, except to people who don’t understand.”

A gift of my diagnosis, treatment and the related side effects is I’ve learned to accept this difficult, crappy situation I’m now in.

I’ve finally conceded that I’m loose in the joints and quite shabby. I’ve still got my hair, but I might not if I need more chemotherapy. And while my eyes have not dropped out, my rectum soon will.

And, I’ve learned that in this, I’m not ugly.

Unless I fail to understand.

14 Mid-January Update

January 23, 2017

“You suck at updating your blog!” my friend Alan reminded me by text recently. Humbly, I agreed. I haven’t posted any updates here over the last month or so.

The fact is, I haven’t had much in the way of new information to report since my last post on December 19. And, with the holidays wedged into the middle of it all, I didn’t take the time to create a new post.

So, for Alan and for you… here’s an update in an attempt to suck less.

Surprisingly, even to me, I feel good. Really good. The only remaining side-effects from my radiation and chemotherapy treatments are that my finger tips are still a bit numb. The last blood test showed my cancer markers are way down, and that my white blood cells are returning to healthy levels. My medical team is very happy with my results so far.

So, given how good I feel, it seems counterintuitive that I need to proceed with surgery, which is the next step of my treatment. But, proceed I must.

After meeting with my surgeon last week, I am officially scheduled for surgery on Wednesday, February the 15th at 9am.

The goal of surgery is to remove the tumor from my rectum and the related lymph nodes that may be cancerous. The tissue will then be tested and will help determine the next steps of treatment, including the type of post-operative chemotherapy my oncologist will recommend, if any.

This is major surgery, so I’m expecting to be in the hospital for 4-6 days, if all goes well. Then home to recover for a period of time after that. I’ll have to learn to use the ostomy bag and get used to my new normal.

I can’t promise to update you of my progress in the early part of my hospital stay, but Becky will send an update after surgery to let you know how I am doing.

Thank you again for your part in the steady stream of support, prayers, thoughts and care I receive regularly. I feel ready for this next stage of the process.

15 Becky’s Update from the Hospital

February 16, 2017

Tom was in surgery yesterday for just over 5 hours at Scripps Green Hospital in La Jolla, CA. His surgeon said the surgery went according to plan; they removed what was left of the tumor and most of his rectum, two lymph nodes and performed an ileostomy. We’ll have the results of whether or not the lymph nodes were cancerous in a week or so.

Tom’s doing really well this morning. The nurses got him up and walking last night, and he was able to sleep for a few hours. Today he starts on clear liquids and is encouraged to walk as much as possible. The doctors are really pleased with his progress. I am thrilled!

Thanks for your continued support. We can feel it!

16 Becky’s Weekend Update on Tom

February 19, 2017

Tom had a rough day on Saturday. The pain in his abdomen was really intense; not so much from the incisions, but as a result of his digestive system trying to work again. Doctor’s orders were to try to eat tiny amounts of really soft foods so his system could get used to processing things again. But that’s a lot easier said than done. He didn’t feel like eating, and when he did he had significant pain.

He’s doing much better today. He’s managing the soft foods better and if he continues to progress, he’ll move to soft solid foods tomorrow. He’s getting in at least 6 walks around the floor every day now too.

He’s been here long enough that the cycle of hospital workers’ which seems to be about 3 days long has changed back to the original group again. The hospital staff (food service, housekeeping, etc.) see him walking and then smile and wave enthusiastically from across the floor. They seem happy to see him again.

If everything continues to go well, he will be released from here on Tuesday. A lot of things must continue to go right, however, in order for that to happen. We’re confident it will happen though. As wonderful as the folks are around here, it will be nice to bust out of this joint.

Thanks for your ongoing support. It makes a huge difference to both of us.

17 Home Again

February 22, 2017

Just around dinner time last night, Dr. W dropped into my hospital room asked if I felt like going home. Enthusiastically, I responded “Yes!”

Becky and I looked at each other and smiled in relief. We were free to go home.

