Friday, April 29, 2011

Fun weekend plans

Grace, Miles, Seth, my mom, and I are leaving soon for Sol Duc Hot Springs in Olympic National Park, returning Sunday evening. Should be fun!

Ethan

Wednesday, April 27, 2011

Seth and Miles

Several times lately when Seth has been at this house but Miles has been somewhere else (at his preschool, at Grace's parents' house, or out with Grace running errands), Seth has said "Where is Miles? I miss him." Some of this may be calculated, because Seth knows that I like it when he is nice to Miles, but I think at least some of it is genuine - he really does like Miles and is happy to see him. The affection is mutual - Miles adores Seth. Last night Miles and I were sitting on the red couch and heard the front door open. I asked Miles "Who do you think it is?" and he said, hopefully, "My brother?" (It turned out to be my mom, and Miles was happy to see her too.) Miles and Seth have started playing together in the upstairs play room, sometimes for an hour or more with no adult supervision needed. Sometimes I use the time to take a break, but sometimes I sit on the futon and watch them or participate in their play. On sunny days it's really nice how the late afternoon light warms that room up.

I played basketball yesterday for the first time in a couple of weeks. Three games of half court. I felt slow and tentative, but I did make some midrange jump shots. I got some nice picks from Mike Henniger.

I plan to cook dinner tonight (chicken tikka masala - one of my favorite recipes) and maybe watch a little of the deciding Game 7 of the Bruins-Canadiens (traditional rivals) first-round playoff series. Go Bruins!
(Sorry Jim - you can take a guy out of New England, but you can't take New England out of a guy.)

Ethan

Monday, April 25, 2011

Death with Dignity

The Death with Dignity National Center contacted me and asked if they could feature my Psychology Today posts on the topic of Death with Dignity on their blog titled "Living with Dying" (coincidentally, very similar to the name I chose for my Psychology Today blog: "Living While Dying"). I agreed because I would like to support their cause. Here's the link to their post: http://www.deathwithdignity.org/2011/04/25/death-dignity-isnt-suicide/

Ethan

Sunday, April 24, 2011

Birthday party on Lummi

Some pics from Seth's friend Henry's birthday party this afternoon on Lummi Island: http://remmel.shutterfly.com/2445

We all had a nice time. Thanks to Henry's parents Michelle and Michael for hosting us!

Basketball note: The Celtics won today to sweep the Knicks and advance to the second round of the playoffs, where they will likely face the Miami Heat (led by LeBron James and Dwayne Wade). I think one key to that series will be whether Jeff Green of the Celtics can play reasonably effective defense against LeBron. Paul Pierce can defend LeBron reasonably well, but he will need help, otherwise he may get in foul trouble and expend too much energy on defense to be effective on offense, where they need him. I think this is why they traded Kendrick Perkins to get Jeff Green - Celtics GM Danny Ainge was more worried about defending LeBron in the playoffs than Dwight Howard of the Orlando Magic. He was right about the Magic, who look like they're going to get upset in the first round (down 3-1 to Atlanta). We'll see whether he was right about Jeff Green, who hasn't looked comfortable yet with his role on the Celtics.

Ethan

Sunday update

I haven't posted much lately because I haven't felt that there was much remarkable to report. This is a very good thing. For the past week or so my life has felt relatively normal, which is great. Although I appreciate all the encouraging messages I have received, I don't really want to be an inspiration, or shining example of something, or a symbol of some cause. I just want to be a normal guy - a husband, a dad - living my little life - going to work, playing with my sons, playing basketball, doing yard work, etc. One thing that helps is that since the transition from aggressive treatment to hospice care my life is not so dominated by my medical care. Instead of going to the hospital, doctor's office, or lab for blood draws every other day, my hospice nurse comes to the house once a week. She also delivers any medications I need, so we don't need to go to the pharmacy all the time. It's just much more mellow.

And over the past week or so I have felt probably the best overall since my diagnosis last May. My energy is good, my stomach is not upset, my appetite is returning, and I've generally been in a good mood. It's tempting to feel like maybe I'm getting better, maybe the cancer is going away, even though I know that's not true and this period of feeling good is inevitably temporary - but I'll take it, gratefully! My main physical problem continues to be the bone pain, which is pretty severe. I was taking a lot of oxycodone to try to control it, but it was still keeping me up at night. On Tuesday Grace, my mom, and I had a consultation at the SCCA pain clinic in Seattle. They seemed knowledgeable and had some useful suggestions. They did not recommend the intrathecal pump, which I had mentioned in a previous post - they felt that the expected benefit did not justify the surgery, and that there are better ways to manage my pain. They suggested adding methadone to the fentanyl I am already using for long-acting pain relief, and also an a non-steroidal anti-inflammatory drug (NSAID). They also suggested "hemibody" radiation, although I would have to wait until a month after the strontium injection (i.e., the first week of May), to avoid excessive radiation exposure.

