Can I get more emails like this?

I mentioned this last week on Twitter, which then automatically goes to Facebook, but I didn't put it up here on the blog (which, come to think of it, also now goes automatically to Facebook). So for those of you who don't read our other feeds, I wanted to share the results of an email from my urologist I got last week. It was subsequent to the followup CT scan that was done three months after my kidney cancer surgery.

I am happy to report that your CT scan showed no evidence of residual and/or recurrent kidney cancer.

I recommend that you have a chest x-ray and blood tests every 6 months. I have ordered these tests for you. I will also order your next CT scan in 2 years.

That's a good thing to read first thing in the morning. What a relief!

I'll see my urologist in January for the first in-person followup visit, but I can now think of myself as a cancer survivor. Which certainly beats the alternative.

Apple Needs a Web Evangelist

This week is WWDC, so I've been doing a lot of reading about Apple's announcements. Last night I drove into SF, and spent several hours talking to attendees to hear their thoughts.

My takeaway: Apple, more than ever, needs a Web evangelist. They don't talk to Web dev/designers, and they don't listen to Web dev/designers. It shows, and it's hurting them.

Just one example: Apple's HTML5 promotion may backfire (InfoWorld). Pushing Web standards (good) by blocking browsers other than Safari was just a bone-headed move—and it's only a small symptom of a much bigger problem.

Yes, I blogged about this 3 1/2 years ago in Apple, Hire Me. But at this point, it's pretty clear to me that Apple first needs to see that they have a problem.

In which avian payment is proffered

I've dealt with so much medical stuff over the years that I've gotten to be pretty decent at diagnosing myself, and often things going on with Dori, too. Sometimes it's for things that I've had before, and other times for new stuff. For example, last year I woke up one morning and noticed that I'd broken out with blisters on my forehead, going up into my scalp. That was unusual. So I looked more closely, did a little online research, and thought, "Crap. I have shingles."

Later that day, Dori was scheduled for a routine follow-up appointment with our family doctor, so I went along. When she was done, I asked the doc to take a quick look at me. He lifted up my hair, looked at my forehead, and said, "You've got shingles." I was on anti-virals an hour later, and the whole shingles experience, while not exactly fun, was minor. Friends and relatives that have had it have just been in agony for weeks or months; my case was over in a week.

Yesterday, I noticed something awry with Dori, and said, "Hey, I think you have [redacted for her privacy], and maybe [also redacted]. Let's get you seen by a doctor." She made an appointment at Kaiser via their Web site, and we went down there today; I sat in. After examination, the doctor told her that she had [redacted] and [also redacted]. The doctor left the room, and I pumped my fist and said "Yes!" Not that I was happy she's ill, of course, but it's a relatively minor thing. She'll need a brief course of drug treatment.

Dori looked over and said, "Congratulations, Dr. Negrino. I owe you a chicken."

I said, "Yes, you do. And I want it to be a rubber chicken."

Let it be known: my wife owes me a rubber chicken. Pay up, honey.

Two Steps Forward, One Step Back

Tom’s back in the hospital—it turns out that he caught some kind of infection post-op, and it’s turned septic (note that this is not the same thing as septic shock, which he had four years ago). They’re pumping him full of wide-range antibiotics, and he’ll be there at least until they’ve figured out what kind of infection he’s got and then gotten it under control. We’re thinking that’ll be Saturday, most likely.

Thanks for all your kind thoughts and wishes, and keep ’em coming, please!

A Picture of Health

Today, it's been three weeks since my surgery for kidney cancer. I thought that I'd put down how I'm feeling, as well as memorializing here on the blog what's been going on since the hospital. It's been on Twitter and Facebook, but not here.

I'm doing well. I spent a total of five days in the hospital. We discovered the day I left the hospital that the surgery was a complete success; the tumor was the "right" type (i.e., it wasn't the "spread and kill you" variety). It was a bit smaller than expected (6 cm, not 7 cm). And most importantly, the pathology report showed "surgical resection margins negative for malignancy." That means that the surgeon cut out the tumor plus a margin, and he got it all. Let me share the important part of the pathology report:

I choked up when I read that; turns out there's a world of difference between "I'll probably be OK" and "I'm going to be OK."

So that's it. No chemo or radiation with this kind of cancer; there will be regular followups for the next five years, but now I'm in the 85% chance of a total cure category. It doesn't look like kidney cancer is what's going to kill me.