I had resigned myself to stay for the night again, as the nurses had informed me that my doctor was really cautious, and I should not expect to go home.

But Dr. W confirmed that the results from the massive intravenous fluid hit earlier in the morning had worked and my numbers looked really good. Plus, my condition was strong enough for her to release me and she wrote up the paperwork.

Less than an hour later, after changing into street clothes and packing my gear, Nicki, my day nurse, stopped into my room to remove my IV tube, have me sign the paperwork and escort me to meet Becky and the car at the front of the hospital to drive home. In solidarity with one of my heroes, I chose to walk out the front door and refuse the wheelchair.

Emotionally and physically exhausted, now alone in the car, Becky and I cried as we exited the parking lot of Scripps Green Hospital. This last week has been one of the most profound of our lives. It’s still all very raw right now.

It will take time for us to metabolize the experience in a way that makes sense to share. And, I promise, I will.

For now, this update is to let you know I am now home, resting and recuperating.

I’m walking 1,200 steps through our neighborhood as many times as I can today and then resting again. Sweet, quiet rest. No interruptions every 20 minutes as has been the case this last week. With the frenetic activity of hospital living gone, I’m aware of how tired I am because of how little sleep I’ve had.

You may wonder about Becky. She too is resting. As much as I went through the actual surgery, she’s been by my side and through every other aspect of this process, solid as a rock. But, she’s also been managing our lives, being a Mom, business owner, as well as communicating with family, friends, you and many others at the same time. I am, without question, the luckiest man in the world to call her my wife.

I also want to specifically thank you today. Thanks for your thoughts, good wishes, prayers and support. Thanks for the messages sent through Becky or Janelle to me throughout the week. I was read every one of them.

You must know I have felt your presence. In every moment where I was feeling scared or uncertain, I reminded myself of the gift of your care. I am humbled and grateful.

As has been the case throughout this last week of my hospitalization, I will remain disconnected from the internet, email, cell phone, FaceBook and other communication media. My most important goal for the rest of this week and into next is to rebuild my strength, take infant steps with my new plumbing situation and adapt to this new normal. As my capacity increases, I will attempt to catch up on a more frequent basis.

A special thanks to our elite team at Flourish Press and WebVitality who have risen to this occasion and have gifted Becky and I with the ability to be focused on this period of surgery and recovery.

Again, thank you. I am truly blessed.

18 The Biopsy Results

February 28, 2017

Last Friday evening, just before dinner, my cell phone rang indicating a call from the Scripps Health system. I answered with anticipation.

Dr. W, my surgeon greeted me and let me know she’d just recieved the pathology report from the biopsy of my tumor, lymph nodes and surrounding tissue.

“First thing” she said, “is all of the lymph nodes we tested were negative. That’s a good thing. We found no cancer in any of them.”

“None?” I queried to confirm, trying to make sure I didn’t miss anything.

“That’s right. We looked at all of them. Additionally, the margins are clear,” she replied.

(FYI – Clear margins means there were no cancer cells found along the actual edge of the tissue that was cut out during surgery. If the margin was not clear, that would indicate there were still possible cancer cells in the remaining tissue inside me.)

“There was a small area of active cancer cells found within the tumor, but that all came out in surgery,” she continued. “Which means, you are T-3, N-0, or effectively, a Stage 2 diagnosis, which is less advanced than the Stage 3 diagnosis we’ve been presuming until now.”

I exhaled and started to take in what she just told me. A sense of relief flooded through me. I realized just how much not knowing the result of the biopsy over the last week was affecting me emotionally, in the same way the incisions had been affecting me physically.

“Your long term survival rate is very good based on this result,” Dr. W confirmed before completing the call.

I hung up and immediately shared the news with Becky. Then the tears came for both of us. For me they welled up from a combination of relief, gratitude and released anxiety. The weight of “what if” no longer hung on me. Given the news from Dr. W, it meant the surgery accomplished what it was supposed to, and clarified the other uncertainties.

