Surgery Date Set

February 3 & 4, 2011

Further to my last post, I have now been approved and scheduled for the sacral resection surgery.  The surgery will take place over two days on Thursday and Friday, February 3 and 4.  Overall surgery time is often over 12 hours so they have recently broken the procedure into a 2-stage approach.

Day 1: Anterior Incision

On the first day the procedure will involve a removal of the rectum and any other cancerous soft tissue from within the pelvic cavity.  I will be fitted with a colostomy at this time.  In preparation for the second day, the arteries feeding the sacrum will be clamped off and a "flap" of abdominal muscle will be cut to eventually fill the void created when the sacrum is removed.    I'll go into recovery following this procedure.

Day 2:  Posterior Incision

On the second day the orthopaedic surgeons will perform an en bloc resection of my sacrum.  The intent of this procedure is to fully remove all of the sacral tumour, leaving clear margins all around.   In my case it will be a "sub-total resection".  Most of the S1 vertebrae will be retained, which should preserve the structural integrity of the pelvic girdle and spine.

Recovery

I'm scheduled for the hospital for 2 weeks.  Whether it takes longer will depend on the surgical outcome, complications, and mobility issues.

Future Mobility

I have been told that the left sciatic nerve will be lost in the surgery and that I could be "wheelchair bound".  Having spent much time with my dear paraplegic Aunt Shirley, I have very few qualms about this.  We really won't know what mobility issues there are until after the post-op assessment.

I will have a few appointments with various doctors and clinics over the next week as I get ready for the surgery.

Curative vs Palliative

Cancer treatment is often classified as either "curative" or "palliative" depending on whether the intent is to eliminate the cancer and cure the patient or to alleviate symptoms and provide comfort.  I've been told that there is not a large enough "population" of this particular procedure to deem it curative.  But there is no doubt that "cure" is the intent of the doctors performing the surgery and of us going into it.  We would not undertake a procedure of this scale if there were not a reasonable hope of a curative outcome.

That said, we will not know for several months as to whether the operation successfully excised all of the sacral tumour or not.

That is about it.  We are of course very excited and hopeful.  But not without some trepidation on my part!  We have the best of surgical teams and are in good hands.  We will do what we have done for the last 6 years, forge ahead and hope for the best.

By for now...

Rob; in Vancouver

A Glimmer of Hope

It is early in the morning on December 23, 2010.  I should be sleeping but am awake with excitement.  Today was a "full energy" day.  This morning Morgan and I did the big grocery shopping for Robyn's Christmas Eve Birthday Party and our Christmas Day Feast.  I spent the afternoon making lasagna for the birthday party from a traditional family recipe handed down from my Dad.  Yummy!   This evening Jerome and Kelly visited for dinner and a Christmas movie ("Christmas Vacation" with Chevy Chase).  They are just back from Jerome's home in Hazelton so there was much to catch up on.  Jerome has wonderful work as a teaching assistant and basketball coach in the Hazelton School District.

It feels good to have gotten so much done and it leaves tomorrow totally free.  Alas, I will probably sleep most of it away now that I have surrendered much of this night to insomnia!

"The hopes and fears of all the years are met in thee tonight..."

Wow, does this ever seem to be the way it is with me this Christmas.  So many hopes and fears converging.  My situation seems outwardly dire.   My level of medical care is "palliative".  I'm living with an indwelling catheter, managing bowel incontinence with "Depends", walking with the help of a cane, and bearing this "pain-in-the-ass" cancer with ever increasing doses of Morphine and its various derivatives.  I'm living through what, in most likelihood, is the terminal stage of a cancer against which I have never really had more than a "faint hope".   Fear abounds!

And yet I do remain hopeful.  Not just hopeful of a dignified death and an ongoing existence of wholeness and bliss beyond the grave (much as this is!),  but hopeful of an ongoing life of joyous love and faithful living in this plane of space/time existence.  Perhaps I am just having another late-night experience of one of morphines beloved side effects - an exaggerated sense of well-being!

A Glimmer of Hope.

