"22,228.09"

The latest bill arrived for my chemotherapy. Between 6/21/07 and 9/18/07, I've accrued $22,228.09 in total charges. Excluding the $200 i paid for my CT Scan back in July, which cost $4,036, I now owe $20.
I have great health care coverage.
but if I didn't I'd be absolutely screwed. The cost for my cancer treatment is more than half what i make in a year at my full-time job.
I haven't the strength to make an argument, or even initiate much of a discussion, about the state of health care in the united states of America right now, but this is something we all need to keep in mind.

Saladitos

Saladitos -- dried, salted plums. I don't really know why, but these help with an upset stomach. It was initially Bean's idea to take them when I was sick a few weeks ago.

Last night around midnight, without any zofran, I sucked on one. surprisingly, it helped; especially given the fact that I was almost positive i was going to vomit.

you can pick 'em up at most supermarkets that cater to Latinos, Mexicans and Central Americans.

three

...more days of chemotherapy to go!
Friday (9/28), Tuesday(10/2), Tuesday (10/9)

love and chemotherapy

(bailando debajo de un mariposa -- Tucson, Az. 2007)


"I can't sleep. There's a woman stuck between my eyelids."
-- Eduardo Galeano

There are some things you expect during chemotherapy: fatigue, nausea, hair loss, etc. falling in love isn't one of them.

I remember reading a July post on Joshua Lilienstein's blog. In case you're not familiar, he's a med student at USC that's also a testicular cancer patient (though given all that he's been through, I'm hesitant to compare our scenarios anymore the the generalization i just gave you). Anyway, in his July 3 blog post, he notes taking a break from seeking advice from some of the nations top doctors to attend a wedding in San Francisco. At the event he met a young lady and briefly described the joy and support she'd brought into his life that otherwise would have been a very dark period.

I remember thinking the guy was amazing when I read his post. to find love and a companion in the middle of something like chemotherapy.

on Aug. 16, Guadalupe Rocio Chavez flew out from Los Angeles to visit me in Tucson and her grandfather south in the town of Amado.

her visit was brief: just four days, but our time together sparked something neither one of us expected, or were even seeking. Funny, though because in hindsight neither of us were totally surprised -- we've known each other for seven years -- and this new feeling and relationship is very much welcomed.

she returned to Tucson two weeks later with my parents (she accompanied them on the eight hour drive from L.A. to Tucson -- how's that for a trial by fire!) when she walked in the door my heart and soul leaped. that week of chemo. wasn't bad and I know it was her love and support that helped make it so.

my aunt maria and cousin gabby came to Tucson that week as well. it was obvious to them, whom had never met lupita, that something was afoot.

seriously, who starts a relationship in chemotherapy? the human body is already frail, tired and irritable. the normal things you appreciate, like dancing, certain foods, bike rides and late nights, are temporarily out of grasp. but our days and nights together, whether it was at the cancer clinic, the san xavier mission for mass or sitting at the kitchen table, were so wonderful.

there was a reason i could rise each morning, with little sleep, for chemo and feel strong as they connected my IV to the drugs.

the photo above is something we created the night before she left Tucson.
every day this week the nurses have said that I look tired. and every time they tell me that, i smile to myself and just nod, keeping my little secret that it's not the sleeplessness that makes me seem so. it's because my companera isn't nearby.

more positive results

all the nurses are starting to tell me I'm looking tired. I suppose it comes with the territory. but I am. this isn't easy.

today was a bit different though -- Guadalupe left after spending three weeks with me out here. like my family, she brought a vitality, life and spirit that has helped me through this with strength and humor. I miss her incredibly. (more to come)

the latest results from my second course of chemotherapy came in the mail today. good news so far.

my red and blood cell counts are low, as is my platelet count, but that's to be expected as a result of a weakened immune system brought on by the chemical cocktails.

the great news is that my alpha-fetoprotein tumor marker is down. as of sept. 18, down to 2.7, which is incredible, because it's never been that low.

the last reading, from aug. 28, showed a reading of 5.6. anything beyond 8.8 is bad, says the docs. before surgery, it was about 35 and before chemo. the level was 15.

no news on the latest beta-HCG count, which is another tumor marker, but the last test, also from aug. 28 showed it was down to less than one, which is also great, because before chemo. it was at nine. anything about three is bad.

today was pretty tough. I had a triple cocktail: bleo., cisplatin and etop. needless to say, I spent much of the day sleeping because of a pre-med. cocktail that included benadryl and ativan. I hadn't had much sleep as my companera rose around five a.m. and left about quarter to six, but luckily at the clinic I got a private room with a bed. I think I'll have a brownie tonight.

