CancerVivor

Happy reunion

2011-12-07T12:50:00.002-05:00

Dr. Joe Boyer and I visit briefly in one of his exam

rooms. (Photo by Susan Jacobson)

I had a couple of brief visits with two of the several men who saved my life four years ago.

Dr. Joe Boyer, the thoracic and robotic surgeon, was my first stop Tuesday afternoon. I kind of felt bad because when I arrived the office across from Florida Hospital was packed, and I took up almost 10 minutes during our brief reunion.

Then I visited Dr. Lee Zehngebot, who was in his Winter Park office. When he saw me, he gave me a hearty hug and said my docs up North seem to be giving me a clean bill of health.

During my visits with each, I gave the two major-league Yankees fans a few parting gifts courtesy of friend Mindy Levine, who has a couple of friends of her own in the Yankees organization.

It was great seeing the docs, and I was glad to be there as a "former" patient, not a current one.

Keep up the good work, gentlemen.

posted from Bloggeroid

The birthday that almost wasn't

2011-11-28T13:14:00.000-05:00

This truly is the birthday that almost wasn't.

A little over four years ago, after my diagnosis of esophageal cancer that September, I questioned whether I'd make it to age 50, let alone 52.

I remember telling myself over and over that failure was not an option. Going through chems and rads, then the intense surgery were better than the alternative, which was basically a quick death via starvation.

My many friends and family kept my spirits up. My friends at work made me feel like a million bucks. I have a wonderful table book of notes and well wishes from my friends at work compiled by Katherine Ramirez Massey, well, before the Massey was added.

So age 48 came that November. We celebrated that I'd made it that far. A few days later, daughter Jennifer married Chris Kuz, with my Mom at the ceremony after months of hospitalization and rehab. All was going pretty well as my body recovered from the radiation and chemicals that helped save my life during a monthlong cooling off period leading up to surgery.

Surgery finally came the Saturday before Christmas 2007, and then I was stuck in Florida Hospital for several weeks, some of that time unconscious or so well drugged I don't remember most of it.

After that was recovery, return to work and my friends -- another excuse for a party -- and my desk surrounded by my alter egos called Battle Keiths, wonderful inspirations created by Jonathan Walton, a/k/a Peter Parker, and Sara Fajardo, a soon-to-be amazing mom now living in Kenya of all places.

Soon after, daughter Aimee married Luis Nunez and later added Emily and Riley to the family. Years continued to pass. Age 50 came and went. I've made new friends, lost a couple to this and other diseases and changed jobs.

And as each birthday comes and goes, they are both reminders and blessings. They remind me of the crap I went through -- and humbling because they almost didn't happen. Each is a blessing, which shouldn't be squandered.

So I will end this post with a reminder to take care of yourselves. Especially when it comes to the potential for cancer of the esophagus. So many of my friends work in high-stress environments. Heartburn is rampant in our business -- and heartburn can cause cancer. (http://cancervivor.blogspot.com/2007/10/about-esophageal-cancer-and-me.html) The best way to avoid the problem is to treat heartburn early. See your doc and get screened. Don't do what I did -- ignore the symptoms for years and years. That way you can think about other things on your birthday other than a moment in time that almost didn't include you.

Four years -- 80% of my goal, at least

2011-10-01T17:21:00.003-04:00

In the past four years I've:

Seen two daughters married;
Gained two wonderful granddaughters;
Seen all my children blossom into amazing adults;
Reconnected with friends and family from years ago;
Connected with my West Coast family of two sisters, a brother and niece and nephews galore;
Moved from Florida to New York for a better job;
Made new friends;
Educated people I'd never met, and hopefully saved a couple of lives;
Met people I never would have under different circumstances; and
Had some downers, too, such as losing my mother and several aunts; lost friends to cancer; found out I lost a brother a year before I met my family in California; lost one son-in-law to divorce; and had far more medical visits than any one person should have in a lifetime.

Still, as I've said during the past four years, it sure beats the alternative. As in not being around during the past four years. And that nearly happened.

It was about this time in 2007 that I agreed to see my doctor, John Pfeiffer in Celebration, Fla. I'd been distracted by an apparently very successful diet and my mother's illness, and put off seeing the doc until I was persuaded to get a checkup.

That's what my esophagus looked like when it was sick.

I was having difficulties swallowing and often spit up what I did consume. Weight loss was another concern. While I was dieting, I was losing weight faster than expected. Together things started to make sense.

It was the start of this disaster known as cancer of the esophagus -- a disease that nearly killed me. It claims about 88 percent of its victims, data show. Let's catch up.

I guess I've been the lucky one. In just the past few weeks, I lost a friend to this ailment and made a new acquaintance who is coping with it at a rather advanced age. Lucky. Depends on your definition. If surviving is luck, then so far I'm pretty damned lucky. But acquiring it in the first place was anything but luck.

Rather, it took years of hard work and practice. Overeating. Gaining weight. Spicy foods. It was the triple crown needed to acquire Barrett's esophagus, a pre-cancerous condition in which the lining of the organ alters to cope with the poor dietary choices. My hiatial hernia didn't hurt the cause either.

So with luck, or the lack thereof, it's been four years since I saw Dr. Pfeiffer, who said I most likely had to have the sphincter of my esophagus dilated. He referred me to Dr. Phillip Styne for an endoscopic exam. I made the appointment and underwent the endoscopy.

I knew something was wrong as soon as I awakened about 20 minutes after the five-minute procedure was supposed to end. "There was some swelling. You may need surgery," Dr. Styne told me when I woke up. He'd taken biopsies of my lower esophagus, where this swelling was really a cancerous mass.

That was a Thursday and I wasn't going to hear back until the upcoming Monday. The weekend really sucked.

My Port after it was removed.

Monday, Dr. Styne called to say he'd made contact with Dr. David Diamond and Dr. Lee Zehngebot, a radio oncologist and medical oncologist, respectively. Dr. Z was no-holds-barred. He told me this was not good, that I was in for a really crappy few months, at the least.

The prediction was not incorrect.

Nutren 1.5. The breakfast of champions, if champions have

no taste buds and can't eat anything else. Anything. Else.

A "port" was implanted in my chest and to my carotid artery; a "g tube" was implanted in my belly so I could consume liquid nutrition (mmm, Nutren) when the radiation was expected to swell my esophagus and I couldn't swallow; I was tattooed and set up for my radiation treatment; and began seven weeks of misery: rads five mornings a week and chemo 24/7 pumped into my port, plus three half-day infusions of chemicals designed to kill my cancer.

All the while, I tried to eat as much as I could even as I was losing weight. We went to TooJays and Outback as often as possible to reward me for putting up with the crap and to fatten me up, so to speak.

A month after the chemo and rads ended, I was tested out to see if I was ready for surgery. A PET scan showed my cancer may have spread to a lymph node in my chest and to my liver. Such a development would rule me out of having surgery because it would have meant my cancer had spread and there wasn't much hope for me. Biopsies of my liver and the hylar node found the so-called "hot spots" were just residuals from my radiation. Basically, they cooked my liver a bit.

A laser is used to align my tattoos to the proper position

for radiation treatments.

So within months of discovering I was being attacked from the inside by cancer of the esophagus, the tumor appeared to have been defeated and the next step was surgery to remove the slain tumor and most of my esophagus, which would be re-created by skilled surgeon Dr. Joe Boyer in Orlando, who had to slice and dice my stomach to mimic my esophagus and still work as a stomach.

My new organ is called a neo-esophagus.

OK, that was then. Since, the road to recovery has been bumpy. Bumpy for my body and bumpier, still, for friends and family who have had to put up with what's left of me.

That's what my belly looked like after

surgery. You don't want this to happen

to you. Trust me.

Along the way, mainly through this blog, I've met some amazing people. A few have gone through this. Some know others who did. And a few are ongoing patients and newcomers to the torture wheel.

For example, just a few weeks ago I received an email from a woman in Georgia about her father. Veleta Floren told me all about her dad, Jack Holley, who was diagnosed in June. He's had a rough go and is still consuming just the wonderful liquid diet I was provided called Nutren 1.4 (artificially flavored vanilla for me, see post at http://cancervivor.blogspot.com/2007/10/is-it-soup-yet.html). But the thin tunnel down his esophagus is opening and he can swallow a minimal amount of liquids. You can read about Jack at http://www.caringbridge.org/visit/jackholley.

There were others, as well. Including friends and family. Friends like Jim Solomons, an amazing and brave man who I met through work; he was a spokesman for the Orange County Sheriff's Office and I was an editor at the Orlando Sentinel. He learned about my cancer after his own diagnosis, when a mutual friend, Bianca Prieto, a Sentinel reporter, told us both about each other's plights.

Jim passed away a few weeks ago after his cancer re-appeared a few months ago by attacking his neo-esophagus and liver. He put up a hell of a fight, something he really didn't want to do. He stuck it out and is one of the bravest men I've known.

I've also done some more research. While cancer of the esophagus is continuing its march of death, the survival rate isn't really improving through advances in treatments. Docs now do the surgery that kept me hospitalized for weeks laproscopically. The length of hospital stays is down and the chemo therapies are being refined.

Yet, last year there were 16,640 new cases of esophageal cancer and about 14, 500 deaths. Thus, the survivability rate isn't very high, based on those numbers. Just 12-13 percent. Officially, the five-year relative survivability rate for localized staged cancer of the esophagus is 37 percent, and the relative rate for all stages is 17 percent.

If you're affected by this disease, there also are numerous trials of chemo and radiation therapies going on right now. You can go to this link and find out about them.

Try not to be among those who acquires the disease. Trust me, it sucks. Americans have experienced a rapid growth of incidence in the disease. Our dietary habits have huge role. And by huge, I mean filling our bellies. We do that with all kinds of crap and then wonder why we get heartburn. Greasy and fatty foods are the behind the growth of our large rears that are, well, behind us. They lead to the heartburn that leads to the Barrett's esophagus that leads to cancer. Sort of like the neck bone's connected to the back bone, etc.

If you've been eating like this, think about it and change your habits. You may also experience some signs that you are developing problems, and if you do please see a gastroenterologist. For examplie, heartburn and acid reflux lead to esophageal damage. Your heart isn't burning. Your lower esophagus is. It's literally being digested by your stomach fluids, and it reacts by adding, over time, scar tissue and then protective cells to block the acid. But these mutations, called Barrett's esophagus, are pre-cancer cells and without treatment will result in cancer. PPIs, or proton-pump inhibitors, which help keep your stomach from creating acid, are drugs that can protect you. They're meds like Prilosec, Kapidex, AciPhex and others. They work. See your doc.

So unless you really want years of horror stories to tell friends, family and children, or worse, I encourage you to see a gastroenterologist and take care of yourself.

If you want a scared-straight type of experience, go to this link, start from the bottom and work your way back up to here. My journey might just keep you from taking the same path.

My buddy Jim needs your help

2011-08-09T15:49:00.001-04:00

Not the best image of Jim Solomons, but he's working.

My friend Jim isn't asking for any help, and he is in need of nothing physical.

But he needs your help. In the form of prayer, well wishes, positive thoughts, good vibes or whatever you want to call it. And he needs this karma now.

Jim has gone through the same cancer treatments I did, just a few years later. The technology and surgery used to fight cancer of the esophagus had been honed by the time it got to Jim. He made it through the chems and rads seemingly fine. His doc was my doc, Dr. Lee Zehngebot. His surgeon was my surgeon, Dr. Joe Boyer.

I was in the hospital a bit over three weeks after my surgery before Christmas of 2007. So when I went to visit Jim a week after his surgery, I figured he was just out of ICU, which was my timetable. One week in the ICU and then it's off the the cardiac care unit for recuperation.

Rather, Jim was being prepped for discharge. One week after surgery. Miracle Man. The esophageal cancer terminator. He'll Be Baaack (insert Arnold's voice here) -- to work.

That was the first time we'd met face to face. As he was preparing to leave Florida Hospital. We'd known one another from the zillions of calls we at the Orlando Sentinel made to the Orange County Sheriff's Office public-information team, which Jim, a civilian, helped direct.

So it was a great day. His wife Judy was there and Jim was in pain but all smiles.

Since then, Jim did get back to work, and I think the Orlando media collectively sighed -- he's the best that office has or had for quite a while. But he's has had a rough go since. He had some kidney issues. He had a minor -- if you can call it that -- stroke. He's tried hard to bounce back.

Unfortunately, so did his cancer.

Jim is back on chemo and as bad as the first batch was -- and take it from someone who knows, it was bad -- this batch is worse. He's home. He can't really eat, so he gets his nutrition from a bag in a backpack and an IV drip. Yum. He's nauseous and couldn't even hold down a milkshake today, he said. Trust me, that means it's rough going.

Jim has another major infusion of chems in a week or and he's hoping things will improve.

So am I. And so should you, because Jim truly is one of the most caring and kind individuals I've ever known. And I know many kind, caring people -- and you all know who you are. Seriously.

So when I heard Jim today I know he was feeling bad, down in the dumps, ill and sick to his neo-esophagus (formerly known as his stomach).

