Category Archives: CounterCurrent

The Adenocarcinoma Chronicles.

2 Replies

2/23/14

Five months past treatment for throat cancer I will set aside The Squamous Chronicles and instead post The Adenocarcinoma Chronicles. Having won the advanced prostate cancer lottery as well, my current adventures involve treatment below the beltline.  Here are my impressions of the experience to date.

Physicians, or more specifically in this context, oncologists, are ethically constrained to apply agreed upon treatments for the indications presented by the patient. I have gotten no “off-label” kind of advice up to now. In my case, my PSA was 39 and the biopsy readings from the pathologist were assigned Gleason 9. Well, sonofabitch. That was a fine kettle of fish. Looks like my watchful waiting was long in the waiting and too light in the watchfulness.

The standard treatment regimen in my case is hormone ablation and radiation. For hormone ablation I have had Degarelix and Lupron. For radiation I have begun IMRT (Intensity Modulated Radiation Therapy) with a dose of 76 Gy to the targeted tissue mass. I asked about scatter dose to the testes just because of the obvious proximity. The Rad Onc looked it up and said it was 1 Gy. I then pointed out that I’ve had a goodly bit of radiation in the last year and was there anyone who keeps a running total on the cumulative dose? As expected, the answer was “no” followed quickly by the standard rationale that the disease was far more dangerous than the radiation. I’d say the same thing I suppose.

Things that my docs are reluctant to offer are opinions on how this whole disease plays out. There seem to be several elements to this reticence. First, predicting the future is difficult, especially with a stochastic phenomenon like cancer radiotherapy. Second, there are good reasons for the doc to not focus on gloomy topics like life expectancy, especially if the survival stats are not the best. Most people at some point spontaneously think of cancer as a death sentence. At present I view it as a chronic condition that will play out stepwise in terms of a convergent treatment and remission series that eventually ends with refractory and widespread disease. Seems pretty obvious. It is the time-scale that I am uncertain of.

I am writing about this because my treatment regimen seems relatively ordinary to this point given the status of the condition. Perhaps there are some fellows who have yet to climb on this train who are uncertain of where it goes. This is my journey and I’ll pass along my notes.

Update 3/13/14

Now 14 treatments into radiation. With the help of medical textbooks ordered from Amazon, I have slowly been learning more about the disease and the treatment. During my weekly consult with the Rad-Onc I asked the question- “What was the T number from the pathologists notes?” He replied it was T3c N1.  The N1 means there is a node involved so it’s Stage 4 cancer. No one actually came out and said this to me so I had to ask. It is one thing to suspect it and another to hear it. Hard to say if this knowledge is in some way empowering.

Gaussling’s 15th Epistle to the Bohemians. Thoughts of a Secularist Liberal Scientist.

4 Replies

If you knew me personally, you’d know that as a reductionist my profile can be reduced to that of a liberal atheist scientist with marginally good manners. I broke the shackles of magical thinking in high school after reading a few books by Bertrand Russell and Carl Sagan. Though I have not been the same since, I have come to sympathize a bit with Quakers and their predilection for peace.

My religious upbringing was quite ordinary for a young Iowegian lad in the 1960’s. Confirmation in the Lutheran Church (Missouri Synod) in 8th grade followed by a short stint as a reluctant acolyte. The church seemed firmly footed in bedrock as an institution and adept at indoctrinating the young. In catechism studies I tried to understand the authoritarian system that is outlined by Martin Luther and the strange collection of narratives that make up the King James Bible.

There were abstractions that didn’t make sense then and are still a mystery to me today. The concept of the Holy Trinity always seemed suspiciously anthropomorphic. Then there is the crucifixion as a kind of “ghostly sorting mechanism” for salvation. It stands out against the backdrop of natural phenomena like physics and biology- mechanistic systems which seem to suffice for everything else. Finally, there is God’s seemingly endless requirement for worship and admiration which has always struck me as a vanity unnecessary for a supreme being. The whole scheme reeks of iron-age anthropology.

