Laird's Blog

What I Learned about My Recovery Going to Salt Lake City

This past week I journeyed to Salt Lake City. The cornerstone of this junket was conducting a four-hour workshop on how to manage difficult conversations about aging in community. It was a prime example of the kind of thing I used to do before getting my cancer diagnosis in late January and undergoing chemotherapy.

Since then I've come a long way in adjusting to my new life and working with my oncologists to figure out the best protocol for winning my battle with multiple myeloma. So far, knock on wood, I've been bouncing back well. I have good doctors, a strong will, an incredibly supportive partner, and the benefit of many others with my diagnosis who have already successfully walked the path I'm on. Thus, though I'm seriously ill, I have chances.

An integral part of the approach that Susan and I have developed is that I keep reaching for "normal." No sooner do I take one step then I reach for the next. Let me give you an example.

When I got out of the hospital Feb 19, I was either in a wheelchair or hobbling around with the aid of a walker. While in a rehab center Feb 26-March 19 one of my main goals was increasing my mobility, which translated into exercising with the walker and working on flexibility. When I graduated from there and went home, I stopped using the walker. A month later, circa April 15, I stopped using the wheelchair. While I haven't been walking fast, and my stamina still needs a lot of improvement, I get around pretty good.

To be sure, I was happy to take advantage of wheelchairs to negotiate all three airports I was in last Wed en route to Salt Lake City, thus avoiding the potential that my stamina would be exhausted just changing planes, but I've come a long way since Feb 19.

At home the bedroom and bathroom are on the the second floor, but I get up every morning and walk downstairs for all meals, and my periodic bouts at my laptop. In the last month I've been walking up and down stairs by working equally with both knees—essentially rehabbing the right one that I have been favoring since hyper-extending it in a bowling accident in 2012. The next step is to try to go for regular walks around the block. Speed is not the goal; just getting around safely (not falling) and working my legs, gradually extending my stamina.

The kitchen is another frontier for me. Instead of relying on Susan to do all the meal prep and cleanup, I am slowly working my way more into the rhythm and rotation of the day. It's important for my partnership with Susan that I keep reaching for the middle ground and am mindful of the gap between where I am and where we want me to be.

This approach makes it possible to notice and celebrate small increments, which helps with overall morale. 

I told you all that to help frame our trip to Salt Lake City, as it was another step in my recovery. 

While the arrival of cancer in my life has helped me see that it's time for an adjustment in how I do my life (less pressing on the gas and more looking out the window and appreciating all the amazing connections in my life), I fully intend to return to some level of engagement in the world of cooperative group dynamics. So this was a stepping stone in that recovery. Next month I have a green light to extend myself a bit further: conducting a three-day facilitation training with Ma'ikwe Ludwig in Portland OR.

So what exactly did I learn last week about how far I've come and what's ahead?

o  I bounced back well overnight (by going to bed early) after running out of gas before the end of the day. On the first day out that was due to the rigors of plane travel; on the second day by visiting with friends and family in the morning, followed by full-on teaching in the afternoon.

o  I slept OK on the train in a roomette. Our journey from Salt Lake City to Chicago was 36 hours long, including two nights. The key, I think, was being able to lie down, when I let all my vertebrae extend and relax. Less clear is how I'll experience coach travel on the train, where I'll be sleeping in a 45-degree reclined position.

o  My back did all right on an overnight bus ride, which is comparable to an all-night train ride in coach, though more cramped. While I didn't sleep that well on the bus, neither was I in much pain. Hooray. That's a big deal.

o  It was smart to get wheelchair support to negotiate airports (much less walking—which I can manage in small chunks, but which draws down on my energy reserves).

o  I benefited greatly from Susan's help with managing baggage. There were a number of times where I only carried one piece of light luggage, while she handled our suitcase, her knapsack, purse, and my tote bag. I have to think carefully through what I can realistically manage on my own when going to Portland. For example, I ordinarily travel with my own food, but that's heavy. For this next trip I'll eat in the dining car. It's harder on my wallet, but much better for my back.

o  There were a number of times when I felt nauseous. Though I never threw up, I was close at times and I'm not sure why. Access to Zofran (an anti-nausea drug) helped keep me from loosing my cookies. But why was I so queasy? It's been a relatively rare occurrence since my initial hospitalization in late January, but if it's associated with travel that's not good.

o  Meals worked better when I kept my portions small and ate more frequently. It's not pleasant feeling stuffed. (From a nadir of 150 lb I've now eased back up to 160 lbs the past three months and my doctor is pleased—I'll need that extra weight to sustain me through the stem-cell transplant.)

o  Reaching out and lifting a light object with one hand (say my laptop) no longer tweaks the muscles in my rib cage. While this is a modest gain, it makes everyday life much easier.

o  I'm still not working full days. I take time off to rest between sessions at my laptop. This routine is working well, yet it's dangerous to work full bore, where I may no have enough recovery time. The metaphor here is that I can reach the same peak output I could before the cancer, but my battery won't (yet) hold the same charge. That means I need to make adjustments in how I handle the pace at facilitation training weekends. I have to protect breaks to recharge.
• • •All and all, my trip to Salt Lake was a success. I was pleased to see so many friends and acquaintances at the cohousing event, and to see that I had come far enough to be able to answer the bell for high end teaching, at least for chunks of time (and field discreet inquires from more than a few potential clients about my availability for consulting after the summer). It also was invaluable to me that Susan was able to witness my work first hand, to see how much I love it and how much the audience appreciates what I can do. My telling her about it is not the same thing.

It was wonderful, having five days in a row with Susan where we didn't need to juggle her work schedule, foreshadowing a lot more travel that we would like to do together. 

One of the highlights was an impromptu dinner at The Parthenon restaurant on Halsted in Chicago between our train from Salt Lake and our bus to St Paul. The lamb with artichokes was divine (a lamb shank slowly stewed in lemon dill sauce, garnished with artichoke bottoms). Yum! Maybe next time I can also enjoy a glass of retsina with the olives and tzatziki sauce. Opa!

Training Back from Training

Today Susan and I are rumbling east on train #6, enjoying springtime in the Rockies. The alpine meadows are unusually green this May, either through above-average snow pack, a wet spring, or both. In any event, I've never seen the high-altitude desert so lush. The water levels are high, wildflowers are abundant, and green is dominating over brown on the color palette.

Though Amtrak and I are old friends, Susan had not been on an intercity train since 1967. I promised her a day to ourselves accompanied by drop-dead gorgeous scenery, and Mother Nature has come through in spades.

The day didn't start so auspiciously. We were in Salt Lake City yesterday, where I delivered a pre-conference workshop on Community Conversations about Aging: What You Need to Talk about and How at a regional cohousing event that continues for the next two days. It was my first time on stage since receiving my cancer diagnosis in January, and it was gratifying to be able to husband my energy and rise to the occasion. It was also the first time Susan had seen me work and it meant a lot to me that she was able to experience first hand what I derive so much satisfaction out of doing.

In any event, I was pretty tired after the four-hour workshop. Although I've regained a considerable amount of functionality after undergoing the initial rounds of chemotherapy (and being completely discombobulated), my stamina is still in question. I need to protect time to recharge my battery between bursts (read sleep), and to recover from travel before stepping on stage. 

Fortunately, sleep accomplishes restorative wonders, and I was able to bounce back both Thursday (after traveling half a day Wed to get from Minneapolis to Salt Lake City) and Friday (after conducting the workshop nonstop for four hours). This is important data as I ease my way forward toward greater strength. On the one hand, I want to stretch my limit as a stepping stone en route to increased capacity; on the other, it's important that no single step be so far that I experience a setback. So far, I've done well by listening closely to my body. If the pain becomes noticeable, I stop and take a break. By letting that be my mantra, I've both been able to increase the range of what I do and not suffer a relapse. Whew.

In any event, Susan and I were scheduled to depart Salt Lake City at 3:30 am this morning, so that we could both: a) enjoy the fabulous canyon country of the Colorado River; and b) get back to Duluth in time for her to be well rested and back at work Monday morning. That meant setting our alarm for 2:10 am, so that there was time for a shower before taking a taxi to the choo choo station. We knew things were going to be tricky when we awoke around midnight (it's hard to sleep soundly when you have to wake up early) and discovered that the power was out in our room. Oops. 

We had been careful to make sure that the train was running on time before ordering the taxi (we might as well sleep in a bed for as long as we could), but when we got our 2:10 wake up call from the front desk and realized that the power was still out, we figured we'd skip showering in the dark. Rats! If we'd known we were not going to shower we could have slept another 15 minutes. Sigh.

The taxi was already there, waiting patiently for us when we made it out to the lobby, and we found out from our cabbie that there was widespread electrical outages across the city, due to a powerful electrical storm that had hit late the previous night—after we had gone to bed.

When we got to the station, the Amtrak agent told us the rain had produced flooding in northwest Utah and that our train had falling behind schedule by 90 minutes as it tiptoed through the high water. Uffda. That meant cooling our heels in the station for all of those 90 minutes. So much for advance planning to maximize our period of uninterrupted sleep.

From there our luck turned. The beds in our roomette had already been turned down by the car attendant and we just tumbled into them once we climbed aboard, happy to enjoy our night's sleep, part II. When we awoke three hours later, right outside of Helper, we had almost had a regular amount of sleep. And after breakfast (think coffee) we were almost normal.

In any event we've enjoyed the day thoroughly, rubber necking out the window at the fabulous geology, and not needing to go anywhere, excepting back and forth from our room to the dining car as we've steadily chugged east, to rendezvous with our car in St Paul Sunday morning.

Trouble in Paradise

FIC has been publishing Communities Directory since 1990, first as a book, and then (starting in 2004) as a searchable online database. It is the thing that the Fellowship is best known for.

While FIC tries hard to be even-handed and fair in how the information is displayed, readers occasionally give us critical feedback about the listings—we get about 2-4 complaints per year. The complaints sort into two kinds: a) someone is unhappy with FIC, perhaps because they feel they've not been treated fairly or respectfully; or b) someone is unhappy with a listed community. Most feedback falls into the latter category.