Right now, Jim can use your positive vibes. As you know, I'm not big into the prayer thing. But like I've said during my treatments and follow-up surgeries, prayer may not help but it surely will never hurt.

So if you take a moment when you read this, think of Jim and his family and all he's going through. And let's see if this positive feedback helps.

It certainly can't hurt.

Back home, whew

2011-05-22T11:33:00.001-04:00

Well, the surgery went well thanks to the steady hands of surgeon Brian Fallon and his team at Southside Hospital.

Results of testing won't be back for a few days - pathology is never quick - but I got a feeling from Dr. Fallon that the three elememts he removed from me were nothing to worry too much about.

He said he removed a thick fluid-like mass that may have appeared on CT scans as a desmoid tumor, plus some tissue. He also drew fluid from my pleura for tests.

And, true to his word, I was discharged yesterday after passing the hospital's requirements.

Since, it's been R&R at home, and I return to work tomorrow.

Woo hoo.

posted from Bloggeroid

Filling in missed months, and a morning mashup

2011-05-20T00:09:00.000-04:00

It's been five months, give or take, since I've updated but there's a good reason. The dog ate my homework.

Actually, it's a bit more complex than that. Basically, since December I:

Was offered a new job in Long Island;
Accepted the new job in Long Island;
Left the Orlando Sentinel but kept many friends;
Left the comfort of insurance for 24 uninsured days with Cobra as a backup;
Was diagnosed with cancer based on pathology taken from my pleura;
Was told I needed a PET scan;
Was told by my longtime caretaker Florida Hospital Orlando they wanted $10,000 down before they'd conduct a PET scan, even knowing Cobra would cover it (note, Florida Hospital is on my poo-poo list -- that's where I encourage anyone who would listen to boycott the hospital and Adventist Health);
Was given a PET scan at M.D. Anderson Cancer Center at Orlando Regional Medical Center with no money down, with the anticipation of Cobra coverage;
Was told I am cancer-free based on the PET scan;
Dr. Z asked pathology to re-evaluate my sample, and the conclusion was no cancer was actually there;
Started work in Long Island with Newsday;
Was covered with insurance starting Day 1 -- which was Jan. 24, 2011;
Found doctors to care for me; they're a good group and I'm confident all will be well;
Love my new job, new colleagues, new bosses and new residence in Bohemia, N.Y. (yes, we're Bohemians);
Found out after a follow-up CT scan that I have a desmoid tumor outside my right chest wall and attached to a rib;
Will undergo surgery in about eight hours at Southside Hospital in Bay Shore.

Well, that is the quick version that led me from then and there to the here and now.

So, I am now off food and water until surgery in the morning at the hands of Dr. Brian Fallon, the hospital's chief of thoracic surgery at the hospital. I'll be at the hospital overnight and then go home. By Sunday, I should be mostly as good as new.

I'll have my smart phone and laptop in the hospital, but I don't think I'll be able to tweet or blog from the O.R.

So until my drug-induced update tomorrow afternoon, behave yourselves.

Three years, and counting

2010-12-06T13:38:00.001-05:00

So, I'm in the office on Friday with oncologist Dr. Lee Zehngebot and he raised a very important point during the brief exam: "You know, it's been three years."

Those are three years I didn't believe I would have; I consider them bonus years. That's because when I first met Dr. Z, I didn't think I'd have much longer to live and, frankly, I didn't know if I'd want to live the tortured life I feared and envisioned.

So I'll say it: He was right, I was wrong. I'm willing and happy to take that loss.

Dr. Z said the CT scan he ordered for a couple of weeks before our appointment came back clean. Perfectly clean.

That's great news, because many statistics for my esophageal cancer report on survivability three years post treatment. In the trials my treatment was based upon, which was coordinated by the Minnie Pearl Cancer Research Network, the survivability three years out was greater than 43 percent. Earlier esophageal cancer treatments rendered three-year survivors at about a third that percentage, and in many instances far lower.

Still, I'm beating the odds just by being alive today. Thanks to people like Dr. Z, Dr. Philip Styne, Dr. David Diamond, Dr. Joe Boyer, Dr. John Pfeiffer and Dr. Adriana Otto, in addition to the radiologists, nuclear physicists, technicians, nurses, therapists, family, friends, colleagues and those I'm failing to mention.

Basically, it took a village to keep me alive.

And here I am today, swallowing a bunch of pills each day, eating less, drinking more (water) but otherwise back to normal.

In the past few weeks, I've seen pretty much all of my docs and all say the same thing: everything looks good.

I have a couple of friends going through similar ordeals, and I just pray they can experience the same successes as I and that in three years, give or take, they can write the same thing.

Statistics being what they are, I hope to update this blog in seven years to say that I'm still here, doing fine and looking forward to more. I have a good chance due to my age and health condition in other areas. And according to the same trials, the projected survivability 10 years out is nearly 30 percent, meaning about a fourth of those still here today won't be in 2017. I plan to be one of those who will be here.

Dr. Lee Zehngebot shows off his iPhone a couple of years ago.

Back to my conversation with Dr. Z on Friday. As we almost always do, we discussed the technology of the day. He tried to make fun of my Motorola Cliq XT Android phone. "You call this a smartphone," he asked, grabbing my phone. "That's not a smartphone," he added, holding up his Apple iPhone. I asked whether it was the new iPhone 4 and he said no. Finally, I had the edge. "This time, my smartphone's smarter than yours," I replied.

To quote Sheldon, the character on "Big Bang Theory:" Bazinga!

Where has all the time gone? The acid reflux redux

2010-10-05T13:17:00.000-04:00

It's truly hard to believe, to imagine, to have lived -- but three years ago this week I began an awkward two-steps-forward-one-back stumble to where I am today: healthy and wise, though still not wealthy. You know what they say about two out of three...

But seriously, A little more than three years ago I was confronted with the real possibility I wouldn't be here today. The dreaded "C word" crept into my life and quickly changed me from who I was to who I am.

Before, I overate with what I thought was impunity -- boy, was I wrong. Before, food couldn't be spicy enough. Before, I let stresses really get the better of me. Now, I monitor my intake and try to moderate it. Now, I still love and desire spicy foods, but limit the volume and veracity of my mouth-melting munchies. Now, I've walked through Hell so there's really not much that can get the best of me.

So it was three years ago, give or take, that I was diagnosed with stage T3, N0, M0 adenocarcinoma of my lower esophagus.

From the diagnosis, my entry into the world of high-tech, high-def medicine was rapid.

As I documented in this blog three years ago:

Dr. Philip Styne, the best gastro doc in Orlando, spotted the tumor at the base of my esophagus -- near the gastro-esophageal junction -- and sent me to the best person he could have: Dr. Lee Zehngebot.
Dr. Z walked me through what my next several months would be like. He told me about the chemo, radiation and surgery awaiting me.
Dr. David Diamond was next on my welcome to the world of cancer. He's a wonderful radio-oncologist and developed my radiation therapy. Together, Drs. Z and D had participated in a national trial of a new therapy to cure esophageal cancer developed through the Minnie Pearl Cancer Research Network based in Nashville, Tenn. So in Orlando I had the two perfect doctors to cure me.
They, plus surgeon Joseph Boyer, had handled dozens of similar cases and the project they'd worked on had increased the survivability percentage rate from the low-teens to the mid-thirties.

Yes, that's what I looked like after my

surgery in December 2007.

And it worked. With a few complications and setbacks, today I'm free of cancer. In the past few weeks I've seen Dr. Z, who gave me a clean bill of health but wants to keep an eye on me every four months or so. Dr. Styne did a recent check-up on me and said all looks good. He's shifting his focus and will work with Florida Hospital as it digitizes all of its records, so he's handed me off to one of his partners. And Dr. Boyer said all looks good after the original surgery and then three others -- all this year -- that were nominally related.

In the past three years, I've come to know some amazing people. Some were in the medical fields and others were the recipients of their treatments. I've also learned about several friends and relatives with some form of esophageal distress, including an aunt who developed the precursor to cancer called Barrett's Esophagus and a friend and professional acquaintance who just recently went through the wonders I experienced. Both of these are doing wonderfully, though a few other people I know or I know of didn't fare as well. In essence, this form of cancer is more common than one would think.

Esophageal cancer is out there and it is not going away. Americans, especially, are likely to see an increased incidence in the disease due to our wonderful "super-sized" eating habits. Greasy, fattening foods are supplying us with more than just the need for extra-extra-large pants. They are key ingredients in the development, over time, of Barrett's and the resulting cancer. Combine that with some salsa, pepper sauce and hot wings and here I am.

Call it the acid reflux reflex. Acid splish-splashes away in your stomach so much, fueled by those Buffalo wings. Some of those splashes seep up from the gastro-esophageal junction into the lower esophagus. You get heartburn and take a Tums. Feels better, more wings. After awhile, your esophagus responds. It tries to protect itself and physically alters -- stomach-like cells develop in the lower esophagus' lining to ward off those splashes. Barrett's esophagus is born. Since it is a mutation of cellular structure, it's not a far leap from Barrett's to cancer.

There are signs to notice. And precautions to take. If you've had heartburn and acid reflux for a while, see a doctor. Simple medications can and will help. If you haven't seen a doctor and the heartburn goes away -- get to a grastro doc quickly. That's a sign that you may have Barrett's and need immediate care.

According to the latest figures from the National Cancer Institute, nearly 10 Americans out of 100,000 developed cancer of the esophagus between 2003 and 2007. Of those, about eight were men. If you were under 20 you didn't develop this form of cancer, but folks of my age at the time accounted for more than 12 percent of the cases. During that period, 11 percent of the patients in my age group died -- I was in the lucky 1 percent who survived.

Sadly, most people died of the disease during that period -- which was just as the treatment that saved me was coming online. So I'm sure later numbers will be better.

There are some good statistics, as well. While cancer of the esophagus was growing among Americans between 2001 and 2007 at 0.6 percent a year, it declined by 0.4 percent a year among women. And deaths from this type of cancer were down among men and women overall -- down 0.4 percent a year -- though that's mostly because of the decline in deaths among women of 1.6 percent a year. Deaths among men during that period were up 1.2 percent a year. Detection at an early stage is directly related to your chance of survival.

One sad note is that while the incidence of esophageal cancer is growing, funding is barely moving up. Federal funding for research into cures for this dangerous cancer has increased only $700,000 a year between 2004 and 2008, from $21.7 million to $22.4 million. That's just a sliver of a fraction of the total National Cancer Institute's $4.9 billion budget in 2008.

Here's a final note, and a warning, from the Institute three years after my diagnosis: "Based on rates from 2005-2007, 0.50 percent of men and women born today will be diagnosed with cancer of the esophagus at some time during their lifetime. This number can also be expressed as 1 in 200 men and women will be diagnosed with cancer of the esophagus during their lifetime."

Please don't be one of them.

Read through this blog and heed the warnings from myself and others. Have check-ups if you experience some of the things I experienced three years ago. And if you do have this cancer or know someone who does, feel free to contact me via a comment on the blog. If there's anything I can do to help, I will.

Surgical strike IV: The unsung hero

2010-08-07T01:41:00.001-04:00

Before I get into the surgery I had this Monday, Aug. 2, 2010, I have to talk about an unsung hero through every one of my surgeries at Florida Hospital.

Dr. Adriana Otto
(Photo: Florida Hospital website)

Dr. Adriana Otto has been with me before and after each of the four operations I have had. At first I didn't quite realize her role in my care, but I soon came to see what a vital part of my care team she has been.

And each time she sees me as I'm prepped for an operation -- hopefully Monday's was the last time we'll meet like that -- she really helps remind me of how lucky I am to have had such a wonderful group of doctors and nurses work toward saving my life. She also reminds me of what a blessing this added time is and has been.

Now, back to the surgery at hand -- or, rather, at abdomen.

Dr. Joseph Boyer, the major-league Yankees fan and amazing thoracic surgeon, needed to go into my abdomen and rip out the mesh holding my abs and other tissue together because either it had become infected or just wasn't sitting right with my body. He removed the mesh and stitched up the insides of my body by hand with actual stitches rather than using staples. He also sewed up my skin rather than using staples. I was released from Florida Hospital's cardiac step-down unit on Wednesday afternoon.

Dr. Otto was there the moment I arrived and throughout my time at the hospital. She checked up on me, gave me encouraging words and made sure I was fine before leaving.

As a hospitalist, the so-called specialty of tending to patients in hospitals, that was her job, of course. But she went beyond that. She explained how serious the threat to my life was in 2007 and how I survived for a reason. I guess I just have to figure out what that reason is and make sure it was worthwhile for all involved. I think I've been doing that, in part through this blog and in other ways.

As I told Dr. Otto on Wednesday, I hope I don't see her under the same circumstances anymore, but I do hope we bump into one another again. That's because she truly has been an important part of my new found life.

Have a medical problem? Now you can be insured

2010-07-01T10:43:00.001-04:00

This news release came out today from the Department of Health and Human Services. It will cover the uninsured who are without coverage due to a pre-existing condition.

