My Cancer Story

1. A Messy Concoction of Uncertainty, Dread and Fear

September 23, 2016

The call came at around 12:50pm last Thursday. Dr Deabes announced himself and my heart started to beat fast.

"How are you feeling" was his first question.

I responded positively.

But that was not the intent of the call. I knew that.

"A couple of things," he said. "The blood tests were unremarkable." He went on to explain that nothing showed up in the lab to be concerned about.

"But…" he lingered on that word, almost like that word in a joke just before the punchline, "the biopsy on the mass we found is cancerous."

It's a weird moment when that "c" word shows up in your life about you. I tried to stay present with the doctor as he explained it more and what would happen next.

But when he told me that the 5 centimeter mass growing in my rectum found during my colonoscopy the previous day was cancerous, an emotional weight latched on to me that was a messy concoction of uncertainty, dread and fear.

Cutting through this new heaviness, I heard him clearly explain that my situation was the "best, worst news he could deliver" and felt a slight sense of relief. The CT Scan showed that the mass was contained in my rectum and was in a good place for the surgical procedure that would need to be done. The kidney, liver and other blood markers showed this was early detection. He already had me scheduled with the surgeon. This was all part of his "best" description.

I asked him some clarification questions, made sure I wrote it down so I could share it with Becky and then hung up.

I stood silently in my office as I tried to embrace this new reality I now live within. I was aware that everyone has cancer cells in their body. But, this is more than a few random cells. This is serious.

The last few days has allowed this new knowledge to settle in. It's life. I don't have a free pass on the ugly stuff life hands out just because I work hard to be healthy.

Granted, I've been extraordinarily lucky so far. The intravenous needle put in my arm last week for my colonoscopy was the first one I have ever had in my 51 years. Besides that, I am healthy. And I have the capacity, strength and resolve to do what I need to do.

I face this all with with incredible support. Becky is an amazing partner is so many ways I cannot describe. She is my rock.

I have a great medical team from Scripps who are experts in all of this. My family and intimate friends are delivering positive and prayerful energy as well as offers of every type of practical help. The team at Flourish Press and WebVitality are seasoned professionals who have already stepped up to give me the time and space I need for what I am already experiencing and what lays ahead.

But, other than the meeting with the surgeon this coming Thursday, I don't know what comes next. The research I did this weekend has me more than freaked out about what this could all mean in terms of surgery, recovery time, complications and next steps.

While I do not know the timing of my treatment as of yet, Becky and I will keep you updated as best we can. I expect and will work towards a full and quick recovery.

Thanks for the support I know you will respond with. I am grateful for your presence in my life.

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2. MRI Required

September 29, 2016

Just got home from the meeting with Surgeon.

We learned a lot about the most likely options and paths, but still more testing is required to know what specific stage of cancer it is.

Essentially, that means they need to determine how much, if any, it has spread within the rectum and lymph nodes. This requires an MRI as soon as we can get one scheduled. We hope to have that done in the next week or so. But much of the direction going forward will be determined by the MRI, specifically what treatment plan comes in which order.

The location of the tumor also means a more complex type of surgery then we originally anticipated. And, the big learning today was my specific situation is likely to require a much longer process than we had hoped for. So, there's lots more things to figure out related to this.

You might be wondering how I feel after today's meeting.

Initially, I'm impatient. I wanted a more clear path forward today. And, then, frankly a little discouraged. I hoped that the tests done already would have been more conclusive. But, at least I know the potential paths. So, that's good.

Plus, I'm feeling fine. No pain. Just some discomfort.

We will keep you posted as we learn more. We don't expect any new information for a few weeks, so in the meantime, "no news is good news."

---

3. Os-to-me... Ostomy

September 30, 2016

Mandy welcomed Becky and I into her small treatment room. We'd been told by the lady who checked us in that she was the "angel" in this department.

Becky sat on the treatment bed. I stood. The air seemed heavy and and the walls felt close.

After some initial hello's we got right to the goal of the meeting – to learn about an ostomy, should I need one after surgery.

Having done no research on this very likely addition to my surgical recovery process, I went in feeling extremely ignorant about what it all entailed.

I had assumptions. I thought that they surgically created some sort of valve that then supported a collection bag. Turn it on and off as required. But, no such thing.

Depending on the doctors decision in surgery, and the pre-defined spot for the hole determined by Mandy, the small or large intestine is bent, folded and cut open in order to attach it to the hole in my skin. Sewn together actually. The intestine just meets the skin and forms the outlet for all the waste. It's called a stoma.

Mandy showed us the diagram and picture of what it would look like. Becky sighed and lay back on the treatment bed, and I started controlled dancing anxiously between both feet. I was experiencing that distinct pre-faint feeling. I kept moving and breathed deeply. It looked really weird. A red colored skin attached to the white colored skin.

"So no valve?"

"No" said Mandy. "It's just the stoma. There are no controls. It just comes out as the intestine pushes it."

She then went on show us the ostomy bag that gets stuck to the skin surrounding the stoma using cutting edge adhesives. She explained the process of filling the bag and to frequency and method to empty the bag. She explored the options and the possible issues that might come with it.

