Author: MichaelHeil

Monday, November 7

We all know how it goes. You surprise yourself with an idea, formulate a plan and it unfolds flawlessly – a most satisfying feeling! Well, that is what happened to me today.

For the past twenty-five years, my brother Rich, has, not so subtlety, tried to convince me to return to the good-ole-days of playing golf together. Yesterday, when asked once again, amazingly, I heard the word “yes” flow out of my mouth! Perhaps this was a particularly weak moment of mine or the stars were correctly aligned. Rich was delighted, as we now had our foursome: The brothers – Mike, Rich, Steve and Jeff. The weather was more than stellar, the spirits high and the camaraderie matchless. The only thing missing was a little friendly competition. My damn good idea on this subject was to pair myself and Jeff, play our best shot each time on every hole and see if we could match Rich’s score. Jeff and I were psyched about this arrangement, as it would clearly eliminate the frustration of that inevitable, depressing ‘duff shot’ and an embarrassing ending score. Well, the idea was perfect, as we played almost even through the first few holes. By the 7^th Rich was up 1. Our par on the 8^th, gave us a one-stroke lead. With incredible acumen (and perhaps a little luck) Rich then sank a 40-foot putt on 9. This sent the crowd crazy! Jeff and I scrambled to log our par on 9, to walk off with a dead even tie!

The standard Heil rehashing of the round’s highlights and the mutual admiration of our golfing prowess followed well into the afternoon. No surprise that Rich wants a rematch tomorrow morning before the poker sessions. All said and done, I must admit, I had more fun than I had ever thought I would – but then again – it is with the brothers!

Rich had the other damn good idea: Organizing this week long brother get-together under the gorgeous open skies of Pendleton, OR. By day, we walk miles of harvested, stubby wheat fields and play golf. By evening, we play poker, chess and pinochle. We dine, sip wine and watch the football games. Best of all we reminisce of wonderful childhood times gone by and speak of our anticipations of times to come. We break down barriers, share hopes and dreams and reinforce how fortunate we all are.

It feels especially good to me to share in person the details of my journey with loved ones. I don’t dwell on medical details, as they often elude my understanding and seem so speculative. Instead, I try answering questions as best I can, while gaining a fresh perspective on the non-medical, emotional aspects of my journey.

 

As always I look forward to tomorrow with great anticipation for yet another superb day on this unfolding journey. More to come…………….

Friday, November 4

Despite the warmest welcome and hospitality of Linda, Chris, Susan and Manfred and the timely heartfelt wishes from our dearest friends, Monday and Tuesday past were most difficult days for Laurie and me!

We departed Eugene early morning for OHSU to address the nagging, worrisome PSA rise. Our two days were packed with lengthy imaging sessions, an early morning consultation with Dr. Beer, a follow-up set of blood tests, the filling of a new prescription, a debriefing lunch and a tense wait for blood test results. By Tuesday evening we were exhausted!

The results were mixed, which, in my opinion, keeps me in the ‘interesting medical case’ category. The imaging indicated a further decrease in the visible liver lesions (-67%). Wow!  However, the PSA continues to rise (+37% in only 5 days). Our healing team is concerned but does not seem to have an explanation. Multiple biological hypotheses have been proposed; most of which elude my full understanding.

We left OHSU with a slightly revised treatment plan – continue with current hormone injections (Eligard, every 3 months), add a secondary hormone oral drug (Bicalutamide, daily), get a second opinion at UCSF in two weeks and see Dr. Beer in a month. Conspicuously missing was a recommendation for a second round of chemotherapy.

Laurie and I walked away from the emotional ups and downs exhausted! We also walked away reminded of the seriousness of my initial diagnosis and how western medical science does not fully understand nor have a cure my disease. Finally, we walked away, once again, extremely grateful for the super strong support coming from all our friends.

Physically, I am feeling as good as I’ve ever felt over the past 6 months. Thus, I must say: “………….What more can I ask for?”

Double Rainbow Blessings sent from Laurie in Ashland!
!THANK YOU!