Visitors

Today began the first day of my third and hopefully final round of chemotherapy. it also was the first time my aunt pookie got to see the digs I've been lurking in since august.

aunt pookie (Priscilla) is my dad's younger sister. before she left LA after getting married, she was one of our babysitters when my brother, sister and I were young.

family visits -- or maybe just visits -- are all the same. they tend to revolve around the kitchen table, where everyone sits telling stories about my generation or theirs -- how my cousin Alicia beat the crap out of me once, how dad chased my uncle johnny when they were kids and caused johnny to vomit and stories about family members before us. the same with Guadalupe, Adrian and even when Matt, fatty and Sarah arrived. stories from another time, be it last year or seventy years ago. but it's wonderful and at least with some of them, clarifies the errors that have been repeated for years or even decades.

it helps. Sunny and Reed, two great young journalists who have established themselves internationally will be coming though this weekend (the photo above is us and a few other characters, notably beloved Luis Gomez and Noah Friedman, part of our rag tag crew of journalists in Bolivia in 2003) as will bean (my sister Tina).

In the past visits were accompanied by cases of beer, bottles of scotch and tequila, and a crazy desire to talk until the sun's rays came through the kitchen window. not this time. but someday again.

so I'm hoping for any easy week of chemo., so i can listen to the stories, though I have to be honest, it's getting harder and harder.

Must be the Bleo

My fingertips were swollen again this week. Actually, Monday they were alright. but by late Tuesday afternoon, after my ten-minute injection of bleomycin, they began to swell and I went through the week with fingertips like small Vienna sausages. so my guess is it's the bleo, which I only get three times each chemo. cycle. I suppose I should mention this to the nurses on Monday, though i doubt it'll change my chemo. cocktail.

The Second Third

I finished the second course of Chemotherapy yesterday.

Like the final day of the first third, Tuesday was a bit longer than normal: blood labs (blood draw to be tested and examined, etc.), appointment with my oncologist and chemo.

Dr. Ahmann, my oncologist, had good news for me. The results from the first round of chemo were all very good.

Let me explain -- before we went with chemo, I was getting blood drawn every Monday to monitor the cancer inside my body. the cancer levels were up and down until they eventually began to increase. on Aug. 13, my Alpha Fetoprotein level was 15. Anything beyond 8.8 is dangerous.

As of Aug. 28, my AFP is 5.6.

At the same time, my doctors were also monitoring my HCG (which I just found out stands for Human Chorionic gonadotropin). by late August, HCG was found to be at 9. Anything beyond 3 is dangerous. As of Aug. 28, it's less than one.

The doctor is impressed with how I'm holding out overall -- nausea but no vomiting, tired but I haven't succumbed to any illness while my immune system is weakened, and I still have the ability to eat. a minor miracle, he has said repeatedly.

He noted that the acne outbreak on my back is normal for chemo. patients, though they don't know why. funny how little we're able to explain when it comes to side effects.

anyway, as things progress, it looks like I'll be done with chemo. by Oct. 9 and i hope to return to work by the end of that week.

for the next two years, Ahmann explained, i will need blood labs every two months and a CT Scan every four months.

My third and hopefully final round of chemo. begins Monday.

More blog from me

The days and nights seem to blend as I look back...more like short vinyets (not sure on the spelling...please feel free to correct me) than anything.

When I finally got settled in, there wasn’t much going on. The funny thing was, they treated you like a member in the fleet. So let me explain: As a recruit, you're not really in the Navy. Suppose that’s true for Puddle Pirates and the Air Force. I guess, you're not really in the navy until you get aboard ship. But the RDC's treated like you a Shipmate (friend, equal), which to say, you got to know a lot of them on a somewhat personal level. They let you wear a Navy Ball cap (meaning you graduated), wear regular glasses or contacts if you had them, if you had the time off, you could use it. There were guys going to Six Flags, going home for a few days, or just going into the city for a day. It was pretty relaxed. Every night there was a movie. Each day the TV was on. They assigned you jobs on the base for something to do, and the best part, the females where right on the other side.

