Today is chemo #5, and I'm writing this from the chemo chair — poison pumping into my body like soldiers on a seek-and-destroy mission. Cue Metallica's aforementioned song if you want to enter my headspace. Wow, I sound like a douchebag. My high school self would punch me in the face just for using the word "aforementioned" — let alone using it alongside Metallica. I'm sure Kaiser will do me the honor next time we meet. First word that popped into my head. I'm sticking with it. Before treatment…
The total poison load in my chemo cocktail was reduced last week. The heavy head feeling was better, but the fatigue dragged on longer than ever. I made it to meetings Monday morning, then tapped out and took Monday and Tuesday off. On Wednesday, I was still running on fumes, but I pushed through. In my good week, head clear, I'm back in CEO mode on my cancer journey. I continued researching CRS+HIPEC surgeons, and through a Facebook group — HIPEC Support Group — I found Dr. Armando Sardi at…
Can a U.S. expat living abroad use ACA insurance to cover a $400,000+ cancer surgery? I'm a 50+ year-old U.S. citizen living in Portugal with a cancer diagnosis that requires CRS+HIPEC surgery — one of the most complex abdominal procedures performed anywhere. At a major academic cancer center in the United States, the uninsured cost runs $200,000–$400,000+. The goal: legally obtain U.S. health insurance through the Affordable Care Act (ACA) Marketplace, cap out-of-pocket costs at $10,600, and…
Where I Am Right NowStage IV colorectal adenocarcinoma. The short version: diagnosed, completed 12 cycles of FOLFOX, recurred in the liver nine months later, reclassified as Stage IV. Now on FOLFIRI — with a measurable response. My latest MRI came back better than expected. The cancer deposits — subcapsular implants on the liver surface and two pelvic implants — have all shrunk significantly. One liver implant went from 28×21mm down to 15×3mm. That is not a rounding error. The chemotherapy is…
Spring of '93. Graduation was close enough to taste. The warm and inviting sun poured through the car windows as my buddies and I returned from lunch, the pulse of Metallica blaring from the stereo. It felt nothing short of a sin to return to the grim classroom's confinements after enduring yet another relentless Iowa winter. My next class was American Lit. Sam had the same class earlier that day and told me there was a sub — a rare stroke of luck this close to summer. He also had insider…
Today marks the start of chemo episode four of season two, and it drops me straight back into the analogy I built during season one. The one that inevitably triggers Down in a Hole by Alice in Chains, looping in my head. Chemo feels like being kicked into a hole. The chemo monster shows up and shoves me in. It takes days of crawling, inch by inch, just to reach the surface again. And when you do, you're more battered than the last time. Most people only see me when I resurface. They don't see…
More than a decade ago, when I first read The Master Key System by Charles F. Haanel, I was a developer who had not yet fully recognized that I was drifting into software consulting. The book did not teach me technical skills. It sharpened something else — clarity of vision. I stopped seeing myself as the person writing code in the background. I started seeing myself as the person in the room — interpreting systems, diagnosing workflow loopholes, translating complexity into decisions. The…
1996 Ledges State Park sits a few miles south of Boone, Iowa — the same stretch of countryside where the Kate Shelley Bridge cuts across the Des Moines River Valley. I'd never been there before. The place was new to me, but the reason I went wasn't. Someone had mentioned an adventure. A small group of guys planned a hike that weekend and asked if I wanted to tag along. One of them was Kaiser. I didn't know him well — maybe a few run-ins through a mutual friend. He was from the Loo too, though…
Not Formula 1. FoundationOne CDx. A month ago, I dropped €3,600 to have my tumor genetically profiled. Today I sat down with my oncologist to review the results. FoundationOne CDx analyzes hundreds of cancer-related genes in tumor tissue to identify driver mutations, biomarkers like MSI and TMB, FDA-approved targeted therapies, and clinical trial matches. It's a DNA-level blueprint of the cancer. My results: KRAS G12V mutation, MSI-Stable, low tumor mutational burden (4 muts/Mb), HRD-negative,…
Shrinkage — not the kind from a cold plunge. The last MRI restuls are in... The cancer is still present — but everything measurable has shrunk. The implants remain on the surface of the liver, not inside the tissue itself, and in the pelvis. What changed is their size: The implant near liver segment VII went from 19 × 6 mm down to 13 × 1 mm. The implant near segment VI went from 28 × 21 mm down to 15 × 3 mm — a substantial reduction. The two pelvic implants dropped from 15 mm to 11 mm and 13 mm…
1986 The Woods were our first training ground — a tangle of trees and hills behind Jon's house on Columbia Avenue, just a block from Heath Street where I grew up. Decades of runoff had carved the hills into earthen ramps that could launch a bike, a sled, or a kid with more confidence than coordination. The trees — spindly young maples, saplings, and thin trunks — were our safety nets, angled just enough to let you grab hold mid-jump and ride them downward like a kid-sized rappel down an uneven…