When this happens we investigate and try to resolve any concerns. It might be that a reader has found the listed information to be misleading. Or it might be that their experience with he community has been upsetting and has nothing to do with the listing. In either case, we step in and try to sort things out.

Sometimes it's simply a misunderstanding. Sometimes there's a disagreement and FIC can play a role as a third party to deescalate the tension and get things proceeding again on an even keel.

Sometimes though, it's too late by the time we arrive on the scene, and the best we can hope for is an amicable parting of the ways.

This past week we fielded a complaint of this last kind and it was a challenge to work through.

We try to approach these situations in a consistent way: our first effort is to reach out to all parties and ask to hear their story about what's happened. Once we have that, we reach across to the folks on the other side and ask what portions of the story, if any, they agree with. In this case, there was precious little common ground. Sadly, both sides claimed that the other had been threatening and belligerent, yet owned none of that behavior themselves (even to the point of having made death threats!). While I did not hear any reports of physical violence having taken place, it was hard to imagine a situation more polarized.

The precipitating issue was whether investors in the community had been promised a warranty title to their property, and the extent to which the lack of a title was making it difficult for people to sell their homes.

The disgruntled folks claimed that they were misled and that their life savings were tied up in property that they could not sell. The satisfied majority claimed that everyone was informed about the title issue up front, and that many property owners have been able to buy and sell their community property even so.

So, while there was agreement that individuals were not being given warranty titles, there was no agreement about when people were apprised of that, nor about the consequences that followed from it.

It is not FIC's role, in situations like this, to act as judge, or to determine who is in the right. Instead, we simply establish where there is common ground and where there isn't. Once we have that sorted, we try to get clear what outcome is desired and help all parties work toward a workable resolution.

In the instance last week it was hard to understand why both both parties were still living together. The hurt and mistrust ran so deep that it was almost impossible to picture a reconciliation.

On both sides of this issue, it took several communications before I got anything other than an attack on the other side, in an attempt to convince me that "those folks" were evil. When I wrote a straight forward summary (something like, "The stories don't match up well, and each side is accusing the other of threatening behavior, without owning that any of that is being done by them.") what I'd get back is more "evidence" of the other side's perfidy. Further, they were starting to suspect me of being a dupe of the other side because I wasn't immediately persuaded by their condemnation. Yuck.

While it may be temping in such circumstances to despair of ever getting out of the starting gate, I think what was mainly going on was that everyone was pretty upset and my summaries were insufficient to establish that I had fully heard them. ("If I really go it how upsetting this was, I wouldn't be so goddamn calm.")
• • •I tell this story because it illuminates one of the pitfalls encountered when publishing a Directory where we do not have the resources to investigate and vet each listing. Instead, we rely on communities to be up front and accurate in their self-descriptions, and then we rely on readers to let us know if something seems out of whack.

While this works quite well in general, it's sobering to see people ostensibly dedicated to cooperative principles and harmonious co-existence engaging in war mongering with one another. To be clear, I don't think intentional communities will eliminate conflict in the world—and neither is that the position of  FIC—yet we do think that living cooperatively can be a building block of world peace. It all hinges on how people (and the groups they create) respond to disagreement.

What is dismaying about the group I was working with last week is that everyone I communicated with (about half a dozen) seemed to be more concerned with being right than being in good relationship with one another. In fact, each went so far as to label those on the other side of the aisle as evil and irredeemable. While there is considerable room for people to have differing opinions about what constitutes the most hopeful approach to world peace, I'm pretty certain that the path being followed by this group will not lead there.

Picking Up the Pen Again

After a hiatus of 16 months this week I have (finally) resumed work on authoring books. While this is a large task and won't end soon, it doesn't advance unless I do the work. Happily, I now have the time and motivation to set aside two half days a week (Tuesday and Friday mornings) to establish some momentum on this. And who knows, if it goes well enough I might throw more time at it. This last Tuesday was my first day back in the saddle.

I notice (with chagrin) that I have allowed all manner of things to get between me and this task since Jan 3, 2015—the last time I'd worked on his prior to Tuesday:

—relocating (twice, no less: first to NC, then to MN)
—heavy workload (both as a process consultant and as FIC's main administrator)
—preference for things I can easily complete (I have a marked tendency to favor tasks I can complete in one or two sittings; as a result, longer term projects tend to languish)

Cancer has helped me digest the uncertainty of how much time I have left in this veil of tears, and given me the impetus to shake things up a bit, pushing to the side the less important to concentrate on those things that might do the most good in the world. In essence, my writing will be an attempt to draw together what I've learned over the last 66 years—especially over the last 42, my time immersed in community.
Although I've become a steady writer, almost all of that has come in short pieces: articles, reports, and blog posts. Now it's time to draw them together by theme, fill in the blanks, and develop a uniform voice.

As I envision it, the work will flow in stages.

Step 1: Review what I have
Ironically, in order to produce a quality book, the very first thing I need to do is a ton of reading. Both of my work (see below) and of my contemporaries on the same subjects, to see what is is already out there.

With respect to reviewing my own work, I can't imagine how this would proceed without a computer, where it's all stored in one place and relatively easily accessed.

This necessitates rereading: 
—all 982 of my published blog entries (from December 2007 forward) 
—all my reports to groups that hired me as a process consultant (from 1987 forward)
—all my published articles (mainly for Communities magazine, for which I've contributed six or seven annually since FIC became the publisher in 1994)
—handouts for my facilitation training program (there are about 100)
—handouts for the dozen or so standard workshops that I offer

It's a gob.

To be sure, there is considerable overlap among these sources, some writing is more about whimsy and bemusement than trenchant insight, some I no longer believe, and some is irrelevant. So I anticipate that there will be an enormous amount of winnowing.

Step 2: Sort my extant writing into themes
When I first conceived of writing a book, it didn't take me long to figure out that I was really talking about a number (or possibly a series) of books. So I sat down and thought through what all the topics might be and came up with 17 different categories! 

It was important to have that framing done at the outset so that everything could be sorted and logged as I reviewed it. Now, as I read something, it either gets consciously (if lovingly) dumped, or placed in one or more of those 17 categories—all of which are potential books (if I live long enough and remain sufficiently motivated).

After the sorting, I'll review the raw material for each topic and contemplate whether there is enough there to warrant a book, proceeding only when my head and belly both say "yes!" (I'm confident that the book total will ultimately consolidate into a number far smaller than 17.)

Step 3: Develop each book individually
All those passing the previous hurdle will be worked from two ends: a) what have I already written (that I still believe is germane and true) and what are the holes; and b) if I started from scratch on this theme what do I think I have to say (I want to guard against missing some big picture, whole forest elements by focusing too much on individual trees).

It's possible, I think, that some of what makes it past Step 2 will stumble in Step 3 and get washed up on the shore. That is, once I get down to the nitty gritty of what I have to say, I may not be all that impressed, resulting in my pulling the plug on a particular theme.

Step 4: Bring in the red pencils
Once I'm satisfied with an overall outline, I'll pause and bring in editorial assistance to help me with conceptualization. I already have one or two friends and peers lined up who know me well, know my subjects well, and have editorial skill and experience. They are willing to help me assess what I have and what's missing.

Once we are agreed on what needs to happen it will be my job to fill in the blanks, craft bridging language, develop supporting graphics, etc.

There is a large creative opportunity lying in this segment of the work, where I need to make decisions about how to reach my audience. Effective writing is much more than cogent ideas well connected; it is also finding ways to make my ideas accessible and compelling to the reader. That means deciding who my audience is and how I think my work will be used.

While I'm sure I will rely on stories to supply vivid examples of the points I want to make, I have a choice between developing a fictional cooperative group that I can use repeatedly throughout the book, or actual live examples from my years in the field.

Step 5: Complete a draft and get it edited
This section could take a while unless I'm highly disciplined. My sense is that it will be important that I work steadily here to bridge the gaps, establish the connections from one point to the next, and flesh out the main ideas.

Following this stage will be another round of review, done at a finer level. First, copy editing, and then proofing, until everyone is smiling.

Step 6: Get the book laid out
Here I'll rely on friends and compatriots even more. While I will unquestionably have opinions about layout (as well as title and cover design—hell, I have opinions about everything), I will defer to others who are more skilled than I am in these arenas. Graphic design is not my forte.

Step 7: Identify a publisher
There are some interesting choices here and I am undecided at this point how best to proceed. Essentially there are three forks in the road: a) self-publish; b) ask FIC to publish; or c) seek an alternative press to publish. Although potential income is a factor, my biggest focus will be on the help I can expect in promoting the book. I don't particularly want to take the lead on that, yet I have a healthy respect for how much of a difference good promotion and marketing can make in a book's reach, and I want my books to be well distributed.

Further, I'll want enough editorial control that the publisher won't monkey with my main points. It's fine for them to ask questions and to push me about things they find unclear or disagreeable, but I don't want there to be any doubt about who's driving the boat.

The Hole in My Whole

You can't judge an internal injury by the size of the hole.

—Salman Rushdie, Satanic Verses

This is the kind of insight that I would ordinarily have passed right by, but when I came across it last month, I lingered. Checking on Wikipedia I was pleased to see that others have found this a noteworthy sentence before me.

As someone suffering from grievous injury (life threatening cancer), I wonder how the metaphoric hole in my health impacts me.

How I Relate to Death
Overwhelmingly, my 66 years (so far) have been characterized by good health. I've rarely been sick, have never broken a bone, and went 27 years as a process consultant before postponing a job due to ill health. Now, perhaps, that good fortune is catching up with me. In late January I discovered I have multiple myeloma, and it represents a major league health challenge. It may kill me.

While I'm working hard with my oncologists to contain the cancer and secure several additional years of high quality living, it's too early to tell who will prevail in the next roll of the dice. I will be undergoing a stem-cell transplant in July (which entails six weeks of treatment at The Mayo Clinic in Rochester MN) and my life expectancy will be profoundly influenced by the outcome of that procedure.

Because expectations have a direct bearing on results, I have learned to be an optimist. Thus, I look ahead to July with hope and a positive attitude. My will and my constitution are strong and I think my time at Mayo will go well.

That said, rosy glasses are not the same as a sure thing, and the several months between diagnosis and transplant have given me ample opportunity to sit with the very real possibility that my life may soon end. Here's what I've noticed so far.