Becky asked about gas. With a bit of a chuckle, Mandy responded, "Yes, that too. It all comes out."

"Is there a charcoal filter?" I wondered aloud.

With confidence, Mandy pointed to the tiny charcoal filter on the bag and described how it worked.

"Yes, here it is. So there is no smell"

"Normally, with the way it is now I can control it. If you have to fart, you hold it or excuse yourself. But you're saying there is not control when gas happens? What do you do?" I asked awkwardly.

"You just muffle it with both arms." She demonstrated the position and continued. "No one will know."

We laughed together, but it struck me in that moment how I much want this process to be simple. But it is not. I want the easy surgery without the need for 2/3rds of my rectum to be removed. I want to avoid the ostomy. I don't want to deal with all this right now. It's almost surreal. I'm healthy. I feel fine. And, I am likely going to need to wear one anyways.

I'm brought back to focus as Mandy reminds us that thousands of people live their lives with an ostomy bag. And she confirms that the technology has improved over the years.

With no more questions we exit her room. While I believe her colleagues admiration, and respect her knowledge and expertise, I secretly hope I won't have to meet her again.

But now I am ready, just in case I do.

---

4. The Diagnosis

October 8, 2016

After a full week of scans, testing and meetings with doctors, the verdict, though still inconclusive, suggests that I have Stage 3 rectal cancer, with possible spread to lymph nodes.

It's Stage 3 because the cancerous mass is, in fact, through the wall of the rectum. It is not contained as originally indicated in earlier testing. The MRI showed enlarged lymph nodes in the immediate area. As best they can tell, there is no indication of any spread of the cancer to any other parts of my body.

The treatment plan uniformly recommended by my medical team includes 5.5 weeks of chemotherapy and radiation Monday through Friday. The goal is to shrink the tumor and kill the cancer cells, pre-surgery. Then after a period of recovery from the treatment, I'll need to have laparoscopic surgery to remove the tumor and related lymph nodes for assessment. This process will also remove most of my rectum. If all goes to expectation, that should do what is necessary to eliminate the cancerous activity. Though, if they find any remaining after they test the cells, there might be extended chemotherapy.

The reality of this diagnosis and treatment plan is starting to sink in. I've rummaged through the stages of grief with all of this all week and found connections to all of them.

Shock catches me as I've sat and waited for a test or appointment with the doctor. There are times when complete and utter disbelief overtake me.

"How and why is this cancer happening to me?" lurks in the background then shows up with regularity.

Then, I catch myself in complete denial.

"It is not happening. It can't be."

Anger, fear, uncertainty and numbness. They all absorb me and grab me for a time.

"What did I do to cause this?" holds my attention longer than most.

In late night hours of sleeplessness and the moments when concentration on the task at hand is lost, I've catalogued in my mind all the causes of this disease for which I might be personally responsible.

Was it my love of Coca Cola in my twenty-something years? Or the extreme stress I lived under during my thirties? Did my time as a frequent flyer and the road-warrior diet that accompanied it cause this? Or, is it the amount of sitting I have done at my office desk trying to build a business over the last 13 years? The list of self-induced causes seems particularly easy to document. The coffee? The sugar? The Scotch whisky? The cell phone? The multiple computer screens? The list grows if I let it.

It's easy for me to think that life is the absence of the crappy and difficult things that show up. Thus, the goal is to get rid of them as soon as possible.

I've looked at my Athletic Greens powder, Vitamin C, and other supplements and conspired to have them work with me to destroy the cancer before the chemo and radiation begins. "I'll just double the dosage." seems appropriate I think.

But then, in the stillness of my morning mediation, or the times when my foundation feels solid from the support I have received from so many, I know the plan. I accept my fate in it and am ready to face that which lies ahead of me.

I have rectal cancer. I will have chemotherapy and radiation. I will have surgery and all that comes with it.

A Zen Proverb reminds me, "The obstacle is the path."

This newly discovered cancer, its treatment and its effects are life. My life. They are my path.

There is a greater meaning to this. It's my task to find it. There is a purpose for this new reality in my journey.

So, I will find it, try and learn it, and if I do, I will share it with you.

Becky continues to shoulder this new reality with me. There is no one you would ever want more in your corner than her. She's single-handedly managing a complex healthcare system, insurance and all the details that come with that. And that's after all the amazing things she does already to make our lives, our family and business work. I am the luckiest man in the world to be her husband.

Thanks for your support and concern, your prayers, your energy and your love.

I am a blessed man to have you in my life.

---

5. The Planning Fallacy

October 14, 2016

There is a phenomenon in business and life called a "planning fallacy" in which predictions about a future project or task display an optimism bias and underestimate the time, expense or resources needed to complete it. And, while I am pretty good at spotting the planning fallacy in my role as a business owner or executive coach, the phenomenon showed up in my world this week.