At present I am undergoing a series of scans (CT, PET, MRI) which will be evaluated by a local surgical team to see if I might be a candidate for a "sacral resection".  A sacral resection is a significant surgical procedure which sees the collaboration of orthopaedic and general surgeons in the removal of all or part of the sacrum and all of the soft-tissue cancer in the pelvic region.  The sacrum is then reconstructed using artificial bone and steel and permanent incontinence is resolved with a colostomy and permanent urinary catheter.

To be eligible for this extensive procedure it must be shown firstly, that I am free of other metastacies; secondly, that the cancer is not spreading up the spinal nerve sheath; and thirdly, that a viable orthopaedic reconstruction option exists given the extent of cancerous bone that would need to be removed. This is indeed a lot to ask.

I've been aware of this option for sometime but only began to pursue it this Fall when it became clear that the chemotherapy was losing its grip on the cancer.  I've been consulting various doctors at the BC Cancer Agency and BC Spinal Centre for the last month or two.  Not all have been encouraging.  It is now getting down to the nitty gritty!  I've had the CT scan and am scheduled for the PET scan in early January.  An MRI is pending too.  Soon I hope!

"Delusion of Repreive"

Thanks to my friend Peter Alexcee I have been reading Viktor Frankl's classic work "Man's Search for Meaning".  Frankl, a holocaust survivor and psychiatrist, uses the term "delusion of reprieve" to describe the belief that many death camp prisoners held that they would be saved, rescued, or otherwise redeemed from their mostly inevitable death.   "In psychiatry there is a certain condition known as delusion of reprieve. The condemned man, immediately before his execution, gets the illusion that he might be reprieved at the very last minute." Viktor Frankl

I don't think that there is any doubt that late-stage cancer survivors can experience this phenomenon.  There is always one more drug, one more surgical procedure, one more clinical trial, or one more exotic alternative that is finally going to rid us of this dread disease and allow us to return to the lives we had before, or even better lives!  From the perspective of survival this is actually not a bad outlook to have.

Perhaps this then is the cause of my tragic optimism at this late stage of my cancer journey, a "delusion of reprieve".  And yet!  My basis for hope in this plane of existence is rooted and grounded in a very real and tangible possibility.  Or perhaps my doctors are indeed collaborators in my "delusion of reprieve"!  We all want to believe that "cancer can be beaten"!

Even beyond this particularly hopeful possibility there are a number of other options that offer hope of some life extension and much life enhancement.  All shall soon be revealed. 

As I took out the Christmas decorations this year I distinctly remembered putting them away last year and doubting at that time that I would be here now to enjoy another Christmas season.  And yet here I am.  So enjoy it I will!! 

Do have yourself a very Merry Christmas... Love Rob; in Vancouver

O holy Child of Bethlehem, descend to us, we pray;

Cast out our sin, and enter in, be born in us today.

We hear the Christmas angels the great glad tidings tell;

O come to us, abide with us, our Lord Emmanuel! 

Pollock Family Christmas

Most of my "Christmas Blogging" will continue at "Pollock Family Christmas", where all friends are warmly welcome to join us for carols, stories, and Christmas cheer!  Health updates and cancer reflections will continue to be posted here.

Merry Christmas...  Rob; in Vancouver

"May the spirit of Christmas bring you peace, 

The gladness of Christmas give you hope,

The warmth of Christmas grant you love." 

Thomas Merton

Thomas Merton 

January 31, 1915 - December 10, 1968

On December 10, 1968 Thomas Merton died of an accidental electric shock from a faulty electric fan in his cottage at the Red Cross Conference Center in Samut Prakan, Thailand. Merton had presented a paper at a conference of monastics that morning.

I engaged in an imaginative pilgrimage with Thomas Merton two years ago as I marked the 40 year anniversary of his journey to India, Sri Lanka, and Thailand.  I followed his journey, and his journals, from day-to-day and posted reflections, historic pieces, and samples of Merton's thought and writing to "Merton in Asia".  This blog continues to exist and remains a worthwhile exploration for those interested in Merton's life and thought, particularly as it emerged from the 60's context and in its continuing significance.

Why Merton?