The next stages of treatment are not yet confirmed. Given that there were still some active cells in the tumor, I’m betting Dr. X, my oncologist will still recommend a round of “mop up” chemo treatment. I’ll see her again in two weeks to formally decide on the plan.

As for my current state, my surgery area is tender and I’m still really tired most days. Every one who has been through major surgery has reminded me that it takes more time than expected to recover. So, I’m going easy on myself and resting a lot. I’m eating a low fiber diet to ease my digestive tract back into full function. And, I’m slowly settling into the next 4-6 months of life with an ileostomy and all the little daily changes that accompany this new plumbing system.

Today I share my joy with you. I’m buoyed by hope. I am grateful to Dr. W, my rock star surgeon and her team. Thanks to the nurses, specialists and staff who served me in the hospital and those who continue to serve me here at home. It takes a village to get through a process like this.

This gift of a cancer diagnosis, treatment, surgery and all that accompanies it continues to provide rich meaning and insight for me. Though I would not wish it on anyone, it has served me and continues to be of extraordinary value in my life.

So while I may not provide many updates related to my physical condition in the near future, I will attempt to draft some different posts to share some of my learning with you in the weeks and months to come.

Thank you again for your incredible support and your interest in my situation. I hope in some small way, the experiences I’ve had and shared with you will be helpful to you or to others you know.

19 Breathtakingly Beautiful

March 16, 2017

It’s been a month since surgery. And I’m happy to report that my recovery is going really well. Over the last week or so, I can tell a significant increase in my energy levels and decreased fatigue. I’m back to work with all my executive coaching clients and active in my role as CEO with WebVitality.

Two walks a day has been an important part of my recovery and strengthening regimen. My iPhone tells me I’m averaging over 6,000 steps a day, the equivalent of three miles.

In my follow-up appointment last Friday with my surgeon, Dr. W, she confirmed after checking me over that I was healing as expected. My next meeting with her will be to prepare for my next surgery which is to remove my ostomy, six to seven months from now.

Earlier this week I met with Dr. X, my oncologist, and got my plan for the next five months. Starting March 27, I begin six, three-week cycles of chemotherapy.

Day one of each three week cycle will include a half day of Oxaliplatin chemotherapy delivered intravenously. The same day, I will also start 14 consecutive days of oral Xeloda chemotherapy, the same regimin I was on before surgery. At the end of each two week cycle, I’ll get a one week break before I go back again for the next cycle.

While this treatment is a whole layer more intense than I expected, it was recommended by a panel of other oncologists, along with Dr. X as the most prudent approach, given my situation. They strongly recommended this treatment as there were still active cancer cells in the tumor that was removed from my rectum. The goal is to stop any remaining cancer cell activity that may have been dispersed in my body as a result of surgery.

I expect that the next few months will be tough, as I experienced side-effects during my initial chemotherapy treatment before surgery. But I feel very confident in the direction we are headed. I’m working with a naturopathic doctor with a cancer speciality to support my food and supplement choices during this next stage. I am grateful to have a really good medical team in my corner.

Frankly, the hardest part of the process so far has been the ileostomy. Along with the weirdness of pooping out of my abdomen into a bag hanging off me all day long and getting used to the 8-10 bathroom emptying procedures per day, changing the entire ostomy collection system every three days has been the most trying.

The ostomy nurses make the pouch change quickly with skill and precision. But on my own, it has been a real challenge. Some days I feel like I’ll figure it out and be okay. Other days, it’s a nightmare.

The process includes removing the three-day old sticky, bandaid like adhesive patch that holds the pouch to the skin, cleaning the stoma (the actual small intestine that sticks out from my belly), cleaning and removing the glue that held the old pouch in place, shaving the area for better adhesion, measuring the ever-changing size of the stoma by mirror for the new device and gasket, cutting the device opening to go over the stoma, flexing and adjusting the protective gasket to fit the device, preparing the skin around the stoma with a protective product, drying it, making sure everything else is dry, then finalizing the process by sticking it all down on the skin and holding it for three to five minutes to ensure the adhesion works.