Becky and I have been deluged with a torrent of information from meetings with the team of doctors, and the results of the many tests initiated by my recent cancer diagnosis. It's compounded by the additional Doctor Google monsoon unleashed by our own research on everything related to rectal cancer, the treatment side effects, chemotherapy drugs, radiation therapy and more. This information overload left me full of data, but in a somewhat delusional state, despite my best efforts to know everything about what would transpire over the course of this cancer eradication project.

Last week Becky and I scheduled a follow-up visit with Dr. W, my surgeon, as a way to make sure we could clarify our concerns and finalize any questions we had before my treatment began.

Earlier this week we were ushered into the treatment room. I was asked to get on the awkward exam table/chair contraption and Becky sat in the regular chair. The nurse took my vitals and declared I was "where I needed to be." I felt like a little kid sitting there as my legs hung off the table, not long enough to reach the ground.

Becky and I had a plan for this meeting. I had two pages of questions. I would ask the questions, Becky would document the answers. If something didn't make sense, we both agreed to stop Dr W. and try to make sense of it.

Dr W arrived, closed the door, logged into the computer and then leaned back against the door. It seemed this was not her first inquisition by extremely "prepared" patients. I started with the first question on my list. And the discussion proceeded.

I felt much more present at this meeting than I did the first one. Dr W didn't seem to be talking so fast. We understood more of the terms she used during this meeting than we did in the first one. Our "deer in the cancer headlights" shock was no longer present, so we were taking it all in as best we could. We were moving into my second page of questions, when it happened – I realized I'd fallen victim to the planning fallacy.

I had employed my own optimism bias around the complexity and implications of my treatment. I'd also under-estimated the timelines associated with it. As Dr W answered our questions and gave additional information to support her answers, it became very clear that I needed to get real and drop the assumptions. I had to get out of my planning fallacy. So, I made sure Becky and I understood as much as we could, not only about our questions, but also any other things I might be missing.

As a result, this is the most likely treatment plan I'm anticipating, along with the explanation, order and expected timing.

• Meet Dr X, my Oncologist. This happens next Wednesday. We'll officially decide on the chemotherapy treatment plan.
• Book a time to do the intake for radiation treatment. This means I need to get measured for the radiation treatment. As best I understand it, this is where they line up the "lasers" to zap you with radiation. I then wait approximately a week while the radiation doctors and physicists program the "lasers" for my radiation treatment.
• Start the combined chemotherapy and radiation treatments. It's an oral chemotherapy which means I take all the pills at breakfast and dinner. This happens on the same day I get radiation, which is every weekday for 5 1/2 weeks. Saturday and Sunday are off as a break. The radiation sessions last about 15-20 minutes each day. Thankfully, the radiation center is about 15 minutes from both our home and office. Each week I will also have blood tests and scan to monitor my situation.
• At the end of combined treatment period, there is a 6-8 week recovery period. During this time I rebuild my strength to get ready for surgery. At the three week mark in this recovery period, I'll be scheduled for another scan with the radiologist to help them know the results of their work. If all goes as planned, we should be into the Christmas season by now. One month after I'm done chemo and radiation, Dr W schedules the surgery, which we anticipate will happen in late January or early February.
• A day or two before surgery, we go back to meet with Mandy, the ostomy specialist. She figures out where on my body the stoma will be placed for best fit and comfort of the ostomy bag and tattoos my skin so Dr W will know where to connect it.
• Then, the surgery. I've learned it is a pretty significant operation. Dr W plans on doing it laparoscopically, using the robots if they are available. The surgery includes the removal of most of my rectum, along with the fat and lymph nodes surrounding it. Lymph nodes and other substances removed will be biopsied for any remaining cancer. My colon then is attached to the remaining parts of the rectum and sewn together. The stoma is also added that links the small intestine to my stomach skin in order to add the ostomy bag. This bag will be my companion for anywhere from 3-6 months. There are 5-7 days of hospital recovery from surgery. Once I am released from hospital, Dr W suggested that my recovery from surgery will last anywhere from 3 to 5 weeks.
• Depending on the biopsy from surgery, there is also the possibility that I will start more chemotherapy in anything is still cancerous. This will most likely be the more intense drip IV or pump version of the treatment. This usually lasts anywhere from 5-6 months.
• At the end of this period – either 3 months of recovery or 6 months if the additional chemo is needed – there is still another surgery to go, the removal of the ostomy and stoma. This is also a much bigger surgery than I was expecting. Hospital recovery lasts another 4-6 days. Then more recovery time at home as my digestive track learns to operate again.
• Finally, there are ongoing tests, exams, blood work and scans to monitor and watch my ongoing condition.

All of this is subject to things going as well as they can. Complications are part of the risk. But, now I know what to expect, as best I possibly can, without the planning fallacy. I hope this helps you as well, if you were in any way stuck in the thinking with me.

There's something calming about knowing the reality. Yes, it's not always pleasant, but at least I know what I am up against. And I am ready to get on with it.

Thanks for your unquenchable support.

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6. What If

October 18, 2016

Scared of what lies ahead for me, I'm often caught in a cycle of worry, fear and uncertainty. I hate the fact that this cancer has shown up. I'm angry at it and what I need to do to fix it.

As a result, all sorts of "what ifs" pass through my thoughts on a daily basis. They hover like a gnat attracted by some ripening bananas.

