Sunday, April 24, 2011

Plans are just plans... subject to changes

Since my last update, a plan was in he making and I was set for a stem cell transplant in May. Everything was contingent on one “minor fact” which is my 5-days treatment sessions working well. Three weeks after treatment-2 (the one I reported about in my last update), I went for tests and got the not so good news: it isn’t working as well as I wanted. The bad numbers go down too slowly, which complicates matters. I will need a few more 5-days treatment sessions before we can consider the stem cell transplant. As we speak I am in the Brig – the hospital (BWH) where I stay for 5 days with 24hours/day chemo treatment for treatment-3. Within a one month interval, I will need treatment-4 and probably also treatment-5. Then we’ll see…This is rather unusual to have so many of these tough treatments. My doctors and myself are very confident that as a “very healthy sick person” I can do it! Now I am sure you agree with the title of this blog update! Lucky for me, I am used to the ups and downs and take them in stride. It is funny how it is possible to get used to a challenging routine. I have my stuff ready for the Brig: backpack, family photo and a photo collage poster, artificial flowers from Shoshi, Kefir and Maitake. This is like “battle stations” on a short notice. In addition, I am at the floor that I like most with the most experienced staff. I can ask them to be more proactive with some of my medications, based on experience and not just the daily test results. The chemo is tough but I manage it well. I feel OK, eat as I should and work, make phone calls and most important host Shoshi every day and enjoy her company and the gourmet lunch of her home cooking. The real challenge is a week after my planned release. My immune system goes to zero (as expected and as it happened after the last two treatments), I get fever and back to the Brig for a week. I hope to avoid this high fever stunt this time. The drill for the next few months is simple: get the treatments, recover at home, avoid getting in trouble and hopefully see the bad numbers go down, enabling the stem cell transplant in this coming summer. In parallel the race to find a donor is on. My perfect match donor which I reported about last time, has a medical issue so he is out. I hope that in a few months a new perfect donor will be found for my stem cell transplant.
Remember my saying that out of every bad situation - a new one emerges? This is another good example. The fact that I now need a few more months of treatments, provide the adequate time to find a match!
A week ago Orbotech US participated in the major annual US trade show in Las Vegas. Sadly I couldn’t join and be part of our great team and also meet our many customers, something which is important in my work to keep in touch with. Thanks to Rick, our resourceful engineer who placed an internet web-cam, I could see everyone remotely from my home.
Last week Lindsey ran again the Boston Marathon on my behalf. Thank you all who have contributed. Donations go to Dana Farber Cancer Institute, where I am being treated for the past 3.5 years. Lindsey web page is still open for last minute donations: www.RunDFMC.org/2011/LindseyW
On the Marathon day I waited at the half point which is very close to our home. Thanks to a chip in Lindsey’s shoe, I got live updates to my BlackBerry about her progress as she crossed the several milestones. Technology my friends! By wearing a shiny yellow shirt, Lindsey easily found me. I was able to take a few nice photos of her running towards me with her great smile (see below).
On a nice weekend in early April Shoshi and I drove to Keen NH to visit Lior. We love the visit routine: see Lior, go for a good walk in nature, do some shopping for her, eat lunch at our favorite and delicious Thai restaurant in town, go back to her place and meet her friends, drive home tired and happy. This visit was no different, except that the weather was on the cool side and in the afternoon we soaked the sun on the black roof top along with Lior’s friends and her cat!
My doctors told ne that exercise is important. Therefore I try to walk as much as I can and thanks to Shoshi and a few friends I mage to do just that. You can see some of the adventures in the photos below. Weather in the Boston area was still cool during the day, requiring be to bungle-up. Now it is getting warmer. Spring is in full swing and I go crazy with the camera after the blooming flowers and trees. In a few days when I am out, for sure the scenery will be much nicer than a few weeks ago. As you can see in the photos, by now I am bald, something I am not used to.
Overall I am doing well. I need a little luck to get my numbers ready for the stem cell transplant.
Very optimistic, still in the Brig for a few more days…
Yours
Guy

































































































































































































































































































































































































Saturday, March 26, 2011

In The Brig!

