Monday, May 26, 2014

Mick McKellar Update -- Day +1190

Today is a special day! I was diagnosed with leukemia on May 26, 2010. Today I become a four-year survivor! Woohoo!
 
An Unexpected Battle
About an hour and a half ago, I was busy changing the battery for the upstairs smoke alarm. Thoroughly disgruntled about prying open the device to end the “chirping” which began an hour earlier, I used my screwdriver to brush an errant lock of hair out of my right eye, not realizing that: 1 -- my hair is too short to get in my eye, and 2 -- my hair does not move by itself.

I glanced to the right, and hovering in front of my face was a humongous, black wasp -- slightly out of sorts about being “brushed off” my forehead. Being a level-headed and calm person, I raised my screwdriver to do battle with the belligerent bug. Somehow, I tapped him with the tool, and he landed on a bedroom door to get his bearings.

As a technical writer, I know the value of a well-written and handy instruction manual, so I grabbed one that happened to be on a nearby shelf and applied the entirety of the instructions to his situation. Overwhelmed by the impact of all that data, he retired from the battlefield with severe injuries. He later was lost in a whirlpool and is presumed to have drowned.

Overcooked?

As I post this update, I realize I may have stayed out in the sun a bit too long yesterday. We were invited to a friend’s graduation party. Because my doctors granted permission to leave behind my cloistered existence on occasion -- and this being an occasion -- I ventured out into the brilliant, suddenly summer day to smile and mingle. I smiled (grimaced?) and mingled (talked incessantly) for a couple of hours, enjoying both the company and actual daylight.

However, my skin is telling me I may have overstayed in the warm sunshine, and will sleep tonight as extra-crispy Mick. There appears to be no sunburn, but very dry skin with a bit of a blush. As Marian is always saying, “Everything in moderation.”

I must remember that…

Good night, and God bless,

Mick


Tuesday, May 20, 2014

Mick McKellar Update -- Day +1184

Deliciously Dim Morning

Dante and I achieved a milestone this morning. We took advantage of the foggy, dreary, misty morn to complete my 2.5 mile walk route for the first time in 2014! It was not a quick trip. Considering stops for me to catch my breath, blow my allergy-irritated nose, and avoid close encounters; as well as pauses for Dante’s waterworks and olfactory investigations; our stroll required more than an hour.
The mist helped reduce the pollen level, and the lack of bright sunshine allowed me to spend more time outdoors without concern for adverse health effects. Our longer walk permitted a more intense session of training to the leash. It is much nicer with Dante walking along beside and behind me, than Dante dragging me behind on a search-and-defend mission -- i.e., he is so protective, he feels compelled to defend his pack leader (me) against all comers.

Attitude

During our walk yesterday, we encountered a nice lady also walking her daughter’s dog. Dante greeted the other dog with aplomb and tolerated his handler without a single growl. Somewhat later, another nice lady walked past our slow-coach parade, and turned to say, “Oh, what I nice…” At which point, Dante went into his berserker mode -- snarling and yapping -- causing her to draw back in alarm and hurry on. Once comfortably a block or so ahead, she stopped, waiting for traffic to clear and allow her to scurry across the street and out of apparent danger.
I felt awful for her and terribly embarrassed.
I very much doubt he would actually hurt anyone, but cannot take any chances, so I keep him on a short leash and watch ahead to plan paths near, but not too close to others out for a walk. He needs exposure to people, so he understands there is no danger. During winter months, I am a hermit because cold air causes extreme problems with my lungs and because my near-senseless feet make slipping and falling a constant danger. Folks avoid visiting because I have to limit exposure during cold and flu seasons. Therefore, adventurous and courageous folks who drop by are treated to the pale and furry fury of a fuzzy kamikaze in full protective mode. As a result, he is not well socialized.

Squirrel!