I remember the day it happened. I was praying for something or other. Trying to have a little spiritual time with the Big Guy. It finally dawned on me that I was talking to myself and in doing so, wishing for some particular outcome to happen. All those years. Praying and wishing were indistinguishable. I’ll admit, I was never one to volunteer a lot of praise to God. Heaping praise on a deity seemed patronizing and wholly unnecessary. Surely if God could elicit wrath, then he’d certainly pick up on being flattered.

Well, in the end, so what? Another tedious atheist commits apostasy. Like most people in US culture, my moral basis was built on what has been described as Judeo-Christian morals or ethics. It’s hard to avoid. But just as the earth does not rest on a foundation, I am not limited to sensibilities derived only by the sons of Abraham in a far earlier age. My culture and my brain tell me that theft, murder, and the other spiritual crimes (sins) are bad for the common good. That respect for others has a pleasurable and sensible aspect that threats of eternal damnation do not improve on.

The reductionist in me can’t resist the following assertion. Deistic religion reduces to cosmology. In the end, a religion offers a theory of the universe. It is a kind of physics that defines relationships between the prime mover and his (?) bipedal subjects imbued with mystical sensitivities. It claims to define the outcome of the disposition of a soul, whatever that may be.  I don’t even believe in the existence of the mind, much less a soul.  As a form of physics, religion lacks means by which theories can be tested. Quantitation of a spiritual element is an idea that has yet to see practice. It seems to lack predictive capability to estimate an outcome that can be validated. It is definitely not a science. It is not about matter or energy. It is about how to conduct ones life against a backdrop of divine authority and within a box of behaviors.

But our brains seem to be constructed in a manner such that religious/spiritual notions are nearly irresistible. Billions of people have claimed to feel its draw and testify to its merits. The projection of anthropomorphic imagery in myth is common in diverse cultures.  The Abrahamic religions congealed from cultures that were apparently unaware of the concept of zero. Where heaven is death with a plus sign, hell is death with a negative sign. To an atheist death is just zero. It has no sign or magnitude. It is unconsciousness and devoid of the awareness of pain or pleasure. Zero sensory processing. It is neither exaltation nor agony. Just zero. Entropy prevails. Such an outlook is hardly appealing enough to gather followers. It is grim and without hope of graduation to eternal bliss.  The take home lesson is to live in the moment, not the future.

Who am I to argue with millennia of religious thought? I don’t know. All I can say is that even as a cancer patient, I remain refractory to the pull of religious and mystical thinking. So it was and so it is.

Post script.

Divinity students! Relax. I’m no threat to your faith. My conclusions on this life of ours offers no ceremony and precious little fellowship. I can say that I’ve had an eye-full of the clockwork of this universe. Adherence to evangelical doctrines could not have provided the amazing insights. And for that I have no regrets.

American Idiopath

5 Replies

I recently developed a condition where I have ear pain and partial facial paralysis. Ear aches I can deal with, but when my face quits working, I go to the doc. So, that’s what happened. The ENT said that it resembled Bells palsy and the cause was idiopathic.

I can just imagine an attending physician and a resident in medical school taking future idiopathic specialists on their rounds. The doc walks in and greets a patient with an ear ache and a face that doesn’t work. “Yessir” he says with resignation, “another case of idiopathic syndrome. We just don’t know what the hell happened.” The resident turns to the med students and says gravely, “Look at this patient closely. Try not to confuse the distant stare and slack jaw with idiopathic disease. Even though this patient is from Iowa, we are convinced that there is an idiopathic condition overprinted on his presentation.”

The attending physician stands there thoughtfully for a moment, raises a bristled eyebrow and glances at his watch. “Let’s go people. The idiopathology wing is full of patients with mysterious conditions.” With that they shuffle off down the hall.

Update

A round of acyclovir and prednisone cleared up the apparent Bells palsy. I am symmetric again and can pucker up to whistle a tune.

A Big Bronx Cheer for the 2014 Jeep Cherokee!!

