Processing time is important.

Okay, so this is getting written because I’ve already gotten a LOT of questions and rather than copy-pasting the same response into a whole bunch of DMs, I hereby designate it a FAQ and give it its own post. 😀

Q: So why the discrepancy between my original surgeon’s opinion on my chances and the MDA surgeon’s opinion?

A: I think there’s a combination of factors involved. One is institutional differences between MDA and Kelsey-Seybold. This drives what is considered an acceptable reason to open someone up and the intended outcome. Another is the difference between the individual surgeons, which is interconnected to the institution to some extent, but there’s more than just that in play. And another is the level of acceptable risk.

I took a little time to process what I heard yesterday, and while I’m still unhappy about it and frustrated that I’m not getting rid of the colostomy anytime soon, I have a better understanding of where he’s coming from.

Essentially, the driving philosophy at MDA is all-or-nothing on surgery (except for immediately life-threatening things), and thus they’d want to get not only the primary mass in my sigmoid colon, but all the mets. And my case is a lot of mets. A. Lot. Of. Mets. The liver is just a bonus complication to having most of the lymph nodes on my aortic column involved, plus a couple bonus ones up under my collarbones (and thus not even in my abdominal cavity). And as the surgeon pointed out yesterday on the CT images, the involved nodes are tucked up near some mission-critical stuff like my aorta and vena cava (just the two primary blood flow paths in the body, for supply and return, respectively), behind one of the renal veins, etc. Just getting access to those is rather difficult, and, as Kim points out, his concern about causing a leak may not just be from a resection issue, but from nicking a major blood vessel.

So, a lot of risk. I understand that better now. I’m still not happy, but as I said last night, I’m not going to shop for a surgeon who’s less risk-averse. Most of my frustration is at the all-or-nothing philosophy at play — I never expected everything, just the primary in the colon, a resection, and no more colostomy.

Which brings me to the part b of this question: why was my original surgeon so confident? Well, attitude. As I’ve previously described, he’s got that gung-ho, fighter pilot attitude. He’s willing to go cowboy. And — this is key — I think he wanted to do it as a make-good for not being able to do it originally (because my innards were an even bigger hot mess then. All the dumpsters were on fire). And he had no intention of getting all the nodes, just the primary. There’s a good chance he was downplaying the risk, too.

And so it is. Thus endeth the FAQ section of today.

I got up way too damn early again today and went back to MDA to meet again with the ostomy nurse. This time it was productive as she had an idea of why I’d been sent to her. It looks like I’ll be getting some different equipment better suited to my stoma (I utterly and completely refuse to name it. I *almost* called it something just now and quickly backspaced and typed “my stoma” instead. There may come a day when I do, but today is not that day. No, I don’t need suggestions), and I’m trying one out now. (ETA: The semi-rigid secondary adhesive ring on this two-piece setup makes it very difficult to do the rinse-out slosh. So there’s that. Also, transparent bags are gross, but that’s all they get for samples at the hospital.)

And hey, this means poop posts will continue for the indefinite future. I might even finally put together the definitive guide to poop types for colostomy patients. And I think I have an ilieostomy (an ostomy that provides an exit where the small intestine connects to the colon, where my colostomy is near the end of the colon) patient (well, a former ilieostomy patient, since they got a reversal) lined up to guest-blog what that poop is like, so we can cover the bases.

Meanwhile, I’ve now taken dose 3 of the oral maintenance chemo. So far, so good. Not noticeable side effects yet. I’m okay with this, but we’ll how the full 2 week run goes.

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Well, shit.

Met with the surgeon today. And his NP, who is a Force of Nature (this is a Good Thing).

They treated what’s left of my seroma/fistula with some silver nitrate and asked me not to pack it any more. Maybe it’ll heal up. That’ll be nice.

There was an anal probe. That wasn’t so nice.

And then was the really not nice part: there will not be any surgery in my foreseeable future.

That means I’m stuck with this fucking colostomy, possibly for life.

I hate it.

I hate all the extra work it takes to clean out properly. A trip to the bathroom is at least a half-hour lost time.  At least.

I hate the leaks.

I hate smelling literally like shit almost all the time.

I hate not being able to tuck in my shirts.

I hate not being able to bend over without compromising the bag. This also means it’s hard to drive my car. It’s less hard to drive the truck, but still sucks. It’s hard to sit at my working desk properly. It’s hard to wear a proper belt.