News Release

FOR IMMEDIATE RELEASE

Thursday, July 1, 2010

HHS Secretary Sebelius Announces New Pre-Existing Condition Insurance Plan

Affordable Care Act Program to Provide Temporary Coveragefor Americans Without Insurance Due to Pre-Existing ConditionsNow Through 2014 When the New Insurance Exchanges Are Established

The U.S. Department of Health and Human Services (HHS) announced today the establishment of a new Pre-existing Condition Insurance Plan (PCIP) that will offer coverage to uninsured Americans who have been unable to obtain health coverage because of a pre-existing health condition.

The Pre-Existing Condition Insurance Plan, which will be administered either by a state or by the Department of Health and Human Services, will provide a new health coverage option for Americans who have been uninsured for at least six months, have been unable to get health coverage because of a health condition, and are a U.S. citizen or are residing in the United States legally.

Created under the Affordable Care Act, the Pre-Existing Condition Insurance Plan is a transitional program until 2014, when insurers will be banned from discriminating against adults with pre-existing conditions, and individuals and small businesses will have access to more affordable private insurance choices through new competitive Exchanges. In 2014, Members of Congress will also purchase their insurance through Exchanges.

“For too long, Americans with pre-existing conditions have been locked out of our health insurance market,” said Secretary Kathleen Sebelius. “Today, the Pre-Existing Condition Insurance Plan gives them a new option – the same insurance coverage as a healthy individual if they’ve been uninsured for at least six months because of a medical condition. This program will provide people the help they need as the nation transitions to a more competitive and fair market place in 2014.”

The Affordable Care Act provides $5 billion in federal funding to support Pre-Existing Condition Insurance Plans in every state. Some states have requested that the U.S. Department of Health and Human Services run their Pre-Existing Condition Insurance Plan. Other states have requested that they run the program themselves. For more information about how the plan is being administered where you live, please visit HHS’ new consumer website, www.HealthCare.gov.

“Health coverage for Americans with pre-existing conditions has historically been unobtainable or failed to cover the very conditions for which they need medical care,” said Jay Angoff, Director of the Office of Consumer Information and Insurance Oversight (OCIIO) which is overseeing the program. “The Pre-Existing Condition Insurance Plan is designed to address these challenges by offering comprehensive coverage at a reasonable cost. We modeled the program on the highly successful Children’s Health Insurance Program, also known as CHIP, so states would have maximum flexibility to meet the needs of their citizens.”

In order to give states the flexibility to best meet their needs, HHS provided states with the option of running the Pre-Existing Condition Insurance Plan themselves or having HHS run the plan. Twenty-one states have elected to have HHS administer the plans, while 29 states and the District of Columbia have chosen to run their own programs.

Starting today, the national Pre-Existing Condition Insurance Plan will be open to applicants in the 21 states where HHS is operating the program.

All states which are operating their own Pre-Existing Condition Insurance Plans will begin enrollment by the end of the summer, with many beginning enrollment today.

“The Pre-Existing Condition Insurance Plan is an important next step in the overall implementation of the Affordable Care Act,” said Richard Popper, Director of Insurance Programs at OCIIO. “We have been working closely with the states and other stakeholders to make sure this program reaches uninsured Americans struggling to find coverage due to a pre-existing condition.”

The Pre-Existing Condition Insurance Plan will cover a broad range of health benefits, including primary and specialty care, hospital care, and prescription drugs. The Pre-Existing Condition Insurance Plan does not base eligibility on income and does not charge a higher premium because of a medical condition. Participants will pay a premium that is not more than the standard individual health insurance premium in their state for insurance that covers major medical and prescription drug expenses with some cost-sharing.

Like the popular Children’s Health Insurance Program (CHIP), the Pre-Existing Condition Plan provides states flexibility in how they run their program as long as basic requirements are met. Federal law establishes general eligibility, but state programs can vary on cost, benefits, and determination of pre-existing condition. Funding for states is based on the same allocation formula as CHIP, and it will be reallocated if unspent by the states. Unlike CHIP, there is no state matching requirement and the federal government will cover the entire cost of the Pre-Existing Condition Plan. While it took more than 6 months for a small number of states to establish their CHIP programs, we anticipate that every state will begin enrolling individuals in the Pre-Existing Condition Plan by the end of August.

Information on how to apply for the Pre-Existing Condition Insurance Plan is available at www.HealthCare.gov. Americans who live in a state where the U.S. Department of Health and Human Services is running the Pre-Existing Condition Plan will be linked directly to the federal application page. Those living in states running their own programs will also find information on how and where to apply on www.HealthCare.gov.

To learn more about the Pre-Existing Condition Insurance Plan and options available to residents of your state, visit www.HealthCare.gov.

An informational pamphlet on the Pre-Existing Condition Insurance Plan can be found at: http://www.healthcare.gov/center/brochures/pcip.pdf.

States by Pre-Existing Insurance Plan Administration

29 states plus the District of Columbia have chosen to operate their own plans.

Alaska, Arkansas, California, Colorado, Connecticut, District of Columbia, Illinois, Iowa, Kansas, Maine, Maryland, Michigan, Missouri, Montana, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Dakota, Utah, Vermont, Washington, West Virginia and Wisconsin.

21 states elected to have HHS run their plan.

Alabama, Arizona, Delaware, Florida, Georgia, Hawaii, Idaho, Indiana, Kentucky, Louisiana, Massachusetts, Minnesota, Mississippi, Nebraska, Nevada, North Dakota, South Carolina, Tennessee, Texas, Virginia and Wyoming.

###

You also can check out the news release online at http://www.hhs.gov/news.

Catching up on the past few months

2010-07-01T02:27:00.003-04:00

OK, so who said doctors and nurses don’t have a sense of humor.

For example:

The home-health telephone nurse from United HealthCare (motto, we put the Hell in HealthCare) calls to check on me and let me know all about their care options for my post-surgical needs.

The first thing she says, and I am not making this up: “To protect your privacy, this call may be monitored.”

Me: “Whoa, hold up. Let me get this right. To protect my privacy, you’re recording this call. [Emphasis accurate.] How is that protecting my privacy?”

She corrected her statement.

Then she explained that to comply with HIPPA regulations, I need to give her my address to confirm who I am.

Me again: “I’ve rejected HIPPA at all levels of treatment, from you guys (United HellthCare) to my doctors, hospitals and anyone else who would listen. I do not want HIPPA protections.”

HIPPA, by the way, is a federal law designed to protect patient privacy. In general, it’s not a horrible idea. It keeps hospitals from releasing information about you to callers unless you opt out. As a journalist, it gets in my way far too often when checking on gunshot victims or car-crash victims. So I remove that barrier for my friends just out of principle. When the hospital asks me who I authorize to call and ask about my condition, I always write "everyone." It's pretty simple. So simple, even bureaucrats and hospital wonks can understand it.

Nurse: “Well, I need this for HIPPA …”

I cut her off: “I don’t want HIPPA protection. I reject it. You don’t have to worry. It does not apply to me.”

She said it was company policy. I told her that her company gets in the way far too often for my liking and I don’t care about her company policy.

I also explained that she called me. To protect my privacy from ID theft, I don’t give out personal information to people who call me. If I call someone like a bank or an insurance company -- I know who I dialed, after all -- I will provide information to verify who I am.

Me: “You called me. You have my number. You know who I am. I am not giving you personal information”

Her: “Do you want me to add you to a do-not-call list?”

Me: “Yes, please.”

Somehow she was able to do that without verifying who I was.

She’s going to mail me the information she couldn’t talk about over the phone. I'll just toss it.

But to catch everyone up, the reason I received this call in the first place, after missing several over the past few months, is because I had surgeries in January, as noted earlier in the blog, and then again in March, which, oops, I haven’t updated.

The March surgery, again by Dr. Joseph Boyer -- the best thoracic surgeon in Central Florida in my oh-so-humble opinion -- was to repair an incisional hernia in my belly that developed at the site of my original surgery 2½ years ago. I’d been doing yard work and, well, my belly didn’t like that.

I did ask if he had a buy two get one free policy with surgeries. Nope, he doesn't.

So the doctor performed the operation in March and I was out of work for a week to recover. (Seriously, two weeks would have been best, but I didn’t want to blow all my vacation time.)

Still, I did recover, though I may need more work to have this incisional hernia fully repaired.

In the interim, I've had numerous tests.

My CT scan of my neo-esophagus came back negative -- Dr. Lee Zehngebot says after one more scan in about a month I won't have to see him three to four times a year; it'll be about once every six months.
An endoscopy came back negative -- Dr. Phil Styne said everything between my mouth and intestines looked good. No cancer, no problems, though no pylorus -- he couldn't spot my pyloric valve though he knew it's there. Go figure.
A cardiac-stress test came back negative -- Dr. Egerton van den Berg said my heart had no clogs and everything looks good. Safe to do some workouts and work -- as long as I don't move anything heavy and damage the incisional hernia.
A respiratory test came back negative -- Dr. Dennis Stevenson says my lungs are at the low end of normal after a chunk was removed in January, but still in the normal range. I don't need lung meds or respirators or inhalers. Whew!
My cataract implants are all better -- they had some cells growing on them but a few laser zaps by Dr. Donald J. Centner cleaned them off and I see better than ever.

That's a lot of doctor visits. Some of those incidents involved two and three visits and there were weeks where I was literally in one doctor's office or another every business day of the week.

I was at the doctor so often that I just didn't have enough time to update this blog. Not that I didn't want to, but it was hectic.

Also in the interim, a few friends have had encounters with cancer. I won't name them to protect their identities until I know they'd want me to mention them. (See, I'm implementing HIPPA protections for these friends.)

One has the same type of cancer I did. He's seeing Dr. Z and already has gone through his chemo and radiation. He's kicked butt and is doing great. Surgery is next, and I think he'll be seeing Dr. Boyer. (I reminded him once to mention how great the Yankees are, which will get him on the good side of Dr. B, a major-league Yanks fan!)

A second is undergoing chemo and surviving the ordeal well.
Another is in wait-and-see mode as docs have uncovered potential for cancer but have him being checked regularly to see if it develops.

And a fourth recently had surgery between the ears and has recovered remarkably well.

To each of these guys, I offer my sighs of relief and best wishes that the worst is behind them.

Because I know each can kick this thing's ass. They're all strong men who have petty logical and positive attitudes. And that's one of the strongest assets someone needs as they fight to be CancerVivors.

More Good News, And More

2010-02-04T22:40:00.000-05:00

The title above sounds like it was written by the Department of Redundancy Department. So I'll explain:

Last Friday I saw Dr. Lee Zehngebot, who reiterated what he'd told me a couple of days earlier: I'm pretty darned lucky.

As it turns out, the tumor removed by Dr. Joseph Boyer was a desmoid tumor, which is comprised of spindle cells, as Dr. Boyer had told me soon after the Jan. 18 surgery.

But the spindle cells formed this desmoid, not a carcinoma, which is a malignant form of cancer. While desmoids are benign, meaning they won't spread throughout my body, they are locally aggressive and quite dangerous on their own. This desmoid was seriously attached to my lung and was touching my esophagus. It could have gotten ugly had it remained for much longer.

In fact, research I've done since the diagnosis indicates I am one of 27 lucky individuals in the English-speaking world on record to have an intra-thoracic desmoid. Dr. Boyer, soon to be an associate professor at UCF's new medical school, might actually write a paper on the case, if his research jibes with mine now that he's becoming an academic in addition to just an amazing surgeon. (Line for autographs begins at the rear.)

So Dr. Z said this was the best possible scenario for me: A benign tumor; not related in any way to my previous case of cancer; removed from my body; no other signs of cancer within; I won't need chemo to treat the desmoid. Whew!

In addition, my severe chest pains are pretty much a thing of the past. Since my release from Florida Hospital on Jan. 22, I have not had an incidence of Prinzmetal's Angina. That is more good news and quite a blessing. After a year of torment, it seems to be over.

So after seeing Dr. Z on Friday, I saw Dr. Boyer on Wednesday. He confirmed that he got every bit of the tumor, which is why he had to take a piece of the lung. He removed the dressing from my incision and said it looks good. There's still quite a bit of swelling, but he said that will decrease in time, as will the pain and the numbness on my right side and chest. He said there's a chance the desmoid would return -- it's not uncommon. But he didn't think it would because of its location and origins. Whew again!

Dr. Boyer also referred me to a new cardiologist. As you may recall, I fired my previous heart doctor in Florida Hospital after he told me he came to the diagnosis of Prinzmetal's Angina "because now I believe you." This must have meant that when I was complaining about severe chest pains for the previous year he didn't believe me. Which must be why he didn't order a simple test to see what was up with my heart, such as wearing a holter monitor to record my EKG for a day or two. But I digress.

Heres the more: Monday, I meet with my new cardiologist, Dr. Egerton van den Berg Jr., whose office happens to be a flight below Dr. Boyer's. I chatted with his medical assistant, Jeremy, who described his boss as not just a great doctor but also a really good person. I like that in doctors -- so far, all of my current docs are great at their jobs and great people.

I know, it wasn't all that exciting, but it's good to me. I want a competent cardiologist to check out my ticker and make sure that after a year of spasms in my cardiac arteries there isn't any lasting damage.