And, while in theory, that should not take long once I know the process, the fact is, I cannot control what is happening with my small intestine and don’t even know or feel when it is about be active. So, I’m racing against intestine time. If my intestine is active, I have a mess on my hands. And depending on what stage of the change process I am at when that happens, I might have to go back and repeat one or more of the previous steps.

Last week, the typical 15 minute change actually took over 80 minutes. By minute 40, I was so discouraged by the process I was in tears. Tears didn’t help though, because I couldn’t see what I was doing as a result. So I had to ask Becky for help. And, with my deteriorating emotional state, I even got angry at her too. It was not my finest moment. But with her help we finally got the pouch on and adhered.

It’s was a pretty surreal experience to say the least.

Imagine standing naked in your bathroom, trying to get a new, unlearned process to happen quickly and without incident. Then, having liquid poop either dribble or squirt out of you at the most inopportune and unexpected times on the bathroom counter and floor, somehow fully missing the strategically-placed paper towels and other towels meant to accomodate this possibility – all happening in front of your significant other. It’s exactly what I experienced.

I felt helpless, humbled and exposed in those minutes that felt like hours. Unable to accomplish the task easily, I couldn’t shake the emotional intensity and tears that showed up in me.

And in that moment, Becky stepped in and helped. No judgement or retribution even with my emotional response to her. Just pure love, unconditional support and action.

I felt a new and different kind of intimacy with Becky that’s hard to describe here. In that raw, messy, humiliating situation for me, without blinking or hesitating, she jumped in to get the tasks of my ostomy pouch change complete. I experienced a deep, enhanced connection coming in the crap.

It took my breath away.

A precious and beautiful gift emerged from this messy, unpredictable 80 minutes of my life. It’s one of many I have experienced so far in this journey I’ve been on.

Melody Beattie, in her book Journey To The Heart writes,

“When we’re lost, when the way gets dark, sometimes we see things we never would have seen in the daylight. Sometimes the lessons we learn in darkness are breathtakingly beautiful.”

Then she adds this simple poem.

“Enjoy the sunshine, but trust the darkness, too. It is more than to be endured. It is to be experienced, and later cherished.”

I will forever cherish those messy, dark moments I experienced in the bathroom last week with Becky that would have never have happened in everyday life.

It was breathtakingly beautiful.

I do not know what you may be experiencing today. If you feel lost or face some kind of darkness, I’d encourage you to stay present to it as you may discover something of beauty hidden there.

Much love to you today.

I am grateful every day for the gift of your support, encouragement, interest, thoughts and prayers.

20 The Grind

May 22, 2017

It’s been over two months since I shared my last update with you. That post was written a month after surgery and a week or so before I began my “mop-up” chemotherapy treatment. Since then, I’ve had moments where I had some idea about what I might share with you beyond a simple update, but often the decision to sit down and type got sideswiped by my lack of energy to do so.

Often, I’m not really sure what to say as I’m still trying to metabolize and make sense of this experience. But, today as I begin a week without chemo, I have some energy to write.

Someone said. “It’s the grind that gets em.” I believe it.

As I’ve met and talked with others who have experienced their own ongoing chemotherapy treatments, they have confirmed that the grind takes its toll.

Eight full weeks into my 18 week chemotherapy mop up treatment, I’m now officially tired of it. Weary of the daily feeling of bordering on nausea. Frustrated, not just with the pervading exhaustion I feel, but also with the complete lack of any reserves in my energy tank to fuel attempts to accomplish more than the day-to-day requirements. Add to that, the numb fingertips, the perpetual dryness I feel on my skin and lips, and the inability for my body to heal itself, even with a simple cut. This process is taking its toll on my body, my emotions and my mind.

The first day of the first week of each three-week treatment cycle includes an IV infusion of Oxalyplatin. In me, this particular drug creates the immediate side effect of neuropathy, which includes intense and painful tingling in my arm where the IV needle was placed. Then, over the next week or so, the intense tingling in my arm fades.