I hate not having any control over its emissions. Audible farts in the middle of business meetings are not exactly professional.

I hate being afraid to travel or do activities that put me away from a place where I can empty the bag if it suddenly fills (see above about not having any control over its emissions), because if it fills, it pulls the seal and it leaks shit everywhere.

I hate it. It keeps me alive, and I hate it.

The surgeon doesn’t want to risk opening me up unless he can get all the diseased parts out. And since he can’t get all the diseased parts out because of the number and location of lymph nodes involved and the liver mets, that means nothing will be happening.

I wasn’t ever expecting everything to be removed. I expected to get the bad bit of colon resected and the ostomy reversed, and get the rest with chemo. That was the plan with my first team.

But this is what I have now. I asked what needed to happen to make it possible, and didn’t really get an answer. Basically, “that door is almost closed”. He doesn’t even want to consider revising the stoma.

The NP is a former ostomy nurse who was kinda pissed off that I hadn’t really gotten much in the way of support, and scheduled me an appointment with an ostomy nurse thi afternoon. Which meant we wound up staying at MDA instead of coming home and going on to work.

The ostomy nurse showed me catalogs, so I can order (maybe) other bags that might be able to fit my giant stoma, assuming the items shown in the older catalogs she showed me are still available (I have had no luck up to this point). And an elastic belt because of the way my stoma is herniated. Yay. Something else to get shit all over it when the bag breaches.

Ah, but it gets better. She apparently didn’t get the memo that the surgeon wanted her to look at my stoma, and thus after I’d gotten home, I got a call from her asking if I could come back in. “Um, I’m home, about 35 miles away, and it’s rush hour. So, no, not so much.” “How about tomorrow?” “I do have to work sometime.” I’m going to get up stupid early again to see her at 8 am.

And they’ve scheduled me with a pshrink. Probably past time I did that again.

I’ve now sent a question to the oncologist about changes to the plan since surgery isn’t a thing now. Are they just intending to keep me on maintenance indefinitely or are we going to do science? I’m not really keen on just keeping it at bay and existing.

Meanwhile, I picked up the oral chemo and took the first dose after dinner tonight. So the keeping it at bay phase has begun. I guess we’ll find out eventually if there’s another phase.

This hasn’t been a good day.

PS: To the business WP pages completely unrelated to this blog who insist on submitting comments, just stop. I’m blacklisting you in as close to real time as I can manage, and if I can figure out how to block you completely, I will. The last thing I’m going to do is get a mortgage from a fly-by-night outfit who advertises by spamming a cancer blog.

The Ostomy Saga, Chapter Whatever

Every so often, I’ll peruse the ostomy supply house websites looking for things that might make life with this thing easier, because mine’s weird. It’s not round (it’s shaped vaguely like the island of Montserrat), it’s considerably larger than the allowable cutout on any ostomy bag I’ve been able to find so far, it’s on a bulge because when my very-distended-at-the-time-of-the-surgery colon shrank back down to a more reasonable size after getting rid of all that poop, some of my small intestine seems to have herniated past my abdominal wall (it, thankfully, does not appear on CT scans to be constricted), and basically I’m relying on extra adhesive strips to seal the bags to me for a reasonable amount of time.

And thus did I see a couple months ago that Coloplast has released a moldable sealing thingy that you can expand and shape to fit around your ostomy, and will theoretically seal between the skin and the bag “wafer” better. Sort of like the paste, but less messy and less likely to extrude into the opening of the bag and gum up the works. So I ordered a sample.

It arrived on Friday, and yesterday, I did a bag change (planned), and, following the instructions, molded the new sealing thingy to shape, applied it to my (clean and dry) skin, then installed the bag over it.

The goal, as always, it to get 4ish days out of it.

And so it came to pass that as I was getting dressed this morning (jeans and shoes on, about ready to finish with the shirt), the thing started to breach (up top, which is an unusual place for a breach). Off with the clothing, back to the bathroom, go through the bag change ritual again (this time without using the 2nd sample moldable sealing thingy).

I got about 18 hours out of this “improvement”.

Yeah, I won’t be ordering any of those.

I meet with the surgeon at MD Anderson tomorrow morning, and I hope that one result of this meeting is a schedule, or a plan to schedule, the surgery that will reverse the ostomy by resecting my colon. We shall see. I’m not the one making that call, just making my wants heard.