Now, there were no 9's and 10's. Let's face it, some of these girls got the shit kicked out of them with the ugly stick, then were pushed down the ugly tree, and hit every branch on the way down. There were some that reminded you of a sister, a friend, or even a cousin. And there were a few, if given a six pack...these girls were ok. This may sound like im being an ass...but it's true. I had made friends with a few of them over the weeks and had some really conversion as well. Somewhere single mothers, newly married, and like me, looking to start over again.

Over the next few days and weeks, many of the guys that have been in the "broke ward" were going home or finally graduating . Many of those guys had been there for months and had a been look to take a leadership role for the new people coming in. There was a void...why in god's name did that sole duty fall on my lap!

the fingertips

yesterday during church I caught myself poking at my fingertips.
after mass I mentioned this to Guadalupe, who said in fact I'd been doing that all week.
I didn't even realize it.
I was stabbing at my fingers because they became really swollen and felt almost numb.
Like my taste and smell, I was told I'd lose my sense of touch. Specifically I was warned by my doctors and nurses that my fingers and toes would go numb. So far the toes are alright, but the fingers have been strange.
In fact, the swelling, like my smell, enhanced the sense of touch in my hands.
I tried to play guitar last week and couldn't for more than about fifteen minutes. granted, I haven't played in a while, but because my finger tips were so swollen, it hurt my left hand to fret my guitar. And these weren't even steel strings; i was playing my Mexican nylon string guitar.
I remember typing last week and being really clumsy because of the swelling.
the finger tips, joints and my right palm all have bruises. I was warned about that: bruising easily.
as of today, the swelling has passed for the most part, though the finger tips are still bright red and the bruises are tender.
so goes chemo.

"it's all fun and games..."

As I've written earlier, I have been really fortunate to have so many people looking out for me during my cancer treatment. everyone expresses this in different ways: visits, prayers, phone calls, letters, cards, e-mails and gifts like food, mix cds and books.
one of the coolest things has been the e-mails from high school classmates that I haven't seen in years (in some cases, since the day we graduated in 1997). I respond to everyone -- it just takes some time.
my aunt pookie has consistently sent me some really funny cards that always bring a smile to my face.
And on Friday, a package arrived from Bolivia via Philadelphia.
my dear friends Luis Gomez and Jean Friedman sent a care package which included a letter, talismans (for lack of a better word) from Bolivia and a t-shirt.
I need to write about the t-shirt.
it's light blue. on the chest there is a drawing of tree with three squirrels playing on one of the tree's branches. one squirrel has three acorns in his hand. another is cracking one in his mouth. the one in the middle, however, is reaching downwards for a nut that seemingly slipped from its hand. the nut is falling down, away from the squirrel and branch.
beneath this drawing is this text: "it's all fun and games until someone loses a nut."
i love it.
thanks jean and luis.

New Blog

Cause George is taking up all the blog space...

It's been awhile since I can sit and think back on a few things. Things have been a little...i'll move on.

Something caught my eye the other day...September 11th. I could remember how the asphalt felt on my ass, my hands as a sat there in unbearable heat. All of the recruits had to either sit, or participate in something. My division just had to march to where we sat...though it was in front of all the Officers. But that was it. Marched and sat. It was hot. It was a day off for everyone so, there was a lot down time on that day.

Then I started to remember small details of my 6 weeks with division...Like, it took 2 weeks to drop a deuce. There was this kid...i don’t remember his name now, but was trying to be a Navy Seal. On one Sunday, I saw him crying in the corner, alone. I stood there for a few minutes wondering if I should say something, or give him a hug. But I didn’t. I just stood there.

There was this other kid from Mississippi. He told me he'd never spook to a black person, ever. There was about 10 black guys in the division. So when it came down to bunk assignments, I paired this Mississippi kid with a black guy.

And there was the look on everyone's face as I told them I wasn’t going to graduate with them...that I was being pulled from the division and put somewhere else. I can image I had the same look on my face as the doctor told me the same thing.

