'The End of the Beginning of the End,' With Apologies to Churchill

“Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.”

- Sir Winston Churchill, 1942

And so it was for me on Dec. 21, 2007, exactly a year ago today.


It was early that Friday morning, cool outside, but cooler in the first floor waiting room of Florida Hospital's main campus. Catherine and I checked in and waited. It seemed quite a while but in reality was only 10 minutes.


When they called my name, it was to go into another room to get the basics done, blood pressure, paperwork, that kind of thing.


Of course, it was the morning after my first-time use of my stomach feeding tube to take in "Go Lightly" to clean out my system. Thankfully, that tube allowed me to bypass my mouth and palate.


So I was ready. It was going to be, like Churchill's reference above, my last stand against esophageal cancer. An hour or two later, one of the finest surgeons in Central Florida, Dr. Joe Boyer (right, from the Florida Hospital Web site), was going to wage a blitz on my cancer and remove it, finally, from my body.


So from the paperwork, we were taken to another room, for some early preps. My chest was shaved, down to the wart near my right shoulder. I was placed on a gurney, wearing a surgical gown. Shivering from the nerves and chills of the sterile environment.


Then another ride, me on the gurney and Catherine riding in a separate elevator, to a staging room upstairs. There, the IV, main line and last good-byes would be completed.


Dr. Boyer popped in to offer reassurances. I had to sign more papers. Nurses joked. I joked. I don't think Catherine smiled too much, because she was more nervous than she let on.


We kissed and I think she was escorted to the waiting room. I counted to 10 but never made it past two or three, I don't believe.


That's all I recall from that morning, one year ago today.


And I'm sure a lot of what I do remember is wrong or fuzzy because they were giving me some pretty good drugs before the operation. I'm sure there was more going on before my chest was shaved, more in that communal prep room. The waits might have been more, or less, than I recall.


And when I woke up (Amen, I woke up!) I remember being alone, but that's because I'd awakened earlier to my family though I was still deep in a drug-induced state and didn't remember that encounter.


My first memory after the surgery was probably a day or more after my surgery. I don't remember several visitors who I know were there. Flowers left by my daughter's in-laws. Cousins who visited me during my hospital stay describing their earlier visit when I was in the ICU. I just don't remember that at all.


But I do remember the small TV in my ICU room needed to be pounded on the side to get the volume to work. I remember the tube coming out of my nose and connected to a suction. I remember that tube was stitched into my nose to keep me from removing it or to keep it from moving. I remember a visit from my family a few days after surgery in which I was bestowed with a curiously shaped Santa hat. I remember buzzing the nurses for drugs every two and four hours (four hours for the Percocet and two hours for the Dilaudid).

And now, a year later, it's hard to believe 365 days have passed. Much of the time was a drug-induced blur, but even since returning to work, the time truly has zipped by.


That last stand in the Florida Hospital O.R. truly was the beginning of the end of the beginning. And I'm up for the rest of the fight to keep my survivability numbers in the win column.

Sigh of relief

I walked out of the office shortly before 11 this morning and the first thing I noticed was the sun. Warm on my back. Ahh.

An hour earlier, give or take, I'd made my tithe of three vials of blood and was waiting to see Dr. Lee Zehngebot. I'd arrived early, so I read my book and relaxed, if that's possible when you're waiting to see an oncologist.

So in the treatment room, Dr. Z walks in and sets me at ease. "The scans looked great." That's great news, coming up on a year after my surgery, which was a year ago this coming Sunday.

He was far more concerned with the state of the newspaper business. What would become of papers? Where are they heading? Did I see the New York Times' version prepared for the iPhone? (I did now!) We talked Kindle (from Amazon) and the New York Daily News (not doing as well as he'd thought) and the fate of the Sentinel (it's still going strong and will be here for some time to come).

I asked about my liver, since he'd mentioned it on the phone. His answer, "It looks funny. But it will always look funny." That's because my radiation treatments in 2007 cooked a portion of the liver, which we already knew. I didn't even crack my regular joke about that, you know, that the docs forgot the onions.

And I mentioned that my stomach is beginning to feel weird again and that I think I need to see Dr. Philip Styne once again. I can't quite say what's wrong, but I know something is. I'm not digesting as well as a month ago, so either the stricture is tightening again or I need another shot of Botox into the pyloric valve. Or both. Or neither. I'll call Dr. Styne later today.

I also need to see a cardiologist, he suggested, after I noted some discomfort from time to time in that area. He reminded me that just because I'm doing well in my fight against cancer doesn't mean that I shouldn't keep an eye on the other parts of my body.

So the bottom line is I don't have to see Dr. Z until the day before my anniversary in April of the coming year, with some CT scans soon before; I need to call Dr. Styne; and I need to get a cardiologist and get some tests.

Sun on the back; it's going to be a good day.

Dr. Z comes through

Late Friday, Dr. Zehngebot called me while I was at work to ease my concerns.

So I didn't have to wait, and wait, and wait.

He said the CT scan I had Monday didn't appear to turn up anything abnormal -- I guess he meant abnormal for my abnormal innards. After all, my stomach is a fraction of its former size, some of it is used to replace a chunk of esophagus that doesn't exist any longer and all of this is practically in my chest.

He said my liver looks a little funny, and I think he was saying that because it looked "funny" after all of my chemo and radiation. The PET scan lit up the liver, but a biopsy cleared me for surgery. So, that's not much of a change.

In any event, I'll find out exactly what Dr. Z meant when I see him Friday morning. But he voiced no concerns about my condition as seen in the CT scan.

So that's another bit of good news going toward my one-year anniversary post surgery. It's so hard to believe it's been that long, and that's a very good milestone to almost have behind me.

Mr. Impatience

I hate waiting.

I really hate it.

Sometimes it stresses me out. Sometimes not so much.

So I had an CT scan on Monday in advance of my appointment with Dr. Z in a week.

I'm sure all is well -- I feel good. And I'm sure because no one has called.

If there was a problem, they'd call.

Right?

That's what I keep telling myself. And I know that's the correct answer. Still, when you're waiting things just don't come fast enough. It's like waiting for that damned bus that never shows up, or the subway train, or the McBurger and fries at a supposed "fast food" restaurant. It's never fast enough.

And so it is today, the end of the work week. No news is good news, right? I'm sure that's the answer. But I sure would love to hear it from the medical staff.

My Old Friend

I visited my old friend, the CT scanner, today (photograph above). We haven't seen one another since August, I believe.

I won't know what's up until I see Dr. Z next Friday. I presume he'll have all the results and that if something is amiss he'll let me know before my appointment.

I just love my time in the CT scan. You know, the yummy orange-flavored contrast drink. Mmmm. The comfortable slab. The iodine IV. Holding my breath in 10-second chunks.

But at least it's over and I'm back home.

The worst part -- honestly -- is the waiting.

Reflections on a year in crisis

A year ago I was nervous, exhausted and physically and mentally drained. I'd gone through chemo, radiation and was preparing for major surgery, all while my mom was either hospitalized or recuperating at a nursing center.

Amid my 48th birthday last year, I wasn't sure if I'd celebrate a 49th.

A year later, I did. It was Friday and up to the task that they are, the Ladies of Kohn -- and their men -- treated Catherine and I to a weekend out of town.

So here I am in Titusville with Catherine. We've gone out on the water -- on a casino boat -- and over to the Kennedy Space Center, where we plan to return on Sunday for the space shuttle's landing. We have to get up early to make it to the visitor complex and just the right spot early enough to have a good view. We'll have both cameras, the Canon and the Xacti -- for stills and video, I hope.

The weather's been great, and it seems as though the weather might hold up for the landing.

I can't help but think this year will be better than the last one.

16,000 ... that's a Thanksgiving

Sometime soon, like within hours, the 16,000th click to this blog will take place.

I know, I know. I keep joking about the same dozen people clicking a bunch of times. But apparently there are more of you. I've heard from folks across the country and a few places outside our borders.

I'm glad. I'm glad word is spreading that esophageal cancer is an unnoticed form of the disease in need of more notice.

I've heard comedians joke about acid reflux as a corporate-made-up illness and I've seen jokes about heartburn. I used to joke about it, as I ate my uber-hot wings and Cajun-spiced desserts.

I don't joke about it any longer. It's very serious stuff.