ADDENDUM 3:30PM: Well, I guess it’s just one of those days. This morning’s bag didn’t make it through this afternoon. Changed again at the office (well, in the shop-area restroom at the office). And it’s not even Poosday yet.

“Stable.” Stable is good.

In contrast to Kelsey-Seybold, MD Anderson uploads the full text of the radiologist’s “read” of my CT scan imagery. And so it is that I had to look up a bunch of words, but “stable” isn’t one of them, and it appears very frequently in this report from the CT taken on January 24th compared with the CT taken at Kelsey in late November. As I haven’t received any treatment between the two, “stable” is very good. Only “smaller” would be better.

Also, my CEA (the blood marker for colon cancer) was at a quite acceptable 2.8 units on the 24th. MDA has a different “acceptable” range, 0-3.8, than Kelsey’s 0-4.7.

Other numbers were acceptable.

And so off we went to MDA at Way Too Fucking Early This Morning (to beat the Houston traffic heading in the direction of the center of town from where we are, leaving before 6 AM is advised if you need to be there before 8:30 AM. As we needed to be there at 7:30 for today’s blood draw (a vial that will be used for the genetic panel the oncologist is doing)… we left before 6). Kim Does Not Like getting up at any hour you can represent with the fingers of one hand. But she was a trooper.

So we met one of the PAs today. She’s sharp, smart, kind enough to laugh at my jokes and make it seem sincere (and it probably really is sincere), and… young. Which means I’m old, I guess (pay no attention to the AARP card in my wallet). No matter — she went through the battery of questions and jotted down my answers and broached the going forward options and masterfully stalled for time until the oncologist arrived (he probably left home after 6 AM). Based on the scan and the numbers, and the pending consult with the surgeon (next Tuesday), they’re going to start me on a maintenance chemo… and even better, we’re going to start on an oral version of the 5FU fluorouracil that is one of the 3 components of the FOLFOX “big chemo” I’ve previously received. The 5FU is what was in the pump I carried around for a couple days.

This oral version is 4 pills in the morning (after food), 4 pills in the evening (after food), daily for 2 weeks, then a week off. Lather, rinse, repeat. And while 5FU does have a laundry list of side effects (and the oral version can make some of them worse), given my largely benign reaction to it when I was receiving it via IV, I signed off on the “Yeah, this could make me poop more” waiver (there’s more to it than just poop, of course, but poop is what draws in the page views to this blog).

The oncologist also reviewed my original CT scan from way back when, before I started treatment, and he was VERY excited that I had responded so well to the chemo “5 times smaller! That’s fantastic!”

It’s not all fantastic, though. He’s a little concerned that both columns of lymph nodes got involved, and not sure if the surgeon will be able to get them, but that’s going to be something they discuss at the inter-disciplinary case review meeting on Monday before my visit with the surgeon on Tuesday. It may be that the surgeon gets what he can, and we just chemo the rest into submission (this was the original plan back at Kelsey, so not a surprise to me). Also, the CT report mentions more calcified bits (i.e. stuff that used to be cancer and may still have some lurking) in my lungs than I was previously aware of, but they’re all stable. I’m still sick. But I knew that already.

So the reasons they’re doing the maintenance chemo for now is at least twofold: 1) we’ll soon see what the surgeon has in mind, and there’s no weaning time necessary for 5FU, unlike oxypalatin, which is the Big Bad of the FOLFOX cocktail. And 2) they’re still waiting to see if they can get the tissue sample from the biopsy I had done in January, 2018, to do the genetic comparison with the blood sample they got today. I’m going to lay fairly even odds that said tissue sample no longer exists or is not viable for extracting DNA, and thus a biopsy of some kind will be in my future again. (I will confess here that I’d be okay with said biopsy being the removal of the naughty bit of my sigmoid colon during the resection surgery, but I’m flexible here. The ultrasound-guided needle biopsy of my liver wasn’t bad, and I’ll do that again FOR SCIENCE!)

The reason for the genetic work is, as I think I mentioned, to look at over 200 different genes to identify protein combos specific to the cancer that aren’t present in the healthy cells, and then tailor the chemo attack to target those specific proteins. This may even be personalized to my specific protein combos. SCIENCE! I’m going to be contributing to science that could save lives and maybe even allow effective treatment of the bigger, nastier versions of colorectal (and maybe other forms of) cancer that so far have been resistant to dying and staying dead. I’ve got some fresh reasons to want to make this happen. We’re going to learn more. Do more. Cure more.