What does it mean “in the brig”?

Brig generally means jail in the Navy.

But it can also mean the military equivalent of house arrest. Meaning being confined to quarters. It is also a sailing vessel with two square-rigged masts. Somehow all related to the Navy…

The hospital I now stay and write you from is called Brigham & Women Hospital (BWH), adjacent to Dana Farber Cancer Institute where I have been treated for over 3 years.

So I call BWH The Brig, for short.

Little did I know that I will spend here a few weeks in a small room in solitary confinement!

The last time I wrote in my blog I was in the middle of cycle-1 of the heavy-duty chemo: 5 days in The Brig. This is part of the preparations for the stem cell transplant.

I was supposed to rest 3 weeks at home and get into cycle-2.

Plans do change!

After a great week at home, I got high fever and was re-admitted to BWH. This time for 10 days! Very long 10 days in the brig!

This was a setback.

I had plans!

We were all supposed to meet in Israel: Shoshi, Inbal, Iris and later myself. My trip plans were quickly axed.

A day after I was admitted, without knowing that it will be a long stay in the brig, Shoshi was supposed to travel to Israel. She really didn’t want to go and I had to convince her that I was in good hands, she needed to start her dental treatments in Israel, see all the family, meet Inbal an Iris. If needed, she could cut the visit short and come earlier. I am sure that it was a hard decision for her and very reluctantly she agreed.

It is also in line of my motto: life goes on, business as usual.

10 days in a small room is definitely a mental exercise. I adopted a life style of a prisoner in terms of having a schedule: eat, work, rest, work again, walk in the corridor, eat, etc.

Schedule is a purpose and helps a lot.

Thanks to Skype, I could communicate with Shoshi, family and friends which was so important to me.

Our wonderful local friends came to see me, brought me some snacks and my bridge team played with me in line with our tradition of the weekly schedule. It was great just to sit and talk with friends.

Lior came from college to be with me over the weekend which was great. I had to negotiate a permit to go out of BWH for a short trip. Lior took me for a walk, good ice-cream, some fresh air and sun. Most important - a good exercise to my flimsy bones.

During the last month where some of my blood parameters deteriorated, the doctors changed many of the medications and stopped me from taking the Maitake immune system booster pills that I took as a supplement. Just as a precaution.

After 5 days at BWH they gave me a permit to continue using them. It was at the right time.

Looking at the results on a daily basis and using an Excel to plot the progress, it was clear to me that my release is not around the corner. That didn’t look good and I was already a week on the brig. So I started negotiating the terms of an early release citing my unique case. If you recall, I was called “a very healthy-sick person” because many of my systems are in a very good condition, in spite of the long disease.

And so, the medical team, with a push from my physician, agreed to a lower threshold and terms. With the Maitake and some luck, this threshold was quickly met after 2 days and I was a free man. Hana came to pick me up and I remember the sensation of being out in the air, riding a car, seeing the things outside that you will never pay attention too.

At home sweet home, recovery was swift.

No IVs and pipelines into the body, good night sleep without the IVs beeping, without thinking which side is it OK to roll over, good food that friends brought me every day, good coffee, and basically freedom and peace.

While recovering at home and in BWH, I got some nice cards as well as tasty packages from friends and relatives. Thank you all!!!

This was very important step in getting stronger for the next cycle of chemo.

In parallel, the search for a stem cell donor was in full swing.

I am grateful to all of you who participated with all your hearts to register and save a life.

I was amazed to learn that Israel has the 4th largest database of registered donors in the world in absolute numbers! Go figure out!