Still no word on my CT and MRI results. Tuesday was Carnival in Portugal — an official holiday — but in practice, much of the country shuts down for the entire week. Soren's home for winter break, so realistically, I'm not expecting anything yet. But Tom Petty keeps looping in my head: The waiting is the hardest part. I spent a large chunk of my younger life in bars playing pool, and Tom Petty was the jukebox. His songs were the soundtrack of those years. Tina and I saw him at Red Rocks on his…
Something bit me on the neck. I was at my desk in Denver — working, not doing anything interesting — when I felt it. Couldn't tell you what it was. Probably a boxelder bug. Those flat, red-striped freeloaders are everywhere in Colorado, and while they're not exactly known for biting, I wasn't about to rule it out. Whatever it was, I swatted at it, went back to my screen, and forgot about it. Then a lump showed up. Slow at first. Just a firmness under the skin, behind my right ear, tucked along…
1988 There's a moment in every kid's life when you realize the world runs on rules — and that some people follow them, and others... test them. I didn't test them to be rebellious. I tested them because I didn't stop to ask whether I was supposed to. And the thing about edges is: once you find one, you start wondering where the next one is. * * * By eighth grade, Sam and I had turned Waterloo into our personal proving ground. We rode bikes everywhere — streets, trails, parking lots, The Woods —…
Here's the content formatted for your blog post: --- On Christmas morning in 1982, my older brother Jason and I excitedly tore through the wrapping paper, uncovering the classic BB gun—the same one Ralphie nearly shot his eye out with in A Christmas Story. We were thrilled, but our excitement died the moment we saw the window. The Iowa winter raged outside, rendering our new toy useless in the biting wind and snow. Dad, always prepared, handed us another box. Inside was the solution: a BB gun…
I was talking to my mom last night when she casually mentioned something she'd recently learned: there are two types of cinnamon, and one can be hard on the liver. Wait, what? Really? I use cinnamon daily in my coffee. Since moving to Portugal, I've been drinking instant coffee, which isn't great, but cinnamon and milk make it tolerable. Back in the States, I had a wonderful coffee maker with a hopper on top that ground the beans on the fly. I loved that machine. After ten years—and just before…
The Rollercoaster ContinuesThis journey is always a rollercoaster — and yesterday was no exception. I got a call from Champalimaud last night: their MRI machine is broken, so I can only do a PET scan. I was secretly kind of happy — the MRI machine's confinement is claustrophobic, and I've never loved being stuffed into that tube. The trade-off? Another drive to Lisbon in rush hour traffic, which stretches a 25-minute trip into 45. But first, the good news. I popped my first Prednisone pill at…
The Last Rack In 2002, I played in the U.S. Amateur Pool Tournament in Laurel, Maryland. To get there, I had to be one of the top players in the APA league and one of two winners from a qualifying tournament. Denver was one of only twelve cities in the country to host a qualifier, and ours was held at Shakespeare's pool hall. The same pool hall I played in after getting laid off from Spiremedia. The same one, only a few miles from my house. This tournament would be my last hurrah with pool. I…
I got the results from my latest PET scan. And the headline is the one every cancer patient wants to read: No evidence of active cancer. The scan showed no signs of recurrence or spread. Even better, areas around my liver and peritoneum that had previously shown activity have regressed. The official conclusion: a "favorable (apparently complete) metabolic response to therapy." In plain English — the chemo is working. There is no active disease showing up on imaging. That's about as strong a…
1987 Just past The Woods, the neighborhood dissolved into something wilder. A fenced-off quarry opened up first — a small lake at its center, deer wandering the edges like they owned it. The guy who owned the land had built himself a floating house out on the water, like he was hiding from the world. Every time we pushed through the fence, it felt like finding buried treasure. Beyond the quarry was where things got serious: a junkyard full of wrecked cars, and right next to it, the railyard.…
As expected, chemotherapy did not happen today, even though it was on the schedule. Because of the last-minute PET scan on Friday, I did not go in for bloodwork and did not expect to receive the scan results by this morning. Given that, I assumed chemo would be postponed. I called my oncologist to confirm, and today’s treatment was officially cancelled, saving me an unnecessary drive to Lisbon. My oncologist does not want to make any treatment decisions until the PET scan results are back. We…