The Dying Die has Many Facets
—There is the practical side, not wanting to leave loose ends for others to clean up and making conscious choices about how possessions should be distributed. (In fact, if you're diligent enough a will is not needed because everything of value has already been assigned.) Because I have not led an acquisitive life, this aspect of the looking was not that difficult to handle.

In the arena of possessions the trickiest part falls under the category of "intellectual property." Over the years I have invested a great deal of thought and time into the field of cooperative group dynamics, and most of that is captured (in one form or another) in my considerable body of writing. Who should own that? What would I like its disposition to be?

While there may be some monetary value in my writing, I believe that's a long shot and I'm mostly concerned with how my ideas are treated after I'm gone. Will they be lost, or will they continue to be alive in cooperative conversations? 

While this is of compelling interest to me, it's more about leaving something of value for others than about ownership or credit. Thus, if you could offer an assurance that my ideas would continue to be worked with I would happily exchange that for attribution (people knowing that the ideas came from me). I want my contributions to last, but have no attachment to people knowing where the ideas came from. Attribution helps when one is alive, because it leads to additional invitations, but it isn't of much value after I'm dead.

—On the social side, I have been amazed at the outpouring of support that has been extended to me in my illness. In addition to well wishes, this has yielded hours of heartfelt emails and a plethora of visits to Duluth, celebrating connections at my time of need.

By setting aside my work obligations there was suddenly plenty of time for relationships (in addition to therapy) and this felt solid as the thing to place in the center of my attention. There is a tendency to let relationships slide in the pursuit of one's work life, and I was grateful for the mid-course correction—reminding me in no uncertain terms that people matter more than things.

Though the adjustment was not monumental, it was noteworthy and I was glad to make it. I figure it's never too late to get your priorities right.

—Emotionally, this marked the first time I've faced my own mortality other than as an exercise. What if I only have a matter of months to live? Am I afraid? 

Though I am not counting on there being a life after this one (and am therefore plenty motivated to make the most of the one I have), I've always known that eventually the sun would set. Unexpectedly getting information that the sun may be going down more quickly than I was anticipating did not change my fate—it just moved it up on my radar screen.

So here I am watching myself for signs of denial or avoidance. I've gone through some stretches of physical pain, and I expect that there will be more ahead. Maybe the pain will become too much and I'll freak out. Though it hasn't occurred so far, who can say it won't down the road? While I don't believe in heroic medical procedures where there is no reasonable prospect of improving one's quality of life, how can I be sure I won't grasp at straws at the end? I think the most honest answer is that I don't know.

—Spiritually I don't know if I'm any closer to knowing God, or her will. I'm convinced that I would not have lasted much longer if my cancer went undiscovered beyond my hospitalization Jan 31. But even being close to the edge did not lead to any epiphany about the meaning of life, or right relationship to Spirit. I have not regretted any major life choices; I have not pined for replays.

Mostly I'm happy with my life. While I'd prefer having more time (to push my thinking and my contributions a little further), I'll be at peace if that doesn't happen. I've had a good run.

My sense is that I've sustained enough damage that I'll never return to the health I once had. Mind you, I may have a number of productive years remaining—which I'm hoping for—but it's hard to imagine that I'll ever portage a canoe again, or hike segments of the Pacific Coast Trail. For that matter, I'll never build another cistern or fell a tree.

That's OK. There are unlimited books to read, conversations to have, and articles to author. There is plenty of wonder left in the world. While there is a hole in my life that will never close, there is still plenty of the whole left to explore, to taste, and to savor. Susan and I prefer to focus on the amazing opportunities that yet remain, rather than lamenting those that got away. 

We think of it as a style choice. If the brave leaves can emerge from the trees of Duluth, as they are now, than surely I can green up again as well.

Bridging to Normalcy

Here's what I penned yesterday:

I know it's Cinco de Mayo, when people's thoughts naturally drift toward Mexican liberation and Mexican libations (not necessarily in that order), but I'm thinking about bridge. This evening, for the first time since settling in Duluth, I'll join Susan in a group playing bridge, and I'm looking forward to it.

The trick for me will be keeping myself appropriate. It's a beginners class that meets every Thursday evening, and Susan participates as a student. She spoke last week with the instructor about my situation, and I've been invited to join them this evening as a guest.

The thing is, I'll be a ringer. I've been playing duplicate since 1999 and would like to get involved with in the duplicate scene in Duluth. Fortunately, Duluth is a large enough city that they have two games per week. One is on Mondays (which runs smack into a regular infusion therapy appointment I have for treating my cancer). The other is Wed evenings at 6 pm, which might work fine.

Tonight I expect to just observe—playing only if they have an odd number of participants (as opposed to a number of odd participants). It's all together possible that I'll have learned some different responses than the instructor over the last 17 years and it would be gauche for me to start teaching heresy (does a negative double in the sequence: one club, one diamond, double promise both four-card majors or only one?), so I'll need to be quick on my feet and not so quick with my tongue (not exactly my forte).

Hopefully there is enough flow among the local bridge players that I'll be able to manifest a partner for the Thursday evening game. We'll see.

While I was already pumped up for card playing after getting in a few casual bridge hands on Saturday, when Susan and I were visiting Ray & Elsie at their cabin in Stone Lake WI, my friend Cecil added another log to the fire last night when he suggested trying to set up a visit in the coming months where we could combine camaraderie with a sectional bridge tournament.

Cecil used to live at Dancing Rabbit before moving to Manhattan in 2007, and we had become regular partners for the once weekly duplicate game in Kirksville MO. We enjoyed good chemistry together and I was sad losing him as my partner. As he started playing duplicate a good bit after I had, he was behind in accumulating master points en route to becoming a Life Master, and we lost momentum when he moved east.

Since then we have managed to get together once (in 2011) for a regional tournament in Saratoga Springs NY, where we had enough success in two days to secure the remaining gold points Cecil needed to reach Life Master. Now he only needs silver points, which are available only at sectional tournaments. So my interest was immediately piqued by his suggestion that we try to line up his prospective visit to coincide with a three-day sectional in the land of 10,000 lakes. We can do this!

Meanwhile, I need to knock the rust off my game—it is not enough reading Frank Stewart's daily bridge column in the Minneapolis Star Tribune. I need to actually play cards.

Much as I enjoy margaritas, chips, and salsa—and I do—for today's Cinco de Mayo I expect to enjoy the piquancy of bidding and making small slams and vulnerable games even more.

• • • OK, now it's the morning after. It turned out that I got to play last night after all. My presence gave us just enough to fill three tables.

The featured lesson last night was negative doubles, and I had sympathy for the students. With a very limited vocabulary, the modern bridge world freights the term "double" with an amazing array of meanings, and it's bewildering for neophytes trying to keep them all straight. While negative doubles are a highly serviceable concept and well worth adding to one's bidding repertoire, it's towered atop employing doubles for penalty or take out, which concepts had already been introduced to the class.

Just to frame this well, there was no mention last night about how the concept of double can mushroom to include responsive, lead directing, balancing, reopening, support, snapdragon, stolen bid, and striped tailed ape. It can get confusing.

The main thing though, was that I was playing cards. Yippee! I met briefly after the class with the instructor, Steve, and he encouraged me to drop by the regular duplicate games Monday afternoon and Wed evening. He said the group is good about finding everyone a partner (which I'll need), so all I need to do is show up. It won't be until the end of the month that I'll have a free Wed, but I'll get there.

A Lovely Weekend at the Turn of the Weather

We got to flip a calendar page this past weekend and I thought I'd share with readers some of what I indulged in from COB Friday until Monday morning.  Sort of a day-in-the-life of cancer survivor awaiting transplant therapy.

o  Today, for the first time since last fall, the entire state of Minnesota was depicted in yellow on the US weather map, indicating that the highs today would be at least 60 degrees statewide. Woohoo! Can leaves be far behind?

Susan and I got a sneak preview of spring Saturday when we drove down to Stone Lake (about 90 miles south of Duluth) to spend the day with good friends, Ray & Elsie Martin. They had leaves down there, and the green in the winter wheat was mouthwateringly verdant. (To be fair, the air temperatures were still chilly and we put the fireplace to good use after dinner. So there's still considerable warming to accomplish before going crazy with Japanese eggplants in the garden.)

o  Yesterday afternoon, Susan and I attended a surprise birthday party for a friend named Nelson. It was held outdoors at a marina in Superior (which worked out OK if you were in the lee of the building, bathed in the late afternoon sun). In addition to meeting gobs of Susan's friends and local connections, they served a catered sit-down meal centered around pasties and a delicious cole slaw. 

There is nothing more evocative of place than characteristic food, and pasties are inextricably linked to the North Woods for me. I last wrote about them the last time I enjoyed a pasty (Catching the Ferry in 2010) when I spent a couple weeks vacationing on Drummond Island off the Upper Peninsula, and it all came back to me with the first bite. Finely chopped potatoes, carrots, and onions commingled with meat shreds in a savory pastry shell. Yum!

o  Since taking the plunge back in 1999, my favorite recreational pastime has been playing duplicate bridge. To be sure, I enjoy many things and love game playing generally, but nothing beats bridge at the duplicate level. I used to play regularly (once a week) at duplicate club in Kirksville when I lived in northeast MO, but I've only managed to play one time (last August, while visiting Sandhill) since leaving MO last June.

Of course, mostly this got set aside in recent moths to attend to my health, but I'm well enough now to indulge in occasional card playing and I was happy when Susan suggested that we play bridge with Ray & Elsie Saturday afternoon. While we only got in about 10 hands it has great fun (especially for Susan—the birthday girl—who was dealt one terrific hand after another) and I had the chance to play a couple of slam hands, the best one being off an ace with the king of trumps lying offside. When the defense failed to cash their ace on the opening lead I was able to wriggle out of losing it by establishing a side suit, and my 12th trick came from playing the seven of spades (a side suit) after roughing out the defense's 10. Very satisfying.