I worked with my hospice nurse Hannah to implement these suggestions. So now I am on a 100 microgram fentanyl patch and taking methadone and meloxicam (an NSAID that specifically targets the COX-2 pathway to avoid the GI problems associated with the COX-1 pathway), as well as oxycodone and Aleve as needed for breakthrough pain. It's only been a couple of days, but so far this new combination seems to be working pretty well. I've been sleeping better. I think my head is still pretty clear. That's the tradeoff with the painkillers - if I take too many I may feel no pain but I descend into a stupor, and I want to be able to teach, drive, carry on a conversation, etc. So I try to use the minimum amount of painkillers I need to be reasonably comfortable, which for me means accepting some pain.

Over the past week or so I have felt physically OK for just walking around (I've been walking home from work up and over South Hill - I love the views of the bay), but not well enough to play basketball. When my left shoulder pain is bad, my left arm is only semi-functional (my basketball buddies may smirk that I never really use my left hand anyway, but I want to be able to at least catch the ball with two hands). The leg pain is annoying but I could play through it, except that sometimes it's bad enough that my leg actually buckles, which would be a problem on the court. Still, I hope to play at least some half-court this week.

On Thursday my mom and I walked over to Village Books to hear my friend Troy talk about his new book Coming Clean: Information Disclosure and Environmental Performance from MIT Press. Later that night Grace, my mom, and I watched our favorite TV show The Office, on which Steve Carell is being replaced (at least temporarily) by Will Ferrell.

On Friday I finished my post tenure review summary letter for our department chair Larry, who normally writes these letters but obviously can't review himself. This was my first real task as associate chair of the department and I felt good about it because I felt involved in the life of the department. My next task will probably be reviewing the teaching of some of the non-tenure track faculty.

That evening I watched the beginning of the Celtics game (they won to take a 3-0 series lead over the Knicks - they can sweep the series with a win this afternoon). Then my mom and I picked up Seth from a play date at his friend Jesse's house, picked up Troy from the weekly Huxley reception at the Copper Hog, and all had dinner at the Soy House (Vietnamese restaurant on West Bakerview Road), followed by ice cream at Mallard.

Saturday was a beautiful warm sunny day here. We got a cool birthday present for Seth's friend Henry and stopped by the farmers market where we saw lots of friends. I finished mowing our yard and did some other yard work (in a t-shirt because it was so warm!) and then cooked dinner (shrimp and pea risotto) for Seth, my mom, and I (Grace and Miles went down to Seattle this weekend to visit her parents). Then Seth and I picked up Ben and his girlfriend Marisa and went to the Bellingham Slam game. The Slam are a minor league basketball team. They play at the Whatcom Community College gym. Most of the Slam players played at WWU. We had courtside seats courtesy of Ben (thanks Ben!) because Mallard Ice Cream is a sponsor of the Slam. The Slam beat the Olympia Reign 122-99 and we had a good time.

Today Seth, Lynn, my mom, and I are going to a birthday party for Seth's friend Henry on Lummi Island. We are giving a ride to Jesse, another of Seth's friends. I am really happy that Seth has made good friends already at his new school.

Ethan

Thursday, April 21, 2011

Old photos

When my mom returned from Maine, she brought a box of old photos of me and our family. I have scanned some of them and would like to share them.

Top: my mom and me (both Seth and I remarked that my mom looks a little like Lynn in this picture)
Bottom: me, age 2, at the back door of our house in Portland (my "humble beginnings" shot)


Left: me, 3 1/2 months old (chubby!)
Right: me with my beloved dog Pilot (I think I look like Seth in this picture)


Top left: me, Spring 1975, age 5 (several people have commented that I resemble Miles in this picture)
Top middle: me, I don't know what age
Top right: me, October 1983, age 14
Bottom: me, age 4, and my sister Rachel, 17 months old, September 1973

Top left: my Grandpa Don Ryan and me (this is one of my all-time favorite pictures)
Bottom left: my Grandpa Don Ryan, my great-grandfather Tony Ryan, and me
Top right: my Grandpa Don Ryan and my Grandma Agnes Ryan (originally Xenia Falderoff)
Bottom right: my Grandpa Don Ryan as a boy in 1935

Sunday, April 17, 2011

End of the weekend update

Today my mom, Lynn, Seth, and I did a private restorative yoga session at a beautiful yoga studio out in the woods off Mount Baker Highway near the Nooksack River. This was Lynn's idea and treat (thanks Lynn!). I really enjoyed it, although Seth got a little restless by the end.