I was among 101,920 people in Florida to develop cancer, in the American Cancer Society's most recent statistical report. That's for all types of cancer, but only among Floridians. Of those, I was among 1,170 to develop cancer of the esophagus. And of those 1,170, 1,010 people died of the disease. Thankfully, I was not among them. Nationally, esophageal cancer is the seventh most fatal form of cancer among men, claiming 11,250 men's lives, or 4 percent of all male cancer deaths.

There is one area where I was a minority: deaths by esophageal cancer when comparing black men to white men. The Cancer Society's review found 10.2 black men per 100,000 died of esophageal cancer, compared with 7.7 white men per 100,000. So to my black friends, be warned and take precautions.

For 2008, the numbers are grim: 16,470 new cases nationwide and 14,280 deaths. There's a five-year survivability rate of 34 percent for those with the cancer contained to the esophagus, as mine was, so I'm not nearly out of the woods yet. For all stages of the cancer, the survivability rate plunges to 16 percent.

I'll conclude the boring portion of this post by saying that one of the reasons the survivability of this form of cancer is so low is because it often is diagnosed when it becomes a problem -- as mine was. By that point, the tumor already has formed and is in a somewhat advanced stage.

So prevention is the key. Eat healthy meals, lots of fruits and veggies. If you have heartburn, have it treated early, something I failed to do. Smoke? Quit. Drink? Moderate. And if you had heartburn and it went away, you may have Barrett's Esophagus, which is a form of pre-cancer as your body tries to defend itself from reflux. See a doctor.

Please remember I know from where I speak. Get help, and get it soon, if any of the above conditions remind you of yourself.

You can see more statistics about this and other forms of cancer at http://www.cancer.org/docroot/STT/stt_0.asp.

Good news from the good doc

I had a good visit today with Dr. Sigfredo Aldarondo (pictured from the Florida Hospital Web site), my pulmonologist. He said everything is looking good even though I still cough up more than I'd like.

He said it's pretty normal considering the surgery I had nearly a year ago and considering all the crap that has happened before and since.

Though he sees many patients and really only saw me once in his office and a couple of times in the hospital, Dr. Aldarondo remembered me specifically. "You're the blogger, right?" he asked when we shook hands. That's me. The blogger. I told him, "This will be on the blog tonight." And imagine, here it is.

But during my check-up with him, Dr. Aldarondo said the reason for my coughing remains a small amount of very mild reflux during my nighttime sleeping, and a bit of aspiration into my lungs. When I awaken, I cough it back out. It's not a good situation, but it's better than, say, two years ago.

He also said my lungs were clear during the exam and everything sounded good. So I won't have to see him for about six months, another good sign of my continuing recovery.

Speaking of which, another milestone will be reached on Wednesday, Nov. 19. It was a year ago on Nov. 19 that I ended my chemotherapy for the cancer. Earlier last year, my radiation ended, so with the chemo's conclusion, the bulk of my treatments came to an end and all that remained -- not that I'm trivializing it -- was the surgery in late December.

Between the end of chemo and the surgery, I had a "cooling-off period" to kind of build myself back up strength and weight wise, clear my body of the toxins and be tested to make sure I'd go through the surgery well. Turns out I did "light up" during a subsequent PET scan and required two biopsies before I was cleared for surgery. A spot on my liver and a lymph node became internal Christmas lights and concerned the docs.

Turns out, after the biopsies, that the hot spots were caused by the radiation. They scared the crap out of me at the time, for sure. But all was well as things turned out.

And after Dr. Alderondo's clean bill of lung health, it looks like that is how things are going a year later, as well.

Oh, the Difference A Year Makes

I find that a year after the heart of my chemo and radiation I am feeling so much better.

It was a year ago that I was about halfway through my double-whammy of medicinal torture. Not that I am complaining now. Was it worth it? To quote a former vice-presidential nominee, "You Betcha!"

But at the time, I was undergoing an internal misery. Suffering from bronchitis, I had to be pulled off my chemo pump for a weekend. I actually reveled in the fact I could shower without a tether of the little clear-plastic tube that linked the 24/7/365 pump to my medical "port" mounted under the skin in my chest.

Ah, the small things.

There were bigger things going on as well. Mom was in the hospital, still gravely ill. I had just lost my Uncle Albert "Buddy" Zuckerbrow, who passed away after a few weeks of serious medical issues.

The bronchitis that prompted Dr. Z to briefly halt the chemo also threatened to send me to the hospital. My blood counts were very low and the doctor thought it could go either way, hospital or no. He actually asked me whether I wanted to go to the hospital and if I had said yes, that's where I would have landed. I preferred to "tough it out" and get back on the chemo at home as soon as possible.

Seems the choice worked. That week I learned a new respect for nausea and its aftermath. The porcelain throne and I became good friends. I went off chemo, then back on, and it struck me with a vengeance. But I soon regained my footing and began to improve, even as I faced several more radiation treatments.

Today, a year later -- I can hardly believe it's been that long -- I feel so much better that the blur of the past year feels as if it's in my distant past. I guess it is, yet I won't ever be able to let it go. Which is why I keep writing about the experience. I hope this helps others find their own footing and maybe avoid some of the pitfalls I experienced.

But those experiences led me to where I am now. I recently joined a fitness center to rebuild the muscles sliced and diced by Dr. Joseph Boyer during my esophagogastrectomy, and after the endoscopy of a few weeks ago, I find I am able to eat and digest food (imagine!) much easier. Hooray for Botox.

So of course I wish the experience had never happened, but it did and the past year led me here. Not a bad place to be.

Botox does the trick

It looks like Dr. Philip Styne hit a home run today.

Doc Styne scoped me, found a clean digestive tract and injected Botox into my pylorus, the valve that regulates the flow of food from the stomach to the small intestines.

I uploaded some photos from my phone to the blog earlier, but they didn't seem to land properly, so I'm attaching them to this post, plus

a view of said digestive tract as the good doctor saw it earlier.

But the results seem evident. I can eat, and the food seems to be traveling as it should. Depending on how long the Botox lasts, I might

need another injection in a few months, possibly more. If it lasts just a short period, the docs might huddle to find a different option, possibly a surgery called something like pyloroplasty. This

would surgically alter the pyloric valve so it would allow foods to move on down the road.
But for now, that doesn't seem to be in the picture.

A day away from Botox

Well, about a day from now I'll be waking up from my snooze during the endoscopy and Botox injection(s) into my pyloric valve.

I spoke with Dr. Philip Styne yesterday, Tuesday, to get a couple of questions answered. First one, I was eating wrong on Monday. I shouldn't have had anything but clear liquids, so the yogurt and pudding were not correct.

Yesterday I corrected myself and had only clear liquids, though I was permitted to have chicken noodle soup. I had a lot of chicken noodle soup.

I also asked more about the procedure. For example, this is not done often. The goal is to loosen muscles of the pylorus so food will flow more often from the stomach to the small intestines. Right now this flow is spotty. The Botox will knock out the nerves controlling the pylorus for a while.

Dr. Styne and Dr. Joseph Boyer, my surgeon, want to see how long it will last before another Botox shot is needed, or even whether it works at all. If it works and lasts a while, I'm likely in for another procedure or two down the road. If it works but does not last all that long, surgery might be the answer.

Thrills.

I also found out that the Botox just numbs out the nerves, but does not kill them as I suspected. That was good news, as I didn't really want to deal with any form of death in my body. Had enough of that.

So here I am, typing and sipping my cup of tea. Mmm, breakfast. For lunch I will have either chicken or vegetable broth, and then the same for dinner at work.

But I can't wait for my breakfast on Thursday -- about a day from now.

Hello, Too Jays.

It has begun ... mmm mmm good!

Well Thursday morning, I have another endoscopic procedure. This one will again be by Dr. Philip Styne, but unlike the last scope or two this will be at Florida Hospital.

Also unlike the others, I have to be on a liquid diet for the three days leading up to my procedure. Which means starting this morning, I've been pretty much off solid foods.

So I've had yogurt, pudding, soup, soup, cereal and, oops, a couple of summer rolls. Yes, I cheated. But they're mostly noodles, which I'm allowed in soup, so I'm not too fazed.

But tomorrow I'll be very loyal to the diet and Wednesday I'm going to stick with mostly clear liquids.

The reason for this diet is because in the last scope, Dr. Styne had a tough time spotting parts of the stomach he should have been able to see. So I had to be intubated again and suctioned while I was unconscious. He determined my pyloric valve -- also known as the pylorus -- isn't doing the job it's supposed to do, namely move food from the stomach to the intestines.