Friday, October 28

 Yesterday morning, we received blood test results confirming my rising PSA levels (See Table Below).  We know this is not good, but are unsure how bad it really is. The truth is that we had expected a PSA rise but were hoping not to see it for 24 months. Alas – we got 2!

We’ve been in close contact with our team in Portland. A Bone and CT Scan (checking for changes in tumor size and location, I assume) has been scheduled for Monday afternoon. These data will aid Dr. Beer with his recommendation for the next treatment regime. Laurie, Susan (our advocate) and I will see him Tuesday morning.

I continue to be impressed by the empathy, courtesy and efficiency of the medical folks at OHSU Knight Cancer Center. I am ever so grateful for their work and feel blessed to have them at my side.

Laurie and I continue to hope for the best and prepare for the worst. Do stay tuned for the next exciting post as I reenter the dubious category of ‘interesting medical case’.  In the meantime, off I go on a 20-mile bike ride to enjoy the rare Eugene autumn sunshine!

 

Date	August 2	October 4	October 10	October 26
PSA Total ng/mL	1.77	2.57	2.70	4.65

 

 

Wednesday, October 26

I’m sure you’ve all seen it before; the airplane wing stretching out into the infinite horizon from your semi-comfortable seat. Well, that is our story today, as our east coast, autumn, family vacation winds to an end. We are on our way home! The last few days have been as fun and fulfilling as the initial weeks, but the playfulness, childhood innocence and hearty laughter shared with Zach and Jacob are not what I want to focus on now.

I view the out stretched wing into the horizon as a metaphor. The wing represents the reaching out by Laurie and me for help on our new journey – the vast horizon simply representing the unknown.

Upon returning home, Laurie and I will face the reality of my changing medical condition. We will address the ominous PSA rise (which may or may not reflect the marginal success of my phase one treatment). Presently, I am scheduled for a PSA retest this afternoon and a hormone injection on Monday coming. Most importantly, however, I have an appointment with Dr. Beer on Tuesday to consult and construct a new treatment plan. I guess, its time to get back to work and challenge those pesky tumor cells one more time.

I commit to continue to share the ups and downs of this transformative and interesting journey no matter where it leads. In the meantime, thank you all for the caring support you’ve shown us. Stay tuned and may the games begin once again!

Ready, Set, Go – Jacob, Zach & Uncle Mikie

Saturday, October 22

 In 1974, I exited New Jersey to start university in Delaware. Shortly after a work stint in Washington DC, I departed the east coast for good in late summer, 1979. I settled in the PNW, found my peeps and only rarely looked back.

This past week, while visiting Chris, Jeff and Jenna, I have been buoyantly jolted back to my childhood and high school years. At every turn, my senses vividly reminded me of years gone by. It has been so wonderful and nostalgic. I have happily experienced:

– Walking the leaf covered paths of the brightly colored deciduous forests

– Hearing familiar caws of NJ crows

– Seeing that noble Blue Jay perched on his fence post. Alas, no sightings of the native scarlet cardinal

– Driving the twisting, rolling, country highways, byways and back roads of the Jersey countryside.

 

– Entering a NJ high school gym during spirit week, similar to the one where I spent countless hours in my youth at basketball practice

-Straining to parse out the heavily accented NJ lexicon.

-Seeing the ubiquitous cape cod house with aluminum siding and the American flag

 

-Fully experiencing the iconic sights, sounds and smells of NYC streets.

– Smelling and tasting the authentic, ethnic east coast foods, especially pizza margherita

 

– Hearing the ever so familiar place names of tunnels, bridges, and towns – like the NJTPK, Pulaski Skyway, Holland Tunnel, Outer Bridge Crossing, Weehawken, Hoboken, Bayonne, the Raritan river etc.

– Playing Poker ‘Jersey’ style – double locked doors, worn furnishings, sticky cards, large, loud personalities, tough talk and great stories.

I hereby publicly acknowledge, with a gigantic THANK YOU, all those family folks who have contributed to our marvelous experience here in the east over the past three weeks. My high expectations for the trip have most certainly been thoroughly surpassed!

Good on ya all mates!