I really like the animated film, Up. There is a running joke throughout the flick, about the uncontrollable response dogs have to seeing a squirrel. Since a squirrel has moved into our neighborhood, I have discovered the unfortunate truth hidden within the joke.

Twice now, Dante has sighted the squirrel crossing the road near our home and nearly pulled my arm off my body trying to chase after it. He will pull into the leash and stand on his hind legs for a better view -- and then walk down the street that way -- looking for the, “Squirrel!”

Working Out


In any case, a walk with Dante is always a workout for both the legs and upper body. There are unmistakable benefits for him and apparent health benefits for yours truly. I am grateful we did not try to find room in our home for a treadmill. One day, I may need to simulate walking outdoors, should my condition deteriorate further. However, for now I love the time outside and plan to find ways to spend more time out there.

Despite one doctor’s tongue-in-cheek suggestion, wearing a burka is not going to happen.

Thanks to all who continue to pray for us, and send us good thoughts. God bless,

Mick

Tuesday, April 22, 2014

Mick McKellar Update — Day +1156

11 Refills


It has been 56 days since I last posted an update. Although I have never been shy about writing what is on my mind, I found it difficult because I felt an overwhelming need to be profound, and my life as a Copper Country snow hermit has been at best, prosaic and tedious; at worst, mundane and uninteresting. True excitement saturated any day my medications did not cause diarrhea. Even my phone calls with friends and family included such tantalizing treats as reports on how many times I climbed the stairs to my room and how many feet of snow Marian shoveled in the past week. Profound was not found.

I am writing now because April 2014 has seen two seismic shifts in the bedrock of my path. On April 10, I visited with my doctor at Mayo Clinic after a full day of tests and was surprised to hear that my pulmonary function tests showed a slight improvement in lung capacity and in ability to process oxygen. The improvement is very small — at worst it indicates absolutely no loss of lung function and may indicate my limited exercises are bearing some out-of-season fruit. He also indicated that we can try a small reduction of my intake of CellCept — the anti-rejection medication that helps keep those redneck T-cells I received from my brother from raising a ruckus. We're watching for new rashes or other signs of discontent in their ranks. So far, all is quiet on the lymphocyte front.


It was also interesting to realize that my care regimen is shifting slowly from a focus on preventative and response care (although those remain important) to include consideration of long-term maintenance. February marked a year since I was last an inpatient. Although I have yet to know a day without pain, I have not screamed in more than a year. Because the snow and ice have retreated from the roads, I can once again take Dante for a walk — more a stroll really. We finally cracked the one mile limit this morning!
 

In the three years plus since my transplant, I have learned to live in the moment and to not waste a second of any day. The future for me remains the prize behind curtain number three. And yet, something happened today that caused the second seismic shift in my daily life. It was a very small thing, almost invisible, and I had to put on my cheaters to see it clearly.

Today was delivery day for my monthly supply of Sprycel (dasatinib) — the specialty medication that helps keep my leukemia in remission. On the label, in the lower left corner was the simple phrase: 11 Refills. Previously that number increased from 3 to 5, but this change positively shouts at me that my physicians think I'll still be here — in a year! My atovaquone scrip was also renewed and I received it a couple of days ago, so I rushed to look closely at that label, and it said: 12 Refills — Woohoo! Apparently, I have been repackaged and my expiration date extended...


I received permission to begin attending church again — as long as I keep a distance from anyone coughing and sneezing, and I also received permission to do a little gardening — as long as I wear gloves and don't throw dirt in my face. However, blanket permission to dig around in my attic and basement was not forthcoming, and it seems I will still have to avoid spending time in musty old buildings — no point in tempting fate, I guess.


Although I still don't know if the glass is half-full or half-empty, I fully intend to enjoy the wine! Thanks for all the prayers and good thoughts!