My walk to the new ship (it was half used barracks for all the sick and broke recruits, and the recruits who had "learning disabilities") was short. It was just in the other side of the mess hall. My new division was 4225...i think. I walked into the male side, only to see a room full of...well to various degrees, broke people. I was given a rack, had a conversion with the recruit in charge, sat for few minutes, and hid in the laundry room and cried. I cried until my eyes where blood shot. It wasn’t until that recruit in charge found me in there and we talked. We talked for a long time. I told him my situation...sort of took him back too...but none the less, he sat there with me for awhile. A few days later, he made arrangements for to go to Ricky Heaven. It was a place to buy stuff like real food, use the net, call, and place games. I had a 4 hour pass. I needed that.

It took a few days to settle in, to learn the rules (I'll get to these in a bit), and how things work. I remember that first week, I had a call from my case work from the Naval Hospital. He's name was RN Robney Dodd. He called over the compartment to see if I was ok and if I needed anything. We scheduled my first appointment, and said if I needed anything, the RDC's had standing orders to let me call from the office phone. This made me feel a little better.

Independence Day

Sept. 15 is celebrated in Guatemala as Independence Day. Specifically, independence from Spanish rule in 1821.
I remember making note of this one year ago during my farewell "speech" on what was my last day at the Monterey County Herald. Two weeks later I would begin working for the Arizona Daily Star in Tucson.
One thing I've often thought about since doctors first discovered the tumor in my right testicle is what sort of medical treatment and health care I might have received had this happened while I was still in Salinas.
Up until this, I never really took stock of my health insurance, though I did have insurance through my places of employment since 2003.
I didn't know how to navigate the health care system in Salinas, so whenever I needed to see a doctor, I either went to the emergency room or I visited Doctors on Duty, a private clinic where I was frequently misdiagnosed. The place was commonly referred to by friends as "doc in a box." a doctor there once hit on me because she was impressed I was reading an "old" copy of Marx's "Capital."
There are four hospitals in Monterey County -- Natividad, Salinas Valley MH, Mee Memorial in King City and Community Hospital of the Monterey Peninsula.
While I am not intimate with what services they offer, I'm pretty sure none of them (to be honest, my choices were really Natividad and SVMH in Salinas because CHOMP would probably be too expensive and there would be no point in going to King City for medical attention) could offer what I found in Tucson. Cancer care is practically a sub-industry here, what with all the research facilities, specialty labs and practitioners around.
Besides, when I left the Herald, Dean Singleton and his MediaNews Group had just purchased the paper. Despite the promises he made in person in front of the staff, he has since cut resources and laid people off. I have no doubt, as part of his companies "streamlining" approach to finances, the Herald's health care coverage has been affected as well.
but I suppose that's a conversation for another day.
que viva guatemala.

nopalitos

I love nopales. They're so simple to prepare and super healthy.
I've eaten a ton of 'em since I began chemo. Their flavor is very subtle, there's no smell that upsets my stomach and nopales are very easy to digest. my mom figures we've bought and consumed at least ten one-pound bags of nopales since beginning chemo about five weeks ago. that's a very conservative estimate.
I realize there may be some of you that don't know what are nopales. They are young pads from the nopal cactus (pictured above on a loteria card). You can cut them off the cactus, though they snap off pretty easily. If you are preparing them fresh off the cactus, you have to wash 'em in cold water and carefully remove the thorns by gently scraping the cactus flesh. After preparing them, you can either leave them whole or slice them into strips.
My friend and maestro Francisco usually pulls a few nopales from his cactus in his backyard, cleans 'em and places the slices on his BBQ. we eat them with tortillas -- tacos de nopalitos.
Around Tucson, you can buy them sliced and diced in small, one-pound bags courtesy of Oro Verde Products (9151 W. Monroe St., Tolleson, Arizona, 85353/(623) 478-5300)) at Food City and even the Safeway at Campbell and Broadway. At home
I cook 'em up with eggs and beans and lately have been rolling it all up into a burrito.

