Olé

In a few hours, Susan and I will depart Duluth for the start of a 10-day adventure on the Iberian peninsula, and we're psyched.

This is a vacation we've been pointing toward for two years, ever since I started recovering from my stem cell transplant for treating multiple myeloma, and it looked like I'd have some extended play after experiencing very dodgy health the front half of 2016.

Being near death helps bring life sharply into focus. Upon reflection, I liked most of what I'd been doing before cancer revealed itself in my bone marrow, but there were nonetheless a few adjustments I was determined to make, principal of which was more time spent enjoying relationships. (I also read more and am less reactive, but in this essay I want to stick with the main line: placing relationships more squarely in the center.)

Some of that is friendships and some of that is family, both of which are scattered all over North America—after nearly 40 years of community networking and process consulting, and the diaspora pattern that characterizes the typical modern family. Thus, when I travel for work (continuing my career as an itinerant process consultant) I try to take the time to visit area friends along the edges of my time with clients—which process is made easier by having a number of clients as friends—double dipping, as it were. And now, after nearly three years in Duluth, I'm developing local relationships as well, notably in the Chester Park neighborhood where we live and among the players at the duplicate bridge club in town. 

Yet foremost among my important relationships is the partnership I'm forging with Susan. That's the one I really want to focus on. She was there for me immediately when I stumbled sick into her home at New Year's of 2016, and almost didn't have the energy or wisdom to make it to St Luke's emergency room at the end of January, where I finally discovered how sick I was.

For the first few months it was nip and tuck whether her relationship to me would more accurately be portrayed as hospice nurse than partner, but now that I've come back from that precipice, we have a chance to create a relationship with room to breathe and laugh and play. For two years now we have been holding onto our upcoming trip to Spain as a marker for where we wanted out relationship to go: I worked on recovering my energy and containing my cancer, and she got ready to retire as the church lady at St Paul's Episcopal, where she had been running the office since 2010.

With both of those objectives accomplished here we are—finally ready for our first major trip together, where we both have the time and energy to enjoy it. To help contain expenses, we're participating in a loosely organized tour through Gate 1 Travel, that provides air transportation, rooms each night, breakfast each morning, a few dinners, and a few tours (think Prado, Escorial, and Gaudi architecture). The rest is free time as we explore Madrid, Toledo, Valencia, and Barcelona. We're thinking about tapas, riojas, and seafood, as well as off-season Mediterranean vistas. Yum.

And this adventure, we hope, is just the start. We also have designs on trips to other places as energy, enthusiasm, and money intersect—Mesa Verde, Quebec, Iceland, New Orleans, and Argentina are at the top of the list. 

It's great to be alive, and have one's consciousness focused on the wonder of it.

At the 16th Pole

The title for today's essay comes from the world of horse racing. In a one-mile race (typically once around the track), there are poles placed every 1/16th of a mile (every half furlong) which are visual indications to jockeys of how far along they are from the finish line. The last pole before the finish is the 16th pole.

In less than two weeks I'll be traveling back to Mayo Clinic to have my Day 60 check-up. Sept 27 marks 60 days since my stem-cell transplant, and Dr Buadi wants to see me then to figure out what success we've achieved in placing my cancer into remission. It's an important assessment, the results of which will go a long way in determining how best to manage my health going forward.

While the cancer was surely knocked back July 27 when I took melphalan (the poison that killed everything in my bone marrow, good cells as well as bad), the question is how far and for how long. As I have a relatively aggressive form of multiple myeloma the doctors need to keep a close eye on my markers, to be alert for its return. Both Dr Buadi (the hematologist who oversaw the transplant treatment in Rochester) and Dr Alkaied (the oncologist who oversees my treatment in Duluth) are anticipating that I'll be placed on a maintenance level of chemotherapy—because of the aggressive nature of my myeloma, how well chemo worked over the winter and spring, and how well I tolerated it. 

The tests coming up Sept 27 will determine which treatment will be selected. It might be pills; it might be infusions. While the latter is more awkward (infusions will need to be administered in a hospital or clinic on an outpatient basis, probably once every two weeks) pills can be taken anywhere. That said, I'll do whatever the doctors recommend.