So as I mentioned, up next week is the meeting with the surgeon, who is not the one I was originally referred to, but upon looking over his qualifications, I’m more than confident in his abilities. I don’t expect to be cut on until the tail end of March at the earliest, because…

…the oncologist was very encouraging about us going on JoCo Cruise this year. We can even pause the oral chemo if there’s any issue. The only precaution I will need to take is to be extra vigilant with the sunscreen and covering of the body to protect it from the evil Day Star, as the 5FU is known to make skin super sensitive to UV. As I come from a pale tribe, SPF100 and covering major parts of my body are my standard practice anyway (and I live in a place where I can get sunscreen year round, unlike, say, the frozen tundra of Michigan), so I don’t anticipate this being an issue.

If you were betting on the over/under on the percentage of Sea Monkeys who tend to avoid the sun as a matter of habit versus the sun-worshippers, take the over on the avoiders.

But this means one very, very important thing: BOAT!!!!!!!!!!!!!

I was prepared to make the case that this trip is mission-critical to my mental and emotional well-being, which MDA says quite prominently is a key part of successful cancer treatment. Didn’t have to. Both the PA and the doctor brought that up themselves.

BOAT!!!!!!!!!!!!!!

I’ll be packing a lot of spare poo bags. Just in case. But I don’t care. BOAT!!!!!!!!!

I’m waiting for the hospital, insurance, and pharmacy to all get synchronized and get my first batch of chemo pills to me. Could take a few days. Not looking like it’s going to be an issue to my treatment, or else they’d have set me up for an infusion as soon as this week.

(Oh, and the PA was quite agreeable to the idea that if I need infusion at some point, I can get it at MDA’s Katy location, which is VASTLY more convenient to get to from our place.)

This shouldn’t greatly impact my ability to work. I’m sure it’ll take a little getting used to, but Kim, who is quick on the Google-Fu, was able to find numerous references to people who have been taking this drug in this dose for YEARS and living fairly normal lives. I’m game. Especially if I can lose the ostomy soonish, which will let me get into an exercise routine. I hope to be on a bike before too much longer, and have some strength and stamina goals to reach (I want to be able to ride the MS 150 and hang with our friend Chet and his crew in the process. They ride, ah, “briskly”. I’m not competitive at all, no, not me). I know it’ll take me a while to get there, but I’m determined.

Because Kim wanted to listen, called Dad on the way back via the Bluetooth hookup in the truck and told him I’d be restarting chemo soon. Long pause. “Elaborate, please.” Then I told him the rest of it. He worries about me and fully intends to be here to drive me around on chemo days, but of course that shouldn’t be necessary for this stuff. He’s got some of his own stuff to handle in the next few weeks, anyway. And we have backup here if it comes to that.

So things are moving forward.

Living the Adventure

Okay, so where was I?

Basically, since my last update-about-me post, not a lot had happened in the “Jim’s health” world, until yesterday. Yesterday, I finally had my first appointment(s) at MD Anderson Cancer Center (They’re stylizing their name with “Cancer” struck out, so I’m doing it, just this one time).

But I have to mention the Preemptive Billing Event first. Sometime just after Christmas, I got a statement from MDA, with an amount due. I found this curious as I was still not quite a month away from my first appointment. Turns out it was a pathology review, because apparently they get a lot of referrals from Bob’s Bait Shop & Hospital in South Lower Podunk that are based on sketchy diagnoses. So of course they had their pathologist look at an electronic slide (that’s right, on a video screen) of the biopsy sample taken by an accredited cancer treatment center located just a couple of miles west of their place on December 7, 2017, during my colonoscopy that got this whole ball rolling. You’ll note that this was from before I even started the year-long-so-far treatment course, and was more than a year old when they looked at it on December 10, 2018. So, “relevant to my current situation” is not a phrase I’d use to describe it. After some calls and emails to try to figure out why this was a thing that a) happened, and b) I needed to be charged for, MDA agreed to eat the cost. Just as well, because it was done in 2018 and thus wouldn’t have counted against my 2019 deductible anyway.

So yesterday’s schedule was thus: 1:30pm: new patient registration. 2:00pm: oncologist. 3:00pm: blood work. 4:00pm: CT scan (start of process). But first we had to get there.