But the painful rush of tingling immediately returns when I touch anything cold at the spot on my skin where I touch it. The feeling I get in that moment can best be described as pins and needles, but amplified by 100. You might have experienced a pins and needles feeling in an arm or leg when you place a lot of pressure on it. When the pressure is released, the blood flow starts again and you experience a feeling of prickling, tingling or similar, often referred to as pins and needles.

Even though I know this reaction to cold will come, I am a slow learner. After grabbing a couple of eggs out of the fridge with my bare hands, the intense pins and needles feeling immediately invades every single skin surface where I held the eggs. But with eggs, you can’t just drop them. And the longer I hold something cold, the longer it takes to subside. Then the feeling returns again when I hold my hands under cold tap water to wash them.

A few days after my previous IV treatment, I emailed Dr. X, my oncologist, and complained of the pain, the nausea, the neuropathy, the issues with concentration and more. I was at the end of my rope. She responded and encouraged me to wait it out for another day or so.

And while the intensity of it did fade over the next few days, the effects remain as chemotherapy is cumulative. Even during the third week of each cycle where I get a week off from all chemo drugs, the nausea, weariness and neuropathy linger.

Despite all my positive intention, the belief I have in the value of this treatment, and my knowledge that this process has profound learning and insight attached to it in my life, I find myself wanting it all to go away.

I’m learning that I can’t horribilize this experience and intensify it in my mind by imagining how bad it might be next week or over the next 10 weeks as I finish my treatment. Even though I’ve been tempted on many occasions to give up this treatment because of how hard it will become in the weeks ahead, I have decided I can’t allow myself to go there.

Instead, I need to focus my attention on this moment, this hour, this day.

When the nausea is most intense, my goal is pretty simple. Just get through the next hour.
When the fatigue is overwhelming, I set my sights on the immediate rest I need to take or the goal of sleep tonight.
When my concentration is shot, I sit back in my chair and allow myself to just “be” for a while.
When the wave of complex emotions hit me, I give space for the tears. I make room for the discouragement.
When I forget the reaction I have to cold and mistakenly drink the glass of ice water, I sit and wait while the pain comes and then goes from my tongue and mouth.

Life, and living for me is all very immediate right now. It is lived in the moment.

I am incredibly thankful to all of the people who have walked this difficult journey and who’ve taken the time to share their story and struggles with me. There is no sugar coating or feel good platitudes from them. They give me their raw, honest, uncensored reality, and that has helped me to know I’m not alone in this process. They’ve reminded me to keep moving through this process “one day at a time” despite how hard it gets.

And through all this, I am grateful for your overwhelming support, love, encouragement and prayers on my behalf. It’s an energizing force that gets me through the struggle. Thank you.

21 Enough

August 8, 2017

Two Sundays ago, I officially completed my final round of chemo. In some ways it’s hard to believe the treatment is done, while at the same time, it feels like it’s been the longest 18 weeks of my life. Fact is, as described in my last post, I’d had enough of the grind.

When I swallowed my last Xeloda tablet, an immediate sense of energy returned. Not a physical boost, but an emotional charge. The side effects linger on. Most noticeable is the numbness in my fingertips and all of my toes. My energy reserves are still low and the effects of chemo on my brain seem strong. I find I am forgetful in inopportune moments.

Yesterday, I exited the office of my Oncologist, Dr. X., with a bounce in my step as the results she delivered felt in alignment with how my body has been feeling this last week or so. My white blood cells are back to just below the very low end of normal. My red blood cells and hemoglobin are in normal range. The two major cancer markers in the blood we’ve been monitoring are well within acceptable levels. My CT scan was clear and has shown no indication of any remaining or new cancer.

This is great news.

Dr X. advised me that it will take 4-6 months before I feel back to any sense of normal. The effect of the drugs in my system will take a long time to wear off.

But, now that the chemotherapy is done, I can work on rebuilding my body to health, especially in light of an expected surgery in early September to reverse my ostomy. I am booked to meet my surgeon, Dr W. on the 22nd to determine and plan the next steps.