Because it might not be working right, I'm going to get a shot of Botox in the pylorus so it will loosen up and let the food flow.

Back to my short-term diet. Soup. Mostly soup. Mmm mmm good. I do like soups of all kinds, yet I don't know if I really like them this much. I fear that once the procedure is done, I'm not going to want soup for a long time.

Murky look

Dr. Philip Styne took a look inside my esophagus and stomach on Friday, and he said it was kind of murky inside.

Apparently this is because I've been eating the wrong foods since the opening to my stomach was dilated two months ago. I grew cocky, daring my system to work right. Of course, it wasn't, and Friday's exam, pictured here (look if you dare) was the result.

Another result is yet another endoscopic exam, this time at Florida Hospital in a couple of weeks, to dilate more and also to inject Botox into the muscle at the base of my stomach, easing its clench so food can pass easier through to the intestines.

I know, sounds both exciting and appetizing.

Meantime, my diet must change. Steaks, out. Burgers, in. Salad, out. Burgers, in. Nuts, berries and fruit, mostly out. Eggs, in. Get the picture?

Hopefully once the Botox is in, things will change I at some future point I'll be able to go back to a normal diet of salad, steak, dessert, you know, the Outback kind of dinner.

Though I hear they have a good chopped steak on the menu.

Busy end of the week in store

Friday will be busy for me. Early that morning I'll be back at Dr. Philip Styne's office and will undergo another endoscopy with dilation.

It's another minor procedure -- in the scheme of things. The good doctor, or, rather, very good doctor, will stretch out a stricture in my stomach-turned-esophagus to help me swallow and digest food.

The procedure is a standard follow-up to the exact same thing I had done two months earlier. It was planned at that time and is not unique to me.

So, back to Friday. I go in early that morning. Son-in-law Luis Nunez will drive there and back because I should be a bit woozy for the ride home. Also, because of the happy meds I may not remember too many things soon after the procedure, such as instructions from the doc and that kind of thing.

I'll then rest at home until it's time for work.

So that's what my Friday has in store for me. As always, I'll update the blog when I can after the procedure is done.

I just hope I don't gain another 10 pounds, as I did after the earlier endoscopy in August.

A year ago

Almost exactly 12 months ago, a nightmare began.

It brought out the worst in me and the best. I learned all about fear. Imminent fear of death, of losing my family, of my ill mother's fate. I discovered an anger within I never knew. I worried about my family's finances, about my family, where they'd go, what they'd do if I were not here. But I also learned that I had an inner resolve. I was not going to be overcome by all of these negatives. I would survive.

A year ago, I'd already been diagnosed with cancer of the esophagus, I'd undergone a PET scan that confirmed the diagnosis through an earlier endoscopy and biopsy of a tumor. I'd been counseled by a few wonderful doctors. My insurance company had expedited approvals -- and my angry shouts -- for the upcoming treatments.

Well, I'm still here. Not quite sure if I've won the great battle. Not sure yet if I truly am a cancer survivor. But I feel as if I am.

I am here a year later. Since the diagnosis, I've undergone radiation -- enough to light a small town, I'm sure, under the direction of radio-oncologist Dr. David Diamond. A great guy with whom I agree on almost everything but politics. I've undergone weeks of chemotherapy, administered by Dr. Lee Zehngebot, perhaps my favorite doctor of all time. Surgery by Dr. Joe Boyer was extensive, but seemingly successful.

Months of recovery and tests and more tests and treatments passed and I returned to work, weak and tired but alive. I'm bouncing back and feel pretty good. I've gone back on the sailboat three times since the surgery and can hold my own on the water, even if setting up the mast and breaking her down again is quite tiring. I'm gaining weight, something I haven't really done for more than a year, and feel like I'm pretty physically able.

Emotionally, scars remain. But you learn from your scars and I've learned a lot. I am no longer easily scared. I've faced death and feel like I've won, though this is yet to be determined. I also am no longer afraid of my anger, my rage. I respect the anger, and have learned how to rein it in. I've lost my mother, a friend and lifelong part of my life, and learned to live with this deep loss.

I still ache, but pills help there. I will forever need pills to help me digest food and control stomach acid. Physically, if you forget the cancer I am in better shape than I have for years.

Like Dr. Boyer once told me, I'll never be able to pitch for the Yankees. But that's OK.

I always played catcher.

Another milestone -- 15,017

Not long ago, just a few hours actually, my two blogs, CancerVivor.blogspot.com and kohnzone.blogspot.com, went past 15,000 page views.

In the scheme of things, that's not a very vast amount of traffic. But for me, it's ginormous. That's because it means my messages of health (cancer blog) and of a reunited family (kohnzone) are getting out to at least a handful of avid readers who keep clicking here, and, maybe, to more than that on a less-frequent basis.

My key goal is to get as many people I can to understand how I acquired cancer of the esophagus so that maybe, just maybe, they will not.

(Advertising interlude here: Please remember to click on the ads on this blog, as any money raised -- so far just $31.13 -- will go as a donation to Florida Hospital Cancer Institute. But Google won't cut a check until there's more than $100 in ad revenue, so get to work!)

So I'll recap. Yes, you can get cancer from heartburn. Heartburn causes acid reflux, which splashes stomach fluids onto or into the esophagus. When it happens too often, the esophagus gets defensive. It changes and takes on some characteristics of the stomach. This change, Barrett's Esophagus, is a pre-cancerous state. It opens the esophagus and other parts of the body to developing cancer. That is what happened to me.

So, almost exactly a year ago, I was diagnosed with cancer thanks to the expert endoscopy of Dr. Philip Styne. Hurriedly, he sent me to my wonderful oncologist, Dr. Lee Zehngebot -- Dr. Z for short -- who explained a lot and hooked me up with Dr. David Diamond, my fantastic radio-oncologist, who started my radiation program like it a matter of life or death -- which, after all, it was.

First, both docs had me go into Winter Park Hospital to be outfitted with my high-tech bodily accessories -- a medical port so Dr. Z could infuse my body with wonderful chemical cocktails and a feeding tube so Dr. Diamond could be sure that if I couldn't swallow food the old-fashioned way I could drink it without it ever passing through my lips.

Then I was tattooed and set up on a radiation program, which began a day or so later. A few days after that I had my first dose of chemo, a several-hour procedure where I was doped up pretty good at first and then -- bang! -- saturated with poisons to kill the cancer, or at least keep it from spreading as the radiation bombarded the tumor. I had radiation five mornings a week for several weeks and at the same time had a new buddy -- a chemo pump that slowly dripped the chemicals into my medi-port 24/7 for the same amount of time.

Nearly two months of this went by -- all while my mom was often unconscious recovering (I hoped) from heart surgery and lung complications -- and then I was free of both forms of helpful torture.

(Remember, this is the condensed version.)

I then had a month or so of a cooling-off period. This was from mid-November 2007 to late December of that year, during which time my mom transferred to a rehab center in Orlando and my daughter Jennifer Kohn became Jennifer Kuz when she married Chris Kuz in December. The Friday before Christmas 2007, it was Dec. 21, I went under the skillful knife of Dr. Joseph Boyer, the chief of thoractic surgery for cancer patients at Florida Hospital and, yes, a Yankees fan. But first I had to undergo a PET scan, which found two "hot spots" of possible cancer and then the two biopsies -- to my liver and chest near the lungs -- to confirm that they were not cancerous.

After the surgery, I spent nearly three weeks in the hospital -- one of them in the ICU with a tube running from my stomach, out through my nose and to a suction and a TV whose sound would stay on after you bash it with your arm -- before I was able to go home weighing about 75 pounds lighter than before I was diagnosed with cancer.

After another recovery period, in which I consumed many oxycodone and then hydrocodone pills to ease the constant pain, I was cleared to return to work and in mid-February 2008 I walked back to the Orlando Sentinel's newsroom. Shocked, truly, I received two standing ovations from the many friends who supported me with cards, letters, calls, a scrapbook, e-mails and prayers during my ordeal. These are the people dreams are made of, wonderful friends and colleagues who kept me going, folks who I'll never in my lifetime be able to forget or repay for their many forms of kindness.