Mick

Tuesday, February 25, 2014

Mick McKellar Update — Day +1100

Different Eyes
I wrote a poem this morning, Different Eyes, a poetic spasm that arose after reading one of those picture postings on Facebook, the ones with an image of a famous person and an inspiring (or aggravating) quote added by Photoshop or some such editing software. This time it was an image of the Dalai Lama XIV, and the following quote is apparently a real one. It was in response to a question about what surprised him the most about humanity.
“Man surprised me most about humanity. Because he sacrifices his health in order to make money. Then he sacrifices money to recuperate his health. And then he is so anxious about the future that he does not enjoy the present; the result being that he does not live in the present or the future; he lives as if he is never going to die, and then dies having never really lived.”
― Dalai Lama XIV
I wonder if he felt that way when he was simply Tenzin Gyatso (born 1935) and had to work at whatever was the Tibetan version of flipping burgers at Mickey-D's? Tibetan Monks were (are?) the top of the social structure and want for nothing much. When he formed a government in exile (in India) and sponsored guerrilla fighting against the Chinese, was he only living in the moment? Easy enough for old folks (myself included) to advise living in the moment — especially when our number of moments is dwindling. It is not so easy for a young man or young woman with a family to feed, to care for, and to shelter. The idea behind his words is a great goal, and I support it. However, a man so dedicated to serving humanity, should not be surprised by sacrifice to make a living.

I assume he was referring to the pursuit of money as an end in itself, not as the needed resource to provide basic needs and common comforts. Still, if he meant GREED, he should have said so.

Easy to be Hard
To be honest about it, I'm hardly in a position to be critical of anyone's personal truths. For the past three years, I have freely shared the scattered and not always coherent thoughts that strayed into my mind as I learned about myself through the lens of personal pain and the certain joy of surviving one challenge after another. I'm hardly the first person to experience CML up close and personal, and not the only person to find out how important friends and family can be when under duress from the threat of leukemia's fatal kiss.

I have learned to live in the present, in part because the present got my attention with a rather large 2x4, and I've been busy picking out the splinters ever since. However, my change of focus has produced a change of vision. By shedding my worries about the future and regrets about the past, I freed myself to deal with the present, allowing time to look around and, perhaps, duck the next 2x4.

Fortunate One
It has been 1,100 days since my transplant. I am a fortunate son, a fortunate father, and a fortunate grandfather. My family is grown and I have a partner to carry the load. I have children and grandchildren to carry the story forward. I have some time left, and I can spend at least part of it (that part not currently involved in wondering when the blasted snow will stop falling from the sky!) observing and commenting on what I see and what I hear.

Maybe some day, my image will show up on a social media page, festooned with a quotation I didn't say about life, religion, politics, or the human condition. Now that would be something to worry about....

Good day and God bless,

Mick

Friday, February 21, 2014

Mick McKellar Update—Day + 1096

Mick McKellar Update—Day + 1096

"Life does not consist mainly — or even largely — of facts and happenings. It consists mainly of the storm of thoughts that is forever blowing through one's head."
—Mark Twain's Autobiography
I haven't written one of these for awhile — the last one was on September 23, 2013 (day +945). I wrote about 60° F weather, light breezes, and enjoying time on the deck (in the shade, of course).

Today, I cannot even find my deck...it is one with a huge snow bank against the west side of my house. The snow continues to fall. The best measure (accurate for Laurium) is the Keweenaw County total, which yesterday reached 260 inches this season. Check it yourself. However, it snowed last night: According to Karl Bohnak (meteorologist at TV 6) they received a notice Laurium (that us) received 4 inches in 90 minutes. It did not continue at that rate all night, but as Marian could tell you, there was plenty to scoop in the driveway after the plow came by this morning.

