265 likes for a fart

This is my journey from regular husband and dad to fighting cancer almost overnight. It’s hard to believe that just 10 days prior my biggest problem was forgetting to bring my readers to a restaurant and having to long-arm the menu. Finally, my blog has morphed into a weekly chronicle of how to understand the ins and outs of someone who is battling cancer, in an honest, humerous, and detailed way. What someone you know may be going through and how it changes everything from going to a party, sleeping, showering, and getting chemotherapy. This is the story of how I went from wondering if I was drinking the wrong protein shake to stage four colon cancer, surgery, and a long road of chemotherapy in front of me.

The beginning.

I’ve bounced around on different diets over the years with some working better than others over the last 20 years. The Atkins worked best for me, but was not practical with young children or an Italian wife. Plus while on business travel it was pretty limiting. One can always avoid fast food, fried food, etc., but grains and starches are sneaky and who doesn’t enjoy a cupcake once in a while? Then a friend invited me to read a book called the 4-hour body. In it the author calls for no sugar and, but most importantly to get your metabolism moving correctly, within one hour of waking up one must consume 30 grams of protein. Well that is great if you are a Billionaire and your chef can have your two chicken breasts and spinach salad ready when you finish your morning dump. But for guys with kids and wives and jobs, protein shakes are really the only answer. So for a while I found one I liked and would work out each morning.

As luck would have it my exercise room consists of dumbbells I’ve purchased, a treadmill my financial advisor gave me when he moved, and a Hoist home gym a buddy gave me. I’d do 30 or so minutes of cardio then about 20 minutes of strength training before work. Combined with the morning shakes, the pounds came off and I was feeling good. Then two things happened. I left my job at Dell and went to a small company. That impacted me in two ways. First, now instead of 120,000 people not caring where I was as long as my job got done I had 20 people who all of a sudden cared where I was at all times and were watching me like an hourly employee. (More complete small company versus large company dynamics will be covered later). I guess it was harder for them to understand that the complexities of the role were not time bound, nor were they location specific, but that didn’t matter. So my work at night, before work and on weekends went ignored if I wasn’t at my desk by 8:30 AM or if God forbid I left at 4pm to work from home for the rest of the afternoon. That impacted my ability to continue my workouts in the mornings. Plus my son Connor started kindergarten last year and he was a full hour ahead of my daughter Josie and my job was to get him to school at 8AM. So my choices were wake up at 4:30, work out, S.S.S., dress, and get him to school, then go to work. Or wake up at 7AM, get him to school, come home and work out, and get to work by 10:15. The latter was not an option.

The second major factor was during this period I had a minor hand injury while playing golf and it morphed into a herniated disk (I thought). Possibly the continuous changing of my swing to guard my hand and still get the big boy yardage, in any case I lost my swing, my confidence, and enjoyment of the game. My back also hurt so bad I could hardly walk at times much less do any cardio and strength training my workout was reduced to lifting kids into car seats and grocery baskets. So the net result was: I stopped the shakes, ate bad food, quit working out, stopped golfing every week and essentially watched sports, drank bourbon all night, and read. This led to gaining about 25 pounds, feeling bad about myself and just general lethargy.

Before the beginning.

Backing up a few years/decades I was quite an athlete. I played year-round sports including soccer, basketball, ran track, gymnastics, volleyball, etc. In high school I wrestled at a high level and won state honors. I played football and won district honors in baseball. I also played baseball through college, and played competitive baseball into my late 20s. Wrestling probably had the biggest impact on me because we had a team of guys who could take anything our coach dished out. Many on that team went on to become Special Forces (SF) guys and we all had a similar mentality that nothing could defeat us. Now when I check back in with those guys they are still the ones who thrive in adversity, are mentally tough, and can overcome trivial issues. The point of this résumé section is: I’m pretty coordinated; have been a decent athlete; and have an athlete’s mind of sacrifice, determination, and grinding through to the win. I don’t expect things to fall in my lap, I don’t ask “why me,” and I don’t think of things in terms of what is “fair” or “unfair.” Things just are. One must adapt, make your plan and execute. There is no time for second guessing. You learn from your defeats and are humble in your victories. It’s how I was brought up to participate in and respect the game(s).

Further, because of this wrestler’s mentality I don’t know if it was by luck or God’s will, but most of my time at Dell was spent with the Department of Defense (DoD)/Intelligence community (IC) teams and through this experience I’ve had the privilege of meeting many SF guys throughout my years. There is a documentary I watched once with a SEAL buddy. It was a Discovery production you can find on You Tube called BUDS class 234. There are six 45-minute segments of what it is like to overcome the first six weeks of Basic Under Water Demolition School (BUDS) training. In it you watch these 20 somethings being tortured and pushed to the brink. Most of them ring the bell to stop the pain. My SEAL buddy told me the secret was controlling your mind. More on that later.