Quiznos IV

I feel like a walking chemical factory. Even when I'm not at the clinic, I can sense the stuff inside of me. I can feel it in the flesh of my face, which has lost much of my hair, and feels slightly waxy. My fingers feel slightly numb today. but the thing that bothers me the most is that I can't shake that damn smell of saline solution and medicinal chemicals.
Guadalupe noted how clean I am: constantly brushing my teeth and showering whether or not I've got the energy.
I'm constantly cleaning myself to get rid of the smell. Even when I'm not hooked up to an IV or sitting in a recliner at the cancer clinic, the smell is there.
Recently a commercial triggered the scent.
My mom and I were watching TV on Monday when this Quiznos commercial came on. The scene is the inside of some office. There's a dude sitting down, eating a toasted sub. then his cubicle mate enters the scene. the mate opens a duffel bag, says he's not eating anymore and pulls two IV bags from the duffel.
the commercial goes on to say something about taste or whatever.
it offended my mom, who said it wasn't funny. I later suggested maybe she's a bit sensitive to the subject given my chemo, but she insists it's not funny period.
but the sight of the bags on television triggered that damn smell of saline and medicine under my nose.
all of this is important for me to note because I've found that many of the observed side effects of chemo that I was warned in fact aren't what people have said.
I was told I'd lose my sense of taste. I haven't. in fact everything tastes like medicine. maybe that constitutes a loss of taste to some. but not me.
I was told I'd lose my sense of smell. I wish.

prostate screenings in Tucson, AZ

just got word of this:

Free Prostate Cancer Screening for Men of Tucson

Nearly 3,500 Men Across the State Will be Diagnosed this Year;
Disease is Second Deadliest Cancer in Men

This year, nearly 3,500 men across the state of Arizona will be diagnosed with prostate cancer, and more than 10 percent of them will die from the disease. Overall, state legislators need to make prostate cancer a priority, especially after Arizona earned a C- on this year’s Prostate Cancer Report Card for the second year in a row (www.fightprostatecancer.org/2007reportcards. Despite the grim statistics, there is hope if detected early, making prostate cancer one of the more treatable forms of cancer.

In recognition of September as Prostate Cancer Awareness Month, the National Prostate Cancer Coalition (NPCC) will team up with KOLD News 13 and Tucson Medical Center to provide free prostate cancer screenings. The event is just one of many stops across the country for the Drive Against Prostate Cancer, an initiative to educate and screen men from coast to coast.

“More lives are being saved every day through early detection,” said National Prostate Cancer Coalition CEO Richard N. Atkins, M.D. “We encourage men across Tucson to come by and get screened. This 10 minute test could save your life.”

Where:
TMC Services at the El Dorado Campus
1400 North Wilmot Road
Tucson, AZ

When:
Tuesday, September 25, 2007
8:00 a.m. – 4:00 p.m. (MST)

What is the Drive Against Prostate Cancer?
It’s big, it’s purple, it’s the Drive Against Prostate Cancer - a mobile screening unit where local licensed physicians conduct a two-part screening procedure, which includes a Prostate Specific Antigen (PSA) blood test and physical examination. The screenings are conducted in a 39-foot Airstream Land Yacht XL, owned by Thor Industries and designed specifically for prostate cancer screenings. The exams are free, thanks in part to Bayer Diagnostics and University of Michigan Labs.

About the National Prostate Cancer Coalition
The National Prostate Cancer Coalition sets the standard for rapidly reducing the burden of prostate cancer on American men and their families through awareness, outreach and advocacy.


Note: Appointments are not required. For more information, please visit www.fightprostatecancer.org

Can I Get a Hell Yeah?!!!

Hell Yeah.
sorry it's been a while since I've posted. I've been tired.
but the report from my first round of chemo just arrived. great news -- my tumor markers are down.
As of Aug. 28, the alpha fetoprotein (AFP) is at 5.6. It needed to be below 8.8. Also, my Beta HCG is zero, where it should be.
my white blood cell count is low, but that's to be expected.
"This is good news," wrote my doctor on top of the report.
I had today off, but we're back at the clinic tomorrow morning.

