Finally. I was just released a few hours ago after staying in the hospital thirteen days. The last two weeks were grueling. I won't go into any nasty details. It was bad. Bottom line - it seems like Humpty's pieces were successfully put together again and zipped up.

Christine is still doing very poorly with back, neck pain and headaches. So I'm recovering now at Mom & Dad's house up in Fairview.

I am glad now to be able to drink and eat freely. I have not been allowed to eat since getting to the ER. And I lost maybe 10 or 15 lbs. I'm going to write a new diet book: "Just Don't Eat"

Just got a call from Greg's dad Jim. The surgery apparently went very well.

Surgery is slated for 7am tomorrow morning at Presbyterian Hospital of Dallas. Dr. Beecherl is the surgeon. I'll keep this NG tube that is currently in my nose until at least Thurs or Fri. The length of stay in the hospital will be determined by how much work is involved in untangling the mess and how quickly the intestines start functioning correctly. My own guess based on previous intestinal surgeries I've had is 5-7 days.

Two weeks ago, I went to MD Anderson for check-up. Things seem to be going well as far as the cancer. There are a few small suspicious areas, but they reamain stable compared with the scans four months earlier. The dr recommended a month of no treatment.

John R accompanied me and we drove back from Houston Tues night. That night I was woke with some abdominal pain. That pain grew during the morning. Long story short, I ended up in the ER with an immense amount of pain and was checked in to Presbyterian-Dallas Hopsital that evening with the dreaded NG tube suctioning my stomach. I have a partial blockage of my small intestine due to scar tissue from a surgery I had several years ago in that area. Things seemed to be progressing nicely once the suction began. Saturday, they removed the tube and by Sunday morning, they thought the intestines were unkinking themselves on their own and I could go home Monday.

But things turned bad Sunday afternoon. (And I'm not talking about Rice getting hammered 17-5 in the College World Series) After hours of misery and vomiting, as things began blocking up again, the doctor decided to reinsert the tube and is now scheduling surgery for tomorrow A.M. at this hospital. I am currently not in pain and feeling about as well as a guy can feel (that is - with a tube up his nose).

I am thirsty. I have not had any food or drink since Wednesday morning. Except a cup of juice and jello on Sunday that ended up in the throw-up pan. It may be true that "man does not live by bread alone" (Mt4). But I do like to eat once in a while. Looks like it'll be another half-week before I get to eat. I'm enjoying thinking about what wonderful meal I'll sink my teeth into. I'll do so with thanksgiving.

My surgeon here and I discussed my going to Houston to have Dr. Rodriguez-Bigas at MDACC perform the surgery as I've grown to trust him and he knows my innards well. But he's out of town this week. So I'm doing it here in Dallas as Presby. The surgery sounds straight-forward. But as Dr. Rod-Big always says, there is no such thing as a simple GI surgery.

One remarkable thing I've noticed - this all seems rather unstressful to me due to the fact that it has nothing to do with cancer.

One request - if there is anyone local for whom it would be convenient to be available to do some pre-surgery errands for me today, please let me know. My parents and family (Peck are in town) have been running back and forth to the hospital all week and we could use someone with some time and energy to assist. The Pecks are returning to St. Louis today and mom&dad live 45 minutes from the hospital.

If you are inclined to pray, please do so for no complications (I am in a weakened state after this week) and that this will not be a recurring issue, as can be the case. Also for Christine, who is continuing to have debilitating head and neck pain. She was able to be with me yesterday, which was great for both of us.

I am not taking calls because I cannot really talk with this tube in my throat. Best way to contact me is email to hewlett at alum dot mit dot edu

As I consider how weighty (or unweighty) my troubles are, I like to recall these words of Yale church historian Jaroslav Pelikan. He uttered them shortly before dying in 2006:

"If Christ is risen, nothing else matters. And if Christ is not risen -- nothing else matters."

Easter blessings to you.

It has been a month since I've written. But instead of updating you with something meaningful just now, there is a timely matter at hand that is not so serious. I know that most of you are excited about March - you know, with it being Colon Cancer Awareness Month. I'm certainly doing my part by being quite well aware of it. But while you've been celebrating CCAM, you may not be as aware that March is also the time for NCAA hoop madness.