Susan plays bridge on Thursdays in a teaching class and I've been invited to go with her this coming week to see where I might fit into the Duluth duplicate scene.

o  Over the weekend, Susan and I started mapping out our support schedule for my coming stay in Rochester (in conjunction with my stem-cell transplant at the Mayo Clinic, starting July 12). We are blessed to have four different folks who have volunteered to do a shift while I'm in Rochester and take over the role of primary caregiver for a few days, giving Susan a break. In all, I've been told to expect a stay of six weeks, and it will be great for Susan to have regular breaks.

While she and I like being together, there are limits. Planning for breaks at the outset creates a more humane schedule. Here's what the support person will be asked to provide: 
—Escort me to and from Transplant House to Mayo's for daily testing and treatment.
—Be my cheerleading squad, helping me stay in good spirits while I cope with the heavy duty chemotherapy.
—Encourage me to get regular exercise  (seeing how quickly my body atrophied after three weeks in the hospital in Feb, I am determined to do what I can to not suffer as much physical deterioration this summer).
—Cajole me to drink enough liquids (three quarts daily).
—Get me to eat enough protein (despite the expectation that my appetite will be diminished).

This should leave plenty of time for visiting, working crossword puzzles, reading novels, and listening to Giants games on radio (streamed via my laptop). Who knows, maybe I can find four for bridge among the transient members of Transplant House.

o  Gradually, I've been upping the ante on social engagements as my strength improves. Susan and I attended a local performance of the Broadway musical, 42nd Street, Friday evening; we drove to Stone Lake WI for the day on Saturday; and we attended a birthday party Sunday afternoon. While I don't intend to be busy like that every day, it's nice to know I can handle it.

In fact, despite the increased activity level, I was able to navigate the entire weekend without once relying on extra medication to see me through. It's nice to have additional spring in my step right as there's additional spring in the air.

MM in the Spotlight

This past week I finished reading Salman Rushdie's Satanic Verses, the book that sparked enough controversy among orthodox Muslims that it resulted in the Ayatollah Khomeini issuing a fatwa calling for Rushdie's death in 1989. (Talk about literary criticism!) Although the British government stepped in to provide the author with round-the-clock protection and Rushdie is still with us today, there remains serious tension over freedom of speech in connection with the novel, and its examination of the Muslim faith in connection with British immigration.

Satanic Verses was written in the style of magical realism (a la Gabriel Garcia Márquez' classic, One Hundred Years of Solitude, published in 1967). I loved the free flowing nature of the narrative as it follows the improbable journeys of two protagonists, Gibreel Farishta (a Bollywood superstar) and Saladin Chamcha (a voiceover virtuoso), after they are the sole survivors of a terrorist attack on their jumbo jet.

Nearing the end of the book, I brought it with me to my infusion therapy session Monday, and was taken by surprise with this opening sentence to the final subsection:

Eighteen months after his heart attack, Saladin Chamcha took to the air again in response to the telegraphed news that his father was in the terminal stages of multiple myeloma, a systemic cancer of the bone marrow that was "100 per cent fatal"…

Three months ago I'd never heard if multiple myeloma (MM), and now it's everywhere. While I mused briefly over how closely I needed to be following that particular plot development, you have to shake your head at the creative ways that art can imitate life.

One of the fascinating things about MM is that it's a corner of the cancer world (roughly one per cent of cancer today shows up as multiple myeloma) about which there is a lot of progress being made in how to treat it. What had been "100 per cent fatal" 30 years ago is not the same sure thing today. The stem-cell transplant procedure that I'll have done in July offers real hope of containing the cancer and giving me several more years of good quality living. 

At the very worst it gives me something tangible and constructive to point towards, which is how my oncologists and I are approaching it. In turn, this helps me maintain an up-tempo attitude as I gear up for this summer's transplant. It allows me to be more thoroughly present for the limbo I am floating in right now, where, for the next 10 weeks, I'll be able to engage in regular email traffic, stay current with paperwork, attend concerts, and otherwise come across as relatively normal—even though I have little idea how much boost I'll garner from the transplant procedure. We won't know until we do it.

While none of this changes my overall fate (after all, we all die eventually), it definitely spices up my immediate prospects, and I am thankful for the gift of March through mid-July—this time out of time during which my pain has been manageable and there is ample room to read, reflect, write, and enjoy relationships. Life is good. No matter what happens with the transplant, I get the time I have right now.

While multiple myeloma is commonly abbreviated as "MM" in the medical literature, I laugh whenever I see that designation. Not because it evokes multi-colored chocolate pellets, but because "MM" conjures up Marilyn Monroe for me—just about as different an image from cancer as I could imagine. Life can be funny that way.
• • •This afternoon I get my dialysis port removed (although I never did dialysis, I had a catheter inserted into my jugular vein to facilitate blood draws and infusion therapy). That semi-permanent installation meant I was able to avoid all manner of needle insertions, but at an increased risk of infection. Now that my body's reaction to chemotherapy has stabilized, the scales have tipped the other way and my oncologist is more worried about infection than speedy infusions. 

As an additional plus, after the catheter is removed Susan and I won't have to be quite so careful in bed, worried about what equipment we might accidentally knock around while cuddling.

To celebrate, this evening we'll attend a reprised performance of 42nd Street, the Broadway musical. Tomorrow, Susan's birthday, we'll drive to Stone Lake WI and spend the day with good friends, Ray & Elsie Martin, helping them open up their cabin for the summer.

Life is good.

April: a Tough Month Along the North Shore

Mondays are my day for blood work, to make sure I'm on the right course with my chemotherapy.

After five hours of running the gauntlet of appointments, here's what's going on in my world:

o  The wind picked up last night and started blowing hard out of the Northeast. As the long axis of Lake Superior is angled from southwest to northeast at Duluth, that direction afforded the water all night to build up a head of steam as it crashed this morning into Duluth Harbor. Think 39-degree spray with waves in excess of six feet. Bracing. There is an ore ship hove to outside the harbor, unwilling to run the shipping canal under such raucous conditions.

Susan and I took an extra 30 minutes on the way home from the hospital and sat in a parking lot watching (feeling?) the waves crash ashore.

o  More good numbers from blood tests: my last light chain number had shrunk to 50, and all others were trending in the right direction as well. Thus, as hoped, my medical forecast is good news: steady as she goes into my July 12 date for a stem-cell transplant at the Mayo Clinic.

Weight, Weight, Don't Tell Me…
As a regular feature of my Monday check-ins, I get weighed. While you might think this is just SOP with doctor visits, it was a feature of concern in my health profile. I had lost about 50 pounds from the onset of my lower back pain in October 2014, and I was down to 150 pounds in early April—while I started this odyssey overweight, enough was enough. The doctors need my weight to stabilize as a precondition for the stem-cell transplant, and I didn't want to slide down any further either.

To be sure, I was interested in losing weight anyway. Now, battling cancer it seems an especially poor idea to be asking my beleaguered body to portage around extra poundage (particularly unproductive plasma cells), and I am motivated to find a new baseline. In this regard, April has been a great month. I've manged to keep my weight in the 150-56 lb range all month. Yippee. (And if I can keep it there the rest of my life, I'm happy with that.)

To get there I made a few subtle yet significant lifestyle adjustments:
—I've cut back significantly on between meal snacking.
—I try to not skip any meals, though I'll go light on lunch if anything.
—I satisfy myself with single servings and resist taking seconds.
—With the modest exception of pushing myself somewhat to eat something at every meal, I generally listen to my body and don't eat a thing if I'm not hungry or not inspired by the food.

In executing this plan it has helped enormously that Susan is a great cook. On my journey toward achieving a resemblance of domestic partnership I have a long way to go before I'm, pardon the expression, carrying my weight in the house, but Susan has been patient and we're both excited by my continued recovery from my February as a poster child for basket cases. Now that I've mostly got personal care needs under personal control, engaging on the domestic front is next up.

In the last fortnight I've taken over full responsibility for seeing that all of my pills and supplements make it to my mouth in a timely manner, and this morning I agreed to take over as chief coffeemaker. Can dicing onions be for behind?

o  As you'd expect, Dr Alakied was happy to see my numbers, and we enjoyed an easy flowing connection today. As it turned out, he had been having a not-so-easy week, where he had to tell patients bad news more often than good, and he shared with us that that's the hardest part of the job—when he's done his best, it hasn't worked, and he has to tell the patients that it's the end of the line what help they can get from medical intervention. It sucks.

It helps him a lot to have patients like me, who have a positive attitude and are succeeding beyond expectations in response to the treatments he recommends. Like a lot of us, it's hard to sustain a positive disposition when you're not seeing enough bounce from your efforts. Thus, my good news helped counterbalance an otherwise tough week.

It was highly satisfying to me to know that at least in a small way I was able to give back to Dr Alakied after he's given so much to me. A tender quid pro quo.

As a bonus, Dr Alakied took the time to explain in greater detail how my form of myeloma is different from more prevalent kinds and why that necessitates paying attention to different markers and recommending a protocol that's tailored to my specific case. As Susan's employment history included a stint as a research lab assistant at the University of Minnesota, she had a working understanding of some of the biochemistry, and it was a fascinating tutorial, complete with graphics.

o  Though April is appearing to be the lost month for spring weather along the North Shore (much as February was my lost month for cognitive engagement), we may be able to catch something nice right at the tail end. It turns out that this Saturday will be Susan's birthday and we're hoping to celebrate by joining friends Ray Martin and Elsie Myers as they open their cabin near Stone Lake for the summer.
When we get there Saturday morning we'll see whether the timing was prescient or wistful thinking.

(And if you think the local residents have been long suffering, the Minnesota Wild and Twins haven't had such a hot month either.)

Of course, even if April holds out until the bitter end, May is not far ahead and I expect a big boost when we flip the calendar on Sunday.

Reservations in Rochester

This week I got the call I wanted from the Mayo Clinic. They will begin my stem cell transplant procedure July 12. Yeehah! Here we go.

By implication this means the doctors are satisfied that my cancer is responsive to the chemotherapy, something I had to establish before they'd proceed, and that the protocol for the next two-and-a-half months is expected to be a continuation of the chemotherapy I'm already taking (and which I know I can tolerate well enough), aimed at gradually increasing my strength and recovery from the mess they found me in Jan 31 when I finally stumbled into the ER at St Luke's Hospital in Duluth.

