Yellow snow

Anyone who's spent much time talking to me knows that I don't go too long without some reference to my grandmother.  This time of year always brings her to mind for a variety of reasons.  As a kid, the holidays generally revolved around her house and her cooking, and to this day, I still make attempts to replicate her recipes for cornbread dressing and other dishes.  One of the recipes that I haven't tried in a while -- mainly because it's difficult to find the ingredients in Houston -- is snow ice cream.  "What on earth?" you're thinking, I'm sure.  Every year, we'd eagerly await the second snowfall of the year.  You see, the first snowfall was contaminated with all kinds of dust, dirt, and other stuff in the air, so by waiting for the second, you'd get much cleaner snow, thereby ensuring that your dessert was completely hygienic.  As the snow built up around her little white house, we'd await the time when the grass was covered enough to be able to scoop up a big mixing bowl of it.  She'd make her way to the kitchen and stir up a mixture of milk, sugar, and vanilla, and then send me out to get the star ingredient.  "Don't get the yellow snow!" she'd always tell me, with a sly look on her face. "Yes, granny, I'll try to remember that."  It's a great memory, and one that comes back to me every year as the holidays and winter weather approach.

I use this as the basis for my latest blog entry because, unfortunately, I've been served up a big metaphorical bowl of yellow snow.  As most of you know, I've been going through a number of tests over the past week to determine the effectiveness of the treatment that I've undergone over the past few months, and yesterday, I got all the results back.  As usual, there's good news and bad news.  The good news is that the endoscope and corresponding biopsy of the primary tumor site was negative, and the doctor saw no evidence of any mass or obstruction in my lower esophagus.  That's fantastic, because it means I can eat almost normally now.  I still have to be careful about bulky, spicy or acidic things, but at least I'm not experiencing the pain of getting things stuck any more.  Clearly, the radiation was a great success in controlling the cancer in the locations that were treated.

The bad news, however, is that in spite of the success of the treatment at the primary site, I now have a number of lymph nodes that appear on the PET scan along my esophagus as having evidence of disease.  I'd been feeling pain in my back for the past few weeks, so it didn't come as a great surprise that something was going on.  My hope was that the pain was related to irritation from the radiation, but it appears that's not the case.  During the lower dose chemo that accompanied radiation and the 6 week rest period, the cancer apparently was able to rebound a in these areas.  Crap.

Now, what do we do about it?  One encouraging bit of news is that the cancer was very responsive to the original chemo regimen that the doctor prescribed, so the plan is to restart that chemo, with a few tweaks to make it a bit more tolerable.  Most notably, I will NOT have to carry Betsy around any more -- instead, I'll take 6 pills per day for 7 days.  That also means we won't have to make late night trips to Anderson to return the pump, and tweak the thing when it decides to stop working. I start chemo again on Monday, 12/5.

Obviously, this is not the blog entry I hoped to be writing at this point -- I really wanted to tell everyone that the primary tumor was gone, and all the outlying disease was quiet; instead, I'm talking about yellow snow.  I've had some really down days over the past couple of weeks.  The holidays have a way of intensifying emotions, I think.  I've actually felt better, however, since getting the news and once again having a plan to deal with it.

So, just like waiting for that second snowfall to clear the crud out of the air, we're going to go for the second round of chemo and knock it hard. We'll rescan in a couple of months and see where we go from there.  As it always has been, this is a stepwise process of treatment and refinement, and I continue to have the utmost faith in my doctors and MD Anderson -- they have truly been remarkable throughout this ordeal.

Thank you all so much for your love and support -- I continue to need all the positive energy you can spare.  Please stay in touch, and I will, of course, let you know how things are going when I have more to report.

Much love to you all,

James