Pizza Lunch at Lombardi’s in Little Italy -Chris and Jeff!

Tuesday, October 18

Traveling ‘old school’ today! We just boarded the Greyhound Bus (rebranded as Peter Pan) en route to visit Jeff, Christine and Jenna.  Alas – Julia, who we will surely miss, but, nonetheless, we are psyched to the max!

We continue to delight in every aspect of this wonderful family visit! The time together, the conversations, the connections and the hiking just get better and better! We feel so fortunate to have all these marvelous, compassionate, giving people as integral parts of our lives. It’s been just plain FABULOUS!

Urban Hike with Danielle and Rents

Front Yard View of Sally, Jon and Family in Annapolis

No new news on the medical front. We continue to trust our OHSU team and hope that this joyful time with family is our best medicine. Upon our return to Oregon on 10/26 we’ll get a new PSA data point and be ready to start a new more aggressive treatment! In the meantime, La Bella Vita!

Friday, October 14

The family visit continues to be Awesome! Laurie, I and the parents (Linda and John) have immensely enjoyed spending time with the millennials (Danielle, her partner Adam, Ryan and his partner, Charlotte). Taking advantage of gorgeous weather, we’ve walked the dog in the park and hiked up a storm. Together we’ve prepared and feasted on scrumptious dinners. We’ve retold endless stories prompted by sorting through boxes of family photographs, some dating back to the 1930’s. We even climbed last night!

This morning early, 7am, I awoke with great anticipation. It was to be a day in middle school – only the second time since my retirement two years ago. Michael, a student of mine eleven years ago, invited me to observe and participate in his 7^th grade language arts class in the DC area. The prospect of connecting with the kiddies and seeing him perform excited me to no end. I was not disappointed, as it was a BLAST – so very much fun! I was, however, vividly reminded of how much energy I used to expend when teaching as I arrived home exhausted. Surley my decision to retire was indeed the correct one. Thank You Michael, you truly made my day!

I enthusiastically look forward to tomorrow’s urban excursion with niece Danielle. We will hang out, tour Baltimore on foot, talk, laugh and then dine together. Yes!

Laurie and Zeppelin

Once again in the spirit of “Keeping it Real”, I report the results of the PSA retest (2.7) which confirms the uptick. We are concerned and disappointed! We consulted with OHSU and considered an emergency return for prompt treatment, but trust that Dr. Beer knows best.  We will follow his recommendation to finish and enjoy are family vacation.  Perhaps, joyful time with the family is our best medicine at this time!

Tuesday, October 11

Our autumn east coast holiday is off to a phenomenal start. The initial visit with my brother Tom and family (Emily, Zach and Jacob) could be summed up by: “Play, Play, Play and Play some more!”

We filled our days as spectators to soccer and baseball games, throwing the football in the street, hitting the wiffle ball, walking in the park, playing card games, working on puzzles and so much more. I am amazed how well my energy level held up – but not so amazed at how excellent a family visit is for the soul!

Yesterday the boys and Emily walked Laurie and I to the Metro Station and we worked our way up to my sister, Linda’s place in Ellicott City, MD.

The mutual joy we felt upon first seeing each other was extremely exciting and heartwarming. After a short athletic walk, the evening just got better as we prepared dinner, anticipating the arrival of Ryan and Danielle. It was wonderful to see them and share stories. They left, yet Linda, John, Laurie and I continued talking and laughing late into the evening despite relegating topic after topic to another evening. AHH – the soul feels grand!

I so look forward to the continuation of our holiday………………

In the spirit of “Keeping it Real” I do admit to a nagging angst about the rise in PSA (most likely indicating a tumor cell resurgence); so much so that we snuck in a retest at a local lab. Our OHSU team and we expect those results early tomorrow and await a recommendation.

Thursday, October 6

I sit next to Laurie in this steel tube cruising at 650 mph, 33,000 ft. above ground. We are en route to visit the east coast family. I cannot tell you how excited I am! Over the next three weeks, I will play with young kids, share the lives of young adult millennials and reminisce with my (not so) young brothers, sisters and in-laws. Oh yea!
That said, now the hiccup…………..Ever since that fateful day of April 14, when it was confirmed that I have a serious form of metastatic prostate cancer, we have received nothing but good news! Well, the streak is now broken.