Looking ahead, here's the front end of what will happen in Rochester. The first week is highly scripted. After that the schedule is more flexible, depending mainly on how I respond.

July 12-14                      Final testing begins.

Afternoon July 14          Meet with Dr Buadi (who oversees all stem cell transplants at Mayo). I need a green light from him after he digests all the test results. While we're expecting no surprises here, who am I to rule out surprises after all that's befallen me the past year?

Evening July 14             They'll start giving me injections to induce my bone marrow to make my stem cells available for collection.

July 18                           Begin harvesting my stem cells. This will proceed until they have more than twice what they think they need.

July 22 (?)                     Once they have the stem cells in hand, they'll give me an injection to kill off everything in my bone marrow.

July 24 (?)                     Two days later they'll reintroduce my healthy stem cells to start repopulating my bone marrow. The rest of my time in Rochester (perhaps six weeks in all) will be devoted to healing under close medical supervision, hoping that a robust response from my stem cells will dominate, placing the cancer in remission.

Mayo's has enough experience with transplants for people with my cancer and the volume is large enough that I'll be able to stay at Transplant House, a private facility in town (about a mile from the clinic) that is wholly geared to support people going through what I'll be going through. They have two large buildings conveniently located in Rochester (with daily shuttle service to the clinic) each of which houses abut 30 people. Each room has two beds (one for the patient and another for the primary caregiver) and a private bathroom. Kitchen facilities are open to all in the house with private storage space in the refrigerator and cupboards for each patient. Amazingly, this is available for $30/night.

I figure it will be a piece of cake adjusting to the housing after all my years in an income-sharing community. In fact, for me, being bivouacked temporarily at Transplant House will mostly represent an upgrade in living space. It will seem spacious. What do I need, after all, beyond a caring companion, a bed, a bathroom, a comfortable chair, a table, and an electrical outlet with a wifi connection?

Among other things, that means I won't miss spring in Duluth, which can be a tricky sighting.
No only am I a patient these days, but I'm discovering that being a Duluthian entails patience. Every day I look at the Minneapolis Tribune and peruse the weather maps. For most of April northern MN has stood out as the font of blue from which all other cold weather emanates in the continental US. It's impressive. And another week goes by without daffodils or lilacs.

I was driving to a rummage sale this morning when a person in the car casually reported that her husband was going to miss the sale because he needed to help out with the family maple syrup harvest. It's the second half of April for Chrissakes! Talk about a time warp. Sandhill would have wrapped up sugaring two months ago.

That said, the delay does not mean I've missed anything. Since I won't be going to Mayo's until July, I'm confident that I won't miss any spring flowers. Of course the upside of the delay is that the mosquitoes have not yet appeared either, which, up to a point, is a trade I'm willing to make. I give enough blood at the hospital; there's no need to give in the backyard as well.

Nutritional Leavening

I had a delightful hour on the phone this morning, catching up with an old friend who has done a lot nutritional training and research in recent years and had a lot to share with me about how nutrition may play a significant role in enhancing my chances to enjoy a happy ending in my battle with multiple myeloma (MM)

It's just another way in which I have landed well after getting buffeted about by the health gods. While no one wishes to contract cancer, all experiences are not created equal and I'd be an ingrate to not see the amazing extent of my good fortunate in the face of my life-threatening illness. In no particular order, let me count the ways:

o  I discovered the cancer in Duluth MN, which just happened to have a crackerjack young oncology team operating out of the local hospital who were up to speed on the latest in treating MM. They recognized what I had right away and got to work immediately.

o  The oncologists have good professional ties with Mayo Clinic (located in Rochester MN, abut 3.5 hours away by car) and were able to get me accepted there as a candidate for a stem-cell transplant. This is highly fortunate in that the Mayo Clinic is one of the leading places in the country for performing this cutting edge protocol for containing MM.

o  I finally broke down and went to the hospital (where the cancer has uncovered) while I was with my new partner, Susan Anderson. Though I had been intending to see doctors when I returned to my home in North Carolina, I didn't make it that far. I was at the tail end of a road trip that had started Nov 13 and thought I was only visiting Susan briefly as a final holiday stopover. However, I had anomalous back pain that was getting steadily worse and never got well enough to leave Duluth.

That meant that, unintentionally, I was with Susan when the bad news was discovered and there is no single thing that has been more valuable to me the last three months of riding the cancer whirlwind than having Susan steadfastly by my side. I have no idea whatsoever how anyone could manage the barrage of information and decisions I was facing without the kind of support that a dedicated partner can provide. I have been highly fortunate.

In fact, things have gone so well with Susan that I have now permanently moved to Duluth so that we can be together regularly instead of occasionally.

o  For most of the last four decades I have lived in an intentional community (Sandhill Farm) that grows 80% of its own organic foods. I enjoyed a diet that was low in animal protein, high in fresh vegetables, and as devoid of inorganic foodstuffs as we could manage. That's an excellent foundation from which to tackle cancer.

o  While my kidneys have been seriously compromised and the cancer is taking over my bone marrow, my health cupboard is not bare. In addition to whatever benefits accrue to me by virtue of my good eating habits (mentioned in the previous bullet point), I have a sound heart, good lungs, no history of major health problems, and all my factory installed teeth. So while my reserves are being called upon in this battle, it's noteworthy that I have reserves.

o  I generally enjoy good balance and have (knock on wood) not fallen once since the cancer was found. This is especially helpful in that a side effect of MM (at least in my case) is that I have been suffering calcium leaching from my skeleton which renders my bones more brittle, and therefore susceptible to breakage. Thus, falling is an especially bad idea right now and good balance has helped keep me upright at all the right times.

o  I have enjoyed an incredible outpouring of support from friends and family. In addition to an avalanche of cards, letters, emails, and phone calls, I've even been graced by a handful of personal visits—all of which have been calculated to buoy my spirits at a time when it was really needed. Wow.

o  Regardless of the ultimate outcome of my dance with MM (who knows how close death is?) I am currently enjoying a time of high lucidity and recovered energy and focus that allows me to reflect on what's happening, to wrap up loose ends that would be impolite to leave to others if things suddenly take a turn for the worse (no matter what, I'm still going to die eventually and all those odd and ends were going to need attention at some point), to reorient my priorities to emphasize close relationships more and a nose-to-the grindstone work pace less, and to be more in the present and more accepting (the flip side of which is judgmental and directive).

o  As a process consultant and professional facilitator I am frequently asked to bridge between parties who struggle to hear each other accurately or to put an innocuous spin on statements that diverge from the recipient's thinking. As you might imagine it's highly beneficial that I have a wealth of personal experience to draw on when attempting such bridge building and it occurs to me that I can now add to my repertoire what it's like to face death in the form of a life-threatening illness.

If I am able to return to active service as a process professional—which I have every intention of doing—this will be one more significant way in which it should be easier for me to hold others in distress who are questioning whether anyone else in he room can understand what they're going through.
o  I had process work commitments lined up that I would have had to cancel but I had already identified competent partners that I could hand the work off to. The clients still got served in a timely way, and my partners got extra exposure and income. 

o  I have money in the bank. While it's not yet clear if I'll have the dollars needed to handle all of the expenses that will ultimately fall to me, I might. Because this didn't befall me until I was 66, I am covered by Medicare and have a decent supplemental program to boot. That means that the vast majority of my expenses will be covered no matter what, but my treatment is not cheap and insurance will not cover everything. In getting sick I face a double whammy: the income ceases (my work life has been suspended to attend to the urgency of my health needs) at the same time that my expenses soar. While this is obviously not a sustainable pattern, I may be able to weather the storm without encumbering myself with crippling debt. I have a chance.

o  In addition to friends who are there for me at the heart level, holding me in the light, some of my friends—like the one I started this blog talking about—are information resources on the road to wellness. 

During this morning's phone call my friend introduced to her research on inflammatory foods: the importance of balancing Omega-3 intake with that of Omega-6, the evils of sugar (now there's a shocker), and being vigilant about pesticide residue on store-bought foods—regardless of whether or not it's organic.

As she suspected, my oncologists were not trained in nutrition. While they are not antithetical to it or hostile, neither are they focused on that approach and my friend was essentially offering to stick her thumb in that dike, or at least train me on where to stick my thumb. Fortunately, information about nutritional sensitivity is not all together new to me and I am not having an inflammatory reaction to her suggestions. Whew.

What's more, the call today comes in addition to an offer I received from another good friend a couple weeks back to help with a raw juice diet aimed in the same direction—better health through careful attention to nutrition and minimally processed food. What with all the visitors I've had lately I haven't yet had time to secure the juicer and get set up. With offers like this can the flow be far behind? Yeehah!

My cup of blessings overfloweth.

Getting Less Conflicted About Conflict

In the last week, a colleague sent me the link for a TEDx talk entitled: Conflict: Use it, Don't Defuse It. The two presenters, CrisMarie Campbell and Susan Clarke, are professional facilitators and they do a good job of laying out their main premise: that conflict is inherently neither good nor bad, yet most people (and most groups) avoid it (or try to contain it) to their detriment.

They claim—and I agree—that conflict is a source of energy and information, and if you can learn to approach it with vulnerability and curiosity you can get amazing results. In the video they share some powerful stories about their personal and professional lives where these lessons were brought home to them.

Unfortunately, Cris & Susan don't take it quite far enough. While making a case for the benefit to be derived from stepping away from defensiveness and combativeness, they do not make clear how someone can make that choice—especially in the heat of the moment.

Over my years as a process consultant and facilitator, I've learned that the point of entrée is working with the belligerents emotionally, where you're able to bring to the surface an accurate summary of what each player is feeling and what those feelings mean. It is crucial that this be accomplished with minimal judgment and maximal empathy, so that the person feels heard and understood (note that I didn't say that they feel agreed with, which may or may not happen).

Often, as the facilitator, I will demonstrate what I'm looking for before asking the other conflicted party to take a turn, simply because this request may be too difficult until they, themselves, have been heard. While it's important that the hearing and reaching out ultimately happen across the lines of the conflict, it is often useful for the facilitator to prime the pump—after which they gracefully exit the dynamic, leaving the belligerents to proceed on their own.

The key here is whether authentic hearing and sharing are happening. If so, the facilitator can step back. If not, then the facilitator steps in.