MDA’s Colo-Rectal Cancer Department is in the Main Building, which is located in the Texas Medical Center. Basically, what happened is that all the major hospitals serving Houston decided build their towers practically on top of each other a bit south of downtown. The streets around there are perpetually under some sort of construction, street signs are often located behind obstructions that obliterate their visibility, the towers themselves have their names up near the roof, so you can see, say, Texas Children’s Hospital is there from two miles away, but once you get in close, is it this brown tower or that brown tower or the brown tower over there? The streets form a maze of twisty passages, all alike. There is probably a Grue. You need to avoid being eaten by it if you are to get medical attention today.

We did eventually find MDA’s main building and the entrance to Parking Garage 10 that we were directed to use by my appointment documents. We’d taken Kim’s Mustang as we knew it would fit in the garage, but we weren’t sure about whether the truck would (more on that later). We eventually found an open spot that wasn’t occupied by part of at least one other car (Parking Is Hard)… on floor 12. Down the elevator to the skybridge at 3, across to the 3rd floor of the Main Building, up Elevator Bank A to the 7th floor.

Registration was painless, as I’d done most of the questionnaire work online the night before. Charged for the visit (the whole thing, because I’ve got a $3000 annual deductible on The New Insurance), then off to the waiting area, then called back by the nurse who took my vitals, then I was seen by The Fellow du Jour, who is an MD on a training fellowship. He was personable and competent, and he did a lot of the questioning and note-taking about my case from diagnosis to treatment-to-date. Then the new oncologist (the one my old oncologist recommended and an old buddy of said old oncologist) came in and he’s very much The Smartest Guy In The Room, which on this subject, he most definitely is. But friendly and personable, and when he suggested doing Science (genetic sequencing to identify my particular cancer-specific proteins), I was totally on board with that.

Come to find out that the imagery from my first CT scan didn’t make the trip over from Kelsey-Seybold, but I have it on CD-ROM, so when he asked if I could get it, he was happy to hear that I had a copy. I agreed to bring it in ASAP (that was today) so they can review and see what a total mess my innards were at the start compared to where they are now.

They’re going to review all my info, including yesterday’s CT scans, and have a case review meeting with the team (including the surgeons), and then I go in for a follow-up to discuss The Plan. (That’s been scheduled, along with more blood work that’s likely for the genetic work, for Monday, Feb. 4, at an hour that will require me/us to leave the house before 6am because of traffic. No, I didn’t get to pick the time.)

This all ran late, and thus it was nearly 3:45 by the time we got a ride in Elevator Bank A back down to 2 for the blood draw. But that took maybe 10 minutes start to finish, and would have taken less time if my wrist band had a readable bar code — the one bar code (out of the *4* different ones on the band) that I needed to check in was misprinted, so I had to enter my MRN manually.

Elevator Bank A was pretty stacked up, so we took the adjacent escalator back up to 3 to the Outpatient CT/MRI center.

Holy. Shit.

The waiting area is about 4 times the size of the CT/MRI/Lab waiting are at Kelsey-Seybold’s main campus. And it was full. Maybe one or two open single seats.

Check-in was painless (and like the blood lab, I wasn’t charged, which makes me think I’ll be getting a bill for those. The CT alone should eat up the rest of my 2019 deductible, so that’s it for out-of-pocket for the rest of the year), and… lo and behold, you get to choose the beverage your oral contrast is mixed into from a suitable selection (for the record, I chose Raspberry Crystal Light yesterday, though the Sprite was tempting if I didn’t have the ostomy), and thus I didn’t have to explain that the barium smoothie style causes me to have a bag blowout (there’s your first poop reference of this post).

I was called to receive my quart cup of contrast a short time later. Then about an hour later, I was called for my pre-CT interview (to go over claustrophobia and reaction-to-iodine-IV-contrast issues) and the nurse taking me back for that noted that I have a port installed and would I like them to use it for the IV contrast instead of starting an IV.

Why yes. Yes, I would.

Two happy things right there.

Of course, while the nurse was getting the port hooked up to the tubing, that’s when my body decided that would be a good time to fill my bag with poop. So I got to visit the bathroom and deal with that. No blowout, though. Good enough. Less poop in me means better imagery, though, right?

Third happy thing: scrubs instead of gowns.

I was supposed to be in the machine at 6:15pm. It was about 6:30ish when I did, I think (I didn’t have my phone or watch with me, and in fact fell asleep in the recliner in the holding pen, er, room, they’d parked me in). The machine was routine, then they had to “de-access” my port and flush it.