So in a nutshell, that is what I went through. And it's why I want to help keep others from going through the same thing. Maybe that's why I've made it this far; to keep you from coming down with this horrid disease. So I'll repeat some of the facts and tips here:

Cancer of the esophagus is among the most deadly forms of the disease an it also is among the fastest growing of the cancers, as society and work habits evolve. By the time you find out you have the cancer, it's practically too late. Luckily, it was discovered in my lower esophagus before the disease spread to my lymph nodes and the rest of my body.

I found it because it was difficult to swallow, so remember, if you find have difficulty swallowing food or drinks, see a doctor. If you've had heartburn for a long time and it seems to have gone away without medical help, see a doctor. It probably didn't. Both problems are signs of cancer or at least Barrett's Esophagus. Remember, Tums and Rolaids won't relieve you of cancer, they just ease the symptoms of heartburn. See a doctor. Get an endoscopy by a qualified gastro doc. Listen to what he or she says very carefully.

Oh, and keep a positive attitude. You'll need it for what's to come.

But first let's pray it never gets that far.

Another chance under the scope

I'm all scheduled now for another endoscopic exam on Oct. 3. Dr. Styne explained that this dilation is a standard follow-up to the one I had in August -- they usually do a second dilation two months after the first, I guess to make sure it takes.

So far the first one has taken, almost too well. I've literally gained about 10 pounds since that endoscopic exam. Dr. Z said that's most likely because now I'm actually able to digest my food. I'm still taking Reglan to help me digest the food. But it seems to be working.

So while I always look forward to seeing Dr. Styne, because he's really a good guy and a talented doctor, I just hope this time I don't put on too many more pounds afterward. I enjoy having a loose fit in a size 36.

Good visit with Dr. Styne

I had an appointment with Dr. Styne this morning and it went well.

After the pleasantries, we discussed my endoscopy from last month.

He said Dr. Levine did a great job dilating the stricture at the union of my stomach and esophagus. He dilated it 18mm, which he said is quite a bit. But he wants to ensure it remains open and is scheduling another endoscopy for me for early October, roughly two months after the first dilation.

Dr. Styne also wrote a new prescription for me to replace the Pepcid I now take twice daily. I've sent the script along to my mail-order pharmacy.

In all, he seemed pleased with my progress. So am I.

My visit with Dr. Z

I had an appointment with Dr. Z today, four months past the last stop in August.

He kind of explained my sudden weight gain, and it's pretty much what I thought. Since the endoscopy three weeks ago (has it been that long?) I've actually been digesting my food better, thus taking in more calories and nutrition.

Who'd have thunk it?

I told him I am feeling good, lifting weights despite some post-op pain, and eating more, though I still cough in the mornings. He seemed to agree with me that it's probably still residual from either the surgery or rads. I haven't been experiencing reflux so it's unlikely to be anything from my stomach making its way to my lungs.

He said I'm looking good and he seemed pleased with my progress, overall.

After business, we talked pleasure. As in his new iPhone G3. I was going to ask, but he gladly showed it off before I had a chance. He loves it, as I thought he would.

(By the way, the photo is an old one with his original iPhone. But he was just as happy today.)

I also reiterated that I would be happy to continue chatting with other patients as needed, to offer encouragement and whatever insights I can pass along. He said I'm already on his list.

I'll see him again in December, which will be nearly a year post-op.

That voice -- again

I had a pleasant surprise yesterday, a call from Nurse Brenda.

Brenda, you might recall, is the heartbeat of the Thoractic Cancer unit at the Florida Hospital Cancer Institute. She keeps the place running smoothly. For a while during my cancer treatments and surgery and all the confusion they generate, she made sure I was where I was when I was supposed to be there.

So when Brenda calls, I answer. With pleasure.

She said she had another patient going through what I did and he'd like to speak with someone who has been through it. I won't mention his name because that is his business, not mine. But of course I told Brenda I'd be happy to speak with him whenever he'd like. I also reminded her to point him to this blog.

(Shameless plug here: I reminded her to click on as many ads as possible because the money generated from Google will become a charitable gift to the Florida Hospital Cancer Institute. At that time the total generated was about $22. Not much since September. But after reminding Brenda that Google won't cut a check until I raise $100 or more, she agreed to click on some ads now and again. So, yesterday more than $3 was raised, bringing me one-fourth of the way toward that elusive check. So folks, click away!)

I won't say when or if I hear from this person unless I gain his permission, because it is personal. I decided at the start to be very open -- some say too open (see photo posted yesterday, for example) -- but others may have different ideas.

So, Brenda, it was great to hear from you and you'll always have whatever help I can provide.

Thanks for everything!

The scopes

Well, it took pretty much all weekend to get me motivated to scan this in. The three images below are from Friday's endoscopic exam.

At left is the balloon at the end of the scope dilating my esophagus.

In the center is a look at all the gunk in my stomach that wasn't being digested, and at right is what it looks like after being suctioned.

I wasn't aware of it at the time, but Dr. Levine soon after intubated me to ensure that the contents of my stomach wouldn't come back to haunt my lungs. Once I got the all clear he woke me up and talked to Catherine about my condition. At one point, he told her I was going to be hospitalized. But I guess he did such a good job I didn't need it.

Good thing.

Back home and awake

Apparently there was some excitement in the Center for Digestive Endoscopy this morning. Just I don't remember it.

Seems I was out cold. But it turns out I didn't have a stricture in my manmade esophagus. Rather, it seems my stomach isn't digesting food properly. It's called gastroparesis, meaning the stomach is not passing the food along to the small intestines properly.

Here's a summary from the Natioanl Institute of Diabetes and Digestive and Kidney Diseases Web site:

Normally, the stomach contracts to move food down into the small intestine for digestion. The vagus nerve controls the movement of food from the stomach through the digestive tract. Gastroparesis occurs when the vagus nerve is damaged and the muscles of the stomach and intestines do not work normally.

In my case, the vagus nerve was damaged when the stomach was reconstructed to replace a majoroty of my esophagus.

The excitement this morning included Dr. Levine discovering the (mmm mmm good) undigested food in my stomach, suctioning it out, then intubating me to keep me from choking on my stomach contents.

I am OK now, save a sore throat and headache.

I don't remember any of this because I was on some happy drugs via an IV. Good thing because it doesn't sound fun.

So now I'm going to take yet another med, the generic version of Reglan. I am not thrilled because it might have odd side effects.

So, if you see me twitching or drooling, if I have hallucinations, anxiety, agitation, spasms or other uncontrollable movements of the mouth, face or hands, please forgive me. I'll only be on this stuff a few weeks to a couple months.

14,017

I am flattered and honored that there have been more than 14,000 visits to my blogs since I launched CancerVivor.blogspot.com in October 2007.

Since then, I also created kohnzone.blogspot.com after discovering a piece of my family I never knew existed.

Throughout, I have tried to warn anyone who would listen about the dangers of ordinary heartburn and acid reflux. Most recently, I logged into Facebook and soon was chatting with a friend from high school whose longterm domestic partner has been having acid reflux for years. She and her partner live offshore, so he hasn't been receiving the type of care we expect here. I implored her to force him to see a doctor and I hope she's read through this blog and forced him to read it too.

That's because heartburn can cause cancer, which can cause death. It's that simple.

So if you or someone you care about has longtime heartburn, reflux or the like, please, please have that person see a gastroenterologist. Soon.

Time is important because this is a dangerous cancer and you don't want it to spread. That's what could make it fatal.

Please keep reading and I'll keep writing. And I hope that helps save a few lives in the process.

Another procedure

Dr. Styne's office called earlier today to let me know he's out of town until the middle of next month. I figured, no prob, I'll wait. But Catherine wasn't thrilled with waiting. So I called Dr. Z's office to get his opinion.

Turns out, he called Dr. Styne's group and spoke with Dr. Henry Levine, (photo from the Center's Web site) who founded the Center for Digestive Health. I guess it's better to be safe than sorry, so I'm going to have the endoscopy with dialation on Friday morning.

I have to be there by 6:30 a.m. and the procedure is an hour later.

I presume they'll just go in, widen the stricture I've mentioned earlier and send me home a short time later.

At least, that's what I hope.

The Incredible Shrinking Man

I know it's bizarre.

First I found out several months ago that I'm no longer 5 feet, 10 inches tall. I'm now 5-9 1/2.

OK, so joints in the spine thin out over time. I can live with that.

Then, after my surgery I determine my size 12-wide shoes are too wide. I'm 12-medium.

OK, less fat on the body means things get narrower. Cool.