The Philadelphia chromosome as seen by metaphase FISH.
The Philadelphia chromosome
as seen by metaphase FISH.|
Special Day
I originally planned an excursion for late this afternoon. Today is the third anniversary of the Gift of Life I received from my brother, Kevin. Early in the morning on February 21, 2011, at Rochester Methodist Hospital, doctors and nurses of the Mayo Clinic BMT unit attached a couple of bags to my Hickman Catheter. The bags contained stem cells and T-cells harvested from my brother. They had two jobs: The stem cells were to find my blasted bone marrow (blasted by several days of methotrexate and other drugs) to engraft and restart my bone marrow AND the T-cells were to hunt down and destroy any remaining non-functional while blood cells (i.e., leukemia). It was a disappointingly simple and low-key procedure, and it scared the hell out of me, because there was no going back from this change.

Obviously, the procedure worked. I engrafted quickly as my bone marrow bounded back and began producing a good variety of cells, and the T-cells really cleaned up on the bad guys in town. However, that was when all the fun started, because although the T-cells knew they were in the right neighborhood, they also knew they were in the wrong house. In about a month, they decided to attack my liver and my skin, and I learned what Graft versus Host Disease is all about. I have remained in full remission of the Philadelphia chromosome positive, chronic myelogenous leukemia ever since, and my most recent molecular testing still reveals I remain 100% donor in my blood stream. Than means although my skin and tissue contain my good old regular DNA sequence, my blood is 100% my brother's DNA. This really brings siblings close, you know?

Tremendous gratitude prompts me to celebrate, and I planned to have dinner at a local eatery. However, the blizzard has short-circuited those plans. Better to rail and cry at the unfair weather, than to suffer the consequences of driving about in supremely inclement weather. My prime concern today is whether or not UPS or FedEx will be able to deliver my anti-cancer drug — the one I take to keep my CML in remission.* When I tell the online pharmacy where to deliver and under what conditions, they tend to whistle and not want to believe. You see the drug is very sensitive to temperature extremes and is horribly expensive. Local pharmacies and most hospitals do not stock it, because of the expense and because CML is relatively rare in the U.P. Ah! The joys of living 14 miles past the End of the Earth. It's ~12 miles from Houghton, MI to where we live in Laurium, MI. (See photo above.)

How Am I Doing?
Most of my friends and acquaintances ask that question whenever we make contact by phone, by e-mail, on Facebook, or face-to-face. It's a fair question and I'm never certain how to answer. Usually, I smile and say, "Great...I'm still here!" That may be the best answer of all. Detailed information about my daily experience would both frighten folks and bore them to tears. Large parts of my day are routine. I take medications four times each day, because some drugs cannot be taken within an hour of other drugs, and some cannot be taken with food, while others need food, both to work properly and not cause incredible distress. Azithromycin, I take only three days a week (MWF) and I don't look forward to those days as much, because the side effects are, shall we say, troubling and embarrassing.

I have a quick response kit: High dose antibiotics and prednisone, which I will take at the first sign of a cold or fever — even before the necessary trip to a hospital emergency room. They might be overkill, but could prevent another air ambulance flight to Rochester.

My lung capacity, when last tested, remains at about 25-27%, so I get out-of-breath easily and very cold air causes my lungs to almost seize (sometimes) making it painful to breathe. This hampers helping with the snow removal and even limits walking Dante. I try to take my turn with Dante, both because it feels right and I rather enjoy my time with my fuzzy friend. I look forward to warmer days, when we can walk (slowly, very slowly) about the area and get much needed exercise (while avoiding that treacherously inviting sunlight).

Recluse
Most have noticed that I seldom appear outside the house. I visit Portage Health once a month for blood tests (and sometimes an EKG
to see if one of my meds is messing with my heartbeat), and I sometimes go to Walmart — shooting for non-busy times and quick trips. Mostly, I stay home and avoid near contact with anyone who might have a sniffle. Although I had a flu shot and pneumonia vaccination, my ability to fight off these nasty bugs is minimal at best. I think I miss going to church the most. However, sitting for an hour in close proximity to so many folks who just might have a bug or two to share is frightening.

One cannot argue with success. On February 5, I passed one full year with no hospitalization for illness or injury.