Then out to the garage, up to 12, out of the garage, and back into the maze of twisty passages, all alike. Took me a bit to get to a road I recognized, and we were off, back to the office to retrieve my truck, then home.

So where are we? We met the new oncology team (minus the surgeon). I got inducted into the MDA system. I got poked. I got scanned. And now I wait a week or so for the team to come up with a plan.

It’s likely that if I’d been able to stay with my original team, I would have had surgery the first full week of this month, which would have been plenty of time to recover before Boat in March. That window is pretty much closed now, so I suspect I’ll be back on some form of chemo until after Boat. I’m disappointed, because I really would prefer to be without the bag come Boat Time, but we’ll do what we need to do. And as part of that plan, I would like to work (in some fashion) at the inaugural IndyCar race at COTA in March. after Boat. But I can’t make any decisions on that until we find out what the docs want to do.

And that’s where I am right now. The movement has begun again. I suspect once we get a plan together, things will move quicker.

Unlike the traffic getting to/from the Texas Medical Center area. I’m going to ask if, once we get started, I can do infusions and scans at the MDA Katy location, which is MUCH easier to get to (and closer). If so, fantastic. If not, well, we’ll just do what we have to do.

Is that a Grue?

(Postscript: truck test of parking garage. Well, I can get up through level 3 with it, but may run out of headroom above that level. For only a little more coin, I can let the valets deal with it if it comes to that.)

For Fran. And Marinna.

Fran Shirley passed today. We were classmates. We both had colon cancer. Hers was nasty. She gave it all she had. She helped me get my head on straight after I got diagnosed.

She was supposed to beat this thing, too.

My heart goes to Lawrence, her love, and Smudge the dog, her other love. And to her family and friends.

I also have to mention Marinna Lee, a fellow Sea Monkey and a person I knew mostly in passing as someone with a lot of love for people. Marinna passed December 26 from some exceptionally nasty cancer that just wouldn’t quit and seemed to consider the treatments as nourishment. My heart also goes out to her husband Matthew and all of her family and friends.

We live to dance another day
Just now we have to dance for one more of us.
So stop looking so damned depressed,
Sing with all our hearts, “Long Live the Queen.”

(From Frank Turner’s “Long Live the Queen“)

I’ll post an update about me soon. Right now, let’s just raise our glasses to Fran and Marinna. And Pat’s dad. And, And, And. Tonight, it’s about our absent friends.

:TAP TAP TAP: Is this thing on?

I’m way overdue on a post, but it’s also 11pm here and to do this proper justice would involve staying up way later than even I think is wise.

So, some highlights to be detailed later:

  • December 11th was the 1 year anniversary of my diagnosis with Stage IV Colon Cancer. I’ve still got it. But I’m getting better.
  • December 11th is also the 10 year anniversary of my pulling out of Michigan (on a 12-degree F morning) to move to Texas.
  • December 15th is thus the 10 year anniversary of my officially becoming a Texas resident as I got the keys to this house that day. My landlord is likely glad I’m still here.
  • Today, December 20th, is the 1 year anniversary of the surgery that installed my colostomy. The colostomy celebrated by blowing out the bag this afternoon at the office, because it’s an asshole. No, really, it’s an asshole, it just happens to be located in the front of my body and lacks any sphincters to control output because it’s just a hole cut into the wall of my descending colon, which has been unceremoniously sewn to a hole cut in my abdominal wall.

Have you noticed any sort of ongoing theme about my colostomy? Like how much I loathe it, even though I acknowledge that it’s partially responsible for my still being alive?

  • After their special “secure” email system lost my completed medical records transfer authorization form and I had to resend it via regular ol’ not-so-secured email (which worked) a few days later, I’ve missed out on any chance of meeting with my new medical team this year, and the earliest I can see the new oncologist is currently January 24th. And I can’t see the surgeon before I see the oncologist. So my plan for having surgery in the first part of January is completely borked. If I’m lucky, I might be able to get it done in the first part of February, which jeopardizes my recovery in time for Boat. Anytime after, say, February 7th, though, means I’ll be packing a bunch of poo bags on Boat and having surgery after even though that will screw up a bunch of other things I’m hoping to do (like work the first IndyCar race at COTA in some capacity).

And that’s where we are right now. I’ll get into this more later, maybe tomorrow.