Now, as of Sunday, I find out my shoe size is now 11 1/2.

Oh well, I guess I have to buy a bunch of new shoes. Worse things could happen.

Not quite sure what's up

I spoke to Dr. Z on Thursday because I've been having awkward feelings at the top of my throat. Sometimes it's nothing, others it's tough to swallow.

Dr. Z said it sounds like there's a stricture -- or narrowing -- in the upper esophagus. Of course, there is no lower esophagus so where else could it be.

Once he mentioned that I realized that while in Florida Hospital after the surgery I remember the doctors mentioning a stricture. This was when I was in radiology swallowing a nasty-flavored drink laced with radioactive iodine so they could watch me swallow the liquid to ensure I could be released and able to eat.

So he wants me to call Dr. Styne's office on Friday. He said Doc Styne will probably want to do another endoscopy and dilate this stricture.

I also have an appointment with Dr. Z set up for August 22 at 10:30 a.m. That will be my eight-month post-surgery visit.

I don't think there's anything cancerous about my current problem but it still remains disconcerting. Dr. Z said he understands my concerns and thinks it's a good idea to check it out. And anyone reading this site knows that whatever Dr. Z says is golden in my book. Basically, the man's amazing.

I'll keep you posted.

13,025

That's the number of hits to my two blogs, kohnzone.blogspot.com and CancerVivor.blogspot.com since I launched CancerVivor late last year.

Wow.

And to think it happened -- surpassing 13,000 visitors -- on this day, Friday the 13th of June, 2008. Maybe my luck is changing for the better, after all.

CancerVivor was borne to help people avoid the ordeal I went through late in 2007 and early 2008, when I was diagnosed, treated, irradiated, extricated and cleansed of cancer of the esophagus. I hope the blog saves lives by educating people.

Cancer of the esophagus is among the most deadly forms of the disease. It sneaks up on you and by the time you find out it's there it's practically too late.

I was lucky. It was discovered in my lower esophagus before the disease spread to my lymph nodes and the rest of my body. Luckily, I had amazing doctors who recently had taken part in a national study of a new way to treat the cancer. It appears to have worked, thanks to their skills, dedication, hard work and good humor.

Dr. John Pfeiffer in Celebration sent me to the right gastro guy. Dr. Phillip Styne found the tumor and sent me to just the right oncologist. Dr. Lee Zehngebot and radiation oncologist Dr. David Diamond -- both fresh from the study mentioned above -- did a one-two rope-a-dope on the cancer and zapped it from existence and kept it from spreading. Dr. Joseph Boyer then went in and cut the tumor and surrounding tissue out.

There were others, but these are the main players. All to save a life so, hopefully, I could save some more with this blog.

Remember, if you find it difficult to swallow, see a doctor. If you've had heartburn for a long time and it seems to go away without medical help, see a doctor. They're signs of cancer or at least Barrett's Esophagus, a pre-cancer condition. Remember, Tums and Rolaids won't relieve you of cancer, they just ease the symptoms of heartburn.

See a doctor.

I did, and I'm here as a result. Also a result is the reason behind my latest blog, kohnzone.

It was created after my Mom died in early April and I discovered I have three surviving siblings, two sisters and a brother, on my father's side. I went from only child to eldest child overnight.

And in two days, I'll be on their side of the continent ready to meet up.

Catherine and I fly off to Los Angeles on Monday afternoon. We'll be there nearly two weeks and have a lot planned in that time.

But before I leave, tomorrow, just hours away, really, daughter Aimee is getting married. Longtime in discussion but just a week to plan, we're having the ceremony and celebration at our Orlando house. I'll update the blog with photos and, perhaps, video during and after the wedding and reception.

Then Catherine and I will finish packing for the trip.

What a weekend. What a couple of weeks.

But, thankfully, what a life!

Exhale, Waiting to Inhale

Sitting in an uncomfortable swivel chair in something akin to an old-time phone booth, but with suction-and-vacuum-sealed doors, I had to inhale, hold my breath, hold my breath, hold my breath, exhale, then inhale and exhale rapidly as if I were trying to hyperventilate myself.

That was just one of the tests by the respiratory therapist earlier today.

I also had a few X-rays of the lungs, which showed up clean (whew!), and a good chat with the doc.

Dr. Sigfredo Aldarondo said my coughing might be caused by acid reflux. Since my reshaped stomach (now in my chest) is so close to the smaller esophagus and since there's no sphincter to keep stomach fluids from the esophagus, that could be the problem.

He prescribed a new med to replace the Pepcid I've been taking.

We'll see if that helps. I'll keep you posted.

Checking In With The Doc

I'm going to see Dr. Sigfredo Aldarondo (pictured at right, from the Florida Hospital Web site), the ace pulmonologist, for a checkup scheduled months ago.

Dr. Aldarondo first treated me while I was in the step-down unit at Florida Hospital. He was very comforting and assured me that my breathing difficulties post-surgery would wane. He was not wrong.

But it's a good thing we made the appointment soon after I left the hospital because off all my post-surgical issues -- other than the pain -- my biggest problem has been breathing, or, more precisely, coughing.

Dr. Z and Dr. Pfeiffer concur in their opinions that my persistent coughing was caused by the radiation treatments that saved my life.

It will be good to hear what Dr. Aldarondo sees as the proble, and whether it should be treated in any way.

I'll be back with an update this afternoon, after my visit with Dr. Aldarondo.

12,000 and growing

It took a lot to get here. But here we are. Since launching CancerVivor.blogspot.com a lot has changed. Much of it for the worse, but it looks like things are picking up.

I say that because of the reunion via phone last month of the Kohn siblings -- Amy, Dan and myself. Meeting Tracy, my other sister, is yet to come and I look forward to it.

But much has passed since the blog went up. I went through seven weeks of intense chemotherapy, six-plus weeks of radiation at the same time, surgery and the recuperation one needs to get over all that -- if one really gets over it at all in a deeper sense.

Then there were the eight-plus months Mom went through, along with the rest of the family, as she wended her way through horrible medical issues that eventually took her life last month.

Which brings us to here, to now. I've begun to develop a relationship with my new family, and we're all documenting it at kohnzone.blogspot.com.

And in that time, as of this morning, May 7, 2008, 12,004 page hits have been recorded on the two blogs. I'd like to reiterate it's probably the same few dozen people checking out the progress on both fronts, and you're very welcome to continue stopping by.

While you're here, click on an ad or two as you stumble by them. The money raised -- so far about $15 -- will go to the Florida Hospital Cancer Institute, the place that helped save my life.

Whew!

I saw Dr. Z today. He showed me a great Web site, actually a blog on this very service, and during the visit also went over my CT results.

"No news is good news," he said at one point. That's because the scans were fine and he said I'm looking great. That was after my three-month checkup, and I don't need another for four months.

What a relief!

He agreed that if there were a problem he'd have called, thus the "No news" comment.

But there was other news. It seems the good doctor is in the running for Man of the Year by the Leukemia & Lymphoma Society. You can go to this link and vote for Dr. Z, and by vote I mean donate to the organization to give him points toward the nomination. http://www.active.com/donate/cflmwoy/mwoyDZehnge

I can point to many of his qualities, such as his depth as a doctor, his bedside manner, his good humor and, of course, the fact he helped save my life, as reasons to help him and the society out. Don't hold his affection for all products Mac against him. He also pitched a wonderful blog my way that spoofs his hero, Steve Jobs. So how bad can he be? The site is actually a blog, and it's at http://fakesteve.blogspot.com/.

Again, whew!

A new blog

In light of the startling news I mentioned in the previous post, I've created a new blog, kohnzone.blogspot.com. Please check it out when you get a chance. - Keith

A lot to add

Greetings all. The past couple of months have been filled with many "ups" and a very dramatic "down."

The upbeat news will follow the sad so this entry leaves you with a smile, not a frown.

First, actual news. I had my CT scan last week and see Dr. Z this coming Friday for my three-month post-operation checkup. I hope that if there were positive results on the CT I'd have heard by now, so I guess things are moving along well.

The sad news was the death of my mother, Beatrice Spitz, on April 5 (pictured at right nearly ready to attend granddaughter Jenny's wedding in December).

While not unexpected after her lengthy illness, it was nonetheless surprising because of her seeming daily improvements.

Between the time of her discharge and her death, though, she had many pleasant moments.