What if I don't do well with the chemo treatment? What if I get some of the side effects of radiation? What if it the surgery goes poorly? What if they find more lymph nodes or cancer during surgery? What if the colostomy bag doesn't work? What if I need more chemo?

What if… what if… what if…

I try to swat them away, but they return with annoying frequency, buzzing around my brain. They seem attracted to my fear.

But, in those times when I stop, quiet myself and connect to this moment I'm in right now, another thought whispers within me.

Life is not happening to me, it is happening for me.

And, from that perspective, new, more powerful "what ifs" emerge.

What if this diagnosis is for my good?

What if this cancerous growth in me is a gift?

What if this sickness will save me?

What if the lessons that come in this process are part of a bigger, more valuable gift I have to give the world? Is there a greater good being birthed in this rectal cancer reality?

In these new "what if" questions, and the others that appear along with them, a bigger, more courageous part of me emerges.

From them, at least most of the time, I feel confident and ready for what is ahead.

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7. A Decision Reached

October 26, 2016

Last Wednesday Dr. X, my new Oncologist, was straight with me in response to my many questions about the side effects of chemotherapy.

"Listen, this treatment will be hard. And, yes, there will be side effects. There will be discomfort and maybe a number of other things will show up as well. You'll be fatigued and quite likely get diarrhea, nausea and even vomiting. Your skin, especially on your hands and feet will likely get really sore. But it's only for five and a half weeks. We're saving your life here. You'll get through it; I need you to Buck up!"

As tough as it was to hear, it was a trust building statement. Many of the other answers Becky and I got from Dr. X confirmed that she was a great choice. She listened and responded to all our concerns. And I left feeling like I was in good hands.

Earlier in the day, I received a very detailed document from the MD Anderson Cancer Center, who I had contacted about a second opinion. It laid out their complete treatment approach to Stage 3 rectal cancer. Their standard treatment aligned almost exactly with what my doctors were recommending for my specific diagnosis.

With my emerging trust in the recommended treatment process, the medical team that supports me, and all the love, thoughts and prayers made on my behalf, I've decided to officially move forward with treatment.

This afternoon I have my "laser" mapping appointment for radiation treatment, which means they'll figure out precisely where on my body the radiation will target. The chemo drugs are on order at the speciality pharmacy. Chemotherapy and radiation treatment will likely begin in the next week.

Internally, I've resisted making a final decision on this treatment because it leads me into my deep fears. Fear of the unknown. Fear of the side effects. Fear of the long term effects. Fear of surgeries. Fear of my own mortality.

"Courage is not the absence of fear, but rather the judgement that something else is far more important that fear." says James Neil Hollingsworth.

Oh, fear is there all right. In full force. But, it is time to proceed. Something is more important right now.

John Wayne reminds me. "Courage is being scared to death, and saddling up anyways."

I'm saddling up. Reluctantly courageous.

I'll keep you posted as my treatment proceeds.

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8. Getting To Yes

October 31, 2016

The radiation technician directed me to lie face down, arms above my head, on a almost-hard, molded body holder that positioned me from my head to my upper thighs on the platform of the CT Scanning machine. She then covered me with a warm, blanket-like sheet.

I was here for the set up and staging for my radiation treatments. I felt like I was awkwardly positioned to look like I was about to dive into the circular portal of the CT machine.

After a few minutes of moving me around and adjusting the mold on the platform, she and her colleague called out some numbers to each other. She then moved up my left side, put her head close to my left ear and let me know that "25" was my position number and that I would likely hear that number a lot.

As she moved away, she informed me she was about to lower the sheet covering me and touch my back. While her touch on my bare skin was expected, I still flinched as her finger landed just above my exposed tailbone. She commented that I must be ticklish. I wanted to explain that I wasn't and why I had the reaction I did, but it seemed pointless. She was already on to something else.

Here's the thing. As she lowered the sheet, I was expecting a needle.

And I absolutely HATE needles.

Even with all the ones I've endured in the last month, I'm still not used to them. When I know they are coming, something inside me revolts. I tense up. I can't look when they draw blood or add an IV tube to my arm.

But I knew what was coming today in this situation.

A tattoo.

A tattoo was NOT on my to do list. Not today. Not ever. I had no plans to ink myself.

My resistance to a tattoo is not so much the unique marking itself, but due to the fact that it requires a needle as the delivery mechanism for the ink.

Thankfully, at this point in the procedure, she explained that she was only marking me with a pen to get the positioning right. I relaxed a little.

She pulled the sheet back up covering me up and informed me they needed to do a number of scans. After confirming I was still doing okay, she asked me to lay very still for the next few minutes as the scans took place.

As she left the room, the machine roared to life. The platform began to move and I pulled my arms in tight above my head knowing how small the opening was in the machine. I noticed the extreme tension I was holding in my stomach, shoulders and legs.

The body mold seemed to harden around me, especially at my forehead and cheeks. I wondered if I was lined up correctly. I desperately wanted to move and adjust, but I couldn't. I had to lie still. So I brought my attention back to my breathing and quieted myself.