Thank you Ofer T. and your dedicated staff for pushing my cause. Also thanks to Ofir B. in Israel that got the info from Ofer and put her energy and heart to support me. Thank all the others who were already registered. Stem cell donation is relatively a simple process that takes a very small quantity of blood and can save someone’s life.

One afternoon I got the most exciting phone call from the coordinator of stem cell transplant in Dana Farber.

She said: “Iris your sister isn’t a match. It is close, but not good enough. However we found a perfect match for you in the US!”

I new it was too early to celebrate, but this news was received with a huge sigh of relief. After all, there are only 15 million registered donors in the world. To qualify, the donor has to be tested again, agree to the process, be healthy, not pregnant and not busy during the time that we’ll need his stem cells.

Still, very good news! By the way, it will be only after a year that I will be able to learn his identity.

The coordinator also told me that she has received about 30 calls a day from people mentioning my name, asking question, wanting to be a donor, etc.

She has never seen something like that.

As part of the planned preparation for the stem cell transplant, last Tuesday (22 Mar.) I checked myself to BWH for the 5-days cycle-2 of the non-stop chemo.

Lucky for me, my admission was late, so with Moshe’s help we brought Shoshi from the airport and this was a nice surprise to her.

As we speak, I am in BWH for cycle-2, getting 4 chemos 24 hours a day for 4 days. So far so good.! Shoshi brings me good food to diversify the hospital menu and keep me a very good company.

The week or so at home before this cycle made me stronger, better prepared and let me gain a few more precious pounds. If all goes well, I will be out of the brig by Sunday (27 Mar.).

So what’s the game plan?

In 3 weeks I will undergo a series of tests to see if the cancer level is low enough to allow the stem cell transplant to take place. This is a must in order to ensure success. The numbers have to be below a certain threshold. This is the purpose of the heavy-duty chemo cycles that I have just completed.

If the numbers will be low enough, the stem cell transplant process will start on Passover Eve! It will require a week of preparations with chemo at BWH and in parallel preparations of the donor and his stem cells extraction. All in all for me – 3 weeks in BWH and a very long recovery at home.

If my cancer cells are not low enough, I will probably get into cycle-3 for another 5 days chemo, 3 weeks off, tests and hopefully the stem cell transplant.

All in all, a very interesting and a critical period of time during the next 2 months.

In the meantime, I am still in my small room in BWH.

To my Orbotech colleagues: the room has HEPA and carbon filters all over!

I put up on the wall all my posters and family photos to cheer me up.

One of the big mind twisters are the variety of parameters from the many tests. When some of the blood numbers improve, contrary to what the chemo is supposed to do, a strange thought creeps into my mind “is the chemo really working”. Future will tell.

As it has been in every year, Lindsey (Inbal Needham high school friend) is running again the Boston Marathon on behalf of her aunt and myself. Take a look at the link:

http://www.blogger.com/www.RunDFMC.org/2011/LindseyW

Your can see my name on her running shirt, Please feel free to donate as you wish. Lindsey is running with the Dana Farber group, the very institute that takes great care of me since I got ill.

I sense the finally the finish line is around the corner. I am ready and with a bit of luck this long story can be soon behind me. Let’s hope.

Always optimistic,

Yours

Guy
















Sunday, February 20, 2011

When the tough gets going

The real test is when the tough gets going. It is especially challenging after a long period of difficulties, where more clouds appear on the horizon.

As someone said: what doesn’t kill you makes you stronger!

In the past 3+ years I have been treated very well at Dana Farber Cancer Institute (DFCI) in Boston where I went through many conventional treatments and clinical trials.

You all read my adventures in my blog.

In recent months things started to go down hill. The treatments didn’t work too well as well as created other problems.

Last week I found myself at a very critical junction:

§ The conventional treatments did not work and there is no point to continue them

§ Clinical trials are out of question at this stage

§ The only possible solution is another stem cell transplant, this time from a donor, unlike last time which was from my own cells (and regretfully it failed).