Not Lonely
Of course, I am not always alone. Marian and Amanda are here and have learned to deal with my "storms of thoughts," and "poetry spasms." I spend a lot of time alone, both to think, read, watch movies, etc. and to give them time away from the grumpy, needy, curmudgeonly old head of household. Winter makes it even more important to maintain some personal space. It helps that I have my own room now. I had to take over the guest room (Michael's old bedroom) because it does not have carpeting and it does have air conditioning (for those rare simmering, sultry summer days when breathing is difficult). I keep the heat very low, and the blankets piled very high, all to assist with breathing. This also makes it less likely I will disturb Marian on those nights I cough myself to sleep.

So, although I spend a great deal of time alone, I am not lonely.

So, Then, How Am I Doing?
I am happy to be alive. I am blessed to have additional time with my family and friends. I am overjoyed that my muse has not deserted me, though some of my readers may wish she would take a vacation. I still try to live one day-at-a-time, with necessary consideration for the future, but no need to dwell on it. I spend my thoughts on fond memories of the past, with little need for regrets or recriminations. I read, I write, and I think crazy thoughts. I dream and I try desperately to remember those dreams, so I can share them. I have friends, and that has been the greatest balm for all my wounds. From early childhood, I had few friends, most of whom died, so I avoided making lasting friendships. Now, I have many and treasure them all.

How am I doing? I'm doing great! --
* BTW, UPS made it. They brought it from Marquette!

Mick

Monday, September 23, 2013

Mick McKellar Update — Day +945

It's a beautiful fall day in the Keweenaw — sunshine, temps near 60 degrees F, and a light breeze from the southwest make for one of those days you just want to go for a walk in the woods. So, naturally, I remain indoors, hiding from excessive sunlight because several of my medications require I avoid exposure to the sun. My doctors have also warned against visiting with old Sol because of his tendency to cause various and sundry forms of skin cancer — a very real possibility because of my compromised immune system.

If I can drag my carcass out of bed, I take my walks (with Dante) early in the morning, when the shadows are still long and there is plenty of shade from the mean old sun. If I don't take him out between my first set of medications (taken on an empty stomach) and my second set of morning meds (taken with food), Dante will bark at me — like Lassie telling everyone that Timmy fell in a well — and run to the front door. At the front door, he stares at me, then at his leash, and then at the door. If I don't respond, he will repeat the process, getting more frantic each time.

For the moment, we walk about a mile each morning. There are days I cannot make the walk, and he is disgruntled with me for the rest of the day. On those days, Dante will walk to the door, sit down, stare wistfully at the door, and then stare balefully at me. Amanda's dog is trying to send me on a guilt trip — go figure.

A Tooth, Forsooth...
On September 11th, I traveled to Marquette for a root canal by an endodontist (a dentist that specializes in root canals), because a regular dentist won't try a root canal on me — I'm too much of a package, I guess. I had to choose between having the tooth removed by a dental surgeon, or having the root canal. Although it is a tooth I don't use (no other tooth meshes with it), I chose the root canal because it is less invasive and the risk of infection is much lower. The root canal was an apparent success, with most of the pain centered much lower on my body.

The endodontist does not participate with my insurance (Delta Dental), so I had to pay the whole bill up front and wait for reimbursement, which the dental assistant said is usually about 70%. I got the check...for 50%. When on a fixed income, this kind of unplanned for expense wreaks havoc with one's bottom line. Ah, well, another bump in the road...

Testing, Testing, 1 - 2 - 3...
My monthly blood tests, done on September 17th, show readings consistent with those for the last two years — no indications of problems — which I find reassuring. A new test, requested in this last batch, determines the fluoride level in my system. I've had some bone pain, mostly phantom stuff (ouch! and gone...ouch! and gone, etc) and the doctors at Mayo Clinic ordered the test because certain medications can result in higher fluoride levels — which can cause such pains. There's always something.