And in those moments, as I was shuttled in and out of the CT machine, a realization occurred to me. Maybe I need to come at this whole experience in a different way.

Instead of saying "no" to the needles, the tattoos and the treatment in front of me, it might make a lot more sense to take a different approach. My "no's" caused me to tense up, fight what was happening. I was internally resisting the very treatment I was agreeing to. And, that likely wasn't going to work very well.

I decided that instead of "no" as my default response, I would start to say "Yes" instead.

"Yes" to the needles and IV's that were to come. "Yes" to the tattoo. "Yes" to the chemotherapy and the radiation. "Yes" to the blood tests, the scans, the rigid molds and the occasional wait times. "Yes" to this treatment path in front of me and all that I might encounter along the way.

And, in that CT Machine, another more powerful thought emerged. It was time to say "Yes" to this Stage 3 cancer diagnosis. "Yes" to this tumor in my rectum. "Yes" to what was happening to me and in me.

I decided to accept what is. Not because I love it or want it in my life. But because it is my reality.

As the scans completed, the radiation technician once again joined me. This time to give me the official permanent markings that will be used to line me up and position me on the radiation machine for my ongoing treatment.

As she described what she would be doing, in my head and in my body I silently affirmed my new "yes" to what was about to happen. And despite her warnings to the contrary, I barely felt a thing as she tattooed me.

Moments later, I got off the machine with not one, but four new tattoo's. Four, really cool small dots on my body. One on each side of my hips and two additional dots a few inches apart on my lower back.

They are my "yes" dots.

Wednesday, November 2nd at 11am Pacific time is my first radiation treatment.

After breakfast that morning and after dinner that evening I will swallow the first sets of my chemotherapy treatment.

Yes! I am ready.

Thanks for your continued care and support.

---

9. Day 1 Treatment Review

November 3, 2016

The prescription bottle of chemotherapy tablets stood beside me through breakfast. I had already removed the first three 500mg tablets and placed them in the overturned prescription bottle cap.

Doctor X. and the pharmacist both stressed the need to take them after food was in my stomach. So I finished breakfast and waited a little bit. After 12 minutes, I tentatively reached for them. But, something caused me to pull back. Almost as if there was a force field blocking me from them.

I looked to Becky for support. But, I knew what I really wanted was the acknowledgement that my, or more accurately, our treatment was about to begin. We're doing this together.

We knew, without saying it, that we had to mark this moment. We needed to engage a ritual that celebrated the beginning of this treatment process. Maybe that's why I hadn't swallowed the tablets yet.

Through breaking tears, aware of our shared uncertainty, but offset with lots of underlying hope, we looked at each other as I raised the three light orange tablets in my right hand.

"Trust the healing power," Becky affirmed.

I took in her words and struggled for my own.

A simple "yes" emerged in my thoughts and released from my lips. It's the only thing that came to mind. And behind this yes was a belief that this substance I was about to swallow would do its work in my body.

Eyes still locked, Becky and I fist bumped. Yes! We actually fist bumped.

We are not fist bumpers by nature. I'm not quite sure if we've ever fist bumped before. But sitting at our kitchen bar, in our impromptu ritual, that's what happened between us.

I lifted up my cup, half full of cold Earl Grey tea, threw the three pills in my mouth and washed them down. Treatment was officially started.

[The full post continues with detailed descriptions of the first radiation treatment experience...]

Day 1 of treatment is done. Just 27 more to go.

I'll keep you posted. Thanks for your amazing support.

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10. Not A 60% Guy

November 8, 2016

Becky asked Dr. L, the Integrative Medicine cancer specialist, directly, "What are the odds that Tom will get the side effects from his treatment given his age and good health?"

Dr. L didn't hesitate. "100%" He then paused for a few moments before adding, "We just don't know which ones will show up and when they will happen."

And then Dr. L made an even more sobering disclosure. "Expect to only be able to do 60% of what you think you can accomplish each day."

His statement hit me hard in the gut. I've had a lifetime of boundless capacity. I've always been able to do more than expected. There's invariably more fuel in my tank. In fact, it's been one of the underlying beliefs I've held about myself for most of my life.

I am not a 60% guy. In Dr. L's office I inwardly fight the notion. "That won't be me. I will give this 150%."

But, over much of this last weekend, as I lay on the couch immobilized by the fatigue, it became evident that my belief about myself might not withstand this new reality. The value I've placed on my capacity to do "more" smacks into a wall of tiredness that I cannot climb over. I feel like I'm lucky hitting 50% right now and I'm struggling with what it means about me.

So, I'm going to try the 60% approach. I'm going to walk 18 minutes a day. I'm going to arrive at the office at 8 and leave at 4:30. I'm not going to start or take on any new projects right now.

I'm going to… Dang, there I go again.

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11. A Heavy Heart

November 15, 2016

She was crying in the change room next to me at the radiation treatment center. It was not a quiet weeping, but a heavy, infectious sobbing that crawled inside me.