5 Replies

The makers of Jeep have resurrected the standard Jeep Cherokee in, well, how else can I say it … a very stupid way. They have abandoned the classic boxy utility vehicle lines of the old Cherokee in favor of the now popular fat and squat ellipsoidal lines of contemporary design. In other words, it looks like a jelly bean or rugby ball.  The classic 4.0 Liter Cherokee had power to spare and it had the fantastic visibility of an inverted fish tank. It had troubles too, namely bad electric connectors and perhaps an under-designed cooling system. But at least it had the classic squared-off Jeep lines and lots of traction.

But the greatest sin of all was abandoning the 4.0 L straight-6 engine for the 3.2 L engines. Jeep?? WTF!! What were you thinkin’? I would love to meet the committee of marketing pencil necks and constipated MBA’s responsible for this one. It’s a travesty.

So Long Year 2013. Hello 2014!

12 Replies

Update:  I sit and write at a desk piled with pdf printouts of patents, journal articles, a Phi-Tec 1 handbook, and a great heap of process safety data and reports. I help coworkers find and study patents for their R&D due diligence. The bigger task is running a thermo lab for determining the thermokinetic safety of bulk chemical processing. These two topics, patents and thermodynamics, would induce instant unconsciousness for most folks. An acute boredom-stroke followed by involuntary somnolence and collapse to the floor. Oddly enough, I rather dig these topics- especially the thermodynamics. A single fellow covering these two widely differing topics is entirely a(n) historical artifact, unlikely ever to be repeated.

Several months following throat cancer treatment, my energy and curiosity are back although I still cannot eat solid food due to impaired salivary glands and taste buds.  The head-and-neck-onco-doc says it’ll take 1.5 to 2 years for the spitter to come back online. It is like serving a sentence in the Nestle warehouse living on Boost. I enjoy food vicariously watching the Food Network. This is what the term “food porn” means- watching others enjoy a sensory and emotional experience with food.

The year 2014 will see me spending more time with the urology oncologist. At the last appointment he promised to help keep me on the top side of the grass as long as possible. I have to hold him to it.

An American Parliamentary Republic? Why not?

6 Replies

Here is an idea for debate. Why not pitch our flawed constitution overboard? Replace it with one that supports a parliamentary form of government rather than the fractious, unworkable presidential system we have now. Who else in the world uses this system of government? Why is it that most other forms of government in the world are parliamentary in structure?

Make the US government more responsive to the citizenry by rendering the election cycle time dependent on confidence in the leadership.

The US constitution needs a rewrite. Among the distortions in the constitution-

  1. The metaphysical equation of money with speech.
  2. The foggy language of the 2nd amendment that engenders armed fanaticism
  3. The indistinct barrier between the secular and theocratic civic influences. Keep religion and other magical thinking out of governance. Preserve freedom from religion.
  4. The near impossibility of getting a bad president or governor out of office.
  5. Clearer language is needed on what is actually meant by the right to petition congress. Currently this has lead to an intractable cancer of corruption between government and the movers of wealth. (Consider the F-35 strike fighter or the lack of tight control over Wall Street investment banks)
  6. Apparently the rules for the waging of foreign wars are indistinct because current constitution or presidential structure seems to allow the US much flexibility and low accountability with invasions and sending ordinance across borders.

There are more problems with the constitution. Maybe the reader has thoughts on this? The problems of presidential systems have been studied and this Slate article summarizing the issues is worth reading.

Attacking Syria for nerve gas use in Ghouta

3 Replies

In the news there are reports of pending action by the US in Syria. Maybe I have a blind spot. Maybe there is some fundamental principle I am missing here. But how is it that a mass killing by gas elicits a response from the US when a larger mass killing by bullets and high explosives does not? Where are sympathetic Arabs in the region? How are they exempt from delivering bombardment as justice for the dead?

Obviously, gas attacks lie across a firebreak of some kind. What is the Syrian death toll now- 90,000 + by bullets and bombs? And that does not trigger international action? Apparently, grisliness is not a deciding factor.