I'll find out in just a couple of days. I'm hoping the good news continues...I sure can use it; maybe 2010 will be a good year after all.

Dr. Z turns a frown upside-down

2010-01-27T17:06:00.000-05:00

What is it about Dr. Lee Zehngebot, the amazing oncologist from Orlando?

Even as he feeds me somewhat less-than-great news it turns out to be really good news.

Dr. Z called a short time ago to let me in on some news garnered from this morning's tumor board meeting.

Turns out that the tumor pulled from my chest last week was not a spindle-cell carcinoma, a very rare malignancy. That's the great news. Really great news.

It was, however, a desmoid tumor, which also is rare but is not malignant. Not cancer.

"A desmoid is a growth of cells that is not malignant," Dr. Z said. "The bad news is there's a chance it will come back."

And after doing some reseach since his call, it's a good chance a desmoid will return.

They most commonly arise near scars due to abdominal surgery, according to WebMD. They also are "locally aggressive" and can cause trouble for nearby tissue, especially muscles. "Desmoid tumors tend to infiltrate adjacent muscle bundles, frequently entrapping them and causing their degeneration," eMedicine reports.

"This course and the tendency for recurrence make the treatment of these relatively rare fibrous tumors challenging."

Of course, I'm always up to a challenge.

I'll visit Friday morning with Dr. Z and we'll figure out a way to monitor the growth of these things. I presume it will be with continued CT scans, which picked this sucker up during the summer and recorded its growth a few months later.

So the really good news -- no malignancy -- was marred a smidge by the fact that I have a new nemesis to keep an eye on.

Home, sweet home

2010-01-25T23:42:00.000-05:00

As wonderful as the folks at Florida Hospital were, it's so good to be home.

During the weekend I enjoyed the birthday celebrations for granddaughter Emily. Aimee and Luis held the party at My Gym in the Dr. Philips area, and though skeptical at first I confess that the place was really cool, and all the little ones had a blast. There was another party afterward at Luis' parents' home in Kissimmee. Family was there in abundance, as were family friends. I was so glad to see friends and colleagues Anika and Eric Palm and their 4-month-old daughter Olamina, or Mina for short.

Though I must say that it was in a mirror at My Gym that I noticed I was standing stooped down, looking old. It was because of the surgery I had less than a week before and the pain pills I was on. But I looked old and rickety, and I guess at that moment I was. (No comments from those like my daughters who would say I look old all the time.)

My days mainly involve sleep. Some of it is created by exhaustion from activity, albeit minimal activity. Some is chemically induced. (You know my motto: Better living through chemistry!)

I get on the computer once a day for a few minutes, give or take. I have received so many comments from friends on Facebook and from this blog, and I'd love to reply to all, but it'll have to be when I can focus for a bit longer.

I have a visit with Dr. Joe Boyer, the surgeon who pulled the tumor from my chest, next week and prior to that visit I hope to hear from the doctor about a new cardiologist.

At that visit I hope to get an estimate of how long my recovery will take and when I'll be able to return to work. Most folks look for ways to get out of work, yet I just can't wait to return.

Maybe that's because it'll mean my life's getting back to normal.

Odds and ends

2010-01-20T22:07:00.002-05:00

Except for the surgery and related pain, my stay at Florida Hospital has been filled with stories of courtesy, kindness, and at least one example of just the opposite.

First, the good.

Surgical prep nurses. They have a tough job with immediate deadlines and still make patients feel like human beings.

Cardiac step-down nurses. After a day and a half stepping down, I had one of my so-called "fart attacks" -- which caused a lot of sweat. Two words after that -- sponge bath.

ICU nurses. Beside another sponge bath, these ladies and gentlemen are amazing at what they do. Last night, when an alarm went off just about the entire staff converged at the room of an 100-year-old woman. She didn't make it, but that is not because of this team's efforts.

Now the bad

An unnamed former doctor of mine. Now up until today this doctor seemed a caring, focused man. Today, as he explained what was wrong -- a diagnosis Dr.Lee Zehngebot had come to more than a year ago -- spasms of cardiac arteries, a form of angina -- I pointed out, "I told you guys about this over a year ago." His response: "Now I believe you" So, for a year, I have been having the most horrible pains I've ever experience because...what? I cannot even fathom an excuse.

Any ideas out there?

Well, turns out it is a cancer

2010-01-20T03:07:00.003-05:00

I learned two things yesterday about the 6 cm by 5 cm mass pulled ftom my chest Monday:

First that it likely is a rare form of tumor called spindle-cell carcinoma and that it most likely has all been removed from my body. It is so rare, in fact, that it stealthily hid in my body past two PET scans designed to detect fast growing tumors like this.

Second, that it was likely not the cause of those faux heart attacks -- or fart attacks as I like to jest. Rather they are likely caused by something diagnosed by Dr. Lee Zehngrbot -- my oncologist -- more than a year ago: cardiac arterial spasms.

Apparently they really were not being taken seriously until I had two of them in the hospital, one Monday on the operating table that freaked out thoracic surgeon Dr. Joe Boyer.

He called in my new favorite cardiologist, Dr. Cal Weaver.

So now I am in the cardiac ICU for a day so they can stabalize my blood pressure and figure out what is going on with my heart.

As for the tumor, the pathology tests should be in later today.

Post-op party? OK wouldn't go that far

2010-01-19T04:23:00.002-05:00

It is nearly 4:20 a.m. Tuseday, about a day after I started Round 2 of surgery here at Florida Hospital.

Went to Rapid In and Out a bit before 5 yesterday. Thankfully I didn't have paperwork to fill out. That was done last week.

Soon I am in a prep room not far from the one I was in a little over two years ago. A couple of notable moments: Warm blankets and "Shave and a chest cut, two bits!" The tech comes in to shave my chest and side and i aked him to avoid a lirrle skin tag on my chest, and he did. Remarkable because when I asked last time the request was ignored. Further, after the young man was nearly done I asked if he could balance me out and shave the other side. He did, gladly.

IV and main lines were injected and before you knew it -- or better phrased, before I knew it -- i was out like a light.

I awakened in post-op recovery, were a person to my left was in far graver shape than I. There was no one to my right, until a 5- or 6-month-old child was wheeled in on a gurney topped with a crib -like contraption.

Soon enough I was ready to move to a room, but there was a "code blue" on the way and so I had to wait.

Finally I was brought to my room, 8840.

As described in an earlier post, it is quite amazing: Wide-screen TV, a view of the sunset to -- um -- live for, and a great nursing staff.

The one downer of the day came when I found out the thumb-size "soft-tissue mass" in me was far larger than thought -- as if you' attached four thumbs together like a raft of thumbs. (Do i get a refund on the CT scan or radiology report from August or December?)

And it no longer is a mass but a tumor -- hopefully benign.

Hopefully, I will find that out today.

Pre-surgery update

2010-01-17T10:06:00.002-05:00

Well, in the past week a lot has happened.

I did make an appointment and saw Dr. Joe Boyer on Wednesday. We agreed I need surgery to remove the "soft tissue mass" that he said is adjacent and possibly affixed to the exterior of my "neo-esophagus."

He explained the risks of said surgery as well as his likely method. Dr. Boyer first will try to operate laparoscopically, by making three small incisions to my right side and going in with a camera and itsy-bitsy tools. Yes, that is the technical term.

If that doesn't work out, my side will again become a slab of flank steak and be sliced open so he can get hold of the growth and yank it out.

The surgery should take a couple of hours.

I have been to Florida Hospital, poked, prodded, peed in cups, oozed blood and glowed in the dark in preparation for my operation early -- very early -- Monday morning.

Tonight and again about 4 a.m. I have to shower with a medicated soap to kill anything alive on my upper torso.

After the morning shower I go to the hospital by 5 a.m. to prepare for the 7:30 a.m. operation.

When I awaken several hours later, I will be in the ICU. There I will still have a foley catheter and a main line into my aorta.

Once I move to a real room, I will be in the hospital's spanking new tower, with its 42 inch flatscreen TVs and unlimited cable and internet and video games.

Of course I will probably be too stoned to enjoy it all.

I should be hospitalized three or more days, depending on the type of surgery Dr. Boyer employs.

Saturday was my last day at work before starting short-term disability. Hopefully I will return sooner rather than later. I will miss my friends and colleagues during my absence but will keep in touch by phone and email.

So here is to hoping today isn't the last day of the rest of my life and that tomorrow's early morning procedure goes smoothly.

Till we meet again!

Surgery is next step

2010-01-10T10:59:00.001-05:00

Dr. Joseph Boyer and I chatted Friday about my situation. He was teetering as to whether to order surgery.

Generally he'd have considered waiting but because i am symptomatic -- my pains continue, only more frequently and with more severity -- he said the surgery is justified.

But he warned that there are risks, namely the surgery will hurt -- no way around that. In addition, it may not stop the faux heart attack as I call them. Finally, he pointed out, the surgery would be so close to his previous masterpiece -- my resected sliced and diced stomach-esophagus hybrid -- that it could cause damage there.

Those are all valid concerns I was weighhing over this weekend.

Until this morning.

That was when I had another incident. The pain convinced me that I really need to make a change. It is so unbearable that I decided right then to phone Dr. Boyer on Monday and schedule the surgery.

I figure the pain outweighs the risks. If I am destined to a lifetime of pains as severe as I have had -- in medical parlance a 10 to 11 out of 10 -- I am not sure whether I would forgive myself for not taking the chance.

So I imagine that after arranging things at work and getting an estimate from Dr. Boyer as to how much time I will need, the surgery will be scheduled relatively quickly.

Hopefully that will put an end to more than a year of these horrible heart attack symptoms.

Glow-in-the-dark editor

2010-01-06T13:18:00.001-05:00

I had a CT scan this morning to see if that soft-tissue gelatinous mass adjoined to the outside of my esophagus has grown in the past month.

The scan was requested by Dr. Joseph Boyer, the chief of thoracic surgery at Florida Hospital. He is trying to determine whether to remoce the mass from my body and if so, whether to remove it endoscopically or surgically.

His colleagues discussed my case last week after receiving results of the biopsy taken before Christmastime, which determined cancer was not the issue because it came back negative.

So Dr. Boyer will first determine whether there was growth and if so whether it warrants removal, then determine how.

When we spoke last week, he told me he was somewhat perplexed, saying he'd never come across such a case before. He seemed to think I probably would end up in surgery but had to exhaust all possibilities first because of the dangers involved.

The would-be surgical site in my body is adjacent to the spot where two years and two weeks ago Dr. Boyer dissected my stomach, removed most of my esophagus and then took all the remaining parts and made a pull-through esophagus-stomach hybrid. So he doesn't want to damage the great job he'd already done. Plus, the area is close to the lungs and heart in my chest.

As Dr. Philip Styne told me, "there is a limited amount of space" there.

So I should find out in a couple of days what might be in store.

Happy New Year!

The case of the soft-tissue mass

2009-12-22T00:48:00.000-05:00

When last we met, I was going to see thoracic surgeon Dr. Joseph Boyer, who might have to remove the growing growth attached to the esophagus he created from the excesses of my stomach.

Dr. Boyer said the PET scan's all-clear might be inconclusive because the CT scan showed this growth had pretty much quadrupled in size since the summer. He felt a biopsy was needed, and suggested Dr. William Mayoral, a partner of Dr. Philip Styne. Well, he said he could do it but the procedure "would hurt more" if he had to surgically obtain the biopsy. Further, Dr. Boyer said if Dr. Mayoral pulled the biopsy, he might be able to suction the entire soft-tissue growth from my body if it was comprised of fluid.

So, the docs got together and scheduled me for the biopsy on Friday -- Dr. Mayoral was going to grab the sample via an endoscopy with ultrasound to locate the growth outside the esophagus, then use a needle or some other small surgical device to obtain the sample.

He did this procedure and it went well. As I was waiting for the car to be pulled around at Orlando Regional Medical Center, Dr. Mayoral phoned me to say it appeared the tissue was not malignant.

Whew! This confirmed the PET scan's findings: I apparently don't have more cancer growing inside me.

So Monday, I saw Dr. Lee Zehngebot, the oncologist who along with a slew of other docs and medical professionals saved my life through chemistry. Dr. Z spoke to Dr. Mayoral, who confirmed that the tissue was negative for cancer. But he was concerned: "I don't know what it is," Dr. Z said. And that concerns him.

So his office is setting up another CT scan for two weeks from now to take another look at the growth to see if it has grown further since my last scan Dec. 7. After that, it's likely he'll want Dr. Boyer to remove the soft-tissue mass.

I asked Dr. Z what the worst-case scenario is. He said I could have cancer. But the pathology tested negative, I reminded him. He agreed, yet was concerned because it was such a mystery.

(I always like a good mystery, but somehow this one I'm not enjoying so much.)

So there will be more tests and scans -- possibly surgery -- and I presume isotopes flowing through my veins as the docs solve "The Case of the Soft-Tissue Mass," coming soon to a blog post near you.

