Friday, November 25, 2016

Giving Thanks 2016

Today is a day of rest and reflection. After a full day yesterday, Susan and I have a gloriously unscheduled Friday with her son, Jamie (up from St Paul). Family time.  

This stands in sharp contrast with yesterday, which was completely orchestrated. I had infusion therapy in the morning followed by a full-court press in the kitchen as soon as I got home, to continue prepping a Thanksgiving feast for eight, the cooking for which started Wed night. Don't get me wrong: I love cooking in general, and celebration cooking in particular. Even better, it's something on which Susan and I are totally sympatico. 

Our biggest challenge is dancing gracefully through the choreography of two busy chefs in the kitchen at the same time. The prime prep spot is a bit too close to the sink, putting wayward arms and hips at risk when the rhythm of wielding sharp knives and sweeping away detritus are executed in the vicinity of quick rinses and sudden tool extractions. But we're figuring it out.

I find 6-8 is the perfect size for a dinner party. It's hardly any more trouble than cooking for two, gives you more latitude to try out dishes (while at the same time honoring de rigueur menu items such as turkey, stuffing, mashed potatoes, gravy, and cranberry relish), is easy to divide between two accomplished cooks, affords us a suitable opportunity to bring out the fancy dishes and linen, and you can fit everyone around one table, holding a single conversation. What's not to like? Talk about slow food, dinner yesterday stretched from 4-9. All the way from hot-out-of-oven crab-stuffed mushroom caps to coffee accompanied by pecan pie topped with whipped cream.

• • •
As I happened to be at Susan's for Thanksgiving last year, this is a great time to take a snapshot of all that's unfolded for me in the past year, enumerating the wealth of things that I have to be thankful for.

o  Last Thanksgiving I was experiencing steady back pain, but the worst was still ahead. I was three weeks away from it deteriorating to the muscle spasming hell that would make it almost impossible to travel or even get out of bed for six weeks, ultimately leading to hospitalization and the discovery of my multiple myeloma. I almost died.

o  While contracting cancer would never be on anyone's wish list, from that grave nadir many wonderful things have emerged. By incredible good fortune, my breakdown occurred in Duluth. Not only did I receive irreplaceable emotional and logistical support when I most needed them, but it turned out that I received superb medical attention once I got over the hump of accepting that I seriously needed help.

Duluth is not a large city (pop 86,000), and has only two hospitals (St Luke's and Essentia). Yet they both have invested in their oncology departments and I could hardly have picked a better place to have discovered my cancer. I was morbidly sick and went to the St Luke's emergency room Jan 31. Within hours I was accurately diagnosed (in contrast with the cancer being missed when I was tested for it in Missouri in December 2014), admitted to the hospital, and started on treatment—my kidneys were barely functioning at 20% capacity, I had been leaching calcium from my skeleton to the point where I was in imminent danger of fracturing something, I had three collapsed vertebrae, and my bone marrow was producing a plethora of unwanted plasma cells. I was one sick puppy. I was thankful for excellent medical care and a loving partner—as the reincarnation of Florence Nightingale who unstintingly jumped into the role without any clarity about their being a future for our relationship beyond nurse/patient.

o  Since bottoming out last winter, I have steadily responded to the protocols laid out by Dr Alkaied, my oncologist. It turns out that multiple myeloma is a variety of cancer for which there there has been tremendous recent progress made in understanding the disease and how to treat it. Not only is Alkaied current with the literature and research, he was able to consult with the rest of his cancer team (seven in all) and he had immediate ideas about how to proceed. I was thankful that of all the cancers I could have had, it was one for which there was hope for containment.

After some judicious experimenting with various protocols, we hit on a chemotherapy mix that my body responded to well and that drove down the cancer. I was thankful for having a strong enough heart and lungs to handle the strain of my recovery. (All those years of healthy living and good diet at Sandhill Farm were coming into play).

o  My gradual recovery was in service to a master plan that called for an autologous stem cell transplant at the Mayo Clinic this summer. It's a procedure in which they are world experts, and my case was overseen by Dr Buadi, a hematologist who specializes in treating multiple myeloma. I was thankful to have access to top-drawer treatment in state. (As Alkaeid necessarily treats all kinds of cancer, he only occasionally sees my disease; Buadi sees patients with my illness day in and day out.) I was also thankful for Ceilee, Jo, Alison, Annie, and (of course) Susan who comprised my indispensable on-site support team during my five weeks in Rochester.

o  Happily, the stem cell transplant was a full success. My cancer is currently in total remission, I have been given the green light to resume my consulting/teaching career (within reason), and I am starting a maintenance course of chemotherapy where I receive a lower dosage of Kyprolis, one of the drugs that was effective in containing the cancer last spring. I am thankful that there is a drug that works well for me and that I tolerate well (which is not everyone's experience).

To be clear, the cancer is dormant (good) but not gone. It is inappropriate to see myself as "cured." The cancer may return at any time, or it may not. Meanwhile, I am fully aware of living in a state of grace. I am thankful that I get to enjoy these days (years?) of "extended play," with sufficient recovery to do the work I love (cooperative group process) with as deft a touch as I've ever had, and to have a surfeit of friends and loved ones with which to celebrate life and smell the roses (as opposed to interacting with people more or less in passing, on my way to the next thing).

o  While my choice to live in an income-sharing community left me rich in relationships and experiences—for which I'll be eternally grateful and don't expect to ever second guess—it did not lead to financial security. Thus, I was scrambling to handle the staggering health bills I ran up this year. I am thankful that this crisis did not bloom until I was 66 and already on Medicare, and that I had the foresight (and good advice) to buy a generous supplemental insurance policy. 

While that protection meant that I was insulated from the vast majority of my bills, I still had thousands of dollars of liability and was facing the double whammy of not being able to work while I focused on my recovery. I am thankful to the 30 some people who generously responded to my June blog appeal for financial support, effectively bridging the gap between what I had and what I owed. Whew!

o  My bedrock in all his has been Susan (how do people make it through life without a loving partner?). Of all the many things that I have to be thankful for today, none is more precious to me than Susan and the unprecedented opportunity that was opened up from behind the clouds of my health crisis for the two of us to enjoy our latter years in curiosity, in laughter, and in the exuberant exploration of love.

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