I didn't see her. I didn't talk to her. But I imagined what she might be experiencing. Maybe she'd just learned of her diagnosis. Or, maybe the treatment was taking its toll on her. Possibly, she was lamenting the sudden life-altering changes that accompany cancer.

Standing there, I felt her heaviness. And in it, I felt mine.

As a result, my heart is heavy today.

In these situations my tendency is to switch my attention to things that make me feel better. I've got a repertoire of positive, motivational and inspirational messages that I can repeat to myself to quickly cover over the heaviness.

But in these last few months, I'm discovering something that I never really understood before.

Instead of resisting or deflecting, I'm learning to sit with this terrible, no good, rotten stuff that's happening, and give it permission to have a voice within me. I'm practicing intimacy with the difficulty and sadness. I'm allowing myself to engage and dialog with the pain and discomfort I feel. I'm holding space for all of it.

And when I do, I'm jarred out of my complacency and the casual beliefs of an untroubled life. I accept my fragility. I adopt the instability and uncertainty of this life.

And in that, somehow there's no need to fix, solve or reverse this heavy heart.

It's fine just as it is.

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12. Man Up

December 5, 2016

Today I complete the 23rd of 28 days of my radiation and chemotherapy treatment. I'll be more than 80% through this first part of my treatment program. And while I wish I could tell you things are getting easier, the fact is, they are getting harder. Chemotherapy and radiation are cumulative, so over time, the side-effects grow. I've been informed that the next couple of weeks will likely be the hardest of all.

As I instinctively react to the various side effects of my treatment, the words "Man Up" ring in my ear.

It was a direct challenge delivered by my Oncologist, Dr. X during our first meeting as we discussed the possible side effects I would experience from chemotherapy. Her point was to give me some perspective. As she and my medical team try to save my life, I need to accept and deal with the tough stuff that will show up.

Earlier this week I started reading the book, Letters To A Young Poet by Rainer Marie Rilke. The following paragraph in the 8th Letter jumped off the page:

"We have no reason to harbor any mistrust against our world, for it is not against us. If it has terrors, they are our terrors; if it has abysses, these abysses belong to us; if there are dangers, we must try to love them... Perhaps all the dragons in our lives are princesses who are only waiting to see us act, just once, with beauty and courage. Perhaps everything that frightens us is, in its deepest essence, something helpless that wants our love."

As a result I am compelled to ask, "What does courage look like for me in the face of this diagnosis and treatment? What does it mean for me to act with beauty toward all this? How do I love the frightened, helpless parts that live within me?"

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13. Stage One Is Done

December 19, 2016

Last Friday officially marked the end of the first phase of my treatment plan. It ended with a blood test. The previous Monday I graduated from radiation and completed my final morning and evening oral chemotherapy treatment. The most difficult side effects are almost gone, while others continue to persist in lessening ways.

For the next six to eight weeks my goal is to get back to physical strength and health in order to be ready for stage two of my treatment plan: surgery.

While it may sound strange to hear, learning of my diagnosis and the resulting experience I've had during the last six weeks of treatment have provided me with some of the most profound and meaningful gifts of my life. The lessons and insights have been life altering in a way I could never have imagined.

I thought I was invincible.

I'd never experienced any health related issues in my life. Along with that, I had a quiet belief that my eating habits, my lineage of long-lifers, my positive energy and life contribution granted me a free pass on the possibility of a major disease, at least this early in my life.

I was arrogant about my health.

A diagnosis of Stage 3 rectal cancer in late September crumbled my belief immediately.

Overnight I knew my fragility. I was not invincible. No longer could I assume I'd live to see 100. This tumor growing in my body could be the death of me.

A gift of my diagnosis, treatment and the related side effects is I've learned to accept this difficult, crappy situation I'm now in.

I've finally conceded that I'm loose in the joints and quite shabby. I've still got my hair, but I might not if I need more chemotherapy. And while my eyes have not dropped out, my rectum soon will.

And, I've learned that in this, I'm not ugly.

Unless I fail to understand.

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14. Mid-January Update

January 23, 2017

"You suck at updating your blog!" my friend Alan reminded me by text recently. Humbly, I agreed.

Surprisingly, even to me, I feel good. Really good. The only remaining side-effects from my radiation and chemotherapy treatments are that my finger tips are still a bit numb. The last blood test showed my cancer markers are way down, and that my white blood cells are returning to healthy levels. My medical team is very happy with my results so far.

After meeting with my surgeon last week, I am officially scheduled for surgery on Wednesday, February the 15th at 9am.

Thank you again for your part in the steady stream of support, prayers, thoughts and care I receive regularly. I feel ready for this next stage of the process.

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15. Becky's Update from the Hospital

February 16, 2017

Tom was in surgery yesterday for just over 5 hours at Scripps Green Hospital in La Jolla, CA. His surgeon said the surgery went according to plan; they removed what was left of the tumor and most of his rectum, two lymph nodes and performed an ileostomy. We'll have the results of whether or not the lymph nodes were cancerous in a week or so.

Tom's doing really well this morning. The nurses got him up and walking last night, and he was able to sleep for a few hours. Today he starts on clear liquids and is encouraged to walk as much as possible. The doctors are really pleased with his progress. I am thrilled!