Revisiting with Dr. Boyer

2009-12-13T13:13:00.002-05:00

Since receiving the all-clear-sort-of from Dr. Lee Zehngebot last week, I made an appointment with Dr. Joseph Boyer, the surgeon who turned my cancerous esophagus and stomach into a stomach that acts like an esophagus.

I'll be at his new office across Orange Avenue from the main Florida Hospital Orlando building Wednesday morning. By then he and Dr. Z will have discussed the scans I've had last week and in August and maybe come up with a gameplan.

That's my hope, at least.

Meantime, I saw my new cardiologist, Dr. R. Charles Curry, who reiterated that whatever is causing my faux heart attacks, it's not the heart, it's not arteries feeding the hear and it likely is, as Dr. James Miner and Dr. Philip Styne explained, spasms of the arteries feeding the stomach and esophagus.

Still, no one is taking into account the cyst or whatever it is in my chest cavity and what role it may have in the attacks. Hopefully after Dr. Boyer works his magic, the attacks will go away.

A negative that is totally positive

2009-12-08T20:25:00.005-05:00

How many times in your life has a doctor called you at 8:15 at night? Not too often, right.

So it's a testament to Dr. Lee Zehngebot, the Orlando oncologist who helped save my life, that he called a short time ago to give me the abbreviated version of the results of my PET and CT scans taken Monday.

In short, he's "100 percent" confident that I have no cancer in me. The PET scan, which detects probable areas of the body in which cancer cells are growing, was negative.

Whew!

He said that the weird cyst-like confab in my chest, though, has grown since the last set of scans in August. While he's confident it's not a cancerous tumor growing, he's not sure exactly what it is.

Most likely, he said, it's "some kind of collection of fluid."

So Dr. Z said I should call surgeon Dr. Joseph Boyer in the morning to set up an appointment for next week. Dr. Boyer is the head of thoracic surgery at Florida Hospital, and the guy who cut and filleted my stomach and esophagus into a working organ from a cancerous one.

I imagine the next few weeks or months might involve a biopsy or two and possibly a surgery. But at least the doctors won't be treating a cancerous tumor.

And that's the best news this holiday season.

A day of testing

2009-12-07T00:36:00.002-05:00

I'll be at the nuclear imaging building across Orange Avenue from Florida Hospital Orlando at 11:30 this morning for a PET scan, then a few hours later in the main campus for a CT scan.

This double-whammy dose of radiation hopefully will allow my doctors to complete a diagnosis begun in August and left undetermined until now.

Back then, a PET scan saw something.

What it was couldn't be determined. So they docs scheduled a PET scan.

The PET scan didn't quite notice the small mass in my abdomen that the CT did, but it found something very small in my lungs.

What it was couldn't be determined. So my docs did what all good docs do: They consulted other docs, and still others.

In the end, Dr. Lee Zehngebot, an extraordinary oncologist, consulted with Dr. Philip Styne, an extraordinary gastroenterologist. They both checked in with other internists, gastro docs, radiologists and the like.

The conclusion? Wait three months. As it turns, it's four, but who's counting?

This will give whatever is in me to either change or not change. The docs felt this was safer than "going in" and performing biopsies on the various spots they detected. The initial thingie in my abdomen is likely a cyst. Probably not dangerous, they thought but didn't know. I think it's the thing in my lung that drew the most concern.

So in less than a dozen hours I'll have radioactive glucose injected in me from something that looks as if it came out of a sci-fi movie and then will spend about an hour or two relaxing so my body can absorb said glucose. Then the scanning doohickey will determine which parts of my body, if any, absorb the glucose quicker than expected. If something does, it's possible that is a cancerous area, since cancer cells and very few others absorb glucose rapidly.

After all that's over, I will go across the street and drink an iodine-laced cocktail for the CT scan, which isn't nearly has complex.

By the end of the day, I'll be warned to stay away from pregnant women and small children for a day as a precaution. However, my eyes will be able to light up a dark road and my hands will glow in the dark. As for other exterior organs, well, we'll just have to keep that private.

A few days later, hopefully I'll get the all clear from Dr. Z. I don't want to get news about these tests in two weeks when I see him.

Thanksgiving for me: Two years ago, I was not sure this day would arrive

2009-11-26T01:53:00.004-05:00

It's amazing how the future looks.

Two years ago I was not certain my future would include today, Thanksgiving 2009, or my birthday a couple of days later.

In my mind, the future looks like today.

Two years ago, I'd just been removed from my 24/7 chemo pump and was preparing -- as I am now -- for tests on Dec. 7. I was thankful then for my doctors, my family, my friends and for life.

Still, I remember telling my cousin David Spitz, the popular Connecticut chiropractor, that I feared I would not make it to age 50. I was panicked, often tearful. But 50 became a goal. At the time, it seemed distant, remote, unattainable.

Today, it's a bit closer -- just a few days away.

So on this Thanksgiving, I feel truly blessed with that family, those friends, my wonderful doctors, their wonderful staffs, and the knowledge that I've reached another milestone, another goal on the road to recovery from esophageal cancer.

And as a way of paying it forward, I'll reiterate as I have probably too often in this blog: If you get heartburn, if you have acid reflux or even if you take a few Tums or Rolaids every day, you could get cancer. See a doctor, have an endoscopy, consult your family doctor or gastroenterologist.

Heartburn and acid reflux could lead to Barrett's Esophagus, a precursor to esophageal cancer. There are treatments at that stage to help avoid cancer. But doing nothing is not one of them.

Be thankful for what you have today, as I am, and celebrate with your loved ones. Be kind to those loved ones and take care of yourself.

Oh, another tip here -- moderate amounts of turkey, sweet potatoes, corn on the cob and pumpkin pie are not known causes of Barrett's Esophagus or esophageal cancer. So eat up and celebrate, with your loved ones of course!

Did I ever tell you about ...

2009-11-10T10:19:00.002-05:00

Not sure if I ever mentioned in detail my experience with these faux heart attacks I've been having lately.

They're not heart attacks, but sure feel like them -- or so I've been told. I become sweaty and exhausted, chest is compressed and my chest and left arm are in extreme pain. Not quite as bad as after my surgery but damned close.

The heart and the stomach/esophagus are fed by the same network of arteries, so what affects one of these smooth-muscle tissues feeds the other. Since they're faux heart attacks and possibly be caused by something I eat, I tend to call them fart attacks. Gotta laugh at something, right?

They began toward the end of last year, when I really thought I was having a heart attack. It's what sent me to Florida Heart Group and Dr. James Miner. But after cardiac catheterization and other tests, I was cleared -- no heart attack.

Dr. Miner suggested my problems might be related to my cancer surgery. Dr. Philip Styne, the gastroenterologist in Orlando, didn't disagree. He said the attacks might be caused by esophageal spasms.

So the docs prescribed a couple of drugs in case another faux heart attack hits. They seem to hit almost nightly now, some more severe than others.

Some I believe are caused by my schedule -- and the fact that I tend to snack at night when I get off work. Others I just can't explain. They hit at night, during the day, once or twice at work.

Thankfully I have the meds and they really work. One, called Nulev, dissolves under my tongue and is supposed to help with such spasms. It works off and on. The nitro-based drug seems more consistent and reliable. Between the two I've avoided most of the really bad attacks. Those occur about once a week and I just can't manage them.

I tend to think these attacks may be caused by one of the two elements that have stymied my docs since August, when I had CT and PET scans with inconclusive results. The CT scan detected what might be a cyst in my chest. I think it is this cyst that is pressing on an artery that feeds both my heart and esophagus/stomach, especially after I eat, when the stomach -- kind of in my chest because of the surgery -- is bloated.

I've been scheduled for another round of CT and PET scans in early December. Perhaps then the docs will get a handle on what is causing the fart attacks.

The check was in the mail

2009-10-01T22:11:00.008-04:00

Finally, I was able to follow through on a pledge to make a donation to Florida Hospital Cancer Institute.

That happened this morning.

In the name of transparency, I just endorsed the check to the Florida Hospital Foundation.

It wasn't a massive amount, just $149 and change. But it felt good to pass the money along from -- you, my friends, family, colleagues and complete strangers. It was all your doing. And I thank you.

Jaclyn Lindsey, a development specialist, was in the Foundation's Orange Avenue office when I arrived this morning. She's a good person and was honestly very happy to have the check. It will be bundled with other, similar small donations and will be used to purchase equipment for the Cancer Institute that might just help save someone's life.

Maybe even my own. Or yours.

There are other ways to donate small amounts. I learned a couple of weeks ago that the Foundation set up a way for cell-phone users to text in $5 donations from their cell phones. Just text the word FIGHT to 90999. The $5 donation will be billed to your cell phone account.

So let's keep up this fight against cancer of all kinds. One of the best ways is by checking out this blog regularly.

Yes, it's been two years

2009-09-21T19:26:00.003-04:00

In the past two years, I have:

Met wonderful people
Lost my mother
Found a brother, two sisters, cousins, nieces, nephews and an aunt
Rekindled old friendships, built new ones and discovered still others
Found inner strengths
Found inner weaknesses
Presumably overcame cancer
Found out my heart is healthy
Found out my resectioned stomach still has some issues
Discovered low-fiber diets are less than adequate and not very tasty
Lost much of my sense of fear
Began to have heart attack-like jolts of pain nightly that the docs still can't quite control
Found a new resolve
Wished for, rather than rued, the day that I'd actually turn 50

I'm sure there have been more discoveries these past two years since I was diagnosed with cancer, and that more are yet to come.

I can hardly believe it has been two years. Not that this time flew by because I was having fun, because much was not very fun, but it has flown by. Much of that was spent in a chemically induced haze, for sure. But most of the time was spent at home or in work while I was wide awake.

Still, two years ago, my difficulties swallowing during the summer and fall prompted me listen to my wife and see a doctor.

Dr. John Pfeiffer thought I might have a minor problem with my esophagus but doubted it was cancer. He referred me to Dr. Philip Styne, an amazing gastroenterologist. He conducted an endoscopy after which he told me, "There was some swelling. You may need surgery. We took biopsies."

Now, as you might expect, hearing the words We Took Biopsies isn't a good thing. It really freaked me out.

Next on my all-time hit parade was the introduction, very quickly, I might add, to CT scans and PET scans and iodine cocktails for contrast in the images, and then Dr. David Diamond, a radio oncologist and Dr. Lee Zehngebot, the premire oncologist in Central Florida, surgeon Joseph Boyer and a cast of thousands among Florida Hospital's cancer-fighting team.

In a whirlwind of events from the day I was told that the biopsies pulled by Dr. Styne were, in fact, cancerous to the start of my concurrent chemo and radiation therapies about a week later, my life was a haze.

I remember basically being fitted for my radiation therapies by having a CT scan so the doctors and nuclear physicists could determine exactly where to bombard my body with intense X-rays, having a medical "port" inserted into my chest in a minor surgical procedure that linked the outside world to my jugular vein, having my head shaved the morning of my first chemo treatment and many other milestones.

Good times.

Since then, the tumor in my esophagus was killed by the radiation, chemo kept cancer from traveling throughout my body, subsequent surgery the Friday before Christmas 2007 removed the by-then dead tumor from my entrails and my stomach was downsized by two thirds so part of it could become a faux esophagus.

And I launched this blog to help educate anyone who would read or listen about cancer of the esophagus.

Because my cancer was not genetic (to the best of my knowledge) and it was not sudden. Rather, it came about through a course of behavior conducted during much of my adulthood. Since my 20s, I'd had heartburn, sometimes severe heartburn, probably caused by poor eating habits. The state-of-the-art treatment of the time was Tums or Rolaids, or their generic clones, which I gobbled down regularly.

Only after I changed jobs and moved to Orlando did the acid reflux subside. I thought the new surroundings eased by stress, thus reducing my dependence on Tums.

Boy was I wrong.

Rather, my lower esophagus was being bombarded with so much acid that it tried to defend itself by developing cells similar to the lining of the stomach. The pre-cancer condition known as Barrett's Esophagus combined with my hiatial hernia was the perfect storm that led to my tumor.

Cancer of the esophagus in recent years has become one of the fastest-growing forms of the scourge. Partly, that's because the disease often is detected in its later stages, when eating becomes difficult. Remember, that's how come I went to the doctor.

Esophageal cancer is one of the most lethal. In Florida, according to the American Cancer Society's most recent statistics, 1,010 people died out of 1,170 people diagnosed with the condition. In the U.S., there were 16,470 new cases last year and of those 14,280 ended up six feet under. Not good at all.

There are some bright spots. The five-year survivability rate is 34 percent. That's more than double what it was before a new protocol was developed soon before I was diagnosed. Esophageal cancer remains the seventh-leading form of cancer among men It accounts for 11,250 lives, 4 percent of all male cancer deaths.

All of this leads to this:

Get help. If you have difficulties swallowing, get help right away. Do not wait. See your doctor, tell him or her your symptoms. Encourage an aggressive diagnosis and treatment. Insist upon it.

I'm now two years out. I plan to be around through years three, four and five.

I've helped several people through this blog and in person. So the effort has not been for naught.

And, to beat all that I'm about to turn 50. A couple of years ago, that was something I didn't think would happen.

