Marshall's Cancer Updates

------------------------------------ Physical Exam (08/30/2024) Constitutional:  General: He is not in acute distress. Appearance: Normal appearance. He is not ill-appearing.  ---------------------------------- Let us get down to brass tacks. The origin of that phrase is unclear, but most likely can be traced back to the turn-of-the-19th-Century in the American South. Some argue that it was coined by British military during World War I. But usage in a local Texas newspaper article in 1904 dispels that idea. Others claim it alludes to tacks hammered into a sales counter to signify the trueness of the cut of fabric, or maybe even the brass tacks associated with fine furniture to mean finishing touch.  In a tangentially related article on lexicography, Anatoly Liberman uses the idiom "copasetic" as an example of idioms of unknown origin: "the earliest citation of copasetic in the Oxford English Dictionary goes back to 1919, and it first appeared in a dictionary in 193...

Health Update #34: Unbroken Circle There's been a lot going on since I came back from Louisiana in late June besides just the insurance snafu and moving treatment back to Michigan from Chicago.  Mom passed peacefully on July 18 with dad at her side in comfort care on the back porch looking out over her blossoming hydrangeas. One couldn't ask for a more fitting transition. Unfortunately, I was in no shape to travel for the funeral the next weekend, but I was able to watch it streaming on Youtube. It was a beautiful ceremony and well tailored to her life experiences and beliefs. She would have felt honored by the testimonies as a good Christian wife and mother who epitomized loving one's neighbors, as well as taking care of strangers. She gravitated toward simple folks and simple living and minding one's own business. She took a "Bless their hearts" kind of approach toward others, except that she meant it. She was that kind of Christian. As we wrote in her obit...

Some of you received text updates and will be familiar with the struggles over the last month, so possibly nothing new. Basically, we're doing ok, taking one step at a time.  June was a long month.  Corrine and I finally got back to Chicago from Louisiana after delays over 24 hours, multiple airports, and an overnight stay in Atlanta.  In terms of treatment, unfortunately, there was an insurance snafu and I am temporarily not covered for treatment in Illinois. I had to cancel all upcoming appointments at Northwestern. Corrine spent a lot of time on the phone with Priority Health and Blue Cross/Blue Shield and Financial Services at Northwestern and HR at OU and finally worked out a one-time exception for the pain pump surgery at Northwestern; I was not able to work out exceptions for further chemo at Northwestern or palliative care or radiation or pain doc treatment despite her best efforts and hours upon hours on the phone. Priority Health is claiming primary provider-shi...

Nighttime Skyline in Chicago If you missed the last two blog postings, they are here ( Comfort and Joy ) and here ( Change of Plans from Phase 1 to Gemcitabine). The other morning for breakfast, I had yogurt and granola with Skittles, M&Ms, and chocolate chips. It’s quite colorful, like something out of Elf. I’ve never really been much of a sweets eater, but here I am.  From the most recent CT scan a couple weeks ago, I still have no brain mets. A clean brain. A good thing. That’s one thing they keep watching out for in the CT scans with each course of chemo. But the latest CT scan did reveal, among other things, a 4 cm metastasis to my left supraclavicular lymph node at my shoulder and neck. That’s a golfball-size mass in the lymph node at the crook of my neck leading to my spine, pushing on the left side, and radiating out to the shoulder and down the left arm. It’s causing quite a lot of pain. They’ve (I’ve) increased the dosage of Hydromorphone (an opioid slightly stronger...

A Chair with a View: Rooftop Cows at Northwestern Children's Hospital UPDATE (5/24/2024): I had the follow-up with the oncologist today. In discussing side effects with the palliative care specialist, I noted that I had much more energy last week while I was taking steroids in preparation for the transfusion. I asked if there were meds I could take to help combat the overall fatigue I've been feeling -- steroids, Adderall, cocaine . . . what do I have to lose at this point? She laughed and said that yes, it's become fairly common to prescribe Ritalin (Methylphenidate) to help with the fatigue during the day. She wrote me a prescription for 5 mg at 8 am and again at noon if I needed it. How many other helpful meds are out there that I don't know about unless I ask? I met with Dr. G, who said that the Northwestern tumor board recommended against surgery and radiation for the kidney mets, partially because of additional mets in my lungs that we had skimmed over when readin...

Papa's Chair May 23, 2024 The last 3 weeks between infusions have probably been the best for me in a long time in terms of dealing with side effects and being able to visit with family and friends. Lots of quality time -- eating, drinking, hanging out, pleasant naps in the afternoon, short walks, longer drives. A visit from Cornelia with lunch al fresco at the Hemingway Bistro in Oak Park, Illinois. A long, first class flight on Delta down to New Orleans to spend a week with my brother and his family. A lot of quality time with my granddaughter Otilia. It's all gone remarkably well, given a Stage IV diagnosis.  For this last appointment, it was time for a CT scan to check on disease progression. I had to drive an hour and a half, practically to Rockford, to climb into an available CT scanner last Wednesday. I still can't lift my right arm over my head, so that was a bit of a struggle. They finally let me leave it by my side. By Friday, I had seen the results in my online ch...

Needlepoint by Cornelia. Quote from The Sopranos It's been two months since my last post. Everything is pretty much humming along as best as can be expected.  After I was sent packing by the University of Michigan in February, we returned to Chicago to meet with Dr. G. at Northwestern on March 8th for a consultation. Instead of Gemcitibine, which Dr. Q had recommended at UofM, Dr. G. recommended Pemetrexed, a class of medications called antifolate antineoplastic agents. It works by blocking the action of a certain substance in the body that may help cancer cells multiply. The side effects are supposed to be milder than the other chemotherapies I've been on (First Line treatment with Carboplatin and Paclotaxel; Second Line treatment with Docetaxel and Ramucirumab). I'm hoping for a somewhat improved quality of life with this regimen. To help with the side effects that I do expect, they've prescribed a steroid (dexamethasone), folic acid, and B12.  There's a pretty st...