While conflict comes in all shapes and sizes, the most interesting forms (read volatile and intractable) involve at least one party being in active non-trivial distress. As such, once you're clear that there is a significant emotional component in play, then I think it's helpful to keep the focus on the feelings until they have been adequately identified and understood. This expressly means setting aside content (the action or behavior that triggered the conflict) until that's been accomplished.

To be sure, people will tend to squirm when you do this (because arguing over content is more familiar and is deemed safer), but it can be done. If you don't, then the unresolved tension tends to distort the information and cripples the problem solving. In short, attempts at problem solving without acknowledging feelings just don't work. Somehow, a bridge needs to be built between two conflicted people (it may be more than two, but any conflict can be broken down into a collection of pairs) or you won't get any constructive traffic between them. Further, it has been my experience that that bridge needs to have emotional girders or it will be brittle and insufficiently resilient.

While it's possible for the belligerents to have done sufficient personal work to be able to understand this dynamic and to unilaterally step back from the fight and reorient with vulnerability and curiosity (as Cris & Susan advocate), don't count on it. It takes an exceptional person to pause mid-salvo, lay down their ammunition, and ask their upset counterpart for more information. I've seen it happen, but not very often.

Better, I think, is developing a group agreement (and the group's capacity) about how you'd like to proceed and then authorizing the group's facilitators to step in and guide the process, reminding people firmly, but gently how they intend to act when conflict surfaces.

I realize that I'm asking a lot. For the most part, facilitators are expected to manage the content of meetings, making sure that the group stays on topic, listens well, and moves productively toward resolution of group issues. By adding responsibilities directly related to conflict, I am significantly expanding what's expected of facilitators—I am asking them to manage energy as well as content, and to work with people emotionally as well as rationally. This is a big jump and won't land well for everyone. Even if you like my thinking about conflict, you need to seriously consider whether you have facilitators who can answer the bell (or be trained to).

When I'm 64

Back in 2013, I took advantage of my 64th birthday to compose a blog about where I was in life, using the lyrics of the Beatles' classic "When I'm 64" as prompts. It was full of whimsy and fun. 

Well, here I am 30 months later and I'll be darned if I don't have an occasion to dust off that title and use it again...

As you know if you've been following this blog and my cancer saga, I have my blood tested every week. It's part of my chemotherapy regimen, helping my oncology team track my progress in battling multiple myeloma. In particular, I was on the edge of renal failure when the cancer was discovered at the tail end of January, and my #1 treatment priority has been reversing the kidney damage to avoid dialysis or a kidney transplant.

In my instance, the doctors are relying on a particular marker called immunoglobulin light chains. When the cancer was uncovered my light chain number was something in the vicinity of 1800 and they wanted it under 100. Gulp.

Fortunately, my body responded pretty well to the chemotherapy and we were able to drive the light chain number down to 66 after about six weeks of treatment. That said, I had a hiccup at the end of March, when my light chain number climbed back to 239—which development had my oncologist's immediate attention. 

In fact, this was considered a serious enough slippage that my doctor was ready to switch protocols, calling out heavier duty chemo guns in order to drive the light chains back down. Ugh. Thus, just 10 days ago I went into the hospital for my regular Monday morning blood draw, prepared to be admitted to the hospital for five days of amped up chemo. At the last moment, however, my doctor rescinded that order because my light chain numbers had dropped back to 111. Whew. Based on that reversal, he wanted to give the ongoing (less heavy duty) chemo protocol more time to get the job done. Maybe there was a delayed reaction and he knew it would be easier on my body if we could contain the cancer (and the light chains) using less poison rather than more.

Naturally, this reprieve was fine by me. It bought me a week of steady-as-she-goes, which Susan and I enjoyed thoroughly. Of course, there is a new blood draw every Monday, so all eyes were on the light chains ha emerged from the blood sample taken April 11, to see if the wind was still blowing in the same direction. Imagine how big my smile was when the nurse called Tuesday afternoon and reported that the light chain were now down to 64.

Not only was that the best news I could imagine getting, but it magically provided a perfect entrée to today's blog. Sometimes everything lines up just the way you'd like.

Does this mean there will be no more glitches en route to my getting stronger in preparation for the stem-cell transplant procedure (probably in July)? Alas, no. Cancer doesn't come with guarantees. There may be more potholes ahead on the road to recovery and I don't have a map that reveals their location. Yet it's good news nonetheless and has understandably leavened the mood for Ceilee and Annie's visit this week. 

I now have a green light to attempt some judicious reemergence as a process consultant prior to the stem-cell transplant, and I am working with Alice Alexander and the Coho Association of the US to have my debut be May 19 in Salt Lake City, when I conduct a half-day pre-conference workshop on how to facilitate conversations about aging in community. The main event, Aging Better Together, will be May 20-21 and there are still openings to join us if this topic grabs you and there's room on your dance card.

Maybe I'll see you there.

Old Home Week

Starting this evening I'll be visited by my son, Ceilee. While that would be exciting and newsworthy all by itself, it gets better. My pleasure will be doubled when his mother (my close friend Annie) will arrive for an overlapping visit tomorrow. Ceilee's coming from Los Angeles and Annie from Floyd VA, and they'll be with Susan and me for five days or so. We're all looking forward to the time together, as my old home intersects with my new one.

Even as I continue the joyful work of establishing Duluth as my new home (having happily thrown in my latter year allotment with Susan) one of the joys of my cancer diagnosis is the bountiful opportunities I've had to make connections with friends and family all over. 

It's interesting when you think about it. After all, no one is getting out of this life alive, and no one knows exactly how much time they have (or more pertinently, how much quality time they have). That said, there is a marked tendency to live one's life as if it will go on forever and to not seriously plan for end of life. A consequence of following that course is that mortality can take you by surprise and you might miss the chance to say goodbye, to take some moments to slow down the music and appreciate what each relationship has meant to one another. 

Thus the cancer has helped sharpen my focus and that of those I know. Not being sure how much time I have, the dire diagnosis created a sense of urgency and people are reaching out now (letters, cards, emails, phone calls, and visits) in incredible numbers. It's been a terrific time for connections (and reconnections). I have received those blessings because I might die soon. As no one will demand their time back if I don't expire in the coming months, this is a pretty good deal.

Thankfully, I'm not contagious and the doctors have placed no dietary restrictions on me (in fact, fattening me up is one of their top priorities). I've been able to bounce back sufficiently from the initial rounds of chemotherapy to participate in most aspects of everyday life, all of which has helped to grease the skids if a dear one is inclined to visit. Susan and I even have a couple of spare bedrooms available at Chez Anderson, easing the logistics.

It's nearly impossible to know how much life I'll be able to fully enjoy going forward, but then, why spend time on that question? Instead, I'm looking at, "How do I want to use what I have, recognizing that there may be little left in my hourglass?"

In my case, this is a Susan and Laird question, not just a Laird question. Susan has been a rock of support for me these past three months and I've made a commitment to enjoy, celebrate, and appreciate with her what life remains to me. So far it has meant a lot of gin rummy and enjoying PBS broadcasts Sunday evenings, but we're also talking about traveling together. Thinking up joyous ways to be together is not difficult at all; the principal challenge is manifesting the time and stamina. We will take these final rapids together, for as long as the fast water stretches out in front of us and we can keep the canoe upright. We are far enough along in our journey that we no longer need a map—just follow the current. Yeehah!

Meanwhile, amazingly, I have been able to return to work on a limited basis. Yesterday I drilled down on the teaching themes for an advanced facilitation training. I made an initial pass at this two years ago. Yesterday morning I doubled my thinking. While there's no knowing whether I'll have the time and energy to deliver that training, I know that it's a natural progression of my body of work in the field of cooperative group dynamics, and would be the thing I'd most like to complete if I can get to it (because it has the greatest potential for doing good in the world).

Thus, I've been able to return to conduct meaningful work less than three months after the initial diagnosis and treatment, to make encouraging headway in containing the cancer, and to enjoy this incredible outpouring of love and support from friends and family. My cup runneth over. Yes, I have back pain everyday, and I've had to reconcile with the reality that I'll never skydive in Montana or windsurf the Columbia River, but every time I open my eyes in bed Susan is lying beside me and it's a pretty good life all things considered.

This week my work output is likely to decline as I focus on enjoying Ceilee and Annie. But isn't that exactly as it should be? There will be more laughing, more cooking, more drinking, and more story telling. I can hardly wait.

Beyond Cancer

I went into the hospital with chronic, debilitating back ache Jan 31 and promptly discovered that I have cancer: multiple myeloma. Not surprisingly, that has been the centerpiece of my reality ever since.

Now though, more than two months into chemotherapy, I'm starting to stabilize and am going through a relatively quiet phase of therapy, where I try to build strength in anticipation of a stem-cell transplant that I'm expecting to undergo this summer at the Mayo Clinic.

Though I was knocked flat on my keister by the initial barrage of medications, I've steadily been regaining functionality, stamina, and lucidity ever since, the upshot of which is that I'm able to tread water with email, and engage in life beyond cancer. For the first time in two months I want to write about something other than knocking on the door of my mortality.

As I sit with the increasing possibility that I'll be able to get my process oar back in the water, the obvious next question is what do I want to do with that? Where do I want to go? That question morphs easily into, "Where do I think I can have the most positive impact?" or "What can I bring to the table that isn't easily found elsewhere?" The truth is, I'm not sure. But I have ideas.

My best arena is cooperative groups—where the members have made a purposeful commitment to operate cooperatively (as opposed to competitively). That cuts down the field quit a bit. Even though interest in cooperative alternatives is rising, there are not that many groups that have taken the plunge, and fewer still that have actually thought through what it means to learn to respond to differences with curiosity rather than combativeness.

Over the past three decades I have concentrated my group work with intentional communities, both because it's more accurate to assume a core commitment to cooperation in that setting, and because living together requires that members deal with at least a baseline level of issues (cleanliness, child rearing, pets, ecological impact, and diet to name a few). To be sure, some intentional communities have proven to be sufficiently clever that they've been largely able to duck functioning cooperatively even when their noses have been rubbed in it, but there are also many who have taken the bit in their mouth and are purposefully trying to pull in rhythm.