Thanks for your continued support. We can feel it!

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16. Becky's Weekend Update on Tom

February 19, 2017

Tom had a rough day on Saturday. The pain in his abdomen was really intense; not so much from the incisions, but as a result of his digestive system trying to work again.

He's doing much better today. He's managing the soft foods better and if he continues to progress, he'll move to soft solid foods tomorrow. He's getting in at least 6 walks around the floor every day now too.

If everything continues to go well, he will be released from here on Tuesday.

Thanks for your ongoing support. It makes a huge difference to both of us.

---

17. Home Again

February 22, 2017

Just around dinner time last night, Dr. W dropped into my hospital room asked if I felt like going home. Enthusiastically, I responded "Yes!"

Becky and I looked at each other and smiled in relief. We were free to go home.

Less than an hour later, after changing into street clothes and packing my gear, Nicki, my day nurse, stopped into my room to remove my IV tube, have me sign the paperwork and escort me to meet Becky and the car at the front of the hospital to drive home. In solidarity with one of my heroes, I chose to walk out the front door and refuse the wheelchair.

Emotionally and physically exhausted, now alone in the car, Becky and I cried as we exited the parking lot of Scripps Green Hospital. This last week has been one of the most profound of our lives. It's still all very raw right now.

For now, this update is to let you know I am now home, resting and recuperating.

You must know I have felt your presence. In every moment where I was feeling scared or uncertain, I reminded myself of the gift of your care. I am humbled and grateful.

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18. The Biopsy Results

February 28, 2017

Last Friday evening, just before dinner, my cell phone rang indicating a call from the Scripps Health system. I answered with anticipation.

Dr. W, my surgeon greeted me and let me know she'd just recieved the pathology report from the biopsy of my tumor, lymph nodes and surrounding tissue.

"First thing" she said, "is all of the lymph nodes we tested were negative. That's a good thing. We found no cancer in any of them."

"None?" I queried to confirm, trying to make sure I didn't miss anything.

"That's right. We looked at all of them. Additionally, the margins are clear," she replied.

"There was a small area of active cancer cells found within the tumor, but that all came out in surgery," she continued. "Which means, you are T-3, N-0, or effectively, a Stage 2 diagnosis, which is less advanced than the Stage 3 diagnosis we've been presuming until now."

"Your long term survival rate is very good based on this result," Dr. W confirmed before completing the call.

I hung up and immediately shared the news with Becky. Then the tears came for both of us. For me they welled up from a combination of relief, gratitude and released anxiety. The weight of "what if" no longer hung on me.

Today I share my joy with you. I'm buoyed by hope. I am grateful to Dr. W, my rock star surgeon and her team.

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19. Breathtakingly Beautiful

March 16, 2017

It's been a month since surgery. And I'm happy to report that my recovery is going really well.

Frankly, the hardest part of the process so far has been the ileostomy. Along with the weirdness of pooping out of my abdomen into a bag hanging off me all day long and getting used to the 8-10 bathroom emptying procedures per day, changing the entire ostomy collection system every three days has been the most trying.

Last week, the typical 15 minute change actually took over 80 minutes. By minute 40, I was so discouraged by the process I was in tears. Tears didn't help though, because I couldn't see what I was doing as a result. So I had to ask Becky for help. And, with my deteriorating emotional state, I even got angry at her too. It was not my finest moment. But with her help we finally got the pouch on and adhered.

And in that moment, Becky stepped in and helped. No judgement or retribution even with my emotional response to her. Just pure love, unconditional support and action.

I felt a new and different kind of intimacy with Becky that's hard to describe here. In that raw, messy, humiliating situation for me, without blinking or hesitating, she jumped in to get the tasks of my ostomy pouch change complete. I experienced a deep, enhanced connection coming in the crap.

It took my breath away.

Melody Beattie, in her book Journey To The Heart writes,

"When we're lost, when the way gets dark, sometimes we see things we never would have seen in the daylight. Sometimes the lessons we learn in darkness are breathtakingly beautiful."

I will forever cherish those messy, dark moments I experienced in the bathroom last week with Becky that would have never have happened in everyday life.

It was breathtakingly beautiful.

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20. The Grind

May 22, 2017

It's been over two months since I shared my last update with you. Eight full weeks into my 18 week chemotherapy mop up treatment, I'm now officially tired of it.

Someone said. "It's the grind that gets em." I believe it.

Weary of the daily feeling of bordering on nausea. Frustrated, not just with the pervading exhaustion I feel, but also with the complete lack of any reserves in my energy tank to fuel attempts to accomplish more than the day-to-day requirements. Add to that, the numb fingertips, the perpetual dryness I feel on my skin and lips, and the inability for my body to heal itself, even with a simple cut. This process is taking its toll on my body, my emotions and my mind.

Despite all my positive intention, the belief I have in the value of this treatment, and my knowledge that this process has profound learning and insight attached to it in my life, I find myself wanting it all to go away.

Instead, I need to focus my attention on this moment, this hour, this day.