Like, days before her discharge, when we took her to a Spring Training game for her birthday (right, with granddaughters Karen and Kim and daughter-in-law Catherine behind her). It was her first Major League game since the 1950s.

She also had many family visits since her transfer to Orlando in late November (such as this one below with granddaughter Kim).
We took her to SeaWorld Orlando a couple of times, to the mall, to restaurants regularly and outdoors from time to time.

She also was blessed in December by being in attendance at Jenny's wedding (at right, with Chris putting the wrong ring on Jenny's finger as Kim, a notary, officiates).

I truly believe she had a wonderful month prior to her death. And I think she was happy I was doing so well post-cancer surgery. She died knowing that I'm on the mend.

There really are no words to describe my feelings about this loss, except to say she was loved by so many and I know that this love will never die. Mom's family, her many friends and even acquaintances have made contact with me to tell me clever quips about her, stories I hadn't heard and stories I have. Those are the things that we can rely up on to remember Mom. I am sure she's in a better place with her wonderful parents and sisters and brothers nearby.

Now for some upbeat news, and Lord, we need it.

It had been about 1 1/2 weeks since Mom's death when I decided it was time. Time to look into the other half of my family. I'd know my father Mel Kohn, died in 1992. He had been estranged from Mom since before my birth and I had no contact with him at all in my life. I'd found an obituary for him a couple of months ago and decided to track down the survivors listed -- four children. They would be my two sisters and two brothers.

So at home before work on Thursday, April 17, I did some computer research and tracked down Amy Jones, my sister. Of the three other siblings, one, my brother Andy Kohn, had passed away in January 2007 after a lengthy illness, but another brother, Dan Kohn, and sister, Tracy Jones, still live out West.

Amy and I had a wonderful first contact, relating some good stories and shedding tears over our too-long separation. Since that time, I've spoken to Dan, an aunt, Joan Kohn, a cousin, Arlene, and two nieces -- two of Amy's daughters, Grace and Abby.

I've sent along photos and my family out West is in the process of getting some to send me.

I've only known myself as an "only child" -- it's part of my identity. So this has come as quite a shock, though a wonderful shock it is.

I'll keep everyone posted as things progress, but for the time being Catherine and I plan to travel to California in June to meet the other half of my family.

I'm protected by a team of 'Mini-Me's'

As my third week back at work comes to an end, I feel as if my life truly is getting back to normal.

First, the pump that would have provided food to my feeding tube -- had I needed the artificially (and unnecessarily) vanilla flavored Nutren 1.5 -- was picked up by Apria Health the other day. Another baby step toward my recovery.

And work is becoming easier to complete each day.

Today, friends and colleagues Jon Walton and Sara Fajardo surprised me with more than a half-dozen likenesses of myself in various "Battle Keith" characterizations that they mounted on tin, cut out to the shape and placed about my desk. They did an amazing job.

At the top of this entry is an photo of one of the seven "mini-me" tin characters placed around my desk. I make a pretty good British master and commander, don't I? And to the upper right is a shot of another version of me with ax in hand and ready to really trim stories. Sam Zell would appreciate the shorter stories.

It really is great to be back, but the coming weekend will be a good break.

First week went well

It's hard to believe my first week back at work is over. It seemed to go that well.

Of course there were a couple of computer glitches but nothing major. After all, we do have a new software system for me to learn and become familiar with.

The welcome I received was amazing. I was deeply touched by the applause when I walked into the newsroom. And thankful that there was no party; I truly hate being the center of attention.

But the next day, my relief was set aside when my friends did, indeed, throw a party to mark my return. The cakes were great, the people moreso. It was wonderful to see everyone, especially everyone with smiles on their faces; in my absence, it seems, changes at the company left little reason at times to for smiles. So the party did serve a greater purpose.

And I will say that the party also helped me...I think I gained more than a pound from that morning to the next.

And each day since I've been able to eat a bit more food. This means that I'm beginning feel my life becoming more and more normal. It's a good feeling.

Today, Saturday, I even went to Publix to grab sushi for Ann and I. Back to normal.

Gotta like it.

Back in the saddle.

I'm back!

Back to work Tuesday

It's hard to believe, but Tuesday at 3 I'll be back at work.

After a few days longer than four months, can't wait.

But as I was saying to Catherine just a little while ago, it's pretty amazing that from diagnosis to now it's been about four and a half months. Pretty amazing. My prognosis at the time I was diagnosed was grim. Somewhere between 17 percent chance of success and 50 percent, depending on which doctor or which report you got the information from. It's much better now: I have a seven in ten chance of being around two years from now and at that point they'll re-assess and hopefully increase my odds.

But I think the docs are pretty eager to see me survive, since we plan to have drinks in a couple of years to toast their success in my treatment.

So to my friends and family at work, I'll see you tomorrow. It will be a fond homecoming on my part.

I'll toast to that.

Weird stuff happens overnight

For several years now, I've worked as night local editor at the paper, which means I've seen a bunch of strange things take place.

In the newsroom and out in the "real world." Bad crimes, good reporting. Crime reporters stuck in bad neighborhoods. Some lost, some not. Cops make really good arrests and some really bad decisions.

But last night, something happened that I never imagined when I began this blog. I knew that sometime this week my blog would reach a milestone, and it happened sometime between my hitting the sack and arising this morning.

The milestone: More than 10,000 page views of this blog since its creation last year. For some blogs, that's not a blip on the radar screen, for others its an enormous amount. A few moments ago, 10,009 views were on record.

I know it's the same dozen friends clicking onto the site off and on during the day. You know who you are. I'd like to encourage you to click on some of the ads on the site since that will raise money for Florida Hospital's Cancer Institute, which saved my life. So far, the site has raised just a smidge under $9. So there's a lot of money raising to go before Google will cut me a check at $100 or more.

But the point of the blog is not to raise money, but to raise awareness about a disease that is little known but growing. In fact, cancer of the esophagus is the fastest-growing form of the disease, and it's hitting men and women alike. And it's caused by a common problem among working Americans: Heartburn, GERD, acid reflux and the like. Which means folks in my profession and others under a lot of stress are highly vulnerable.

So please, please if you have recurring acid reflux or heartburn, see a doctor who can conduct an endoscopic exam of you gullet. You'll be asleep during the procedure and you won't feel a thing afterwards. But it could save your life.

Really. Would I lie to you?

A good time was had by all

It was great to return to the newsroom today. Better yet was the news from Dr. Boyer that I may, in fact, return to work on Tuesday.

And nearly better news still was the removal of my "J-tube" at the doctor's office.

I no longer am "Keith of Borg," as I named myself early on in this ordeal as bits and pieces of artificial equipment took over parts of my body.

With the medical port removed Friday, the "J-tube" was the last of these devices. Dr. Boyer easily removed it simply by snipping the stitches holding it in and then just sliding it out of my abdomen.

But the best part of the day was dropping off my medical releases from the docs and then visiting everyone in the newsroom. It was great to see everyone. I'm now eagerly anticipating my return on Tuesday.

Dr. Boyer said that I'm also cleared to do just about anything I'd like physically. So, I plan to visit Busch Gardens and go sailing this weekend. I've done neither in months.

It'll be just another series of ups, downs, loops and dips on this wild roller-coaster that began in September.

Can't wait.

Visit to doc tomorrow should clear way to work

I'm scheduled to see Dr. Boyer Wednesday morning and hopefully he'll give me the all-clear to go back to work next week.

Except for occasionally overeating (this means swallowing a dash more than 8 fluid ounces of food and/or drink at a time, heaven forbid) and the resulting bloated and nauseated feeling I'm doing very well. I hope the good doctor agrees.

Dr. Boyer knows just where I'm coming from. Several years ago he donated a kidney to his sister and recalls the post-surgical pain, etc., he experienced. Imagine, a surgeon with empathy. He knows what I'm feeling to a large degree.

This also shows what the man's made of. Everyone says surgeons, especially heart surgeons, are filled with themselves. I haven't seen that in Dr. Boyer. Sure, he's confident. You wouldn't want it any other way. But he's a regular kind of guy, even if he does like Mac products. He's also a good guy, one who anyone can befriend and who would befriend almost anyone.

I say this not to sway his opinion of my condition but to convey my admiration.

I'm going to go from Dr. Boyer's office to Dr. Diamond's to gain his okie dokey, then I'll drop the papers off at the Sentinel. Might even see some folks in the newsroom.