Some will ask... "Why Merton?"  I addressed this question in the early stages of my virtual pilgrimage with Merton and summarized it in terms of his significant contributions in the areas of:

• Inter-faith Dialogue and Action
• Non-Violence and Peace
• The Ecological Consciousness
• The Prophetic Voice
• Contemplation and Spirituality

These remain areas of vital importance today as people of faith struggle to find an authentic spirituality that has relevance for the significant challenges we continue to face as a people on this increasingly threatened planet.  Merton's insightful critique of contemporary culture, his passion for the earth and all its inhabitants, his willingness to embrace others of diverse religious traditions, his deeply non-violent approach, and his own rootedness in his Christian spiritual tradition continue to make him a uniquely gifted voice in the world of contemplation and action.

Merton wrote against the backdrop of the turbulent 60's.  1968, the year of his death, was considered to be a particularly significant year, Merton described it as a "beast of a year!".  The issues arising in that time remain the significant issue that we face as a human community today.  Merton's voice continues to challenge us to wake from our slumbers, to turn from our idols and illusions, and to love our neighbours in truth and in deed.

May it be so...  Rob; in Vancouver

“The whole idea of compassion is based on a keen awareness of the interdependence of all these living beings, which are all part of one another, and all involved in one another.”
Thomas Merton

Highlights from "Merton in Asia"

• Why Merton?
• Merton and Khan - Kindred Spirits
• A Passion for Peace 
• Interfaith Merton 
• A Life in Letters
• Merton's Three Epiphanies 
• Polonnaruwa
• The Death of Thomas Merton 

 

"Happy Christmas" - John Lennon

John Lennon was shot and killed on December 8, 1980 outside of his Central Park home in New York.  I remember hearing the news the following morning in northern BC where I was working as a timber cruiser.   I was on my way to pick up my friend Gary to head into the mountains for a day of work.   We were both Beatles fans and deeply saddened both by the loss of a great musician and the silencing of a prophetic voice.

John and Yoko released this classic Christmas song as a protest song against the Vietnam War. It has become a Christmas favorite. It is wonderful in this video to see the faces of the children who sing the beautiful chorus pieces. The kids are from the Harlem Community Choir.

Happy Christmas!!

A Good Day

Enjoy this short meditation on gratefulness from Brother David Steindl-Rast.  Visit David and learn more about the practice of gratitude at www.gratefulness.org.


Have “A Good Day”!!   Rob; in Vancouver

“Love wholeheartedly, be surprised,
give thanks and praise,

then you will discover the fullness of your life.”

Brother David Steindl-Rast

Well Enough!

Most cancer survivors are familiar with the inevitable "How are you?" question from family and friends.  It is innocuous enough in most instances but can become challenging when it can't be answered with the obligatory "I'm Fine".

For the most part we have reduced "How are you?" down to a rather meaningless greeting.  It fits in very nicely with "Hi!" as in "Hi! How are you?".  Likewise, the response has mostly been reduced down to a meaningless "Fine", or perhaps the lengthier version "I'm doing good", whether or not we happen to be "fine" or "good" at all.

Ah... but for the cancer patient, and their circle of friends and family, this becomes a much richer exchange.  To begin with, the friend comes with a genuine curiosity, heartfelt care and concern. They earnestly want to know "how you are", and equally earnestly want to hear that "you are well".  Family and friends are our strongest hope bearers.  They want us to be well, and if they could will it, we would all be well.  There is no stronger healing power in the world than the love and prayers of family and friends!

Be that as it may, the problem arises on those, not infrequent, occasions when we are not feeling "fine", "well", or "good".  For myself, I wonder "How much do I say?"   My experience has been that people's eyes often begin to glaze over when I launch into a litany of minor medical problems, or they begin to squirm when I relate the nasty details of the latest disease progression or treatment regime. 

Those who know me and have followed my blog know that I have always been forthcoming and detailed about my condition, my treatments, and my options going forward.  But still... the greeting "How are you?"  challenges me.  How do I answer, honestly and succinctly?