In previous posts I’ve alluded to the deeper meaning that this diagnosis and treatment has birthed in me. As time has progressed, these insights have grown stronger, although they are still evolving. As I talk to others, and even in what I write here, it becomes more clear.

Life is fragile and uncertain.

Despite all attempts to the contrary, this process has reminded me that I am not in control of the situations life or fate delivers to my doorstep. My belief that my health practices, vitamins, meditation, positive thinking and the like could somehow protect me from life’s unavoidable suffering, proved to be more fantasy than reality. This in itself has been a humbling revelation for me.

I’ve worked hard in my life to be healthy, physically, emotionally and spiritually. It’s clear that these practices have supported me in this journey and my treatment thus far. And I will continue to employ them going forward. The big realization has been that my intention and practice were not enough to keep cancer from happening to me or in me.

Thus, it’s no longer an intellectual exercise to contemplate my mortality. Even with the good news from Dr X. this week, I’ve come face to face with the certainty of my impending death. When it may happen, I, of course, don’t know. And, to be clear, it’s not a morbid preoccupation for me. It is a reality-altering awareness that now permeates my perspective and thinking. This fragile fate brings clarity on what really matters. It’s allowed me to begin to distinguish what is important and what is not. Most profoundly, I’ve learned this.

I am enough. Just as I am.

I’ve spent a lot of my life struggling to ensure that I am worthy and acceptable. I’ve worked hard to ensure that others see me as smart, intelligent, witty and wise. I’ve labored to create a persona of success and accomplishment. I’ve built businesses. I’ve been a professional speaker and consultant. I’ve produced and hosted TV shows. I wrote a book. I’ve studied and read and learned, almost fanatically, to gain the knowledge I felt like I needed to succeed. And, this pursuit translated into some cool accomplishments along the way.

But behind my public presence â€“ when it’s just me in the mirror or alone with myself in the darkness â€“ the effort and struggle has not translated to self approval. I’ve been more prone to witness and pay attention to my failures and screw ups. I can recite much more succinctly the litany of bad decisions and stupid actions I’ve taken over the years. It’s been easy to see in my life where I didn’t measure up. I’ve built lots of muscle at comparing my “success” to others and coming up lacking.

But when the rug got pulled out from under me with my cancer diagnosis, and my life felt like it was on the line, the need for external approval seemed to lose its power on me. I had to be okay with me, as I was. No one else had a vote on this one.

In my darkest moments within the fragility and vulnerability, I chose to accept that I am worthy… I am of value. Nothing more is required of me than what already is, and who I am at this moment in time.

The person I see in my mirror every day is already enough. Just as I am. Valuable, not because of my accomplishments or success, a lack of failure, or approval of others â€“ but just because I am.

Because I am here.

I accept that I am both my extraordinary muck-ups and my moments of grace. I am the result of this crazy and wonderful journey I’ve been on.

I am light and dark.

Flawed and flourishing.

Yin and yang.

Perfectly imperfect.

Enough.

And, if I’m enough, and accept this in myself, I can give up the struggle to somehow convince you of this fact. The pressure is off. The striving is gone. I can just be, as I am today.

A 52 year old man sans rectum, uncertain about the ongoing presence of cancer in my body. Tired from the battle of this last year and the side effects of chemo that don’t seem to go away. Frustrated by this ostomy that is adept at humbling me daily and a little desperate to get rid of it once and for all. More likely to go for comfort food than health food. Often impatient. Prone to lazy. Confused about my next professional moves.

But at the same time more alive than ever before. Grateful to be here today. Relishing every moment with my beloved Becky as we live in these moments and plan the next stages of our “empty-nest” life together, including building a new home in Lewiston, New York, in order to be closer to our family. I’m having profound conversations with clients and others along the way. I’m spending time with those I love and cherish. Reading books that challenge and inspire me. I’m hanging out with dolphins and whales and pelicans on the ocean most weeks and capturing them with my camera. I’m walking and seeing things I never saw before. I’m okay with the silence and not knowing.

