what the next 6 weeks look like

This is what 27 scheduled zaps look like on a calendar. Makes you feel like there is no end in sight but it is what it is.

to the dungeon you go for your first zap

Ever get the feeling that you are being set up for something bad, well, when you have cancer, you get to spend a lot of your time in a basement. In Paul's case, this involves daily visits to the basement at UCLA where he gets his daily zap for the next six weeks. We have affectionately dubbed it "The Dungeon."

The first plan of attack against Timmy and his mates is radiation oncology. What does that mean, you might ask? It means that not only will Paul have daily radiation of the pelvic region and lower back but he will also start his first chemo in the form of a pill called Xeloda. The oncologist gave Paul a choice at our first appointment: either have a port installed in his chest and do what is considered traditional chemotherapy in the form of 5-Fluorouracil or 5FU (I kind of love that it's called 5FU, it's like giving the big FU to cancer in a way), which would entail Paul wearing a pump for 48 hours and having the chemo continuously pumped into a vein in his chest or take it in pill form. Well, when given this choice, it was easy to opt for the pills - less mess and fuss. So twice a day, more particulary every 12 hours, Paul must eat at least a small meal and then take his chemo pills within 15-30 minutes. Now most people don't adhere to these "take with food" cautions on most medications, but in the case of Xeloda, the process of digestion is paramount for the pill to work. See, the pill isn't really chemo when you just ingest it. It must hit digesting food in order for it to transform into chemo. Kind of cool, right?

But back to radiation, first they gave Paul another CT scan so that they could map out where the primary tumor aka Timmy is and then they gave him teeny tiny pinpoint tattoos so that they can line up the laser to the specific point that they want to blast. Paul ended up with three of them but I only found two. I call one of them his tramp stamp since it's in that area of his lower back.

After this initial set up, they then do a dress rehearsal where they put you on the machine and do a test run sans radiation.

And Paul, being Paul, thinks he will be able to not only return to work, a thing he hasn't been able to do for the last few months thanks to being ill, but he truly thinks that he will be able to go to work after his morning zap, thus, he has booked all of his appointments for the next six weeks for 7:00am! Um, yeah, thanks darling! I, of course, demand to take him to all of his appointments as I serve as an interpreter for Paul since the doctors insist on speaking that mystical medical jargon as if everyone has gone to medical school. So the next few weeks, I should be a right bitch what with waking up at 5, getting him to radiation by 7, then back home, then to work. Thanks a lot cancer!

Colonoscopy Round 2

What barbaric masochistic bastard invented the prep for a colonoscopy? Seriously, that guy was one messed up dude. Thanks to Paul's first test not being a clean read after a sleepless night that involved drinking, every 30 minutes or so, some seriously nasty concoction that supposedly removes any trace of food from your body, he had the pleasure of doing it again. And not only just drink a gallon of this stuff but also a 2 day fast to ensure that he was completely void of any food in his system.

I sat there waiting in the waiting room for him to be done or for the doctor to have me sent to his room so he could inform us of his diagnosis. One would think you would have one's spouse in the room when you are telling them that they have Stage 4 cancer but, alas, Mr. Gastrolenterologist Man didn't think like that and used the excuse that no one could find me and god forbid, anyone try calling me on my cell phone.

And trust me I was in a hurry to get out of the waiting room since there was a family of ten  who were waiting for a loved one to get out of either a procedure or surgery and seemed to think that the hospital waiting room is the appropriate place for a tailgate party. Seriously, they had portable tv's with them that were being blared over the multiple tv's that were in the lounge, laughing, shouting loudly at each other and to complete the whole scenario they set up a picnic on the floor. I just sat in my little corner shooting death looks their way with a host of other people who were in no mood for their campfire. So if you happen to ever run into any of these people (see the gang in the corner of the room), feel free to kick them in the shins for me.

After about two hours, Paul emerged like nothing had happened. I asked him how it went and he told me how there was a woman, who was also in for a colonoscopy, who was a crying shaking mess and Paul, who now has suddenly become the expert in colonoscopies, managed to calm her down and make her laugh by accusing her of trying to take a cheeky look at his bum. If there's one thing the boy is good at it, it is to make light of any situation to take away its seriousness.

He told me that the doctor confirmed it was cancer and we opted to memoralize this event with a few cocktails at Barney's Beanery and then get ready to find out what the plan of action would be.

the week of reckoning

Well don't we feel popular! For a man who never got sick for over 50 years, this whole cancer thing means he has a full dance card. It is the week from hell:

Monday - 2nd colonoscopy (prefaced with a 2 day fast and another gallon of salty bath water to drink)

Tuesday - our first appointment with an oncologist

Wednesday - our first appointment with the radiation oncologist

Thursday - the patient's birthday - nothing like getting the gift cancer, the gift that keeps giving, for your 52nd birthday

Friday - appointment with a surgeon

the day time stood still

After being severely ill for almost a year and not having any health insurance in this god foresaken country, Paul made an appointment for a full MOT on June 2, the day after our new insurance went into effect. On June 3,  he was told that he needed to have an immediate colonoscopy, which we had already assumed would be the next step. Over those preceding 11 months, we thought it might have been food poisoning, detox from not drinking (out of nowhere, Paul no longer fancied a bevvie, a sure sign that it was something serious), celiac disease or our latest guess of Crohn's disease. What came a week later, we never suspected - a diagnosis of Stage 4 colorectal cancer with metastases to the liver and lung (in layman's terms that means cancerous tumors in the liver and lung also refered to as mets). The main tumor in his colon was quickly named Timmy the F*cking Tumor and he was causing a 99% obstruction.

Of course, Hornby luck would be in full effect and the first colonoscopy which was performed on June 9th did not provide a good read of Timmy's true extent, so Paul had to retake the test which involves one of the most barbaric preps in all of medical history and had the pleasure of  having yet another camera insertion on June 13. To demonstrate Hornby luck a little bit more, the doctor had informed Paul that he had cancer while he was still coming out of anesthesia so Paul had no idea why he was being wheeled immediately down to the CT scan area of the hospital for further tests. I only knew something was up because I took a peek at his bloodwork and all of his levels were all over the place. But no one that day told us. By the time we got home that afternoon, we came home to  voicemails from two medical offices: a surgeon and one that was a garbled message that we decided to disregard until the morning since we were both exhausted.

The next morning came and after listening to the garbled message about five times, I finally managed to make out what the phone number was and googled it. My worst fear was confirmed. The message was from an oncologist's office. Paul had woken up and asked me in a sleepy haze if I had figured out the message and I said that I had and he then asked, "Well what was it." I replied, "It was from an oncologist." His next questions was, "What the hell is that." I meekily replied, "It's a cancer doctor," and then ran out the door already late for work reminding him to call the gastronentrologist and have the scan results sent to me at work.

About an hour later, I sat at work staring blindly at the scan results that said in big bold letters, "DIAGNOSIS: STAGE IV COLORECTAL CANCER WITH METATASTASES TO THE LIVER AND LUNG." I not only totally broke down but became enraged at the doctor, flew across town and confronted  him in his office where he explained that he thought Paul was alert and awake when he had informed him that he had cancer.

The question on my mind was "How do I tell my best friend he has Stage 4 cancer?" The answer was I didn't and, of course, the doctor didn't follow through with my request of calling us that evening to tell him. So there I sat for three days knowing the worst news ever and having to just keep it to myself until his next scan on the 13th. This is when I learned quickly that the caregiver's secret weapon in times like this is Vitamin Xanax. Needless to say, it was a long weekend.