When my buddy found out about my cancer he called me and said, "The true secret is to find one thing, anything, but always find a reason to keep going. Never let go of it, you hang on to it and keep going. Do NOT ring out!"

8/28

After a week of trying those protein shakes again and getting diarrhea so bad I had to take an Imodium, my wife Nita asked me to either switch brands or stop all together. So Thursday August 27, 2015 as I went to a Doctors appointment with her, my stomach started hurting. It could have been any number of things. Stress, I didn’t have time to eat what normally eat, I changed shakes, stress, etc. Anyway by that evening my stomach was distended and I was feeling sharp stabbing pains in my abdomen. That night was terrible. I couldn’t get comfortable, couldn’t pass gas, and even my old standby Alka Seltzer didn’t help. In the morning I informed Nita that I was going to just get a laxative and maybe buy an Activa yogurt, but I the way I was feeling, I couldn’t take Connor to school. I said I’d wait at home with Josie until she got back. She made me promise to go see a doctor.

There is a new Austin Regional Clinic that is the best kept secret in Austin. They have an awesome facility and hardly anyone knows about them, so you can always get a convenient same day appointment. I made my appointment and by 9:30AM was able to see a provider. He didn’t like the stomach distension and asked for some X-rays. Luckily this facility had an x-ray lab on premise. Other facilities would have farmed me off to some other lab and it might have been hours before the results were read and orders given. When the film came back he pointed to two lines that he “didn’t like.” He asked me to pick an emergency room (ER). I had that cooked head “Really” look like is it that big of a deal? He said I needed a CT scan immediately, and although it might be nothing more than appendicitis, it could also be a blockage and there was no sense in messing around with it.

Now I’m thinking, this is going to get expensive quickly, but what are you going to do. So off to the hospital I go. I chose a facility where a very good friend of mine does surgery and performs his rounds and regularly. I texted my situation and location to him and he said he’d stop by. The CT scan showed an inflamed appendix and a blockage of my colon (upper intestine). The general surgeon was just coming around to say they were going to install a nasal gastrointestinal (NG) tube (runs from nose to stomach) to relieve some pressure because I wasn’t releasing any gas, waste (poop), there was a blockage, and frankly something would rupture if we didn’t relieve some pressure. It would also buy us some time to figure out what might be causing the blockage.

My doctor friend walked in and asked if he could look at the CT scan. He introduced himself to the surgeon on call as he had never met her. When he had seen the scan he came back and held my hand and said, “Marco, there is more than just appendicitis here. I’m sure this doctor is very capable, but with your permission, I’m going to replace your entire surgical team. I’ve got guys who are specialists in every field you’ll be needing, and it might get a little political early on, but the NG tube will buy us enough time to get the right people in place to do everything the right way. I also want you to know that the CT scan showed some nodules on your lungs. That indicates that the blockage may be caused by a tumor in your colon that is cancerous and may have already started spreading to other organs. But you hang tough, and try to relax, just know that I’m going to do my very best to get you the best. I was beyond shocked.

He came to visit me that night and said I would spend the next three nights in the hospital getting drained, and having his team gear up. They all accepted my case as a favor to him and I do not say lightly that I firmly believe Dr. Shaw saved my life that night. He said he was up all night assembling this team and I later learned how hard the news was for him to hear. Apparently all his experience in a clinical fashion did not include someone close to him and it hit him like a splash of cold water to say the least. Afterwards I told him I would be one of the five people he meets in heaven.

Dr. Shaw showed up with (insert your all-star band line up here) Neil Peart, Paul McCartney, Jimi Hendrix, and James Brown and said, I put together a little band for you, I hope you don’t mind. In reality he did assemble the best colorectal, oncology, GI, etc. team who checked on me daily. The surgeon Dr. Lakshman is a pioneer in robotics and because of him I left surgery with minimal entry points, small scars (mostly laparoscopic), no NG tube, and more importantly no colostomy bag. He cut out 9 inches of colon, several polyps, 30 lymph nodes, my appendix, and then reattached my upper and lower intestine. He then went inch by inch over my colon to look for any polyps. He found a few and removed them. He was operating somewhat blind because the blockage was so severe they could not perform a pre-op colonoscopy.

Most were encouraged by my attitude, ease of acceptance of my situation, and willingness to do whatever it took. I don’t think they see a lot of resolve anymore and it may have been refreshing because the oncologist was really wanting to come at me aggressively. He then said, for the sake of your children and their medical history (any my lack thereof), I should schedule an MD Anderson visit to see his colleague. He said the facilities are great, equipment is superior, and they can do some better genetic testing that my children can use down the road. They were also very straight with me and this is important. There is no cure! This will be a constant battle of getting me to a state of remission, testing, and re-attacking when it springs up again. The finish line is when I decide to ring the bell. The fight will last as long I choose to continue the fight.