The more positive experiences live with the struggles. They both belong.

As I settle into this enoughness, I can share my journey with you and others along the way. There are times and places I know I’m lost and need help from you. There are other times, where I have a feel for this section of the road we’re traveling, and I’m ready to help you.

In all this, if I can offer you one thought from this place where I am, it’s this.

You, too, are enough.

However hard you are trying to prove to yourself, to someone else or even to an unnamed or unknown expectation that seems to demand something of you, I want to remind you to let it go. If I can be one voice reminding you that in the muckiness of what is your life, the screw ups, the failures, the lack of success, it doesn’t matter.

You are enough. Just where you are.

You might be struggling with debt, or an addiction of some kind. You might have some pretty nasty things you’ve done that only you know about. You’re afraid to let it out for fear of what it might mean and say about you. You might hate parts of yourself that seem unacceptable.

But if today was your last day, I’d want you to know and live and experience this last day from a place of enoughness… of being okay, just as you are. Because if I know one thing, it’s this.

You are!

Enough.

Much love to you today!

22 Surgery, Part Two

August 29, 2017

At the meeting with my surgeon last week, Dr. W gave me a full exam, checked my CT Scans and looked at my labs. She confirmed everything she saw was supportive of my ostomy reversal surgery.

If you’ve read any of my previous posts, you’ll know the ostomy part of my treatment has been one of the hardest parts for me. So this surgery has been greatly anticipated.

I assumed that because it had taken over three weeks to even see Dr. W for my pre-surgery appointment, and because she only performs surgeries every second Wednesday, my surgery date would be late in September. But, I completely lucked out and got on her schedule for tomorrow.

Last Friday, I had an ink enema test to ensure the original surgery connection was sealed. And it was. Yesterday I did my pre-op labs and paperwork.

Today I’m on a clear liquid diet, and a full fast until surgery tomorrow.

While it’s a relatively simple surgery, I will be in the hospital between three and five days as the medical team needs to closely watch my digestive system, especially my colon, restart after almost seven months of dormancy. Once out of the hospital, my recovery time should be relatively speedy.

Thanks in advance for all your support, love, prayers, healing energy and best wishes. They are deeply meaningful to me.

I’ll catch up again once I get home and recovered.

The Rest of The Story

After that last post, there is a void in any further information. The fact is, once I could get back to regular life, I jumped back in to work, but also completed a massive move to our new home in Western New York. But, I want to let you know that I had a great ostomy reversal surgery, and subsequently, my ongoing tests have been good with strong, positive indicators. I completed five full years of quarterly testing and reviews at Roswell Park Cancer Hospital in Buffalo.

In the fall of 2022, I was officially discharged from the cancer follow-up program due to five years of clean scans, blood tests and colonoscopies. They informed me that I was to watch for symptoms, stay healthy and do my colonoscopies.

One of the most interesting and important steps in the process was the opportunity that Becky and I had to work with the UltraWellness Center in Lenox, Massachusetts. This is the clinic that was founded by Dr. Mark Hyman. In the work we did at the clinic, one of my focus areas was to build, as best as I could, a body that was designed or built to resist cancer. The concept was to make my body inhospitable to cancer—not that it couldn’t come, or that it isn’t currently there, but that if cancer cells were in my body, they would decide that this just really wasn’t a great place to fight, so they would just disappear and go away.

I’m also grateful for many of the more emotional and psychological lessons that I received after this dramatic cancer journey. Specifically, the concept of somatic intelligence and how our bodies are our brains, holding and continuing to hold trauma and unresolved emotions.

Through somatic training and some equine therapy work with Nancy Proulx and her horses, I was able to learn a lot about how my body held things in ways that do not support health and wellness on an ongoing basis.

In conclusion, I would never wish this journey on anyone, but I wouldn’t trade it for the world.

This has been, for me, a profound experience. I hope in reading it, it has served you in some small way too.