• When the nausea is most intense, my goal is pretty simple. Just get through the next hour.
• When the fatigue is overwhelming, I set my sights on the immediate rest I need to take or the goal of sleep tonight.
• When my concentration is shot, I sit back in my chair and allow myself to just "be" for a while.
• When the wave of complex emotions hit me, I give space for the tears. I make room for the discouragement.

Life, and living for me is all very immediate right now. It is lived in the moment.

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21. Enough

August 8, 2017

Two Sundays ago, I officially completed my final round of chemo. In some ways it's hard to believe the treatment is done, while at the same time, it feels like it's been the longest 18 weeks of my life. Fact is, as described in my last post, I'd had enough of the grind.

Yesterday, I exited the office of my Oncologist, Dr. X., with a bounce in my step as the results she delivered felt in alignment with how my body has been feeling this last week or so. My white blood cells are back to just below the very low end of normal. My red blood cells and hemoglobin are in normal range. The two major cancer markers in the blood we've been monitoring are well within acceptable levels. My CT scan was clear and has shown no indication of any remaining or new cancer.

This is great news.

Life is fragile and uncertain.

Thus, it's no longer an intellectual exercise to contemplate my mortality. Even with the good news from Dr X. this week, I've come face to face with the certainty of my impending death. When it may happen, I, of course, don't know. And, to be clear, it's not a morbid preoccupation for me. It is a reality-altering awareness that now permeates my perspective and thinking. This fragile fate brings clarity on what really matters.

I am enough. Just as I am.

I've spent a lot of my life struggling to ensure that I am worthy and acceptable. I've worked hard to ensure that others see me as smart, intelligent, witty and wise. I've labored to create a persona of success and accomplishment.

But when the rug got pulled out from under me with my cancer diagnosis, and my life felt like it was on the line, the need for external approval seemed to lose its power on me. I had to be okay with me, as I was. No one else had a vote on this one.

In my darkest moments within the fragility and vulnerability, I chose to accept that I am worthy… I am of value. Nothing more is required of me than what already is, and who I am at this moment in time.

The person I see in my mirror every day is already enough. Just as I am. Valuable, not because of my accomplishments or success, a lack of failure, or approval of others – but just because I am.

Because I am here.

Perfectly imperfect.

Enough.

And, if I can offer you one thought from this place where I am, it's this.

You, too, are enough.

However hard you are trying to prove to yourself, to someone else or even to an unnamed or unknown expectation that seems to demand something of you, I want to remind you to let it go.

You are enough. Just where you are.

Much love to you today!

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22. Surgery, Part Two

August 29, 2017

At the meeting with my surgeon last week, Dr. W gave me a full exam, checked my CT Scans and looked at my labs. She confirmed everything she saw was supportive of my ostomy reversal surgery.

If you've read any of my previous posts, you'll know the ostomy part of my treatment has been one of the hardest parts for me. So this surgery has been greatly anticipated.

I assumed that because it had taken over three weeks to even see Dr. W for my pre-surgery appointment, and because she only performs surgeries every second Wednesday, my surgery date would be late in September. But, I completely lucked out and got on her schedule for tomorrow.

While it's a relatively simple surgery, I will be in the hospital between three and five days as the medical team needs to closely watch my digestive system, especially my colon, restart after almost seven months of dormancy. Once out of the hospital, my recovery time should be relatively speedy.

Thanks in advance for all your support, love, prayers, healing energy and best wishes. They are deeply meaningful to me.

I'll catch up again once I get home and recovered.

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The Rest of The Story

After that last post, there is a void in any further information. The fact is, once I could get back to regular life, I jumped back in to work, but also completed a massive move to our new home in Western New York. But, I want to let you know that I had a great ostomy reversal surgery, and subsequently, my ongoing tests have been good with strong, positive indicators. I completed five full years of quarterly testing and reviews at Roswell Park Cancer Hospital in Buffalo.

In the fall of 2022, I was officially discharged from the cancer follow-up program due to five years of clean scans, blood tests and colonoscopies. They informed me that I was to watch for symptoms, stay healthy and do my colonoscopies.

One of the most interesting and important steps in the process was the opportunity that Becky and I had to work with the UltraWellness Center in Lenox, Massachusetts. This is the clinic that was founded by Dr. Mark Hyman. In the work we did at the clinic, one of my focus areas was to build, as best as I could, a body that was designed or built to resist cancer. The concept was to make my body inhospitable to cancer—not that it couldn't come, or that it isn't currently there, but that if cancer cells were in my body, they would decide that this just really wasn't a great place to fight, so they would just disappear and go away.

I'm also grateful for many of the more emotional and psychological lessons that I received after this dramatic cancer journey. Specifically, the concept of somatic intelligence and how our bodies are our brains, holding and continuing to hold trauma and unresolved emotions.

Through somatic training and some equine therapy work with Nancy Proulx and her horses, I was able to learn a lot about how my body held things in ways that do not support health and wellness on an ongoing basis.

In conclusion, I would never wish this journey on anyone, but I wouldn't trade it for the world.

This has been, for me, a profound experience. I hope in reading it, it has served you in some small way too.