A decent link

Yahoo! has added a pretty decent article with graphics and such about GERD and heartburn, both of which can lead to cancer of the esophagus. The package was prepared by the folks at the Mayo Clinic's Web site.

This is the link: http://health.yahoo.com/gerd-overview/heartburn-gerd/mayoclinic--EA5EDE79-8C89-40EB-8D46C714D1E91710.html

Remember, it's not a certainty that you'll get cancer from either of these ailments, but you could.

Minor surgery was a success

It's not a ship in a bottle, it's a port in a bottle. It's my newest paperweight -- the port removed from my body earlier today.

The surgical procedure went well this morning and I was out the door shortly after noon.

I even passed on anesthesia -- well the kind that knocks you out -- and opted instead for needles to numb out the area being cut. It was a good choice. After the initial pain caused by the the numbing agent, which lasted just 15 or 20 seconds, give or take, I didn't feel a thing. The nurses and I chatted about XM radio's benefits and pricing as Dr. Alberto V. Mansilla, right, removed the port.

Ironically, Dr. Mansilla (image from the Florida Hospital Web site) is the same man who placed the port and my former "G tube" last year in the same operating room. He remembered the procedure because I had both done at the same time, which is less common than one might think.

The procedure took about 20 minutes, though paperwork before took far longer, and even preps in the operating room took more time. Go figure.

Jenny and I were gone shortly after noon but not before a hug with nurse Kim after she rolled me out to the driveway.

Guess where Jen and I went for lunch? OK, I know it's a tough one. I was only able to eat a small piece of the potato latke from TooJays, but Jen ate most of her corned beef sandwich and one potato pancake. I then went home and am relaxing as the feeling returns to my upper right chest -- and a small amount of pain with it.

I had to photograph the port and post it, since it is what funneled my chemo into my jugular vein for seven weeks. It'll be a new addition to my desk when I return to work. It's fully sterilized and the nurses say a lot of people keep their ports as a reminder of what they've gone through. After all, it helped save my life. But I promise I will not keep my "J-tube" when it is removed from my body by Dr. Boyer next week. Promise.

A 'celebration' of sorts

In about 10 hours, daughter Jennifer and I will pull up at Winter Park Hospital for what a nurse described to me today as a "celebration" of my victory over cancer. Doctors will remove my medical port -- now implanted in my upper right chest near my shoulder. It is a sign that I'm closer to being cured than to the contrary.

Guess I am a CancerVivor -- at least for now.

For this, I have thanks for my docs -- Z, Diamond, Boyer and the cast of thousands at Florida Hospital South and Winter Park Hospital -- my lovely wife Catherine, my family, my friends and colleagues and others who I haven't yet met but have corresponded with.

The fight isn't over, as Dr. Boyer put my chance of survival overall at 70 percent. Not bad, but not 100 percent. There's still a 3 in 1o chance things could go south in the coming two years. So, I'll be checked over every few months for the next couple of years. Then my doctors and I will share a celebratory drink one evening, when I will be able to officially thank them for saving my life. Until then, I have to thank them little by little each day and each time I see them. Thanks guys!!! Really!

I see Dr. Boyer next. My visit with him is Feb. 6 and hopefully he'll agree that I can return to work the following week.

But at hand right now is the minor surgery to remove the port. It's connected to my jugular vein, and the tube going from the port to the vein wends under the skin and over a bone to link up. My big dilemma is this: Local pain killer or the good stuff to knock me out? I'll decide in the morning, but I gave the nurse who phoned today a chuckle when we discussed this decision. Like I've said before, the only allergy I am aware of is pain. It's very bad for me.

Once the surgery is over, I'll probably be at the hospital a couple of hours before my release. I'll let ya know how it went Friday afternoon or evening, depending on my state of awareness.

Normal life kinda returning

Friday morning daughter Karen will drive me to Winter Park Hospital for what I hope will be the final surgery of this whole ordeal. Radiologists there will remove the medical port they installed a few months ago.

I both look forward to this procedure and dread it. I dread it because ... well, geez, because all these things are getting old. But I look forward to it more. Once removed, my life will be one step closer to normalcy. I won't have this metal-and-silicone portal to my jugular vein bulging from my chest. I won't have to worry about a car accident that could really hurt me with the darned thing in place.

Another way normalcy is returning is my ability to eat. I'm eating a tad more each day, though a few days ago I overate -- by consuming one bite too much of chicken wings -- and became horribly ill as a result. It really is amazing how one bite can practically paralyze you. I'm sure this will change with time. Until then, I'm not even getting close to getting full. So a wing and a half will max me out for now.

Ah well, there goes my ribs or steak at Outback -- for now.

Getting the OK to work

I had a good visit with Dr. Z today. He signed my return-to-work authorization giving me a green light to return to work the second week of February. Now I just need the same from Dr. Diamond -- who is out of the office for a week -- and Dr. Boyer, who I see the week before my anticipated return, on Feb. 6.

But in the meantime, Dr. Z has put in for me to have my medical port now buried in my right shoulder surgically removed on Feb. 1. It'll be an outpatient procedure and I hope it doesn't hurt too much; I've discovered my main allergy seems to be pain.

On some of the paperwork Dr. Z filled out today to extend my short-term disability through my return date, he wrote that my prognosis looks "excellent." Gotta like it.

I did, of course, remind Dr. Z to be safe on his helicopter ski vacation to British Columbia. No broken legs. No avalanches. I encouraged him to log into blogger.com and create a trip blog similar to the one Catherine and I posted during our trip to Yellowstone this past summer (momanddadonthego.blogspot.com) so he could post his thrilling moments using his fabulous iPhone. It was meant for something like that. But the good doctor said he's likely to be too busy to blog, but he will write during the trip. So I'll pass along some of his comments (as long as they're printable!) when I receive them.

Remember, this is one of the guys who saved my life. I'll see him next in April. Hmm, figures it'll be pretty much near tax time -- one of the few things in life we can't avoid.

Eating with impunity: The ups and downs

When Dr. Boyer told me the fact they want me to take in so many calories and the fact I have to eat several smaller meals meant I could practically eat anything with impunity, I thought I'd practically be in hog heaven.

Look out buffets. Look out O'Boys all-you-can-eat-ribs Tuesdays.

But the truth is I can pack away about 8-9 fluid ounces of food at a time. A bite or two too much and I feel sooo bloated that it practically puts me down for an hour.

So much for eating with impunity. The doctor wasn't kidding when he said it'd take about a year to heal, and most of that would go toward healing my stomach and surrounding areas.

A full month after surgery, I'm feeling so much better. I'm eating food. I'm sleeping in later than a few weeks ago. Staying up later. And when I eat, I eat for calories. Imagine that. Just a few months ago I was eating salad bars and counting every calorie I could avoid. Now I'm eating cereal bars, Little Debbie snack cakes, and whatever else I can take in during these mini meals I consume to get my calorie count up to maintain my weight. Oh, and that's way below where it was a few months ago.

But on occasion I get a bit overconfident. I'll eat just a tad too much fruit cocktail or too much house special fried rice, and the price I pay is this bloated feeling that borders on nausea. I hope that these meals will slowly begin to stretch my stomach a smidge, but so far that doesn't seem to happen.

But in time, Dr. Boyer said, my stomach will stretch a bit and by the end of a year it should actually allow me to eat larger meals, though never as much as I used to eat.

And if you recall, it's not such a bad thing that my meals will be smaller.

Just a fun photo

Dr. Z shows off his upgraded iPhone. I had to post this photo on Friday. I had to see Dr. Z to pick up a fresh prescription for pain pills and of course we chatted about his iPhone and other things.

Like helicopter skiing. In British Columbia. Holy crap, right? The good doctor and a friend plan to do just that in a few weeks. As in flying to the top of a mountain in B.C. in a chopper and then returning to sea level or thereabouts using skis. Talk about being a thrill seeker.

I did have to point out, however -- and Dr. Z agreed -- that using the map function, or even the iPhone, may be difficult. As he noted, there's only one cell tower out there near the mountain. Maybe.

But he did upgrade his phone with the improved mapping software Apple announced at the MacWorld show, so my earlier post was correct that we'd discuss that even it was before my actual appointment next Friday.

More than 9,000 reasons to keep writing

Sometime yesterday the 9,000th page impression of the blog was uploaded to someone's computer. It's good to know that the same 10 people check out the blog so often during the day.