A solid Foundation

2009-09-14T15:41:00.005-04:00

I've repeatedly asked friends, family, colleagues and others to support sponsors of my blog and learn from the information they provide.

I'm quite thrilled and humbled that you did.

It's enabled me to donate to the Florida Hospital Cancer Institute, the organization that -- under the direction of the best doctors in Orlando -- I credit with saving my life.

Monday, I met with three representatives of the Florida Hospital Foundation -- each of whom works directly or indirectly with the Cancer Institute.

Jaclyn Lindsey, development specialist with the foundation, contacted me a little over a week ago with a bit of curiosity about the blog. With Jaclyn today were Kimberlee Strong, executive director of the Foundation; and Beth Schaan, another leader with the foundation.

I think our meeting was great for the three Florida Hospital Foundation execs and myself. They heard a lot of good things about their hospital and the doctors who saved my life -- John Pfeiffer, of Celebration, my family doctor; Philip Styne, the gastroenterologist who first discovered my tumor; Lee Zehngebot, my oncologist; David Diamond, my radi0-oncologist; and Joseph Boyer, the surgeon who pretty much had me as a fillet and then put me back together minus a dead tumor.

I told them my story and that I wanted to raise money for my cause, their cause.

They told me how the $150 I raised and any future money will be used, and about other ways they're trying to raise money.

The small donations such as mine will be bundled with others into a much larger pool. A committee of doctors and administrators then will pick something to buy and get it. Most recently they used this fund to purchase a state-of-the-art endoscopic ultrasound device.

As we advance in the whole wireless-wi-fi-blogosphere revolution, there's money to be made -- or raised for a charity. I found a way to do this with the blog -- a penny at a time, it seems -- and it would be great if other patients could do the same with their blogs.

Jaclyn told me about another fund-raising method of the digital era. A donation via cell-phone text messaging. It's the latest, and it lets folks text donations $5 at a time. If you text the word FIGHT to 90999 you will be making a $5 donation to the Florida Hospital Cancer Institute -- the money will be billed to your cell phone. I encourage you to send the text.

Tick. Tick. Tick. Tick. Tick. Tick. Tick. TIck. Tick.

2009-08-31T18:14:00.004-04:00

I heard more from Dr. Lee Zehngebot the other day, who explained more about what he and, apparently, several other doctors have not found.

Dr. Z said they haven't figured quite what is going on with my body, and all agree the best course of action for now is to wait. For three months. Then scan my body again.

"Nobody thinks we should do anything now," Dr. Z told me.

He was referring to himself; my gastroenterologist, Dr. Philip Styne; two initial radiologists; an interventional radiologist; and Dr. Styne's partner at the Center for Digestive Health in Orlando, Dr. William Mayoral.

They'd all gone over my CT scan and PET scan from earlier in August and come to the same conclusion: There's something in there and they're not quite sure what it is.

"Nothing we could do would help right now," Dr. Z told me, and, in fact, doing some things "could make the site worse."

So for now there'll be no endoscopic ultrasound, as Dr. Z had initially proposed, and the CT and PET scans will have to be sometime in mid- to late-November.

There might be an up-side to all this: for now ignorance is bliss -- if there is bad news I don't have to deal with it right now.

So here's the deal

2009-08-21T19:43:00.003-04:00

I had a good conversation with Dr. Lee Zehngebot on Thursday evening, who explained what they know -- and don't know -- about what's going on in my body.

Dr. Z said he consulted with a radiologist and they both agreed that I'm just going to have to be confused and frustrated for about three months.

That's because it's safer for me to wait that time and have a new series of CT and PET scans that it'd be for doctors to punch holes in my body to extract biopsies from where they'd need to extract them. A CT scan last week showed a 2cm by 3cm thingie in my chest, not far from the body cavity where the esophagus, the pulmonary artery and other important organs are located. A PET scan this week lit up a tiny spot in my carina in the bronchial airways that may or may not be something to worry about.

But pulling a biopsy from either site has risks and Dr. Z said the safer course is to wait. And wait. And wait.

"I know I'm scaring the crap out of you. But I'm in the scaring-the-crap-out-0f-you business," he told me.

One upside, though, is he wants me to have yet another endoscopic exam, but this time using E.U.S., which is endoscopic ultrasound. Basically, they'd be looking at these growths from the inside-out and that might help the docs determine the density of these masses or what they are.

My gastro-doc extraordinaire, Dr. Phillip Styne, doesn't do these procedures, but one of his partners does, and I'll be calling Dr. Styne on Monday to set things up.

So for now, to quote the Three Stooges, it's time to "hurry up, and go to sleep," or in my case, I guess, hurry up, and slow down.

And the results ... really aren't in

2009-08-19T18:29:00.003-04:00

I really hate waiting -- especially for something as important as test results.

What's even worse is waiting after you receive test results. But that's what I have to do. The question now is how long of a wait?

Here's why:

Dr. Lee Zehngebot, the most excellent oncologist and iPhone user I can think of, said this evening after I waded through 35 minutes of phone-hold hell that my PET scan Tuesday found a "very small" anomaly in my chest. So small that doctors don't quite know what to make of it.

Dr. Z said he'd probably just have me wait three months and do another series of CT and PET scans. But he's consulting with other docs to see whether a biopsy would be worthwhile. I'll find out that answer on Monday.

The small mass may or may not be the 2 cm by 3 cm blob a CT scan picked up last week. I'm going to call Dr. Z on Thursday with a few questions I've come up with.

The mass picked up by the PET scan is located in the carina, which is the bronchial windpipe where the bronchi split into the two lobes of the lungs at the base of the trachea. (See diagram, courtesy of Wikipedia.)

"We don't know what it is," Dr. Z said.

Thus, my results that really aren't results.

So the waiting continues. Ugh!

Waiting ...

2009-08-19T15:10:00.001-04:00

Today's the day

2009-08-18T10:49:00.001-04:00

I hate when that happens

2009-08-17T15:32:00.002-04:00

So I saw Dr. Lee Zehngebot today, a week after my most recent CT scan.

After small talk about our toys -- his new iPhone and me about my G1 Google phone -- we discussed results of the scan and other medical issues (imagine that!).

They were not as I had expected. In the past, it's been S.O.P. for me to go in and hear that everything was fine with the scans.

This time, however, the results aren't clean. "I don't know what it is," Dr. Z explained.

That's because the radiologist who went over the scan and reported to Dr. Z wasn't quite sure, either.

It appears there's a 3 cm by 2 cm nodule of either fluid or something else near my stomach/esophagus that puzzled Dr. Matthew Hesh, D.O.

"It is difficult to determine if this represents a recurrent neoplasm lesion, adenopathy, or loculated fluid." Yeah, I don't understand most of that either.

But this I do understand: "I would suggest a PET scan for further evaluation."

So that's what Dr. Z has done. Stat.

Tuesday at 1 I have to be at the advanced nuclear medicine lab across Orange Avenue from the main Florida Hospital campus for what will be my third PET scan.

I have a few instructions to follow before the scan. Starting about midnight today I can't have sugar, caffeine and such stimulants. No exercise or anything strenuous, either. After about 7 a.m. Tuesday, I can't consume anything but meds and water.

Then when I get to the lab for the test, a nurse will hook me up to an IV (always fun) and inject me with radioactive glucose. This stuff is stored in something right out of Star Wars or Star Trek -- a metal canister that is turned until the radioactive liquid in a glass vial is released. It's injected via the IV and then I relax in a closed room for about an hour, listening to bad music, and then basically travel through a tunnel like an MRI. This machine, though, scans for concentrations of the injected glucose sugar. Cancer cells absorb the glucose faster than other types of cells, so the theory is they'd have gobbled the sugar up in enough quantities for the scanner to pick it up.

Hopefully, this nodule near the upper right lung area is nothing and the test will confirm that.

I'll keep you posted.

Check out this site -- it's worth the click

2009-07-21T21:20:00.003-04:00

A few weeks ago I was asked to write an essay for a wonderful Web site that focuses on survivors of cancer, in all its many forms.

My essay was published today. The site is http://www.voicesofsurvivors.com/, and I encourage everyone to check it out not just today, but everyday.

That's because each day, site manager Lynn Lane posts another story by another survivor. Lynn, a documentary filmmaker, also records these tales visually on video. These also are available on the site.

So please give Lynn's site a read. And if you have any comments, I'm sure he'd love to hear them.

A little Botox goes a long way

2009-07-21T21:04:00.003-04:00

Well, I'm back on solid food -- thank goodness for that -- and breathing a sigh of relief after may endoscopic exam yesterday, July 20.

Dr. Phillip Styne and his crack team of nurses, assistants, anesthesiologists and aides at Florida Hospital Orlando injected a dose of Botox into my pyloric valve, also known as the pylorus, to make it easier for me to digest food.

It was kind of quirky because I was taken into the procedure room at 1:19 p.m. Monday but Dr. Styne couldn't do the procedure yet -- the Botox hadn't yet arrived from the hospital's pharmacy.

I was slightly doped up on anesthesia when the doctor told the nurse anesthesthetist to hold off on fully loading me up. I had the mouthpiece in place for the endoscopic tube to be used, and I was allowed to remove it until the drug arrived. (Good thing, because I was drooling a little; sorry if that's tmi.)

One of the nurses joked that if there's extra they could use it elsewhere if I wanted.

Then folks started getting a little peeved at the pharmacy. I even offered to phone down and complain that 'I'm here lying on the gurney, the the stuff up here!' But a few minutes later, it arrived and about 1:32, if I recall correctly, I went lights out.

I woke up about 20-25 minutes later in the recovery room with Catherine in attendance. She'd already spoken with Dr. Styne, who said all went well. (She even snapped a photo or two of me unconscious. Tweeters can find my images on Twitter if you search for my live-at-the-time tweets under #endoscope.)

I'm adding the above photo here as a sample.

So in the end, all went well, the Botox seems to be working, I'm eating again -- though being a bit gentler with my dining -- and as I tell people all the time I'm happy to be here.

There's always room for Jell-o

2009-07-18T14:31:00.003-04:00

I'm on Day 2 of a three-day clear-liquid diet leading up to an endoscopic sojourn down my gullet by Dr. Phillip Styne on Monday afternoon.

This means soup, Jell-o and water. It's pretty bad that Jell-o is about as solid a food as I can consume. (Kind of a glimpse into the future if I don't keep my teeth in good order.)

Dr. Styne thought I'd be able to make it to January without needing another endoscopy, but I missed by several months because I think my pyloric valve, known as the pylorus, isn't cooperating.

In simple terms, the pylorus opens to let food travel from the stomach (in my case, what is left of the stomach) into the intestines. (More at http://en.wikipedia.org/wiki/Pylorus) Because of the surgery to my stomach to replace by cancerous esophagus, nerves were severed that control the pylorus and other aspects of the stomach's function.

So, Dr. Styne & Co., will use his endoscopic device to peer into my stomach and see if the pylorus isn't opening as it should. If so, he'll inject Botox into the valve to deaden some of the nerves keeping it closed. This should open it up, hopefully for good.

I'll Twitter from Florida Hospital on Monday, but I don't think the good doc will let me bring the phone into the procedure room. Besides, I'll be on some good drugs and won't be able to spell my name -- or put a cohesive sentence together. (I can barely do that on a good day.)

But I will get a photo of the doc before the procedure. Styne is a good and decent man -- and one hell of a doctor.

So until then, I'll be swilling coffee sans cream; tea, both hot and iced; chicken noodle soup (yes, the doc says the noodles won't be an issue because they're quickly digested); and, of course, good old Jell-o.

After all, there's always room for Jell-o. Especially on the other side of my pylorus.

Time sure flies when you're having fun?

2009-06-25T23:21:00.006-04:00

It's really hard to believe, but two years ago this week I first started noticing something wrong.

Catherine and I were on our vacation -- a drive from Central Florida to Yellowstone National Park and back via Baltimore, Chicago, Minneapolis, Mount Rushmore, Badlands National Park and several other stops -- when I became nauseated at a Ruby Tuesday restaurant. It happened again the following night after a late meal. And again later at a casino in South Dakota.

I dismissed the symptoms. I was on a diet. I was traveling and not drinking enough. I thought the two were causing food to just not make it all the way down.

After the two-week trip, I traveled to South Florida, where my mother was about to have a cardiac catheterization. I dismissed the symptoms more in the coming weeks and months as my mother was swept into a deeper illness following open-heart surgery. My inability to even eat a doughnut as I drove to or from South Florida was ignored as a diet issue. I actually kept extra grocery bags in my car in case I gagged while driving. I was that ignorant as to what was happening to my body.

I couldn't check in to see a doctor; I had work during the week and on weekends I was visiting my ailing mother. I just didn't have the time.

But Mom was falling deeper and deeper into a medical nightmare and I finally listened to my wife Catherine and went to see my doctor.

Dr. John Pfeiffer in Celebration, Fla., suggested I needed to see Dr. Phillip Styne. He suspected the sphincter of my esophagus was not dilating properly and that Dr. Styne could enlarge the opening during an endoscopic exam. There was a very small chance I had cancer of the esophagus, Dr. Pfeiffer said, but I was too young and he'd never come across an esophageal cancer patient. He doubted that's what I had, though the chance was there.