Last year a bunch of folks joined the 1st Annual Greg's Place Bracket Challenge. Some were basketball experts. Others had no clue. In fact, Hannah knows nothing about it, but last year was one of the leaders after the first day of the tournament, ahead of too many male ESPN addicts. In the end, my boss Gary won the deal. (no, I didn't rig it for favors) Can he repeat this year? You can help me prevent it if you fill out your bracket - whether you know what you're doing or not.

It is easy to fill out a bracket. Just click on who you think will win each game. Hints (1) The lower the seed, the better the team. (2) You have to fill out the whole chart, not just the first round. (3) The person who picks the winning team of the final game is very likely to also win the bracket challenge (like last year), and the tiebreaker will likely go to the one who picks most of the final four.

If you want to play, just click here. You may need to know the following:
Group ID#: 131175
Password: nomorecancer

Don't delay, the window to fill out your bracket ends in 2 days and 12 hours.

Your Tournament Pick'em Commissioner,
Greg

I got the results from the PET scan (which looked for signs of cancer around whole body) and pathology (which examined biopsy samples from hilar lymph nodes).

PET: No signs of cancer outside the two lymph nodes. In other words, the pulmonary nodule did not show up as cancerous. (doesn't mean there is no cancer there, only that if it is there, it is not big enough to register).

Pathology: Samples from only one lymph node were examined so far. There was a "few groups of distorted malignant cells in a background of extensive necrosis and microcalcifications." [necrosis = daed cells] In other words, mostly dead with a few stubborn cells remaining.

Result: Dr. Eng and Hofstetter consulted and, based on these results, cancelled the surgery. It is not even an option for me. Don't get me wrong - I'm not disappointed. The basis for surgery was weak to begin with. It was to get the lymph node (which is mostly dead, we now know) and the pulmonary nodule (which is not showing signs of being cancer - maybe scar tissue). They decided the right course is to continue chemo because it is currently so effective. Maybe it can keep killing the bad stuff. Surgery does not make sense right now.

I'll be in contact with Dr. Eng next week to find out what the plan is now.

Clarification
Based on some emails and calls I've received from yesterday's entry, I believe I should clarify. Cancer is not gone until it is all gone - every little cell. The results yesterday did not suggest a 90% chance that cancer was gone from my body - just that it was gone from the lymph nodes. Stage IV cancer is a long grueling war. Currently, I've got some good momentum in the war. And that is great reason to celebrate. But no one has yet suggested cure with these recent events - even yesterday before there were a few cells discovered. I have found it useful to not overstate how good or how bad things are. As my good friend John told me about his experience with his wife's cancer: don't get too high in the highs or too low in the lows. Or as St Paul put it, let your yes be yes and your no, no.

I am emerging from sedation blur after a broncosopy today. They went into the trachea with a stiff pipe, through which they can do ultrasound and take needle biopsies into the neighboring lymph nodes. They extracted samples from the two "bad guys" threatening me. The result left everyone perplexed. Let me back up a bit and explain, as I have not written in a while.

I came to Houston last week for the big week of scans. I have been pressing for surgical removal of these two lymph nodes. The surgeon has been relucatant and I've been dutifully doing six months of chemo, hoping that a window of opportunity would open up.

The good news last week was that a window has opened to do the right nodule. This would be a right-side thorocotomy (basically, lung surgery). He would also remove the suspicious lung nodule that has appeared recently in the right lung

The bad news was that he told me that it would be all but impossible to remove the left lymph node. It is too deeply located and the risk of major problems (severing the pulmonary artery) is just too high. This was really the first time I have heard that a tumor was inherently inoperable due to its location, not just size. In the past I have heard "inoperable", but when there was shrinkage, I heard "operable" again. This isn't about shrinking, but where it is. Thus, this news about the left side means that the cancer is considered non-curable, and only manageable. Pretty devestating news.

Then came the very difficult decision - whether to do the right side surgery at all. The benefit is quite small because if you go in to deal with the right problem with no plan to go in and take out the left, then you are risking trauma and complications knowing there is no data showing any increase in life expectancy.