I have finally found the response which now works best for me...  "I am well enough."   "Well enough" seems to sum it up for me at this particular stage of the journey.  I am certainly not as well as I would like to be.  I am not able to work in the job that I love.  Nor I am not able to travel to Florida to visit my folks and many friends there. I can't even take a lengthy roadtrip to visit friends in the North, the Okanagan, or the Kootenays. It is difficult to plan much of my life beyond a few months at a time. Each of these things, and many others, are a cause for disappointment and some sadness. Alas!

However...  I was well enough to attend Robyn's wedding in Edmonton and dance 'til the "wee hours". I am well enough to walk the forests and seawalls of Stanley Park with friends and colleagues.  I am well enough to enjoy lunch and a matinee movie with my daughters Kelly and Morgan.  I am well enough to anticipate with great joy the birth of Robyn's child next Spring.  I am well enough to enjoy the occasional night out at the symphony or a play.  I am well enough to explore the many different options for living well (enough) with this deadly disease. And I am well enough to enjoy each day and night, each moment, with my beloved wife and partner Pam.

And that brothers and sisters is  W E L L   E N O U G H!!

Be well enough... Rob, in Vancouver

Guess I'm Doing Fine

John Tinker: Rest in Peace

I lost a dear friend, and fellow pilgrim on the cancer journey, last night.  John died peacefully at home, free of pain, and in the arms of his beloved partner, Adrian.  In his last few days he was remarkably free of the pain that had racked his body for the last several months.

John was a deep thinker, an avid reader, a gifted writer, an inspiring teacher, a good friend, a passionate gardener, and a fun and faithful partner.  Others could say more, but this much, at least, I know to be true.

John and I met in cyberspace through the American Cancer Society's online support network. John, his partner Adrian, and I made a quick connection and found that we were bound in part by the common cards this dread disease had dealt us.  John and I both had colon cancer that had spread to our sacrum, the lower vertebrae of the spine, the "Holy Bone".  A painful and deadly recurrence.

Our relationships grew to include personal e-mails between John, Adrian, my wife Pam, and myself.  In time I called John and we began to converse about symptoms and treatment options on the phone.  Finally, last April, Pam and I traveled to San Francisco, where we were met by a smiling John and Adrian at the airport (SFO), and where we enjoyed much of their company over a wonderful 5-day visit.  Highlights of our visit included a roadtrip to Point Reyes park and a pizza dinner at their beautifully restored home and garden.

In addition to sharing a common ailment, John and I shared much in common in our approach to living with cancer.  John engaged the experience of living with a life-threatening disease deeply.  (John engaged all of the experiences of life deeply!)   After much thought, wrestling, and a transformative hypnosis session, John came to the point of understanding that is best summed up in his own words...  "I cannot control the disease; I can control how I experience the disease."

John lived deeply and joyously through his life with cancer.  He focused on what was "life-giving", which for John was his relationship with Adrian, his garden, his writing, his friends, and "Hogarth", John and Adrian's lively boxer.  This is not to say that he did not have times of deep pain and suffering.  He most certainly did, both physically and psychologically.  Yet he was able to reflect on such periods, write of them, and ultimately transcend them.  Where some might become embittered and resentful, John remained gracious and loving. 

John shared some of his writing on the experience of living with cancer with me.  His writing of this experience was detailed in its descriptions, insightful in its analysis, and graceful in its conclusions.  I hope some of it finds its way to publication.  It is certainly most worthy of it.

The picture of John above is not complete.  It is cropped from a larger picture and a larger context...

... the context of love.  I have not known John, apart from Adrian.  Together they lived a rich life of creativity and love.  Their home and garden is a living expression of such creativity and love.

Robert Louis Stevenson said that... "Life is not a matter of holding good cards, but of playing a poor hand well."   John was dealt a bad hand with a deadly cancer, but he played it graciously well.

God be with you John Tinker... until we meet again...

My deepest and heartfelt condolences go out to Adrian and to John's great circle of colleagues, family, and friends.

Peace and blessings...  Rob; in Vancouver

"Despite all of this, we focus on good things.   

As I write, Adrian and I are sipping champagne.  

 Hogarth is nestled up with us, and life is good."

John Tinker

John Tinker

I have put this together using some pictures from John's CaringBridge site and a few of my own.  A small tribute to a wonderful person.  Gone far too soon...