I am halfway through the 3-month post chemotherapy-waiting phase of my cancer treatment and it is blood test time. Yesterday, I received results, which show a 45% increase in PSA level. This is the first increase since treatment commenced. Laurie and I did not expect this! Perhaps alarmed is too strong a word; disappointed or concerned may be more accurate.

Dr. Beer, our oncologist, is equally concerned and has immediately laid out a comprehensive plan, starting with a PSA retest in 3 weeks. We feel extremely fortunate for his empathy, guidance and expertise and continue to hope for the best and prepare for the worst.

Our rollercoaster saga continues……………….

Monday, October 3

I returned late last night from a fun get-away to San Francisco with my old friend, Goelzie. Although the trip was a little different than the old days of traipsing around on bike or foot, it was equally enjoyable and insightful.

The time with the millennium-aged crew – Nick, Cassidy, Diana & their friends – was marvelous. Their youthful exuberance, optimism, interesting and thoughtful perspectives and downright intelligence was captivating and refreshing. I cannot fully explain how good it felt to be around these wonderful people. It’s more than feeling that our world will be in good hands as these folks mature and work themselves into positions of power and influence. When around them, I feel a spirit, a joy, and an energy that lifts me up – significantly more than simply living vicariously through them.

Now the other side: How fortunate I am to have two stellar friendships, which have not only withstood the test of time but have improved and deepened. Goelzie and I have been paling around for 40 years. For over 35 years, Lana and I, dare I say, have been soul mates. What a joy to spend time with both of them. I cannot say enough about the power of shared experiences in these relationships. The depth, the respect and the reciprocal support are so powerful! Growing old together with these soulful connections is like aging as a fine wine. We walk together (instead of run) continuing to appreciate and enjoy the world around us.

I come home tired…………..but extremely grateful. What a fabulous adventure I had sharing time with the young and the (not so) young. I enjoyed it immensely and continue to be thankful of what life continues to offer up to me.

Tuesday, September 27

As spring turned into summer, I began to realize that the doctors’ insinuations about not being able to seriously rock climb nor hike strenuously for the season were becoming true. Sad but sure enough.

A few days ago, I posted about the exhilarating experience of climbing Mt Yoran in the Diamond Peak Wilderness Area. Admittedly, I surprised myself by being able to do so. Laurie saw my excitement and when I asked her if she would consider trying to summit a major PNW peak with me she readily accepted. We choose Mt. Mcloughlin, the 9495 ft. volcano, which dominates the horizon of the southern Oregon Cascade Mountains.

We arrived home last night after our successful hike. The reality is that I ever so slowly trudged, as Laurie bounded up. She patiently waited at every turn. Nonetheless, I am now a happy, somewhat content, tired guy, as I never thought I would be able to climb a major peak this summer!

Glorious!

Sunday, September 25

Welcome to this glorious sunny autumn afternoon in our PNW. I happily report that physically I continue to feel better and better. The metaphor seems to be climbing up a steep beach sand dune – two steps up for every one step of backsliding. My guess is that the chemo drug is slowly wearing off allowing me to exercise regularly thereby regaining some level of conditioning.  Feels grand!

I also feel a little better emotionally. I don’t seem quite as frazzled nor quite as prone to breaking down. I seem to somewhat better manage anxiety and respond to unsettling situations. Admittedly, I do work extremely hard at this and appreciate the results. So, although still not 100%, I guess I’ll accept the success for now!

As a final note, I’d like to acknowledge some of the more private feedback I’ve received from friends. Some of these friends have been saddled with anxiety issues or panic attacks throughout their entire lives, while others are merely introverts who shy away from the stress producing social interactions. The message I receive is empathetic, but quite simple: Welcome to my world. Wow, that sure makes me appreciate all those years I’ve experienced almost anxiety free.