Loving Life
It's easy to complain about small stuff, like pain in a bone (or in the wallet), but only because it is just so wonderful that I wake up each morning — still alive and functional. I have not stayed in a hospital since last February — a great pleasure for me, and a grand relief for Marian, who spent so many hours in waiting rooms and on uncomfortable chairs in hospital rooms. My perception about what is important in life has changed dramatically after avoiding three close calls with leaving it. I am learning to live with my new limitations and not get angry and frustrated when I have to stop because of my minimal lung capacity. It's like getting angry because the hair on my head is more decorative than protective these days — pointless. I just put on a hat and a smile...and walk (slowly) out the door.

Good day and God bless,

Mick

Tuesday, August 6, 2013

Mick McKellar Update -- Day +897

Dante joined our household this summer.
Wow! Friday, August 9, 2013, will be day 900 since my blood and marrow stem cell transplant! I still cannot fathom how lucky and blessed I am to have made it this far, despite a few missteps and a couple of "Duh!" moments (like eating clam chowder a few months ago...). I'll admit the road is rough in patches, more potholes than pavement, with chasms yawning to each side and a precarious footpath to follow. Yet, I am happy to continue my journey of discovery.

We're Baaaack!

Marian and I journeyed to Mayo Clinic in Rochester, MN on Sunday, so I could spend all day yesterday (yeah, we rose at 5:00 AM to walk to the clinic) for blood tests and pulmonary studies. I had both an oxygen titration test (on a treadmill) and the usual pulmonary function tests. I met with a lung specialist and my BMT doctor. Apparently, I am doing exceptionally well, because once again there has been no decrease in lung function. I have been holding at my present values (with minor fluctuations) since this problem (bronchiolitis obliterans) took away most of my lung capacity. I still have between 25 and 27% capacity. To give you some idea of the loss, when I first arrived at Mayo Clinic (in 2010), my lung capacity was about 3.0 liters (fairly normal for an overweight 60-year-old). Beginning approximately February of 2012, my capacity has been between .9 and 1.0 liters.

So what's the problem?

Well, it seems any nastiness in my lungs -- irritations, viruses, infections, etc. -- can trigger reactions that tend to invite investigation and response from my renegade T-cells, and could cause further devastation and loss of lung function. Many of the medications I take (and a new one I will be starting) help to prevent the reactions that draw interest and allow those renegades to look elsewhere for opportunities to create havoc or just chill indefinitely.

Rapid Response Kit

The lung specialist also prescribed some medications for me to keep handy as a rapid response kit. Basically, we're talking a powerful antibiotic and prednisone. It is a simple idea...if I get a sniffle or think I might have picked up a bug, I take the pills immediately...THEN I call the doctor. Any sneaky germ or viral visitor that might give you a sniffle and a sneeze and dim your lights...well, let's just say it could put out my lights for good. If I didn't need the medications, well there is no real harm done (other than the side effects) and we taper off and stop the meds once again. Sounds like a plan to me.

With two grandsons, who just
left the area. Gonna miss them.
Looking Forward

I still take each day as it comes, each one a gift and and a joy. Yet, I cannot help looking forward to visiting with my grandchildren and children I haven't seen for quite some time. It seems that, maybe, I will have the chance to do that.

A Good Trip

Our trip was relatively uneventful. There were multitudes of deer scampering across the rural highways we drove -- especially on both M-26 in the UP, and US 63 in northern Wisconsin. Our car, a recent reverse legacy from our son, Andrew, performed perfectly. That 2009 Ford Focus achieved 40.5 MPG on the trip to Rochester and nearly 39 MPG on the return leg.

Marian drove about half the trip down and I drove the entire trip home. I think I was energized by the test results and the good news about no further deterioration. We are home safely and appreciate all the good will, good wishes, and great prayers that spirited us on our way.

Thanks to you all, God bless and good night!

Mick