In other words, I asked, him, "If there are two Greg's in front of you - just like me - and you do surgery on one followed by chemo and radiation, and you only do chemo and radiation on the other, and you were a betting man, which would you put your money on to live longer?"

Greg #1 and #2

"No way", he replied, "there is no way to tell." So if it is a toss up, why take the road that includes traumatic lung surgery (it is not fun). That is the big question.

One oncologist whom I trust advised against it. Others were open to it, but could not recommend it. No one encouraged it.

We went ahead and scheduled the surgery because I wanted to take out what we could while we have the chance. My logic is somewhere on the spectrum from brave to stupid to crazy. It is scheduled for for Monday February 18. So Tuesday night, I came down to Houston again for the biopsy, among other tests, etc. There is a "99.9% chance" we know what we are dealing with here. But a surgeon typically wants 100% certainty before opening you up. Thus, the biopsy. Incidentally, if I had chosen definitely against the surgery, they would go back to chemo and not waste time or effort on the biopsy.

BUT... back to the drawing board
So as Christine prepared to come down (she has been in a lot of pain recently), I came down early for the biopsy today. She was going to come down tonight and family members and friends were preparing to come down this weekend for the surgery Monday.

But when I emerged from the biopsy incredibly groggy (the procedure requires full general anesthesia), the doctor came to me with a smile and a perplexed look on his face. "We took three needle shots in each lymph node, which is the practice. And an initial look in the microscope revealed only a bunch of dead cells. So we went back and took a total of ten shots in each lymph node, twenty in all. All we can find is dead cells. No cancer cells. Apparently, the chemo has obliterated these tumors." I figured I was dreaming because I was in this sedated, dream state. But I heard right. They sent all the samples to pathology and they'll take an official, closer, look. I will hear the results come Friday or maybe as late as Monday. But there is a 90% chance, he says, that there are indeed no cancer cells in these samples. And that these two tumors are dead [or perhaps, "mostly dead" - Princess and the Bride]

So for now, it looks like there is not much motivation to do surgery if it is just going to go in and get a bunch of dead cells. The body will clean them up in a period of several weeks. Could there still be some bad cells in there? Yes, that would remain a possibility, and it only takes a handful. But I suspect the surgeon is going to rescind the offer tomorrow to do surgery - for good reasons.

I'll let you know what the results are. And what the plan is - everything is now up in ther air.

In the meantime I'll just soak in some good news and celebrate. So after two nights in a row of fasting for tests, I walked to Goode Company Seafood down the street for some oysters on the half-shell to celebrate.

Life is a roller coaster, isn't it? And we humans are so easily whipped around. I am once again reminded of a passage in St. Paul's letter to the Ephesians. In Christianity, there is a concept that God's blessing extends beyond what can be immediately seen. Paul writes, " Now to him who is able to do immeasurably more than all we ask or imagine, according to his power that is at work within us, to him be glory in the church and in Christ Jesus throughout all generations, for ever and ever! Amen."

I have been driving everyone crazy sending emails and calling, looking for advice in making the decision for surgery. I've written former doctors and family members. Several of you have written back very thoughtful, helpful things to think about in this decision, which seemed to be one of the biggest of my life. I have thought about every possibility, every detail, every if, and, and but. I rarely lose any sleep, but a couple nights this week I stayed up thinking about all the possibilities.

But I didn't consider everything! The thought that this biopsy would just discover a bunch of dead cells never even crossed my mind. It was indeed more than all I asked or imagined.

I'll probably have difficulty sleeping tonight again tonight - thanking God and wondering in amazement at what possibly could be happening here. I haven't a clue.

Again on Monday they deemed me too sick to take chemo. But today, we're on. It's been 28 days since the cancer last saw the chemo. It's in for a surprise this afternoon. Shock and awe, baby.

This is the last round to include Avastin. Then, in 14 days, I'll take another round with no Avastin. Avastin affects blood vessels and thus cannot be used near surgery. The earliest I can have surgery is 8 weeks from today.

I will go to MD Anderson after the next round to see if I can do the surgery. Then, if they decide to operate, we'll have to wait until the first week of March at the earliest for the actual procedure.

Over Christmas, I wrote this dedication to all those who are addicted to mass quanitity, particularly my sister-in-law Anne, who is a costcoholic.