Thursday, September 22

Before introducing you to Conner, I want to report that I am feeling considerably better. I am not exactly sure why, but I do like the feeling! Perhaps my overnight stay in the Diamond Peak Wilderness and subsequent climb of Mt. Yoran was instrumental – natural beauty, great exercise and tranquility. Otherwise I have been quite passive and have tried to go with the flow, while not packing too much in. I will try to continue this, do a better job recalibrating and setting more realistic physical goals.

Approximately ten years ago I met Connor. He was a smart, insightful, witty, quirky 7^th grader. Over the next two years, I grew to like him a great deal. After his 8^th grade promotion ceremony, I was milling around and he excitedly came up to me, reintroduced his parents and with a stout handshake, thanked me for being his math teacher over the last two years. He looked me in the eye and with all sincerity told me: “Mr. Heil, continue to keep it Real!” I was puzzled, but after 25 years with teenagers, I had become accustomed to not understanding every interaction. I simply moved on.

Unknowingly, perhaps my last post was an acknowledgement of Connor’s advice of many years ago. It feels good to be honest and true to my feelings, thus: Keeping it Real!

 

Sunday,  September 18

I find myself in new territory – not off-route on a new multi pitch climb, nor turned around in search for that return ski track as the white-out intensifies, nor unsuccessfully communicating with the peoples of the Guatemalan highlands who speak their native Quiche. My new territory is an uncharted, deep personal emotional terrain – where I am struggling intensely!

I really thought I had gotten my head around my diagnosis and was settling in for the battle. Whether that battle requited a fighting determination or a careful yielding I thought I was equal to the task. Now I am realizing that I might not be ready. My emotional compass seems broken and I feel rudderless. It continually amazes me how often I break down (often to tears) and how unstable I feel – novel, sad and disturbing.

I feel like I am straddling a crevasse on the side of a mountain. The ground shifts slightly and I sway off balance – slipping, teetering, floundering, wobbling. I don’t know whether to hop right or left, proceed forward or back………………which way do I go – or do I just stay?  Heck, most times I don’t feel control enough to even decide!

My hope is that this thing can be turned around soon – regardless of whether I take an active or passive role in doing so. I wish to embrace this new terrain, make it my new friend. After all, throughout my life, I’ve always gotten a kick out of navigating the unknown territories. I’ve always liked the thrill of not knowing exactly what is around the next bend. So then, I ask,……..………

Why should this be any different?

A view from the top of my hike today!

Thursday , September 15

Laurie and I returned last night from OHSU and our quest for a silver bullet.

We were very happy to hear the good news of August 30. However, still weighing heavy on our minds were the realities that relatively large lesions still remain in my liver and these tumor cells are likely to grow and mutate, thus, becoming resistant to hormone therapy.

After voicing this concern to Dr. Beer, he consulted with Dr. Skye Mayo, a surgical oncologist who specializes in liver tumors. I was fortunate to get an appointment within the week. Laurie and I were hoping that Dr. Mayo might provide us with the silver bullet – a hepatectomy that would whisk the remaining tumor cells away for good! We knew this was a long shot, but what the heck; optimism has never been my short suit.

I somewhat disappointingly report that Dr. Mayo suggests that I am NOT a good candidate for liver surgery. He believes that there are still too many metatheses sites and even with major liver surgery he will not be able to remove all tumor cells. Additionally, after major liver surgery my body would not be able to tolerate another round of chemotherapy for at least 3 months, which might be a disaster if we find the cancer returns with vengeance in the near future.

All our discussion at this appointment served to reinforce that my original diagnosis was indeed quite serious!

Despite no silver bullet (yet), I continue to be thankful that my situation is not worse. I don’t have metastatic brain or pancreatic cancer nor some other painfully, horrible disease. I am eternally grateful for the continued support of my family and friends, as I am grateful for the ongoing efforts of researchers and doctors – as perhaps that is where my ultimate cure lies. In the meantime, tomorrow I will take advantage of our gorgeous PNW weather and climb outdoors for the first time in over 3 months.

I am psyched!!!!!

Our drive back from OHSU (again).  Moonrise and Sunset!  Are we too serious?