Fortunately, I've been assured by Alkaied (I met with him this past Monday for the first time since June, before my trip to Mayo's) that there can be flexibility about dates. This is important to me as someone who hopes to resume his consulting/teaching career on a modified basis, and thus needs some latitude with respect to travel.

Meanwhile, the tests done Monday looked good. (I can hardly tell you how reassuring it is to watch your doctor scan the computer screen looking at your test results and saying, sotto voce, "Good" and even "Excellent." What you don't want to hear is, "Uh oh" or "Yikes!") Unfortunately, my Monday appointment with Alkaied did not allow enough time to return the most important test result: the amount of light chains in my blood and urine. In the kind of myeloma I have I was producing way too many light chain plasma cells and thus, in my case, this has been the most important indicator of the strength of the cancer. 

When I was first hospitalized in late January my light chain count was around 1600 (where 100 is considered acceptable). By the time I went to Mayo for the stem-cell transplant in July, the chemotherapy had driven that number down to under 50—proof that the chemo was working. So it was good news when Alkaied's nurse called Tuesday (I had left for Oregon by train Monday night) and told Susan that my light chain count was practically nonexistent. Whoopee!

Essentially, the test results at this stage (Day 48) could not be better. (Can you see me smiling?) Yes, it's early days and there will be more challenges ahead, but right now I'm enjoying the sun shining on my face, with the wind at my back. Today, life is pretty damn good.

Driving the Road to Recovery at a Safe Speed

I recently got this message from a regular consumer of my blog:

I am scratching my head. I had full faith that you would make it through, but I am taken aback by your—appearing to me utterly foolhardy—upcoming schedule. Do your doctors know?! Shouldn't you be resting and drinking lots of fresh juices, and work on de-stressing your life?

Usually, when people survive cancer they make changes in their lifestyle in order to rebuild their body's defenses. Let us know how you see that... reading your missive, I worry. 

As this is not the first time this question has come up, it seems worthy of a response. The inquiry comes from a concerned place and expresses reasonable questions. So… in no particular order, here are my thoughts about why I am doing what I'm doing as I recover from multiple myeloma, keeping in mind that I have every intention of rebuilding my body's defenses:

o  What can be more therapeutic than pursuing one's passion?
I'm convinced that attitude plays a large role in health. As such it's valuable to my health that I keep my social change work oar in the water, at least part time. While I no longer work full days (excepting when I'm on the job), it's important for my self esteem that I continue to contribute to making a better world, one meeting at a time, putting to use the knowledge I've accumulated over the years about the nuts and bolts of what it takes to function well cooperatively.

o  Yes, my doctors know my travel plans
I have two main doctors: Buadi (a hematologist) at Mayo and Alkaied (an oncologist) in Duluth. I have deep respect for both and both have signed off on my returning to work in moderation. So long as my body is telling me that my recovery is continuing and I'm not relapsing, I have a green light. They have even told me that ongoing maintenance treatments can be flexibly scheduled to work around my travel plans. If I go overboard I have no doubt that my body will let me know that I'm being overzealous.

o  My work is not aerobic 
While it requires sustained focus, process consulting does not strain my lung capacity, tax my kidneys, or pressure the tensile strength of my compromised bone structure. Further, you have to take into account that I have been doing this for work for three decades and have a fairly solid idea of what it takes. One of the distinct benefits of honing one's skills is learning how to conserve energy without compromising effectiveness. It's an art form.

o  I'm working about half rate
While my schedule may seem breakneck to others, it feels like coasting to me. For example, I expect to participate in no conferences this fall (last autumn I attended three). Here's what travel I have lined up from now through the end of the year, which covers a span of 16 weekends:
—one weekend community consultation
—four facilitation training weekends
—one FIC meeting (for which I have no organizing responsibilities)
—one visit to see my son and grandkids

o  Most of my work this fall will be training facilitators
The majority of what I'll be traveling to accomplish this fall will be conducting three-day facilitation training weekends. In each instance I'll be working with a co-trainer (not alone) and all three of the women that I'll be partnering with understand that they may need to fly solo for a time if I run out of gas and need to lie down to recharge my battery. What's more, I tested the waters in this regard last June (when I was weaker than I am now) and the training weekend went fine.

o  I'm a veteran train traveler
Per my wont these past three decades, I will generally travel to and fro via Amtrak, where I find the rhythm of the rails to be mostly relaxing; not draining. I know how to slow down my metabolism on board the choo choo and rest up for the work ahead (or how to recuperate from the work just concluded). Having done it already, I know that I sleep reasonably well in the reclining coach seats, bad back and all.

o  I am not you
Like most everything else, there is considerable variance among people's temperaments and accustomed sense of pace. What suits one may be overwhelming for another, or perhaps painstakingly slow for a third. In making choices for Laird I am not asking others to make similar selections. I am only asking others to give me room to find my own way.