This isn’t about justice at all. It is a smack down on setting a precedent with NBC warfare- nuclear, biological, and chemical. It is a genie we cannot allow out of the bottle … in the land of the genie.

So, here is the scenario-  the US will begin a strike at 3 am with cruise missiles to soften up the target area and air defenses. Stealth fighters will fly in to attack everything that flies. Penetrator missiles will demolish air, missile, and command and control bases. But what to do about the nerve gas armaments? Are they bombed or isolated? Who recovers them right after the attack? Al Qaeda? Let’s hope not.

This whole thing is a troubling moral discontinuity. By policy we watch many tens of thousands murdered by bullets and high explosives, but act on policy that triggers when gas is used. There may not be an answer, but there certainly is a smell. The smell of death.

The Squamous Chronicles. Finish one and start another.

10 Replies

8/27/13.  As of today, I have 3 more x-ray treatments culminating in a dose of 63 Gray to the throat. The pain has required narcotics pretty much continuously and the attendant constipative delights that go with that. Pills are difficult to swallow and the gag reflex is heightened. The final chemo was yesterday so I am done eating platinum.

I began hormone ablation treatment for an aggressive form of prostate cancer two weeks ago. While the throat cancer is substantially beatable, the prostate is a different story. Here is the deal fellas. While you can gauge with PSA numbers, it is the Gleason grading system that tells the tale. And to get that you must do a biopsy. In order of increasing severity, the Gleason score goes from 2 to 10. I pulled a 9.

Hormone ablation is delicate way of saying chemical castration. The spread of prostate cancer can be controlled somewhat for up to 2 years by shutting down testosterone production. This they do by injecting a synthetic peptide, Degarelix, into belly fat to control the dosing to the pituitary gland. Had my first hot flash a week ago. It was a eunuch sensation.

Interesting anecdote.  My medical oncologist described an MD patient who had been using sunscreen on the radiated area of his throat. He soon experienced an increase in surface burning of the throat on continued x-radiation. Turns out he was using a sunscreen that had titanium dioxide that was scattering/absorbing radiation on the affected surface. He stopped and the accelerated damage ceased.

Schneier on Security

1 Reply

Schneier on Security is one of my favorite non-chemistry blogs. The particular link here is to a post on the NSA and It’s apparent commandeering  of the internet for its own, opaque purposes. Bruce Schneier developed the Blowfish encryption algorithm.

While I have previously criticized Libertarianism and its peculiar conflation of civilization with Austrian economic thinking, I am enough of a civil libertarian to be deeply alarmed by post-911 security paranoia with its narrow readings on the 4th amendment and attending case-law.

Ask yourself, how much of your life do you want to be subject to structural snitch features that trigger silent alarms when your face is recognized in a building, when you called the front desk of a business or agency, or when you download particular information from the internet or just do keyword searches on Google?

You can bet that hordes of NSA folk as well as contractors are working feverishly on what else they can do with this metadata and location data accumulating in datacenters.

Many friends have said half joking that they feel sorry for spooks who have to sift through their chatter and insignificant browser searches. But what if an NSA spook were standing over their shoulder while they did it? How would they feel then? Maybe fellow citizens who approve of this kind of activity should be flagged for participation and the rest of us left alone. Would they feel the same about it?