This assessment was a result of a consultation with the medical team. After having so many theoretical options, the funnel was finally narrowing down: one course of action, the donor matching challenge, timing issues and new risks. A tight spot to be in.

It took me 24 hours to digest the not so good news and implications. But like last time, when I was diagnosed, I managed to re-collect myself and my spirit into the new plan. Not easy at all, but doable.

And so the race is on to find a donor!

There are some 15 Million people around the world registered as bone marrow and stem cell donors. Pretty small number for the whole world.

Most amazing is the fact that Israel is #4 in absolute numbers!!!

My medical team will soon start to look at all the world databases for a match.

I was overwhelmed by your response so far. Many of you responded that you are already registered.

What’s the game plan?

First step, my medical team will prep me for the transplant.

This will take a couple of months (or more…). It involves sessions of 4-5 days session at the hospital with high dosage chemo. No picnic.

How can you help?

By registering to one of the Bone Marrow Registries you can increase my chances of finding a match. You all got by now the details how to do that. If not, please go online and look for the nearest hospital or organization that allows registering and test for bone marrow and stem cell donation.

There is an age limit (some 50, some 55 or 60).

In Israel on 28th Feb. there will be a bone marrow drive:

http://www.scooper.co.il/pr/1012651/

While it says that it is a specific drive for a sick person, by registering you will be available to bone marrow and stem cells for all, including for me. Basically, the possibility to give life to someone in need.

The search includes the all databases around the world.

So this is it!

I know I am asking a lot and I will be OK with whatever you decide to do, for me and potentially for others whose life can be saved by a donor matching.

I am optimistic and hope that between all the Jewish, Polish, Russian, Moroccan and Colombian genes of our family, and your diverse genes, we will find a match!

Last Tuesday I was admitted for the first session – 5 days at BWH (a Hospital near DFCI in Boston).

As we speak I am getting 4 powerful chemos continuously 24 hours/day. The goal: aggressively bring down the bad MM cells and in parallel take care of the body with blood, platelets, and other infusions to allow the body to function.

If all goes well, they will time the stem cell transplant in such a way that I will get the stem cells from the donor when I am ready for that (my Myeloma is under control).

My secondary goal is to eat! I remember all too well the 3 months in 2009 in which I couldn’t eat anything and needed the special lines with IV foods and liquids. Not pretty or convenient.

So with Shoshi’s help we are improving the hospital’s food and getting me all the possible calories. Not that I have any appetite, but I have programmed myself not to miss any meal, so far!

Friends come to see me, which is nice. We even had our weekly Bridge game here which was fun.

To cheer me up, I am dressed with colorful shirts. Forget about the hospital gowns!

Today I had talked and Skyped with all the family around the world. As you can see in the photo below, I have decorated the room with a nice collage of photos that Inbal gave me last time plus the world map.

For all my Navy friends, see my T-shirt?

On Monday I will be discharged and in 3-4 weeks it will start all over again. I am ready!

Other updates since last time:

The house in Needham got empty again. The girls went back to their lives and activities. Inbal returned to Uganda after a few more weeks of work in Boston, which was a gift to us. I had the pleasure of being the driver back and forth to/from the train every day. Lior went back to the college in NH. Neta took off to Israel for a 5-month volunteer program on behalf of Oranim/MASA. I am sure she will enjoy Israel!

So for now we are home alone: Shoshi, myself and Shadow the cat!

We had more snow than ever before, which brought some challenges. In spite of the inconveniences, I still think it is very beautiful.

In between I am trying to work as much as possible and not miss any beat, thanks to the remote technologies. You know my motto: keeping busy is a very good medication.

I say to my colleagues: business as usual unless I say otherwise. I hope they listen.

To finish on a high note, I have some quotes from Churchill. I had a CD with a variety of important speeches of the 20th century and his are the most inspiring. Churchill’s optimism and determination in the darkest hours of Britain during WWII, were an inspiration to all. To quote a few, plus my add-ons…

What is our policy? To wage war by land sea and air (try every possible treatment).