Friday

it's the last day of the week.
to be honest, I'm exhausted. with all my friends and family around it was easy to walk into the clinic Monday morning feeling strong, but my body finally crashed yesterday. It was nice to sleep in today (I don't have to be in until about 12:30 today) but I'll be glad when the afternoon is over and I've got a couple days off.

my entourage

Suzanne, the first nurse at the cancer clinic to deal with my aversion to needles, asked me today about all the ladies sitting with me.
she's flattering.
so I've got a entourage, I suppose.
On Monday, my aunt Maria flew in from Michigan to help out this week. the following day my cousin gabby followed suit. of course my mom is here as is Guadalupe.
I'm incredibly lucky to have such loving friends and family willing to put aside the stress of daily life to come out to the desert and help out.
Their presence does wonders for my spirits. This first week of the second course isn't as hard as the first week. as much as I can, I'm not taking the benadryl and atavan. I don't need to be any more knocked that I already am. Besides, it helps me sleep more naturally.
There are a few reasons for my entourage though. And I must note there's more family headed to Tucson over the next few weeks.
One of the reasons the family has banded together is that there is no history of cancer among the Sanchez's or Tello's. At least none that is known or I've been told.
My father's father died of kidney failure as result of his WWII service. His wife, Pipa, the Sanchez matriarch, held on to life after two strokes, but eventually the fight was over. She needed a rest. My mother's father passed away from a heart attack in Arcadia. And Big Alicita, Papa's beloved wife, died after suffering from dementia. Other than Coco, for whom I'm named, all the uncles and aunts and cousins are alive and healthy. so I'm the first cancer survivor in the family. Needless to say it's unnerving to have something like this appear and from seemingly out of nowhere.
but the other reason is we're a tight family. always have been and always will be.

"Oh Salinas"

The 831 -- you can never get away from it.
Though yesterday was a holiday that signifies the end of summer for most,it was the first day of my second course of chemotherapy. My second full week of treatment. Since it was a holiday, the clinic had a skeleton crew and they only took in about a dozen patients.
I was in an infusion pod (infusion pod: place where they administer IV therapy)with a young lymphoma patient and two people getting post-bone marrow transplant therapy.
Everyone knew each other because they were normally placed in the other infusion pod. But I worked my way into a conversation.
the one man receiving treatment for his marrow transplant heard I was from California. So am I, he said.
"I came from Salinas," the guy told me.
I was shocked.
"For real," I responded, my jaw hanging. "That's where I moved from. I worked for the Salinas Californian and the Monterey Herald when i was there."
He said he graduated Salinas High class of '93. His name was Raul. Didn't give me his last name though.
Turns out his girlfriend was also a Salinas transplant.
it's a small world. I love it.

"61"

My mom spent her 61st birthday driving from Arcadia, CA, across the desert, to Tucson, AZ. This was, of course, yesterday.
She's tough. Even her childhood stories from Guatemala belie this truth. She's been strong through this whole new experience as well. And the timing hasn't been great. This past Mother's Day was the Sunday before my surgery.
My father, mother and Guadalupe arrived to Tucson in the early afternoon. Adrian and i (Adrian Bravo has been here all weekend) were out buying her a birthday cake, wine, a six-pack of bud light (her favorite beer) and roses when they pulled into the parking lot outside my apartment.
to celebrate, I took everyone to La Fuente, this great Mexican joint just north of downtown Tucson. I was able to stomach half a plate of mole poblano.
After the mariachis serenaded my mom, our bartender brought out a big 'ol pink sombrero for her. once I figure out how to get the pictures from my phone to the web, I'll post 'em here.
feliz cumpleanos mom.

Note to self: You're in chemo

not like I've forgotten I was in chemo., but there were a few things this week that were sharp reminders.
I've been trying to stay physically active throughout the treatment -- mostly via evening walks throughout the neighborhood. I can't risk going to the pool, given all the crap that's usually hanging around the locker room and in the pool water. I had the strength to go out for a bicycle ride last night. i rode around the neighborhood and then up to the university. I stopped to listen to the marching band that was practicing for today's game. while I watching the band march back and forth in formation, the president of TUSD's governing board, Joel Ireland, walked by. I said hello and he replied the same. but he clearly didn't recognized me. eventually I had to say 'It's me, George Sanchez,' which was followed by a stunned look of surprise on his face. I can understand the reaction; after all, last time he saw me I was in slacks, a button shirt, tie and my hair was in a pompadour. not the case last night. we spoke for a bit and before he left he said I looked well.
but it was a bit awkward.
Every chemo. patient is warned to stay away from people that are sick because your immune system is compromised. my friend Adrian was hospitalized with strep throat when he was in chemo., so I'm taking this order to avoid the sick very seriously.
but that meant I had to stay away from some friends this week.
I guess it all comes with the chemo. order, but it's nonetheless an odd feeling when you actually experience it.