#####  Encrypted: decrypt with http://www.alltextencryption.com/
ZZZZZ AMLWM LXUBJ RWEEP LRCUC OJIQN IXJHN MUDSO TLUCF SUALW SXGUJ
EQXHJ MPAJT RMBDB NFMVR DJRUU OVPWB HBKNB HAIDK TBGHS MGMPH UWBWQ
XMMHV NSFQM TXPIA SBTMG BLRMN WRBJQ CEQPA RFGEA BEPUM KNVGF CJVEL
VFNOI DIGGQ URKFN QEABQ NLDIM HEPBK KFKPS PSJGG QEIVG RXIBG QRTBN
CIEQM BRCVI TPANX GEIQF HMKGP VUMMM PQCJK DJBQL IHUFI LKRLQ JFCCH
GUUCI BCGVG FTHAW NWSSI PCTXD ANGTH QLWDT LDIDE RBPIB VITCE ALJEL
UVCUP ATVTO OOQPM MDOXO QVDQE DTWOG QJPJF PBKJG IQMXU REHIR ERTUP
XXMBQ JDQJQ IVALB GDOJB IUBKD PLWKL MEMHQ RJDXT IOTJV AOXVO LUWKH
IDIDK GLFWR GJTTH TPLFH FWUXB OBQDJ KUPGU RBXDI WTLSA LGHXW WCHXJ
WHLPX KFQGW KLAKE QBSXE EOAXK UWFPM MXVTA NMRRB PCGEI CTKXA FGPPH
FNEEJ OBVKE FJGCD VJMON KFHRJ VAGAE PMNTO ABKCQ XVEIE UXPFE NGRKH
NDOPP XWSQD TOXDX RLPTJ WQUMB WFKIM NCNXR GHWEM CRVSH MPTWH VRCNT
EHBTG RDIMV ASRBB DICNJ GOJIN TJQBW HNWFM XGJIK HBSQP FQKGM VBKXM
IAQSL DEJQE DKFRJ TPLGE PGTEJ EMUAX WNLPQ RCRXR UPTUQ UHOUE TJIQK
EMQLH PQIMW ORDLR JXNFO MLXNU OOIVX DRISP WMLNE LWDBB PIRDX UOLQP
MUXON QGQRG WWSVW OESNV SJNUX XSKIT JIDCW XPVLX KHMIF JSJCD UDQHX
MPEIQ VMWTU EVNAG IAMPR ULOAW PTSMN ICDIM FRNJJ BPOTV MEMBB TOKJR
IERQV CONBI IEMAE JBPKS KNSAI FCORP UPWSG PQSGF IGIPH LFKWE LHTHI
TJEVI FLDDF TNPHC JKCWP JCUWJ QLDIO BFXCB FCFNL VVTVA XPXET BXRDV
KGNAU MTACT RGEKE ONNLU ENGOM LNUPL ECWAN JRWGB HFJPR BNSXK BLAGC
PMIUD MRDBB CRAFC QWHMT GITXL MTITS GNMUT OPOAW WILAK ORFRP EVIEJ
XTFRW LSGTX HFCXN QLWBJ TPQOB MKPND QOOJS HCVTO NDGMJ VSNFG VNOGM
PULQC TCRUR HQTTI BCDEH CSSMX CWLGR FGGCJ LVVWO JKBSW QTSTW DQFJB
WQCXX KFHVN FJKPN KGDKP ITVGF OSWTU PQMKN GEBPB QWSMU JHGRA KWSIU
BVRQM TJUJM EWUOS NFLPQ DSWXM QEWIU QEGSD TLEDF VLBGM AXLLS TNWFF
IHKJH SIIIT VFKUF PTGTS XATWE JAQRC MTIKL GJGXI DSOTG EJHMV BFSSB
FWKEW OPCXU GTEFI ABGTE IHTFU POIDT TJEHT SNJUX NPUFA RPKVF FQQHO
WWUJB NDUXP JTXJP GOEVL ECHTG IULAQ LVFUC BXKBB FJBLV XLHOB SGOBJ
XTMUU TKGOR QIJVJ BJRXF GIOBN LIKWA HUQFB VUOBI MMUHV SSOOX ELRGO
ENSPI XCQDA JAGOS WCIWB MJFTM RQBSG UGQKM PIOFI DTFPT RAMAM XCEBL
XDJHQ UKDIS PAAMK HEAIJ RWLIR KINJM OVWFU CSOHQ MIPBT HGCUI UABIB
AHCIO SJHJI ITUSM IGSIX PVONM PREBB LFFPB DIWPE VGWWM CLBSM TDENR
RLMAJ OTBCM PIPKL QJMOC WSXBK UXRJM MERJC VLLDJ AGOXP CHVMF UUVKE
EQXEN JEIOK VJWRV DJWKM ANBKD NTMAF XKJXC VFNJK MTPUL BBKOC AAPUP
HOKHM UIUMX QBJKP NDEMB OKVQA QJEBC GUMBB NPBTA DHTFC RVXUH NGGSI