Seriously, I hope each day more and more newcomers find their way to the site. It's a way to spread the word that they should see a doctor if they have troubles swallowing, if they have severe heartburn or if they had heartburn but it seems to have gone away without medical assistance.

That is what happened to me. Years ago I had heartburn and used the state of the art treatment plans of the day: I spelled relief T U M S. Then, I took a job in Orlando, I liked it and found it to be less stressful, heartburn seemed to go away, Tums bottles were not needed. Little did I know that this couldn't be farther from the truth.

Heartburn went away because the cells in my esophagus were changing. They were becoming similar to the lining of my stomach, which meant my severe heartburn, now called GERD, was not pummelling the esophagus in quite the same way. But those altered cells opened the door to cancer forming in my esophagus.

It did. Years later -- this past summer -- I found it difficult to swallow some foods. A couple months later I went to a doctor who sent me to a specialist, Dr. Styne, who discovered a tumor at the bottom of my esophagus and occupying the lower third of the organ. He referred me to Dr. Z and Dr. Diamond, who treated me with chemo and radiation for a month and a half. Then, four weeks ago today I had surgery.

I've been declared cancer free but one can never be certain during the first couple of years after treatment. So while I have a damned good chance of a full recovery I'll have this uncertainty lingering for the next couple of years.

All because of some heartburn and a lack of desire or knowledge to see a doctor about it.

The moral of all this is get help. Get it early. See a doctor. Get treatments. Otherwise, you never know what's down the road.

Slow and steady improvements

For the most part I'm feeling better every day. Like Wednesday, when I saw Dr. Boyer. It was a good visit.

Dr. Boyer said I'm doing very well, better than many in my predicament. He said the recovery should last about a year -- mainly for my stomach to fully improve -- but that I'm making good progress. My prognosis has improved dramatically from the start of this journey, and now the next two years really are crucial. I have a 7 in 10 chance of survival, but after the two years that should "shoot up" -- and he didn't see any reason at the moment why that would not happen.

Still, there's no certainty. That's why this crack medical team I believe in will aggressively monitor my status every three months. It is possible, he said, for cancer to re-appear. I feel confident that won't happen, but one never knows.

I also finally learned the current capacity of my newly reconfigured stomach. It's about a fifth the size of a regular stomach, so each of my five or six daily meals should be about 8 ounces, give or take.

Most of my meals lately have been on the take side of things -- just haven't been all that hungry. This has led my weight to decline to a point close to my desired weight of 180 pounds. So if I can hoer around here, I'll be a happy camper. But that means eating about 1,800 calories a day, and I'm really not coming too close to that each and every day. Bagels, cheese, pudding, even milkshakes just don't add up fast enough for me.

Dr. Boyer said this is a good opportunity to eat as much as I want and enjoy amnesty in the process. Not a bad deal, but I just can't eat enough.

The doctor also told me that the "tumor board" of doctors, nurses and other members of the Cancer Institute's staff have had a good time joshing around about earlier mentions of the Yankees and Mets. It's good to see that we can all joke around in the midst of a very serious subject. It's always fun to poke fun at the Yankees and to have my Mets made fun of as well (they've earned it often enough).

Dr. Boyer said he probably will clear me to return to work the second week of February. I will have a visit with him soon before then, and he expects to clear me for work. Whew! He also expects to remove my "J-tube" at that visit. Right now it's a "safety valve" in case my diet falls too far below my caloric needs. I don't think I'm at that level just yet, but I agree it's good to have the option for now.

So for now I'll see Dr. Z in a week and after the big Apple conference (image of Steve Jobs at MacWorld by Getty Images) this past week I'm sure we'll have a lot to talk about. Like super-thin Mac laptops, needed improvements to the iPhone and the like.

Recovery is aptly named

It's true. Each day seems to get easier and easier. Fewer pain meds. More food. Less exhaustion. Amen.

I finally feel that I'm getting better. I'm noticing the improvements daily and while they're just baby steps they are steps forward.

Yesterday, for example, I took just two pain pills. Same for the day before. And along with this I'm also eating more. Cereal for breakfast, then a bagel (not from TooJays) and then more throughout the day.

For those wondering how painful the surgery site is and was, it is somewhat but was awful. Without the pain meds, the site on my side and back would be a 9 out of 10 early on, though now it's just a 2 or so. The site on my abdomen never really seemed too painful at all.

Numbness, though continues on my chest, side and down the right side of my right leg. I'm hoping it will go away with time. But as I told Dr. Boyer, if the choice is numbness or death I'll take the numbness.

Speaking of Dr. Boyer, I see him tomorrow (Wednesday) morning. I hope he'll agree that everything is looking pretty good. I think it is.

As long as the docs agree, I'm planning to return to work in early February. And I cannot wait. I'll have to adjust my body clock to be back on the night shift, but that will be fine with me. I've missed too much news already -- interstate shutdowns, killings, bombs on campus, etc.

Surgery + three weeks

It's hard to believe I had my operation three weeks ago today. My, how time flies when you're having...fun.

But seriously, yesterday and today were the two best since I've been out of the hospital. I've taken far fewer pain pills each of these days and I've just felt better overall. Nowadays I seem to have energy in the morning and then fizzle by the mid-afternoon. I have to work on building up this energy so I can return to work in a few weeks. (I am targeting early February for my return.)

I also have begun to eat a bit more food than I had earlier in the week. A doughnut here, hot dog there. All in all it adds up to more calories than I took in initially.

I've received more calls and comments from friends and I truly appreciate all the kind words. I Truly believe that this method of treatment, new as it is thanks to the Greco trials out of Nashville (and Florida Hospital), I hope more and more will be saved. Patients might experience pain, but that's what the happy pills are for. They might experience a small amount of numbness that may or may not go away, but I'd much prefer a numb knee to, say, death. It's a good tradeoff.

I continue to thank the docs and nurses and the many others who helped save my life and to hope more people in my prior condition find wonderful medical professionals like these who can assist.

Meantime, I'll keep writing and urging those with difficulties swallowing, with severe heartburn, or those who had heartburn that seemed to go away to be examined by a doctor specializing in gastric matters. It could very well save your life. Take my word for it. Please.

There's no place like home

I must say, the past few days have slipped by like a breeze.

Maybe because I'm keeping up on my meds. Maybe because I'm comfortable. Or maybe it's the fact I can sleep through most of the night and know I won't be awakened in three hours for a blood draw or a check of my vitals.

I any event, It's good to be home.

It's a good time, though to thank the many doctors, nurses, techs, therapists and others who made my stay at Florida Hospital so successful and -- mostly -- comfortable. These folks didn't just save my life. They expanded my perception of their jobs. And they're not easy jobs. I don't need to explain the complexities of surgery, doctoring or nursing, but others with jobs we sometimes take for granted also kept me going. Techs monitor your body and try to keep you comfortable, dietitians make sure you're eating properly, and the list could go on and on. You get my point.

I never did compile a full list of foods to eat or avoid at the hospital because soon after I started eating I had to stop and never got around to testing or tasting much of the fare. But let me suggest avoiding the hot cereals. The oatmeal and cream of wheat tasted like boiled and mashed cardboard. The fish dishes were good, as were some of the chicken items. That's about as far as I can go.

Since leaving the hospital I've kept up the meds and am today really feeling the best I've felt in a long time. The pain is down and my attention span seems to be increasing. The pain is down and my attention sp... uh, I just wrote that, didn't I? Oops.

I would like to than my friends and relatives who called and visited while I was in the hospital, and the many of you who wrote before and during my stay. You really made my days and gave me a sense of purpose. I don't know what to say, so I'll limit it to thank you very much. I appreciate all the prayers I was mentioned in, the wishes I received and the fact that you were all there for me. Thank you!

Enough of the sappy stuff.

I'll keep updating the blog daily or more often and keep you informed on my progress.

As for my cancer, I think I mentioned it earlier but might not have: I am 100 percent cancer free at the moment. All the pathology tests from the biopsies and items removed from my body indicate, in conjunction with the PET scan and CT scans, that there's not a lick of cancer in me.

I find it amazing that the doctors could do this -- and make it look relatively easy. They did. Drs. Z, Diamond, Styne and Boyer and their teams are just amazing. What more can I say? And I can't tell you the relief I feel knowing that for the moment I am a CancerVivor. I think I named this blog pretty aptly after all.

Going home!