Those last are my best clients. They know they're doing something radical, they know it isn't easy, and they're willing to ask for help.

Having said that, the world of intentional communities is relatively small and obscure. Yes, it's growing and its relevance to the wider culture is becoming more easily recognized all the time, yet many people simply dismiss lessons gleaned from community living as a sideshow oddity—it's too far beyond the pale to be applicable to mainstream issues (such as how to solve problems without resorting to threats of war).

I have tossed in this last parenthetical example as an incendiary. How could anyone not be interested in exploring and developing more effective, less belligerent ways to solve problems? And yet the golden nuggets painstakingly mined from cooperative living that bear on this challenge are blithely ignored almost everywhere I turn. It's discouraging.

Thus, one reason to pause before returning to work in the trenches of intentional community, is to weigh whether my efforts there will be seen and available to inspire others.

Going the other way, intentional communities are concentrated cooperative groups, rich in complexity and complications—just the kind of environment where learning can be sustained at an accelerated rate. It is also where I have my best connections and am most likely to find meaningful work quickly. While I know that the application of my work is far broader than the micro-world of intentional communities, I may have to leave it to others to make that case, narrowing my focus to identifying the lessons, rather than disseminating them.

It's an interesting fork in the road. In the end, it comes down, for me, to which path appears more attractive: would I rather do the field work (panning for the ore) or the promotion (packaging the refined products)? Put that way, I'll choose the field: working to identify and access cooperative options in a dynamic; learning better how to see competitive traps before we fall into them; increasing my capacity to work with the whole person—all of us, after all, are rational, emotional, intuitive, and kinesthetic beings all rolled into one.

Presented with all these delicious options, you can see why I'm in no hurry to depart this veil of tears.

A Double Snouter in Duluth

Yesterday I went into St Luke's Hospital for a blood test, a consult with my oncologist (Dr Alkaeid), and infusion therapy (part of my regular chemo-therapy regimen to combat my cancer: multiple myeloma). My doctor had given me the heads up last Wed that one of the key markers for how my body was responding to the chemo was headed in the wrong direction. 

He was sufficiently worried that he advocated a sharp change in my protocol: giving me a much stronger course of medicine, requiring five days in the hospital, starting Monday (yesterday). While this course would be a risk in and of itself (we're dealing with serious poisons here, after all), he felt it was justified based on my deteriorating light chain numbers (up from 66 to 239, where 100 is the boundary of what's considered acceptable, and high numbers are bad). I agreed with his recommendation, and Susan & I went to the hospital yesterday with our loins suitably girded: we expected this to be a critical test of my ability to contain the cancer, and were not at all sure how strong I was relative to what was going to asked of me.

Then things got better. 

In the five days between last Wed (when I got the bad news about the light chain numbers) and yesterday, there was time for another round of testing to be completed and the newest light chain numbers came in at a svelte 111. While still north of the all-important 100 marker, it was less than half of the previous test, and suddenly the sun came out from behind the clouds.

Alkaeid's main concern at this point is establishing clearly that the cancer is responsive to chemo-therapy, and it's essential in that regard that all markers of the cancer's progress are moving in the "right" direction as a result of the my undergoing the chemo protocol. Poised to pull the trigger on the more drastic, heavy-duty chemo regimen, he saw definite signs (albeit delayed a bit) of the cancer remission he wanted in the light chain numbers, and that switched his thinking about whether the heavy artillery was warranted.

The much lighter light chains numbers translates into reasonable hope that the current (less-draconian) chemo regimen is being effective, which we all prefer be the case. My body has already handled the current protocol fairly well (I can hardly tell you how much I was relieved and pleased when Alkaeid—someone not prone to blowing sunshine up patients' asses—admitted that I had surprised him with extent of my positive response so far) and I feel quite confident that I can stay the course with the current regimen and come out ready for the stem-cell transplant.

Having switched abruptly from good news to bad and back to good within the course of five days, Susan & I are just now coming out of the revolving door of our emotions, and are not sure what this all means relative to when the stem-cell transplant is likely to happen (are we back to July now?) or what wiggle room exists for doing some extracurricular activities between now and whenever the transplant is scheduled. 

These are somewhat minor details in that we'll do whatever the doctors recommend; it's just nice knowing what that is. I am at the cusp of being ready to do things away from home (I'm aiming to attend a performance of the Duluth Symphony this Saturday) and Susan and I are past ready to starting enjoying being together, not just surviving it.
• • •The semi-obscure title for today's blog has its roots in the dice game Pass the Pigs. It happened that my youngest sister, Alison, visited me Wed through Sunday of last week (more or less the entire stretch of living under the pall of the hospital watch and Alkaleid's dire diagnosis). We enjoyed a wonderful connection, full of stories, reflections, and connections. 

Among other things we played a few rounds of a Schaub family-favorite: Pass the Pigs. In our version we play with two pigs each (the "dice" are actually molded in the shape of pigs) and you score them based on how the pigs land. As long as you score positively, you can keep rolling. If you "pig out," achieved by having the two pigs landing flat and on opposite sides, then your cumulative score for that round is lost and you pass the pigs to the next roller. There are many ways to score and one of the more exotic is by having one of the pigs land upright, leaning on its snout (worth 10 points). Even more unlikely is having both pigs leaning on their snout, whence the term "double snouter." This is worth 40 points if your playing Pigs, and a world of relief of you're a cancer patient living on he edge of recovery and suddenly delivered great news.

You might wonder how things could have shifted so dramatically in such a short period of time. Part of this is a consequence of how Alkaeid has chosen to handle what he shares with patients. He believes in giving news straight and not sugar coating dangers. If there is a possible bad outcome he's going to let you know what it is. That's what happened last Wed. There had been a significant degradation in the light chain numbers and he was worried. Following that thread he felt a shift in protocol was justified, which he vetted with his counterpart at the Mayo Clinic before recommending.

The other side of that is that he was happy to walk us through his analysis of the better test results Monday. It tuned out that there was also a positive immunoglobulin test result that had gone undiscussed on Wed but corroborated the notion that the current chemo-therapy protocol may actually be working fine, if a bit delayed. This helped him reach the conclusion to take his foot off the gas and stay the course with the less aggressive treatment. Whew. Now I don't have my next date with him until April 25—a glorious three weeks of giving this treatment (which I already know I can handle well) more breathing room.

I tell you, there's never a dull moment around here.

Fortunes Reversed

Yesterday I got another chance at my prime lesson in battling cancer: letting go of the illusion of control.

No sooner had I established (at the encouragement of my oncologists) that I was meeting or exceeding all my markers for a good response to my initial rounds of chemo-therapy, then a blood draw Monday turned up an adverse number, triggering a sea change in how I was being assessed.

In particular, there was a rise in the amount of "light chain protein" in my blood (there's also a heavy chain protein, but it's the light ones that are used as a marker of my cancer's progression) and this is something that the doctors think is critical to keep at a minimum leading up to my having a stem-cell transplant.

While there's part of me that's amazed and shaken that a single test could be so destabilizing to my treatment plan, this has not eroded my fundamental faith in my doctors. We will be in this together, wherever it leads.

In any event, after first laying out the expectation that I'd be entering a relatively quiet maintenance phase of the chemo protocol from now until a July transplant at the Mayo Clinic,  all of that shifted yesterday. Determined to get back on top of the light chains, the doctors in both Duluth and Rochester have agreed that a more aggressive plan is in order that will entail the introduction of some additional new drugs.  

This new cocktail is potent enough that I'll be readmitted into the hospital for five days, starting Monday, followed by a crucial week of observations to see how I respond. The doctors were straight with me. This will be my most severe test yet, and there's no guarantee that I'll survive it. (Quite the change from the calm waters I had woken up to when the week began!)

Once again it's time to set aside all other concerns and opportunities to prepare myself to simply ride the waves of my treatment, doing all that I can to be my body's ally. It is not yet time to be planning presentations or to be crafting book outlines. First I have to get well.

While it has been a jolt to have my plans knocked down (I liked the picture of a predictable, playful spring) and to again be staring down the chaotic barrels of what my cancer hath wrought, there is also a part of me that is relieved to be facing the hard stuff sooner, with minimal delay. It was always coming, and it feels better to be turning toward the boogie man, rather than away. If the cancer is stronger than I, so be it. If I am stronger, let's find out now and move forward.

The Flight from Here to July

I'm sitting at the dining room table, listening to the outdoor background music: deep bellowing of horns from ship traffic in the harbor. The St Lawrence Seaway officially reopens for business yesterday, and here at the extreme corner of the system, they're not hiding their light under a bushel (much less their horns in a bell jar). There are one or two hefty ore boats freshly loaded with taconite outbound for steel mills somewhere in Ohio or Indiana, and away we go.

Just as the Seaway opens, Susan and I are at the cusp of segment two our four-stage journey through the gauntlet of cancer treatment. While I'd like to tell you that all will be smooth sailing, our journey comes with no such guarantee.

For a quick review of the bidding:

Segment 1
Discovery of the cancer, diagnosis, and initial treatment, to see if the bad signs can be turned around and if my body is sufficiently responsive to treatment (did we get there in time?). In my case this included collecting all the information of a complicated and aggressive cancer and its attendant side effects. While it's turned out to be a lot, my team of doctors felt we had good reasons to be hopeful of a positive response to immediate treatment and wasted no time in going there once they'd secured my approval.

To be clear, there was no certainty I'd come through this initial phase well, but I did. Without going into details, I've been able to turn around every single marker associated with the cancer, and it appears I have an excellent  chance of being able to come out of this with functioning kidneys (read no kidney transplant; no dialysis). My sense is that I was very close to not being able to come back from the kidney damage I had already suffered (about which I was unaware until I was hospitalized in late Jan and began looking under the hood), but it appears I've dodged that bullet (at least for now--my kidneys will be challenged again by the stem-cell transplant therapy in July).

So it's wonderful news to be in my position, having successfully ridden the storm-tossed seas of Segment 1, with all its uncertainties, and finding a stretch of calm water in front of me.