This evening John Tuxill came over to hang out and watch the Celtics game (a dramatic comeback win over the Knicks in Game 1 of their first-round playoff series). Crispin and "Baby Eric" (who is not really a baby anymore, but Miles still calls him that) also came over. It was very cute to watch Miles and Eric play together. Miles is older and a little bossy, but Eric is starting to hold his ground while still being very sweet. A couple of pics from my semi-functional camera:


Pain; Busy Saturday

Things are going relatively well here. My main health issue these days is bone pain. I was hoping to be getting more pain relief from the strontium injection at this point. The pain makes it hard to sleep, so I have been up most of the past few nights (like right now), but then I am tired during the days - not a fatigue tired but a lack-of-sleep tired, which is not as bad. The pain is not as bad during the days. I'm not sure why, maybe because I am moving around and distracted by other things. I actually feel pretty good other than the pain. I am taking a lot of painkillers, but I am trying not to take so many that I get mentally compromised - I still want to be able to drive, teach, etc.

We are exploring other options for pain relief. Grace and I met with a doctor at the pain clinic here in Bellingham and on Tuesday afternoon we are scheduled for a consult with the SCCA pain clinic in Seattle. An intrathecal pump is a possibility. It is surgically implanted under the skin of the abdomen and delivers medication straight to the cerebrospinal fluid around the spine at a programmable rate. This delivery method is much more efficient, so you only need about 1/300th of the dose you would take orally to get the same pain relief, and thus the side effects are much lower. However, it would require abdominal surgery and a lengthly recovery process.

We are also working with Whatcom Hospice on pain management and quality of life in general. My hospice nurse Hannah is great - I love her. The feeling of working with hospice is so much different and better than the regular medical system, which often feels mechanical and impersonal. Hospice feels like a team designed to support my decisions. The regular medical system often feels like an auto-repair shop - my body is like a broken-down car which they prod and poke and tweak and tune, but with less consideration for how I feel. And even though the infusion nurses were all very nice, I hate hate hated the chemotherapy. I am so glad to be done with that disgusting and depressing process.

Yesterday (Saturday) was a full day. We went to the monthly Swedish pancake breakfast at the Sons of Norway Hall. Then we went to a special treat for members of the Bellingham Railway Museum - the museum folks had cleared a section of unused train track near the Birchwood neighborhood and were giving free speeder car rides. Here's a video of us on the speeder car:


Then we stopped by the farmers market, which reopened for the season last week. It sometimes seems like we can see everyone we know in Bellingham at the farmers market. Here are two videos: one of Seth doing two hula hoops and one of Grandma and Seth (standing on the right) watching one of the many performers:



We returned home and I took a nap while my mom took Seth to the Bellingham Flight Museum for their monthly "fly day," when they fly vintage aircraft around. When I woke up, the sun was out and I mowed some of the lawn. Then we all, including Lynn, went to a potluck/student art show for Seth's school at Bloedel Donovan Park by Lake Whatcom. It was a nice mellow event. Thanks to my mom for making our contribution to the potluck.

Ethan

Tuesday, April 12, 2011

Celtic Pride

Seth, Lynn, and my mom Kathy all returned to Bellingham safely and it has been nice to see them. I didn't feel well yesterday (Monday) and spent most of the day sleeping. I had class this morning and after class I felt better, enough so that I worked through the afternoon in my office. I find that teaching my class focuses my mind, activates my brain, and distracts me from my problems. It helps that I have a good group of graduate students - smart, engaged, inquisitive. I walked home and got to meet and spend some time with Grace's good friend Lorraine from Penn State (where Grace taught before WWU), who is attending a conference in Seattle and so was able to visit us in Bellingham.

The NBA playoffs start this weekend. The Celtics are setting expectations low lately, losing lopsided games to their chief Eastern Conference rivals Chicago and Miami in the past week. I'm hoping for a resurgence of this:


Celtic Pride! (And mullets too.)

Speaking of the NBA and resurgence, I am not happy about the resurgence of the Bulls for the Celtics' playoffs chances, but I am happy for Bulls first-year coach Tom Thibodeau, the former Celtics assistant coach and defensive mastermind. He should win NBA Coach of the Year (although I wouldn't argue with Spurs coach Gregg Popovich).

Ethan

Short story

Last Thursday evening Troy, Eric, and I were watching NBA basketball at NY Pizza & Bar. During halftime, one of the in-studio commentators was former Celtic star Kevin McHale. I like McHale (he was unstoppable in the low post in the 80s), but his appearance and mannerisms on TV led to this exchange:

Me: "Kevin McHale looks like a gay Frankenstein."
Troy: (to bartender) "Did you hear that?! He just called one of the Celtic greats a gay Frankenstein!"
Eric: "Not that there's anything wrong with that..."
Me: "That's true - some of my best friends are Frankensteins."