I'll never forget Dr. Styne's greeting to me as I awakened from the anesthesia of that endoscopy. He told me there was some "swelling" and -- drum roll -- he took a biopsy.

This was on a Thursday. Talk about a miserable weekend.

But by Monday it was confirmed. Dr. David Diamond, who would become my radio-oncologist, called to say I did have cancer and I needed to get in pronto. I needed to see Dr. Lee Zehngebot, my oncologist. Together, this team -- Styne, Zehngebot and Diamond -- plus, later, Dr. Joseph Boyer, would be the men who saved my life.

But I digress.

Dr. Z explained that esophageal cancer was rare and deadly. In my case, it was likely caused by a combination of factors, including years of heartburn treated with antacids but no real medicines. My odds were not good, but the docs were not ready to write me off just yet.

Dr. Diamond initially told me I was stage 2 to 3. Not good. He said I had a 50-50 chance of survival. Again, not good. But each step of my treatment could lead to a new assessment. As I passed a new threshold, I'd be re-assessed. Still, 50-50 meant I had as good a chance to live as to die.

I chose to live -- though later during treatments I briefly questioned the sanity of that choice.

In the weeks that followed I underwent daily zaps of radiation, heavy-duty jolts of X-ray-like doses of isotopes I'm not too familiar with that, weeks later, I'd learn affected my liver and other hot-spots in my body, which resembled new cases of cancer. Thankfully, biopsies would find that not to be the case.

I also was attached 24/7 for seven weeks to a chemo pump injecting poison directly into my jugular vein.

This one-two punch sapped me of my strength and, at times, my will. But I didn't want to let depression get the best of me. I tried to remain focused and positive. I would not be distracted by my condition or the deteriorating state of my ailing mother.

After these treatments were completed I had about a month of a "cooling-off period" to recover before major surgery to dissect and resect my esophagus, stomach and lymphatic system in my chest. Also during this time, my Mom seemed to be getting mildly better. We were able to move her from the hospital in Fort Lauderdale to a rehab center in Boca Raton, then, days before daughter Jennifer's marriage to Chris Kuz, to a rehab center in Orlando.

I finally told Mom about my cancer and how I was doing pretty well. I mean, I hadn't died during the chemo (several people had during trials of the treatment) and I was still standing. We moved her belongings from her apartment in South Florida to our garage. A week before my surgery the weekend before Christmas 2007, I traded in my beloved Mazda RX-8 sports car for a larger and easier to enter Saturn Vue SUV. I'd never be able to squeeze into the RX-8 after my surgery, and I'd need the SUV to haul Mom's oxygen tanks after she was discharged from treatments.

Mom had a couple of setbacks in the interim, and on Dec. 21 I underwent surgery. I had an esophago-gastrectomy -- basically, most of my esophagus was cut away. To replace it, my stomach was cut, spliced, pasted and pureed into a faux esophagus and a smaller stomach, now planted in my chest not far from my heart.

It took about three weeks to be discharged from the hospital and another several weeks to recover before returning to work.

Since then, I lost my mother, I've regained about 15 pounds but still am far lighter than I was during those days of dieting two years ago.

Like I tell friends and others, I like the results but I would not recommend the diet program.

So, friends, it comes down to this as CancerVivor.blogspot.com has reached more than 19,000 page views, if you have heartburn, then lose it; if you have problems swallowing; if you suspect something amiss in your digestive system, please see a doctor and be open to treatments. Even if the dreaded "C-word" -- cancer -- is the diagnosis.

Two years later and I'm still here.

A great big sigh of relief

2009-05-26T12:52:00.002-04:00

After my first visit with Dr. Phillip Styne since an endoscopy in January, I have one word: Whew!

That's because Dr. Styne affirmed Dr. Miner's observation that my chest pains were, indeed, caused by spasms to my esophagus. He said the nitroglycerin-based meds I'm on do relax smooth-muscle tissue such as a heart -- its most common destination -- and the esophagus.

With that behind us, along with a brief amount of schmoozing, we agreed I won't have to see Dr. Styne for four months, and I most likely will not need another endoscopy until January, a year after the previous one.

In other words, my body finally is healing as it should. Before all this began, the docs said it would be a long road and would take a year or two for me to heal. They were not wrong.

With the expertise of my medical team, Dr. John Pfeiffer, Dr. Styne, Dr. David Diamond, Dr Lee Zehngebot, Dr Joe Boyer and many other docs and nurses and techs and assistants, I'm pretty much back from the brink.

In September 2007, I wouldn't have believed it. The news was so grim, the odds so low and external factors in the tank, I wasn't hopeful at all.

But today, I must say my optimism is back. I might even think about buying some stock. Well, that one I'd have to think about.

Bloody Well Right (with apologies to Supertramp)

2009-05-21T22:54:00.002-04:00

Wednesday was a watershed day for me in a couple of ways.

First, it was the first time since my cancer diagnosis that I made a blood donation. I hope the people who receive my donation use it in good health.

Second, it was sort of an affirmation that I am healthy. I received the blood center's seal of approval to prove it -- they took my blood, after all.

Not long ago, if you had certain cancers and were treated with either chemo or radiation, you had to wait five years before donating blood -- if you lived that long.

Today it's just a year.

So in another eight weeks I'll go to work early when the bloodmobile shows up at the Sentinel and make another donation. I've always liked giving blood -- besides helping others, I just always feel physically better afterward.

And I encourage you to make a donation if medically able. Call the blood center nearest you to see if you and your particular medical issues would keep you from donating. If they do, perhaps a year from now you'll be better able to make a donation.

Changing meds, soon changing docs

2009-05-11T16:33:00.003-04:00

I saw Dr. James Miner, my cardiologist, today.

The visit was to check out the chest pains I've had the past few months. They're the same one that led me to Dr. Miner in December -- the ones that led to my catheterization. My EKG looked normal to the doc, and said the pains are more likely caused by my digestive system than my heart. That's a good thing for sure.

He did add a med and told me to drop another. Now I'm taking nitroglycerine tabs twice a day, but no longer taking hydrochorathalazide, or whatever it's called. This should ease the pains, since nitro works with the arteries of the esophagus and stomach just as it does with the heart. It also drops blood pressure, thus the change in BP meds.

Sadly, Dr. Miner also told me he's leaving the practice he's been with since 1990. He said he's moving over to a practice in The Villages up near Lady Lake -- a vast senior development that straddles three counties. While parts of Florida's population are declining, people still are moving into The Villages.

He plans to commute. Ouch.

I'll see Dr. Miner again on June 1, but that likely would be the last time as doctor and patient. He's a good guy and I'm sorry my time as his patient has been so brief -- though not needing a cardiologist until this time certainly isn't a bad thing.

I plan this weekend to toast Dr. Miner at breakfast -- a cup of juice, wheat bread smeared with heart-friendly spread, egg white omelette and a cup of oatmeal.

Cheers, Doc!

Mostly a clean bill of health

2009-04-27T13:04:00.003-04:00

Got back from Dr. Lee Zehngebot's office a short time ago, and I received some very good news.

My CT scans earlier this month showed no signs of improper tissue mass anywhere in my chest or abdomen.

This means no cancer. The past year and a half of physical, radioactive and chemical torture seems to have worked. It also left some odd "scars" inside my body. Like a liver that was "cooked" a little too well done by the radiation. Lungs that also were sauteed by some isotope and produce a little bit too much fluid along with the oxygen my body needs.

Because there's so much going on in my scan, the docs want another one before my next appointment with Dr. Z in August. Soon I'll be glowing in the dark, if I don't already.

And then there's my heart. Dr. Z said my recent weirdness in that arena might be caused by coronary spasms and he'd like some more tests done with Dr. James Miner. Not sure what's going to happen, but I presume I'll find out soon.

But as for my CT scans, everything looks good, the doc said. The report from the radiologist said everything pretty much looks as expected. I just wish they'd expected, oh, maybe someone in better shape with a smaller gut. Then I'd be really happy with those findings. Though I am quite pleased with the findings. Dr. Z was pleased as well, though harried in his new set-up.

Oh, speaking of Dr. Z, he has new digs down the Florida Hospital Plaza hallway from his previous office. Not that the practice moved, just his partners moved him into an office all to his own.

Yes, he's just that good.

As one nurse said to me, "This is like the Hilton" compared with his old office.

And, I'm guessing, the rest of the practice wants to use PCs, not Macs.

Gulp, the scan

2009-04-01T10:19:00.004-04:00

In just four months since my previous CT scan in December, things at Florida Hospital's imaging labs have changed.

What used to be a couple of swills of horrible orange-flavored drink prior to the scan has morphed into two pints of bottled water spiked with an iodine solution an hour before the scan and then one more pint of a different iodine solution minutes before. So while I loved the flavorless solution, far superior to the faux store-brand-Tang-flavored drink we had before, that is outweighed by the wasted hour one must spend at the hospital prior to the scan.

It's not as if I -- and most every cancer patient -- has not wasted countless hours at hospitals and doctors office waiting in lobbies or in infusion rooms for and during treatments. But just when you thought you'd escaped that routine, it's back. I didn't even bring my traditional time-waster -- a sudoku book. But, thankfully, Catherine joined me so we had some time with each other.

The CT tech who snapped my internal photos and also gave the most pain-free IV poke I've ever had said Florida Hospital changed the procedure about a month ago and that the protocol is better. Perhaps the chemicals in the bottled water provide better contrast for the CT. I wouldn't doubt it. That place is always improving upon itself.

The tech also said it has to do with distributing the contrast drinks. I mentioned in 2007 about the milky contrast drinks they make you consume before a PET scan and some CT scans (use liquid strawberry-flavored Quik to make it go down easier). Well, by administering the drink prior to the scan -- not the day or days before -- Florida Hospital's imaging service can't be seen as distributing medications like a pharmacy. Maybe the lawyers got involved.

Florida Hospital also changed the procedure at its Advanced Nuclear Imaging center across the street, where PET scans are produced. So be prepared for a wait there as well.

I won't hear about the results of the scan until later this month -- the 27th -- but I figure no news is good news. If something shows up that shouldn't be there, I think I'll hear from the doctor sooner. I'm hoping I don't.

So don't panic about taking the scans, just be prepared to wait a while once at the hospital. Arrive an hour or more before your appointment -- and bring something to read.

Another day, another scan

2009-03-30T23:41:00.004-04:00

I have a confession. I forgot about an appointment for a CT scan on Monday. I just went about my business and realized it only when I had my first cell call of the day and noticed the notification.

So I go to Florida Hospital on Tuesday afternoon for the scan. No biggie. I've done these things every four months for nearly two years, and even more frequently prior to my surgery. By now I should glow in the dark.

The scan will allow my doctors to see if anything is growing inside of me. Well, let me rephrase that. The doctors will see if anything bad is growing inside. I don't think so; there's no blockage that I can tell.

So I feel pretty good going into this scan. I see Dr. Z in mid-April and I feel certain I'll have a relatively clean bill of health.

As I go through this scan, this Web site is about to be visited by its 18,000th viewer. With that milestone, I hope to remind everyone that esophageal cancer is among the fastest-growing cancers in the United States and around the world. Primarily affecting men, it now also is crossing the gender gap and striking more and more women.

But there are ways to avoid it. It all centers on seeing a doctor regularly and -- unlike what I did -- tell the doctor if you have persistent heartburn. Further, tell the doc if your persistent heartburn goes away, because that's not normal either. It could indicate an advanced condition known as Barrett's Esophagus, which is a precursor to cancer.

Take your medications as if your life depends on it. If your doctor put you on any of the meds that keep your body from making acid, use it. It could save your life and is a small price to pay to watch your children grow up, celebrate holidays or enjoy a spring afternoon.

So, going to the CT scan Tuesday is just a small inconvenience, and hopefully it will confirm to my doctors that they did an outstanding job in 2007 and 2008 keeping me alive.

New news about esophageal cancer

2009-03-23T16:20:00.004-04:00

In recent weeks, there have been a few developments in the fight against cancer of the esophagus.

Esophageal cancer in general is among the fastest growing forms of the disease. And a study by the National Institute on Alcohol Abuse and Alcoholism, first reported in The New York Times, indicates even a small amount of alcohol -- a glass of wine or half bottle of beer -- could increase the chance of developing squamous cell esophageal cancer. This is even more so if the patient is of Asian ancestry.

Squamous cell cancer is most often at the upper end of the esophagus, while the type of cancer I had, adenocarcinoma, generally affects the lower end of the esophagus near the stomach. Squamous cell carcinoma also can be caused by smoking, or in combination with drinking.

Here's a link to the New York Times article.

The other development was the death earlier this month of the actor Ron Silver. Silver had been in a two-year battle with esophageal cancer. He died Sunday, March 15.

His death opened my eyes to the fact that even though I feel pretty good now, I'm not out of the woods 18 months after my initial diagnosis.

I'll continue to update on a more regular basis.

A year ago this date ...