What is our aim? Victory! Victory at all cost, in spite of all terror (the tough chemos and risks).

Man will still say: This was their finest hour! (in the remission party).

Yours optimistic

Guy
































































































Tuesday, January 18, 2011

In Memory

This blog update is hard for me to write. I will share some sad news.


Rachel Hodis (Moti’s wife) has died of cancer last week. The Hodis family are our good friends in the Boston area, whom we see often, play bridge every week, celebrate the holiday parties and sometime ski.

When a good friend passes away it is hard.

When the reason is cancer, it is harder for me.


My rewards for writing my blog are all the calls and emails from people, some of which I don’t even know, asking for info, specialist contacts, or sharing how my blog made a difference to someone.

And so when Rachel got sick a few months ago, I felt compelled to help by talking to Rachel at eyes level – my experiences, what worked well and what didn’t, etc.

We didn’t have the same blood cancer so my focus was on the mental side – how to manage look straight and stay above the rough waters.

We were treated in the same room at Dana Farber Cancer Institute (DFCI) in Boston, and when needed we were hospitalized in the same hospital nearby (BWH).

I sometimes met Rachel at DFCI and remember Moti asking me “what are we doing here?” I am asking this question for over 3 years. How come I don’t get 1/3 off for good behavior?

I also visited her at home and at the hospital. I still feel that I didn’t do enough.


For those of you who didn’t know Rachel, she was the “Duracell Bunny” as Shoshi says. She was very active in everything, with lots of energy, charm and no drama.


Therefore, when she got ill, the contrast was huge and saddening. I am still asking how can any illness bring down such a lively and active good person.

Sadly Rachel didn’t make it. When I heard the news it was hard to believe that this time the cancer won. All along I felt invincible, like a stupid teenager! Overall my Multiple-Myeloma is aggressive, I was the most sick person in MM they have ever seen, I went through 4 clinical trials and 3 standard protocols, a failed stem cell transplant and still I was not really worried that my situation was a life threatening one. Until Rachel died, It gave me a sudden jolt that cancer can kill you. This thought is always in the back of the mind of any cancer patient. The question is simple: do you let this thought drive your life? Not in my case. I did, I do and I plan to do whatever I can, live normally, work, travel, enjoy life with the family and ignore as much as possible the “bad thoughts”.


It is a great satisfaction to win against the beast and I do it on a daily basis. As Inbal uses to say “in small victories”. I even make forward plans. At worse, I’ll have to cancel or reschedule. My great and faithful doctor knows the drill: I ask, explain, negotiate and in the end I do whatever she says.


Last Friday I attended the funeral. It was a day after I had a surgery to insert a port in my chest. It will be used for treatments, blood tests, infusions, etc. and eliminate the needles which killed my arms. It was a very cold afternoon (well below freezing with light snow) and no matter how well I dressed, I was badly shivering. It was touching to see how friends reacted. One person took off his coat and gave it to me. Another gave me a scarf to wrap up my face. Shoshi hugs me all the time and two other people stood very close to shield the wind. Being there for paying the last respect was a must for me to do regardless of my condition or the weather.


I shared with Moti a nice story about my recent contact with Rachel.

As a cancer patient myself, I could have related to Rachel in a way that others couldn't.

I had no problem sharing my experiences and vice versa.

I went to see Rachel during a weekend to consult with her about nutrition.

She had some success with microbiotic foods and told me about what she tried and that it worked.

Not that I am a great believer in special foods, but this was the last resort. I like to eat everything and a lot, even if it wasn’t friendly to my stomach.

For months my stomach has not been cooperating with me, to say the list.

All the treatments had their negative impact. You may recall the last update where I described the challenges of driving and always looking for the nearest pit stop…

So, I had nothing to lose.

Rachel gave me some very good advice and pointed out the things I should eat, how much and where to buy them.