Segment 2
Relatively quickly, my oncology team agreed that my best long-term chance for turning the cancer around lay in a stem-cell transplant, where the healthy remnants of my bone marrow (ravaged by the cancer) could be salvaged and harvested from my system and then reintroduced to my bone marrow after wiping out the unproductive stew that was currently dominating my marrow (so that I can resume the efficient production of red cells, white cells, and lymphocytes—the things my bone marrow should be doing).

First though, I needed to stabilize and reverse the deterioration of my system, which included courting renal failure and heavy-duty calcium leaching from my skeleton. Having turned things around (as planned) it will still take a while strengthening everything for preparation for the stress of the stem-cell transplant itself (no point in undertaking the cure of it swamps the boat).

Thus, this is a purposeful pause between Segment 1 and Segment 3. While this is a relatively "quiet" time in the overall protocol, it's a needed step.

Segment 3
This is the stem-cell transplant itself and the immediate recovery afterwards. It should only take about a week to harvest the healthy stem cells, kill off what remains in my bone marrow, and reintroduce my stem cells. Thereafter it's a battle between my body, bolstered by the judicious application of myriad meds to reboot my system. It will basically be up to my body to handle the trauma of the transplant, to regenerate the stem cells, and to take advantage of the opportunity of a clean slate to push the cancer out of the way and proceed on a healthy path.

Segment 4 
The recovery from the transplant will happen by degrees and there is an important marker after 100 days, at which point I'll be thoroughly tested and evaluated for what we've achieved. It will be at this point (probably somewhere in October) where the oncology team will be able to offer a new prognosis about how much cancer-free time all this effort has earned me. I will be given no guarantees. I will simply have purchased a chance.

Based on what I learn at that stage, I can plan accordingly.
• • •In meeting with Dr. Alkaeid Monday (who's playing point person on my Duluth oncology team), we went over where we were and where we were headed relative to the recommendations from Mayo (secured last Thursday in my meeting with Dr Buadi).

First off, the doctors were in alignment about the treatments and their timing. Whew. They further agreed that my responses to Segment 1 were strong and positive, which was what I wanted to hear, and they gave me permission to resume any aspect of my life that I felt healthy enough to attempt between now and the July transplant. While no one's thinking about sky diving, I'm toying with a modest resumption of consulting and teaching.

This last has been a great buoy to my spirits as I can now indulge in some proactive thinking about life as a cancer survivor. While I have little clue about long-term possibilities, my life doesn't not have to be on hold as I go through the calmer waters of Segment 2.

I especially enjoyed a metaphor about the first three segments of my cancer protocol that Dr Alakeid passed along to me in the context of Monday's consult. He suggested that I think about it in terms of learning to fly. All parts of flying are not equally dangerous. In fact landings are the most dangerous, with the challenges there being the only times that are more stressful than take-offs. Actual in the air flying is rarely a problem. 

Mapping that onto my cancer protocol, he was pleased to report that I had successfully negotiated the take-off (Segment 1) and was in the air! Not everyone makes it this far and he was quite happy with my progress. Now we're entering the relatively safer in-flight portion of the protocol, putting ourselves into the best possible position for the most critical step: landing (represented by Segment 3, the stem-cell transplant).

So hurray for where we are Serious works remains yet my current position is as good as I could hope for. I aim to make the most of this pause to have a terrific landing (and enjoy the flying time between now and then). As far as I know, everyone is down with that.

Good News from Mayo

Thursday I was accepted for stem-cell transplant therapy at the Mayo Clinic, as a protocol for addressing and containing multiple myeloma. It was what I wanted, and it's a big deal that I got it. Now the challenge is making the most of the opportunity.

Here is what lays ahead:

o  Between now and when the transplant is performed (projected to be mid-July, but that's a soft date)), I'll likely go through 4-6 cycles of chemo-therapy, all geared toward boosting my kidney functions and eliminaing calclium leaching from my bones. While I've made significant progress on all of these markers across the board, I can do better and the doctors, understandably, want to make the best possible use of the transplant.

o  Once we get the OK for the transplant (because the markers are good), we'll temporarily relocate to Rochester for about 6-8 weeks, where the finer detailed road map looks like this:

Mayo will conduct their own blood tests, to make sure they align with the numbers coming back from test results in Duluth. According to what we were told yesterday, there are few surprises at this stage and 90% of the time the evaluation phase results in a green light.

Next step is collecting my stem cells. They will inject me with a shot every day that will cause my bone marrow to cough up its stem cells. The doctors will start collecting the stem cells five days later and continue that process until they have more than enough to do two transplants. Excess cells can be frozen for long-term storage and viability.

Once they have enough stem cells, they give me a single shot of something to kill off everything remaining in my bone marrow (the good and the bad indiscriminately). As you can imagine, we're talking about heavy-duty poison here and this begins a stretch where I might struggle again with the chemo. Let's say sterilization takes place on Day 1.

—Reintroduce my own cells
Two days later the doctors will reintroduce my own stem cells to my bone marrow, on Day 3.

For the following three weeks my job is recovery. By Day 6-7 my blood counts will be low and I'll lose my hair. There won't be many good days. I'll be taking heavy-duty chemo and just trying to ride the choppy waves without swamping my boat. This projects to be the darkest time.. Somewhere around Day 14 my blood counts should start to recover. From here on recovery tends to accelerate. Most transplant recipients are sufficiently far along that they no longer need close monitoring and can return home in the range of Days 18-21.
At this point the key question is how much the cancer has been brought under control: it could be anything from hardly any to full remission. While the transplant treatment is not dangerous per se (that is, few die of it directly), there is no guarantee that this will contain the cancer—which is the point of all this.
Huddling with my doctors after the transplant (perhaps 100 days afterwards) we should finally be able to make a reasonable assessment of my post-transplant prognosis—how much I can look forward to time with little or no pain, which opens the door for Susan and me to think about how to use that precious commodity. Until then it will be difficult to suss out exactly where I stand, yet that doesn't mean we have to stand on the sidelines until October.

No Trips Abroad
Though from this point on most of the chemo will be conducted as outpatient therapy, I will still need to remain near enough to Rochester and Duluth to have minimal complications with scheduling. That is, I'll need to be tethered to my Minnesota treatment centers. While brief forays out-of-state might be possible on rest weeks (between active cycles of chemo-therapy) they will be limited.

One Thing at a Time
Job One from now until transplant is my getting stronger (turning around weight loss, eliminating dependency on walkers and wheel chairs, managing daily needs and hygiene with minimal dependency on Susan, and continuing to push my kidney functions in the right direction). This will directly translate into my being to make the best use of the transplant.

Resuming "Normal" Activities
I asked my doctor when I might prudently be able to return to some of my work (as a process consultant or community networker), and got an interesting response: I can resume any time it makes sense. It's simply a question of what I have the capacity and motivation for taking on. This was something of a surprise (I had been thinking that career resumption, if at all, might happen only after the transplant and we got to see what that protocol had accomplished.)
Among other things, this significantly changes how Susan and I will be viewing the months ahead in Duluth. If we aren't looking at the transplant happening sooner than July, then I have over three months to get stronger, to enhance my capacity to handle the chemo well, and start crafting the life that Susan and I want our partnership to be. I'm limited only by my energy and my body response—rather than by the calendar (I have to wait until July) or by the stigma of cancer. Though I'm still coping with back pain on a daily basis, I'm jazzed to begin this work.

We do not have to put off conversations about what we want. We can start now. I especially like how this allows us to start moving toward a rebalancing of focus after two months that have been intensely unbalanced, coping with Laird's emerging health crisis. Now we can shift to Laird & Susan's opportunities.

Sounds better, doesn't it?

Mushing South

We've been blessed with a mild winter in Duluth (which is assessed mainly along the lines of the Ice Index: the less ice I have to navigate between house and car, the milder the winter). Given my compromised health (multiple myeloma or MM) necessitating many visits to and from doctors  for treatment and therapy, that's been fortunate.

Wednesday Susan and I traveled by car to Rochester and an important date with specialists at the Mayo Clinic to see if I'm a suitable candidate for stem-cell transplant therapy, which is one of the most promising new protocols for treating MM. Our date was at 8 am Thursday which mean arriving on location no later than Wed evening.

Wouldn't you know: even though we're in the post-equinox, tail-end-of-the-dog days of March, the US Weather Service predicts that we'll sashay through 3-5 of wet, glumpy snow to get there. I reckon winter couldn't resist taking at least one more bite of my apple.

On the other hand, Susan drives a Subaru—the official car of the North—and 3-5 inches of crystalline sunshine should be no match for all-wheel-drive. We just left a little earlier.

While Mayo has let us know that they'll orchestrate all my appointments in Rochester, and my oncology team has made sure that all the test results and their diagnostic thinking has been duly passed along, Susan and I are driving south with just about as much surety as the Fellowship of the Ring headed for Mordor—after sifting through all the choices, what remains is the best option, regardless of its improbability. Like the Fellowship (an appellation I have a strong affinity with) I head south on the wings of trust and the loving support of many. 

Beyond what room I'll be in for my first appointment and the name of the doctor that I'll be meeting, tomorrow is another exercise in letting go. I don't know what questions I'll be asked, or even the basis for Mayo's decision about whether to accept me for stem-cell transplant therapy. I don't know how long it will take them to make a decision, or my options if I get turned down. In short, there are many unknowns and I head south thankful that I am not making this journey alone, that Susan will be participating with me as a team.

We arrived in Rochester and got settled in around 6 pm, right before the spring snow started arriving in earnest. When we woke up this morning, there were 10 inches of fresh snow on the ground. Luckily, we were able to make it to all of our appointments without leaving the block of buildings that comprise the essence of the Mayo Clinic, and thus were able to avoid any nasty weather encounters. Whew.

I felt drained from the ride down and went to bed early. What's the best way to get psychically ready for the unknown? Not sure, I had a small dinner and cashed in. I figure that laagering my energy for today was the right call. No dancing; no blackout bingo.

So here were are, on the cusp of finding out what Mayo is willing to support in my effort to place my cancer into remission. I have only the vaguest sense of probabilities, but I know what my doctors have faith in, and I have faith in my doctors. While there does not seem to be a serious risk to my mortality in attempting stem-cell transplant therapy, neither is there any guarantee of a positive bounce. We'll have to do it and find out what we get. It's part of the adventure.