Hows about those lungs?

We went to New Orleans for an evaluation of how well the oral chemo drugs have been working.  I have been taking 1500mg of Xeloda morning and night for 14 of 28 days and 300mg of Temodar for 5 of 28 days.  The Xeloda has been causing me some additional diarrhea along with some hand and foot syndrome (dryness and cracking of the skin) but have been tolerating it relatively well.

We brought down disks from a CT on 7/2 and an MRI on 7/3.  Both were done without contrast as my kidney function is not sufficient to tolerate the contrast in my body.  This means that the scans are not as precise as desired and it is a bit more fuzzy compared to scans with contrast.

The radiologist for the MRI was a bit of a dumbass and compared back to a CT in 10/12 rather than the MRI from 2/13 that they had in their system.  10/12 was prior to my surgery in 11/12 so the comparison is mostly useless.  Dr Campeau in New Orleans will do a comparison in the next few days to get a real understanding of the difference.  However, the CT was done with a reasonable comparison to 2/13 and the abdominal and pelvis tumors seem to be mostly unchanged or a slight amount of growth.

This time, the CT included the chest and we got a good image of the lungs and that is where the issues showed up in this scan.  A 43x14mm mass was detected in the lung and, of course, we don't know what it is and, right now, we don't know how long it has been there.  Dr. Campeau will be looking for this mass in previous scans to try and determine if we have seen it before and how it has progressed.  Dr. Ramirez is concerned that it could be early stage lung cancer or it could be typical carcinoid or, if it has grown quickly, it is a-typical carcinoid (more aggressive).

The plan for now is that we will have a PET scan in the near future.  Typical carcinoid does not respond to PET so if this mass does respond, then it is either a-typical carcinoid or it is a lung carcinoid.  It is also likely that we will perform a biopsy of this mass to accurately classify its type.

Once again, this means that our future is uncertain.  We will be continuing the chemo, at least the Xeloda.  Just before we left, we got a letter from the insurance company saying that that I was receiving the Temodar due to, essentially, a clerical error.  They need to get some more documentation from my doctors to ensure I am truly in need of the drug so we have about 1.5 weeks to get that taken care of or I will miss this round of Temodar.

In other news, I will be attacking the Triple Bypass on July 13th.  This is a ride of 120 miles over 3 mountain passes with a total of 10000 feet of vertical.  I am planning on starting at 6am and hope to reach the top of the first pass (Juniper) by 9am.  This is 3500 feet of vertical over 17 miles.  A couple of weeks ago I rode Monarch pass which is 3000 feet of vertical in 10 miles and I did it in under 3 hours.  This makes me think that Juniper in 3 hours is roughly right.

There are then three rest stops, echo lake at the top of Juniper, Georgetown at 42 miles and Loveland basin at 56 miles.  My goal is to then make it to Loveland basin by 11am.  This is about 15 miles of screaming descent and then 26 miles of climbing with 3000 feet of vertical gain.  This may be a bit optimistic but they have one lane of Loveland pass closed from 10am through 2pm so I want to be on my way up the pass in that window.

Given I make the previous, I have another 1500 feet of vertical over 4 miles to crest Loveland pass and then I fly down the other side into Dillon, CO.  This includes a short climb of 500 vertical feet before I hit the next rest stop at Summit Highschool with a goal time of 2:30.  This is 77 miles into the race and, if I make this point, I believe I can finish.

I then have 1000 feet of climbing past Copper Mountain to get to the fifth rest stop at the top of Vail Pass and mile 92 with a goal of 4:30.  Reaching that point is key because I now have 3000 feet of decending over 38 miles that takes me into Avon.  There are going to be ever so slight climbs at places and my legs will be screaming at me until I make that final stop in Avon and a finish time of around 6pm.  They close the ride at 8pm so that gives me a little bit of slack in my schedule.

Will I make it?  I hope.  If I make it by 6pm, I won't be last but I will have finished.  Even if I don't finish, I will have started.  As my best friend told me, Dead F'ing Last > Did Not Finish > Did Not Start.  I know he stole it from a running blog but it applies to anything.  Just attempting something is an accomplishment.  Finishing is fantastic but not necessary and, even if you finish, DFL is still something to be proud of and is even a point of pride in some of the highest levels of competition.