JRXVW XLGXL OVMHO EHWHT FHWFC QUNLM GWCAJ TVJLE TQQMR TILJB PIVKU
GQWSP MWTLR ETFDB LEKLA AFIIB XQFIR NIGDQ OPVDQ GERAO CSWKC BXJFK
TWUFE SRALS LSJKH VOWPB TKIDF LSKEM AEKVB UOHVM NQPHO ALDEL TIKNG
XLMHO OLBID HHNIB RHFSW LQXJI PNTNU XQUDH EOXUI SSHBE FIGGK SCGAF
ILGVH RNUVR SADCI BFBDQ PKBPO MHPLF SGRNK HNTAN FMIPF KCAUN GPKEE
DKTVA JGQHH VNNVK KXRGK PFTGA LBKFC EJXAR IMMIL KAABK VTNFI EPXGP
OKHWX PHDSH HLGWK VABCS GFBLG PWJAI XGGMF GWHKK AMWEG WLEGM URDTP
PFOKP ORAAV QKONR ULKDT NVXGF VTPOM MCXNI SICPO CJQGE AKUNX UCBJB
QPEWX UQKLS STGKI DLAOA GFJVT SSRLJ SJKNN LMEUO BFECR KPGGG NGRSI
STFMT QIMNE IVLBV HSVTN BJJRJ FTMTN LNTNO GUVHJ JGBEV LNIQU IOMMB
HVFSH XVCGH QTHLQ MCRQB EPJQK FCICV UCPQW FWGEE KGQIB PUCUN AAIAK
NPTIO MFUGX DGWNJ XDHSU WXMUX RHMQT UPEVN LXDWP AEOHT NLMLR WMTFR
LPTHW LFEWL WJEJI EGQQO PJWTD WOGIT LCPSR PDCII CWXVA ODECW RCHXH
IKRSV NLLKD JAIKF NWMBR PDLHU ONDKT SWISL SCGMR NACEX NOQTM SJXTR
VJXWD OOCWU UBFOE SIBLH SQGFC OVUCQ XWDPK IFNQT OFPTV OSUUO FVNID
VPIMI FMOIE FSQTE TSUSH LNAML ROGKJ FSOQD XCTLB KUKKJ IPSHT VRKVH
JHNMM CXUEC DUIJR WLMKQ CBSXS DJXVW HFMLR RNPAK QFHXI SJAKV LLNTH
ASSOJ RUGEP PJGSI VNDPP LFHNR WSIRX AEWIU RDJWX CDGCF TOEFK LKNGD
WKXDJ PFREN OHTVH PTBKI HTRPJ AQTEC HAFUP FAAPQ JBTVM QNQSJ HDVGQ
OPDNE SJIAX VZZZZ YYYYY
#####  End encrypted message

The Squamous Chronicles: A flea market of side effects.

2 Replies

So, here I am wide awake trying to recall what the Ambien molecule looks like. I’ll probably have to look it up.

Later this morning is my 3rd chemo treatment of 6. Something is knocking me down. The x- radiation plainly has been doing what it does best- giving a 3-D sunburn. The throat is developing mucositis and Is crazy sore. Blistering should start soon.

I’m using magic mouthwash, comprised of lidocaine, benedryl, and Maalox. This pharmacy concoction has the snotty rheology of melted ice cream.  The throat issue is definitely interfering with getting enough calories for body weight maintenance. Have lost ca 10 lbs to date. I’m gonna get a talkin’ to from the dietitian today.

Other than sore throat, the next unpleasant drug side effects are those from the anti-nausea meds. The anti-emetic meds prevent one from hurling through a sore throat. They are also very effective at constipation. So, one gets to know the offerings at Walgreens.