Recovery has been painful, and I'm really ready for it to be over. The wonders of Percocet and Vicodin have been plumbed, and found wanting. My side hurts less now, of course, but it's still not exactly a picnic. I've been back to work this week just a little; maybe a couple hours a day. It's no surprise that recovery from major abdominal surgery takes weeks, but I'm impatient for it to be done. I get tired easily, and almost always need an afternoon nap. Healing is hard work. Who would have thought?

Once again, I thank those of you who sent your kind thoughts, your best wishes, and your warm encouragement. It's really meant a lot to me, and I am deeply grateful to have such a community of friends and family.

How to Follow My Progress

My surgery is on Friday April 9 around noon (if you don't know why I'm going under the knife, see here). We expect that I'll be 3 hours in the operating room, followed by a couple of hours in the recovery room before they bring me upstairs to the ward. I expect to be in the hospital for about four days total.

If you would like to follow what's going on with me, the easiest way to do it will be to read Dori's Twitter feed:

http://www.twitter.com/dori

You don't have to use Twitter yourself to read that page.

I expect that once I'm on the mend, I'll be tweeting from the hospital from my iPhone, which will also show up on my Facebook account.

Thanks for all of the good wishes and kind thoughts. I really appreciate them.

Oh, I finished writing my part of our Dreamweaver book, so it's done. A friend tells me that after this, I should teach a community college writing class, and when some kid whines about his deadlines, I should lean in, and patiently explain to him that I've had a heart attack, and I've had cancer, and I still made my freaking deadlines both times. Punk.

Talk to you all soon.

Personally, I thought I already had enough character

A week ago, I wrote this on Twitter:

I've had one of those days that I understand are quite character-building.

I was alluding to that old chestnut, "Adversity builds character." And what made me think of that was a phone call I'd received earlier that afternoon.

Around noon, I'd gone down to the Kaiser campus in Santa Rosa for a routine CT scan that was meant to see if I had any kidney stones. We switched our medical insurance to Kaiser in December, which meant a whole new set of doctors. I'd had some bladder stones removed in late November, and the protocol is to do a follow up ultrasound three or four months later, just to make sure that things are clear. Instead of the ultrasound, my new urologist wanted a baseline CT, because, he said, "It's the gold standard for finding stones."

Kaiser is pretty darned efficient. I walked into the Medical Imaging department at 11:58 AM, and I was done with the CT scan by 12:08 PM. As I left, the tech told me that I should hear from my doctor with the results in a couple of days.

Two hours later, my phone rang, and my urologist told me I have kidney cancer.

Let's jump right ahead to the good news we've learned since then: the tumor is fairly large (7 cm), but it is confined to the right kidney, and hasn't spread beyond it. It hasn't affected nearby lymph nodes. And it hasn't invaded the major kidney vein, which would act as a superhighway to spread the cancer to other parts of the body.

On April 9, I'm scheduled for surgery intended to remove the tumor and save the rest of the kidney. About 30% of the kidney will be taken. I'll be in the hospital for four or five days, then back home to continue recovery. After ten days, I should feel well enough to start working again. If all goes well, recovery should take about a month, except for no heavy lifting for six weeks.

Kidney cancer (or to put it more specifically, renal cell carcinoma) doesn't respond to chemo or radiation treatment. As long as it's in one place and can be cut out, that's the way to go. There's no good way to know before surgery just what kind of cancer it is; there are different types of kidney cancer. If it is the most common type, removing the tumor is considered curative. Most of the time, there aren't many symptoms, and tumors are found incidentally when doing a CT scan for another reason, as happened in my case. For me, my right side aches a little bit, but not all the time.

For a couple of months, we've been working on Dreamweaver CS5: Visual QuickStart Guide, a revision to a book that is one of our main sources of income. Happily, our deadline was always set prior to what's turned out to be my surgery date, and even with the distractions and general freaking out since last Wednesday, we've still managed to get some work in and stay on track. It will be a relief to have the book done and behind us before I go into the hospital.

We're holding up well, I think. It's a frightening thing to learn you have cancer, that there is this literally malignant thing growing inside you. It's scary for me and scary for Dori, who has been wonderfully supportive. Our family and friends have likewise been completely forthcoming with love and support. I'm going public with this because I could imagine Dori tweeting something like "Arrived at the hospital for Tom's surgery" and taking all of our friends and colleagues who follow us on Twitter and Facebook by surprise. We don't want that. Better to let people know what's going on now.

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