Getting Stronger

It has now been 137 days since I went into the emergency room at St Luke's Hospital (with excruciating lower back pain) and discovered I had an advanced case of multiple myeloma and was close to renal failure.

Placing everything else on hold, my life since then has been focused on putting myself in the best possible position to contain the cancer and regain as much life function as possible. On the one hand, I'm 66 years old and have already had a full life. Maybe my allotment has run out and everything I've been doing the last four-plus months will distill down to looking for a graceful exit. 

As it happens, I've been able to devote a substantial portion of the last few months to connecting with friends and loved ones. If this is indeed my swan song, then I'm pleased with how it's unfolded. I've seen and been able to have heartfelt connections with almost everyone I'd like to, and the outpouring of support and well wishes directed my way has extended well beyond what I imagined it might be. It has been a very touching winter and spring.

However, I don't feel done. It feels much more like a new chapter to me than the end of the book. 

Though my prospects for living well with multiple myeloma are still difficult to assess, I am working closely with my oncologist in Duluth to try to push the cancer into remission and to regain what I can of my vitality and stamina. I have a lot to live for and am fully behind the joint efforts of my doctors, my friends, my partner (Susan), my kids (Jo & Ceilee), and myself to bolster my prospects.

Since the initial diagnosis and the onset of chemotherapy I have been making slow but steady progress in regaining durability, focus, and flexibility. My kidneys are recovering and I have suffered no falls or broken bones despite how much the cancer has weakened my skeletal structure through calcium leaching.

While it's pretty certain that I'll need to cross sky diving and alligator wrestling off my bucket list without accomplishing either, I'm fine with that.

I want to devote more time to writing and teaching; to laughter and the enjoyment of good food, to leisurely travel and the general enjoyment of sucking on the marrow of life's bones. To the extent possible I'd like to manage doing this with Susan as my fellow traveler and life enthusiast. I figure we could do that for the next 10-20 years and be a very happy couple. While it remains to be seen if my psyche is sufficiently strong to manifest this vision of Laird's future, it is a compelling image and will be more than enough to keep my eyes on the prize as I undergo a stem-cell transplant at Mayo Clinic July 12.

Thus, I have 25 days to go before surrendering myself to the rigors of Rochester, where we'll reboot my blood producing capacity and see how the cancer likes that.

I am freshly back (yesterday) from a trip to Portland, where I field tested the range of my recovering strength to hop back in the consulting/teaching saddle long enough to conduct Weekend III of a facilitation training program I launched there in December. I worked with long-time partner Ma'ikwe Ludwig and the teaching went fine.

Though I came in for a landing each evening on fumes (and was glad that the training did not extend to a fourth day), each night's rest restored me for the day that followed and I missed no sessions. While Ma'ikwe prepped the various two-person teams that facilitated meetings for our host group each day, I would work with the remainder of the class (say seven students) to simultaneously offer a deeper exploration of choice cuts of the facilitator's craft. With two interchangeable teachers on the flight deck, we were able to keep everyone engaged and working with fresh material throughout the three days. 

While this is the last piece of on-site professional work that I'll attempt before the July transplant, it was highly gratifying to see how well it went and that there are excellent prospects for my being able to return to effective pedagogy after the summer. This is valuable both to me economically (it's how I earn my bread) and psychically (I can still follow my career path as a social change agent).

In the three-plus weeks remaining before Rochester, Susan and I will attend the 45th reunion of our college class (marking the first time I've attended—it should be quite the time, and an unparalleled opportunity for yet more conversations with people I haven't seen in many moons), and a wedding reception for the daughter of a long-time friend. Who knows, maybe we'll even see a baseball game (if you could label what the woeful Twins are up to these days "baseball").

Life is full of surprises.