I sat in her kitchen and wrote down everything in my Blackberry.

It was a funny discussion because of the combination of foods, their names and origin.

Some of the items I still can't pronounce well. Kukicha tea???

This was nothing of the kinds I expected.

I was suspicious but Rachel encouraged me to give it a try. We laughed about the whole thing. I called it voodoo nutrition.

Rachel was in a good spirit and probably in her best physical shape in weeks. It was the last time I saw her and for sure it’s better to remember her smiling and joking.

And so I went shopping, got all the items on the list and carefully started eating this bizarre combination of foods. Even my family was surprised that I actually did it.

Three days later, when my stomach stated to behave, I was so happy and still in disbelief.

I didn’t laugh any more about the special foods or called it “voodoo foods”.

I called Rachel to let her know that the not-so-voodoo foods worked!

The special foods still work well!!! Every day when my stomach is normal, no pains, no worries when driving, I think of Rachel. Having a normal stomach is one less hustle in the whole ordeal.

It is amazing how even in her very difficult situation she was able to help me so much.


Rachel was an avid reader of Inbal’s blogs from Africa. In memory of Rachel, Inbal decided to donate her long her for charity that provides free wigs for women with cancer.


Now to some other updates. The last two months have been a roller coaster in my treatment. What I took for granted during the last 3 years, slammed into my face in early November. The treatment worked well but took a toll on a few key parameters that prevented from me to continue this treatment. Probably thanks to the Maitake my immune system is holding up very nicely. Over the past 3 years I have seen other patients around me where their treatment was stopped as a result of complications. Now it was my turn. One by one the doctors stopped certain treatments, which did not help. This week I will start a new protocol with a hope that this is it. There is no other choice. Except for a brief hospitalization due to high fever, I feel good.


The head nurse which takes care of me every time I visit DF summed it nicely. When taking my vital signs last week, she asked “what is you pain level?” I said “none”. Her answer was “you wouldn’t tell me even if you had some pain”.


In the past few months I anxiously waited for the end of December – the family reunion. Luckily for everyone, all the many flights and connections were on time, no luggage was lost.


Inbal came from Uganda. Her plane was the first to land in Boston after a snow blizzard closed everything for 24 hours.

A few days later Pierre too. Neta came from Colombia after a year as a volunteer teacher. She had 4 flights in less than 24 hours. Lior and Ryan (her friend) came from NH. Rhonda and Dan (Inbal fiends) came from Canada.

On 31 Dec. in the evening we were a happy bunch, the whole family, plus a few more..

We were 9 (10 with Shadow the cat) for a few days.

Somehow Shoshi pulled off a miracle and made room for everyone.

On New Year’s eve we went to a great New Year party that our friends organized with food, drinks, an entertainment program, games, dancing and more. We stayed until 4 am!

Thank you Hana, Galit and the girls for organizing such a great party. What a way to start 2011!

My girls know the drill. When the 5 of us are all together (a rare event) I go crazy with the camera. Everyone cooperated with the photographer’s demands and this is how I got the many photos of all of us.

We also had two snow storms. The white puff is always magic and we all take pictures as if this is our first winter in New England. As you can see in the photos, we still enjoy it, though the shoveling is hard work. As Inbal mentioned recently: one person shoveling the snow and three others taking pictures! This is really funny.

As we speak I am flying at 39,000 feet to visit a few customers in Arizona. When I can, I do! There is nothing like face to face meetings.

I hope that 2011 will bring me luck and health. At the same time, my spirit hasn’t changed a bit and I am ready for the inevitable roller coaster.


Yours truly

Guy


The photos below: l

Lots of family. This is my treat.

You can see us skiing (yes, I got an OK from my doctor), the snow storms, shoveling snow, making lots of good Colombian coffee with the espresso machine (thanks to Neta who brought us the excellent Juan Valdez coffee from Colombia).