Sunday, April 10, 2011

new Psychology Today post

I just posted something new on my Psychology Today blog:
http://www.psychologytoday.com/blog/living-while-dying/201104/the-meaning-suffering

This weekend has been OK, not great. I've been tired. I find that I can easily sleep most of the day if I let myself. I worked in the office Saturday afternoon and some at home this (Sunday) morning. This evening was fun - we had some good friends over for a casual potluck dinner and to watch the Red Sox beat the Yankees (always satisfying). To relax lately, in addition to watching sports on TV, I've been doing a lot of crosswords in my NY Times Wednesday crosswords book that Grace got me.

Seth and Lynn return from visiting her sister and her family in Denver tomorrow afternoon and my mom returns from visiting my sister and her family in Rochester late tomorrow night.

Ethan

Saturday, April 9, 2011

A couple pics

A couple of pics from Eric's visit:


Miles calls this his "Grandpa train," because Grandpa Chuck got it for him:

Thursday, April 7, 2011

Thursday

Today was a good day. Last night was not a good night - the bone pain was excruciating and despite taking a lot of painkillers I didn't sleep much. The bone pain was also awful this morning - I couldn't really talk. But I limped to my class anyway (thanks Grace for dropping me off!) and lo and behold either teaching took my mind off it or the pain just happened to get better then, but by the end of the class I was feeling much better.

I haven't taken any pills for breakthrough pain since then, which is the longest stretch in a long time. I still feel some pain but it is much better. I hope this means that the temporary increase in bone pain due to the strontium has peaked and now I may get some pain relief, and maybe even start to decrease my dose on the fentanyl patch, which would be good because it makes me constipated and mentally loopy. But I would have to decrease the fentanyl gradually due to potential withdrawal symptoms.

I attended my first departmental faculty meeting in almost a year. It was nice to see all my colleagues, although I can't say I've missed the meetings themselves.

After the meeting, Eric picked me up and we had lunch at Busara Thai. Then we went for a nice walk on the North Lake Whatcom Trail - a little over 3 miles, partially sunny, good conversation.

It continued to get warmer and sunnier by the time we got home. I mowed half of the yard.

For dinner we went to New York Pizza & Bar. Grace and Miles ate with Jim, Crispin, and their son Eric in the restaurant area, while Eric and I sat with Troy (and later Scott Miles and Mike Medler) in the bar area and watched the Celtics lose to the Bulls. Despite that, it was fun to be out and I felt pretty good.

There was a table of psychology graduate students in the bar area, including some who were in my class this morning. They said that I made sense during class and did not doze off or drool, which made me feel better (I was worried after all the painkillers I had taken), although maybe they were just being polite. :-)

Eric leaves tomorrow morning, sadly for me. I wish I could clone him temporarily, so I could have him here with me and he could also be with his family (thank you Meredith for lending him to me!). But tomorrow and this weekend I need to do some work anyway, on my syllabus and post tenure review files.

Ethan

Tuesday, April 5, 2011

Tuesday

Seth and Lynn left this morning for a week in Denver visiting Lynn's sister Leeanne, her husband Todd, and Seth's cousins Josh and Nathan (this week is Seth's school spring break).

I taught my class this morning. I was a little worried about teaching because I have been so tired lately, but I thought the class actually went pretty well, despite my relatively low energy. It is a good group of 15 graduate students.

After class Grace drove me down to the University of Washington Medical Center in Seattle, where I got a radiopharmaceutical injection which is supposed to help with bone pain. Unfortunately, although we requested the drug samarium, they gave me strontium instead, and didn't tell us until after the injection (the order from my oncologist Nestor apparently said strontium or samarium). So that was annoying, but it's too late to do anything about it, so I'm not going to worry about it. Strontium and samarium are supposed to have similar efficacy, but samarium is supposed to cause less bone marrow suppression (which affects blood cell production, which affects immune system function, blood clotting, and anemia).

After that, we met with Dr. Whiting at Seattle Cancer Care Alliance. After that, we had a surprise: Eric flew back up from San Francisco, so we picked him up at SeaTac airport. Apparently he finished the work he had in San Francisco and decided to spend a few more days up here. We are happy to see him again. Grace drove us all home (thanks Grace for all your driving today!) and Eric immediately made us a nice dinner.

Eric and I watched basketball on the red loveseat and Miles snuck down from his bed and cuddled with me until Grace put the kibosh on that.

Radiopharmaceuticals like strontium and samarium often cause an increase in bone pain for a few days which usually decreases after about a week. I am definitely feeling an increase tonight - my bones really hurt! :-(

Ethan

Sunday, April 3, 2011

Sunday

Eric left this afternoon and Jonathan and Toby leave early tomorrow morning. Seth and Toby had fun playing together. Eric cooked for us all. Unfortunately I did not feel well, with very little energy or appetite. I spent a lot of time sleeping even though I wanted to socialize. I did take some pics: http://remmel.shutterfly.com/2433

Ethan