Greetings subscribers/people I choose to email.

I know it's been some time since the surgery but until recently there was not much of a concrete update to give.

I lived after the surgery, obviously. I thought it was a 3 or 4 hour procedure so I was a bit shocked when I walked in and they told me just before going under that it would be 9 or more hours.

But on the plus side, I only had to sit with that anxiety for about 45 minutes before the anesthesiologists came in.

Woke up on the PACU and of all the possible outcomes of the surgery, the reality was the most favorable one. It could have been worse. The interdisciplinary team of surgeons seemed pleased.

Hospital stay itself was uneventful. I was walking around on day 1. Off pain medicine day 2. Sent home day 4/5 and I walked out of the front door on my own two feet. No wheel chair needed.

Over the entirety of May and most of June I dealt with infections which are common with the type of abdominal surgery I had. 3 or 4 rounds of oral and IV antibiotics got me better but it was a long slow annoying process.

The rest of the time in those two months was adjusting and recovering which is generally easy when you're not showing signs and symptoms of an infection. It was up and down. Sometimes fine. Sometimes more hearing excruciating.

By mid June I went to Galveston for fun, went to a Noah Kahan concert in the woodlands, worked on the bronco. In July the hurricane came through. No real issues except wind damage and some downed trees. I actually had a doctor's appointment at peak hurricane hour for my location and drove to the Drs office. It was a bit harrowing. Almost got blown off the road, but it was memorable, my appointment took place, and the drive home was uneventful.

In the later half of July I flew to Maine and spent time in the cabin. Rode e-bikes in Acadia, saw more bald eagles than I ever have up there. Drove to Canada, saw sunrise from Cadillac mountain, ate blueberries, etc etc etc.

August 6th I caught a plane to London and I've been there since. I come back on the 22nd.

Eifel tower. Olympics closing ceremony. Train to Switzerland, Taylor Swift concert in Wembley, etc etc.

So: 9 hour surgery was good. All surgical margins were negative for cancer meaning in theory nothing was left behind.

After some CT scans and an MRI in July there are some questions marks that indicate cancer is still active though.

So I had a followup PET scan where they Inject radioactive sugar in your blood. Cancer likes to eat lots of sugar, so the sugar goes in, cancer grabs it up, and those areas are temporarily radioactive so they light up on the CT scan. It's semi accurate but not infallible.

After the PET:

-3 new spots on the lungs (common area for the cancer to move to)

-maybe a new liver spot

-possibly a lymph node

Best outcome post surgery would have been "hey, we don't see anything, have a good life, we will rescan in 3 months"

But in this case it's "hey looks like there's some stuff going on still. So more chemo"

Chemo starts on the 26th when I get back.

They're adding a new drug this time, a monoclonal antibody that has pretty good efficacy in certain people.

So it's all the normal poison drugs plus this one.

To be honest I think my liver might be fine, I think the abdominal lymph nodes could be an anomaly, and I think the lung spots are legit.

Lung metastasis are usually slow to grow and easier to treat via cryo ablation or laproscopically, so that's a potential plus.

But if it's any testimate to how bothered I am about it, I'm writing this on a high speed train traveling in a tunnel deep under the english channel at 220mph from Paris to London while I drink French Syrah and have been walking 5-8 miles a day. I feel good.

The chemo is probably going to suck. First round back in always seems to, but usually gets better afterwards and life goes on.

Cancer cells are smart and build immunity to chemotherapies and evolve so it's an ever changing game until eventually you run out of treatment bullets.

Obviously the hope is that the new drug, cetauximab, works, there's a complete clinical respone, and all signs of cancer are undetectable for a time.

The statistics say that's possible, not probable. But those are good enough odds in these matters.

Two week cycles, 6-8 rounds. Scans in-between to see how it's working and if it's working.

After that, who knows? But that's the immediate future.

Or near future, rather.

The immediate future is this wine and a Taylor Swift concert tomorrow....

-C

An update. (Spoiler alert: I'm still not dead.)

Updates from beyond the grave (kind of)

Pre surgery update