2009-02-12T10:25:00.002-05:00

Exactly a year ago this date, I returned to work after nearly five months of cancer treatments, surgery and recovery.

It was too long to be away but necessary. Oddly, before my bout with cancer, I was a relatively -- if not overweight -- person, hardly ever availing myself of sick days, let alone using up my annual allotment.

So last year, my return was the start of my work week, Tuesday, Feb. 12, 2008. Everyone in the newsroom welcomed me back, and while I was a little slower than I'd been I got right back into it.

We had a couple of parties at work, with cakes, fruit and other desserts over two days to celebrate my return.

My friends at work truly were that during my absence and return. While away they visited, wrote, sent plants and flowers, food and warmth. They visited me in the hospital, at home, constructed a scrap book to cheer me up (which it did, immensely) and in many other ways made me feel good. When I walked back into the newsroom I was greeted by two rounds of applause. I was at a loss for words, which, my friends will recall, doesn't happen often.

Since then, I've gone off my pain pills entirely, gained back about a dozen pounds and seem to be doing well at work.

Some friends have left the paper and a few others have come aboard. Change, hopefully with health, seems to be the norm nowadays.

Records come, records go

2009-01-26T19:04:00.001-05:00

Earlier today, the 17,000th visitor to my blogs, CancerVivor.blogspot.com and kohnzone.blogspot.com, stopped by for a few.

They were greeted by either photos of a really cute newborn named Emily (kohnzone) or some less than cute images of the inner workings of my body (CancerVivor).

At the former, I was announcing the birth of my first grandchild and showing off some photos. That's pretty self-explanatory, so I'll focus on the cancer site.

There, as I have since it launched, I am trying to educate as many people as possible about esophageal cancer and how to avoid it.

So I'll rehash some things I've said in the past:

First, YES! You can get cancer from heartburn. It's not all that difficult, apparently. I did it. Just eat spicy foods -- lots of them -- mixed with greasy, unhealthy items. For a long time. That will set you in the right direction. To follow up, avoid seeing a doc about heartburn or taking meds to treat it. Then, when the heartburn fades away suddenly, think of it as a blessing that your self-medication has helped, not the condition know as Barrett's Esophagus which masks a pre-cancerous condition. If any of these symptoms occur, longtime heartburn or sudden discontinuation of heartburn for no real reason, see a doctor.

Second, esophageal cancer survival is so low because it often is diagnosed in advanced stages. For me, the tumor was large enough to block much of my swallowing, but not all. So if you find it difficult to get food from your mouth to your stomach, see a doctor. The sooner the better.

Third, statistically, esophageal cancer is growing, both nationwide and in Florida. It continues to be very lethal, as noted above. Of the 1,170 Floridians to come down with the disease, 1,010 people died in the American Cancer Society's most recent statistical report. The numbers were grim nationwide as well in 2008: 16,470 new cases 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.

When diagnosed, I was staged at 2 to 3, meaning it was advanced but had not yet spread to the lymphatic system. That's what saved my life -- so far.

Across the country, esophageal cancer is the seventh-leading form of cancer among men, claiming 11,250 lives -- or 4 percent of all male cancer deaths.

So please, please, if any of this sounds like you, get help. Get it now. Do not wait. I'm not a doctor but I can speak from experience and, sadly, this is an area in which I have experience. Be cautions and take a proactive stance.

It could save your life.

Ah, food

2009-01-23T19:04:00.003-05:00

I had a gyro and fries this afternoon, my first solid food in a couple of days. A better 3 p.m. breakfast was not had by me in recent years.

It was at the Daybreak Diner on Curry Ford Road, and it was a tossup between the gyro or their special sloppy joe.

But why have breakfast at 3 in the afternoon? The answer is simple. That was the quickest we could get there from Florida Hospital after my endoscopic procedure.

Dr. Philip Styne conducted the endoscopy and had to inject Botox into my pylorus to get the valve at the base of the stomach to better regulate food flowing into the small intestines.

This is why I have had various forms of chicken soup and Jell-O for the past two days.

And it's why I was dying to have food this afternoon.

In short, the good news is the procedure worked. The bad news is I had to drink my meals for a couple of days.

Below is a look at what the good doctor saw when he went digging into my insides. The numbers correspond to descriptions at the bottom.

Now can you pass the ketchup?

1) Surgical site; 2) Pylorus; 3) Small Intestines; 4) Pylorus; 5) Surgical site; 6) Surgical site

Souper duper

2009-01-22T09:53:00.002-05:00

If we lived in ancient Rome, I'd be very wealthy.

That's because I'm on day two of a "clear liquid diet" that will lead to yet another endoscopic exam on Friday.

But let me explain. The exam will likely involve either dilation of a stricture in my reshaped, remade, bionic esophagus or an injection of Botox into my pyloric valve at the base of my stomach. All this to help me process and digest food just a little better than I'm doing now.

So since Wednesday I've been dining on Jell-o and soup. That way by the time Dr. Philip Styne peers into my insides the path will be clear of gunk and leftovers and other nasty-looking contents. He'll be able to navigate and treat whatever it is that's been keeping me bloated for a month or so.

Dr. Styne, the best of the best of the best in his business, will perform his magic at Florida Hospital's main campus. I'll have some happy juice and snooze a few minutes and then go home. The procedure is scheduled for the afternoon, but I have to arrive at noon. Daughter Karen is my ticket there and home, since I won't be able to drive afterwards.

Oh, and as for the wealth remark above? Ancient Romans viewed salt as a measure of wealth, and, for a time, it was used as currency. With the amount of soup I've consumed yesterday and expect to consume today, trust me: Lots of salt.

Beat goes on

2009-01-09T17:33:00.008-05:00

Turns out I don't have heart disease. That's the outcome of today's cardiac catheterization, and I couldn't be happier.

Well maybe I'd be happier if I didn't need to undergo the procedure. But shy of that, I'm about has happy as can be.

A couple weeks ago, we thought I may have had a heart attack. The symptoms matched and it had the Dr. Catherine Seal of Approval. But after today's procedure, there's no blockage to be found. So my climb up Mount Everest earlier this week on the doctor's treadmill kind of threw Dr. James Miner for a loop.

As he said, they'd either find nothing or something. I'm very happy, and so was Dr. Miner, that the test found nothing.

Conducted by Dr. Alejandro Franceschi, the cath went smoothly and did discover one thing -- my heart has one anomaly. An artery in the heart branches out at the wrong place and then doubles back to its proper location. It's weird enough that Dr. Franceschi plans to send the films of my exam to a doctor who compiles all the weirdness that has to do with hearts in a book, sort of the Guinness Book of Records but for hearts.

The procedure begins with a shave and a haircut -- two bits -- and the usual IV and a swap from my bed to the procedure table in a very refrigerated room. Monitors are suctioned to your body and a sterile drape is placed over most of the body. Once the doctor steps in, things move quickly. He injects local anesthetic to the groin and a short time later the catheter is already inching its way up the femoral artery to the heart -- a show that's visible on a computer monitor above the table. Once in position, the doctor injects a dye that shows up on the screen. That's when the docs can examine the various arteries for blockages.

After the procedure, a nurse applies pressure for a while and you're sent back to a recovery room, where another nurse applies pressure for about 20 minutes, followed by two hours of sedentary rest with a sand bag adding pressure to the site to ensure it seals. You don't want the femoral artery to leak.

Honestly, my jitters before hand were quite misplaced. I barely felt the catheter enter my body and had no discomfort at all during the procedure.

Another obstacle overcome.

8 hours until my procedure

2009-01-08T23:55:00.002-05:00

I'm not sure why, but for some reason I'm more nervous about my cardiac cath than I was the night before my esophagogastrectomy -- the cancer surgery more than a year ago.

I know this is misplaced and all yet there's this lingering feeling of dread.

I'm sure in about a dozen hours I'll be back here writing how ridiculous I was tonight, so all will be well.

But until then, I have the pre-op jitters.

Just when you thought it was safe...

2009-01-08T09:28:00.004-05:00

Just like the ads for the Jaws sequel, there's always something lurking.

For me, I learned this past summer when I met my family in California, heart disease is a part of my genetic history. My father had the first of his three heart attacks at age 35. My brother Dan suffered a heart attack just a few months ago; thankfully he survived and is thriving.

So while I'm surprised that I've had some discomfort and all in the past few weeks, I'm not shocked. After all, some 24.1 million Americans had some form of heart disease, roughly 11 percent of the population, in 2006. There were 652,091 deaths caused by heart disease in 2006, ranking it as the nation's top killer with a rate of 222 per 100,000 people in the general population.

All that said, I met with Dr. James A. Miner of Florida Heart Group on Tuesday (photo from the Florida Heart Group Web site). He was concerned with the repeated chest discomfort I've experienced in the past few weeks and sent me onto the treadmill. I kept up well, though got out of breath when the tech set the machine at the Mount Everest-level climb. Dr. Miner sat in on the test and then reviewed the printouts.

Afterwards he offered this summary: "Either it's nothing or it's something." I'm happy with the former, less so with the latter. If it's something, it may be a clogged artery, meaning I'd need a stent.

To find out, on Friday I wake up very early and go in for a cardiac catheterization. This is where they slink a very thin tube up to the heart through arteries in the leg. There, with the aid of X-rays and a fluroscope, the doctor can observe the heart and decide whether there's a problem.

I've spoken to a few people who have undergone the procedure and all pretty much assured me there's a very low level of discomfort. Actually, one assistant at Dr. Miner's office said there's some pretty good pain drugs afterward. I guess that's the reward for good behavior.

I'll post updates Friday after the procedure and will tray to grab a couple of images from the doctor to post.

Meantime, it is safet to go into the water. Just watch where your step.

Holidays swoosh by, like meeting with Dr. Styne

2009-01-02T10:28:00.003-05:00

I failed to mention the other day that on Monday I had an appointment with Dr. Philip Styne to discuss some digestive issues.

For the past couple of weeks, I've had a bloated feeling and I think either the stricture in my esophagus (what's left of it, that is) -- previously dilated with a balloon-like tool during an endoscopy -- or the pyloric valve -- forced to remain open with the use of Botox -- might need another treatment.

So in the coming weeks I will have another endoscopy at Florida Hospital to fix either or both of those problems. Before that, however, I have an appointment with cardiologist James A. Miner this coming Wednesday to clear me for the procedure and related anesthesia.

It's sort of a downer because after both of those treatments I seemed to feel nearly normal. I mean, I still can't eat as much as, say, two years ago (Do I want to eat that much any longer? No!) but I was feeling quite normal. Now I'm more cautious and also feeling more full -- even when I wake up in the morning.

I'm sure Dr. Styne will get that all under control. He's the best of the best.

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

2008-12-21T07:26:00.005-05:00

“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

2008-12-19T11:36:00.002-05:00

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

2008-12-13T23:52:00.003-05:00

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

2008-12-12T13:50:00.003-05:00

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

2008-12-08T14:19:00.005-05:00

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

2008-11-29T20:15:00.002-05:00

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

2008-11-24T11:41:00.003-05:00

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

2008-11-17T21:53:00.003-05:00

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

2008-11-09T11:54:00.002-05:00

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

2008-10-23T20:55:00.005-04:00

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

2008-10-22T10:07:00.003-04:00

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!

2008-10-20T21:23:00.002-04:00

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

2008-10-06T12:48:00.005-04:00

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

2008-09-30T12:16:00.003-04:00

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

2008-09-26T11:03:00.003-04:00

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

2008-09-21T00:32:00.005-04:00

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

2008-09-17T10:43:00.003-04:00

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

2008-09-04T14:01:00.002-04:00

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

2008-08-22T12:32:00.006-04:00

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

2008-08-05T11:25:00.004-04:00

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

2008-08-04T18:20:00.002-04:00

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

2008-08-01T13:38:00.003-04:00

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

2008-07-28T21:59:00.002-04:00

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

2008-07-28T21:44:00.007-04:00

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

2008-07-28T21:40:00.003-04:00

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

2008-07-25T02:12:00.002-04:00

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

2008-06-15T01:38:00.002-04:00

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

2008-05-22T20:47:00.002-04:00

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

2008-05-22T10:00:00.004-04:00

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

2008-05-07T09:40:00.001-04:00

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!

2008-04-25T15:03:00.003-04:00

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

2008-04-24T10:21:00.003-04:00

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

2008-04-22T12:16:00.020-04:00

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'

2008-03-01T22:43:00.003-05:00

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

2008-02-17T01:22:00.002-05:00

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.

2008-02-14T22:23:00.000-05:00

Back in the saddle.

2008-02-13T20:02:00.001-05:00

I'm back!

Back to work Tuesday

2008-02-11T22:18:00.000-05:00

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

2008-02-07T08:41:00.000-05:00

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

2008-02-06T20:12:00.000-05:00

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

2008-02-05T17:31:00.000-05:00

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

2008-02-01T18:08:00.000-05:00

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

2008-02-01T16:26:00.001-05:00

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

2008-01-31T22:36:00.000-05:00

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

2008-01-29T22:27:00.000-05:00

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

2008-01-25T14:48:00.000-05:00

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.