I had my PET scan today. It was scheduled in the usual Portuguese fashion. My oncologist requested the scan on Monday. At 3:00 p.m. on Thursday, I got a call telling me to be there at 9:30 a.m. Friday morning. At least it got done in 5 days. I not sure I could say the same in the States. Why the PET scanI've been dealing with systemic pain across my chest, back, and neck. That combination raised concern. After consulting both Dr. GPT and my oncologist, we agreed the right move was a PET scan to…
Time to get serious about this clavicle and shoulder pain. This can’t keep dragging on while my strength erodes. I need mobility, strength, and pain control to keep moving forward through this. This didn’t come out of nowhere. After season one, episode two of chemo, I finally got back into the ocean. I’d been craving it since May. Cancer had hit pause on everything. Guincho was firing on the north side—rising tide, closer to high than low. I was cooked, caught a wave all the way in, felt…
Looks like I'm back on track. I submitted bloodwork earlier Saturday. The results came back the same day, but I waited until Sunday morning to open them. Creatine kinase dropped from off-the-charts high—1123 U/L to 83 U/L. The normal range is range 46–171 U/L. Overall, the bloodwork was good. • CK normalized • Kidney function stable • No lingering muscle damage Clear confirmation that I overdid it in the gym—and that stopping fixed it. The correction worked. What;s still concerning CRP is 3.10…
Today was supposed to be episode four of chemo season two. Instead, it turned into a reminder that some setbacks are self-inflicted. In a previous post, I wrote about the pain I’ve been dealing with. Turns out, part of it is on me. On Friday, I did an upper-body workout and pushed too hard. I’ve been trying to keep things conservative—only two gym sessions a week, low weight, and only during my good week. Mondays are lower body. Fridays are upper body. Simple. Controlled. Sensible. Or so I…
How am I doing? The ongoing question. The honest answer: I feel like shit. My body never fully recovered from chemo, season one. Nine months post-chemo, I was *close* to normal—but I’d already been told full recovery can take up to five years. I finished season two, episode three almost two weeks ago. Episode four starts tomorrow. And I’m dealing with systemic pain. Primarily: shoulders, neck, clavicle, lower back, and my big left toe. Season one chemo was **FOLFOX**. The “OX” is…
What Autophagy Actually Is Autophagy is your body's cellular recycling program. When you go without eating for an extended period, your cells start breaking down old, damaged, or worn-out parts and reusing them for energy or repairs. It's not some exotic new discovery—your body does this naturally at a low level all the time. Now, here's an important distinction I need to clear up: autophagy and ketosis are not the same thing, though they often get lumped together. Ketosis is a metabolic state…
After learning how to properly prepare broccoli—chop, wait, cook gently—I assumed the lesson ended there. End of story. It doesn't. Cruciferous vegetables don't naturally contain large amounts of sulforaphane or indoles in their active form. Instead, they store precursors called glucosinolates. Myrosinase is the enzyme that converts those precursors into biologically active compounds when the plant is damaged by cutting, chewing, or crushing. Myrosinase doesn't have to come from the same…
While researching nutrition strategies to put my body in the strongest possible position to fight cancer again, cruciferous vegetables consistently rose to the top. I still have to slow down to pronounce it correctly: [kroo-sif-er-uhs]. This does not mean these foods "kill cancer." They don't. What the evidence supports is more restrained: cruciferous vegetables contain compounds that can modulate pathways involved in cancer growth, detoxification, inflammation, and cellular stress. In other…
I want to confirm a few technical details about my diagnosis and treatment and clarify whether any complementary approaches raise concerns. 1. Tumor Classification (Confirmation) Can you confirm that my tumor classification is correct? -- MMR status: MSS / pMMR -- Meaning: Microsatellite stable; mismatch repair proficient 2. Immunogenetics What is my HLA (human leukocyte antigen) type? -- Has this already been tested? -- If not, is there value in testing it now? 3. Compatibility With Eastern /…
I want to clarify something when I talk about neuropathy. I don't mean cold sensitivity. I mean nerve damage. In my case, it shows up as pain when pressure is applied to the top of my left big toe. This wasn't happening last week. It started after my third chemo treatment, which matters. On day 7, I also woke up with significant back and neck stiffness—tight enough that turning my head was difficult. The day before, I did low-intensity lower-body weights, and combined with chemo, that's a…
As season 2 of chemo cycles began, I wanted a tool to help me decide when and what to eat. I built a simple chemo helper to track these foods, supplements, and timing across each cycle. Today, I wanted to learn more about omega-3s from food. What are the benefits of Omega-3s, and why only on certain days? Why omega-3 matters Omega-3s (specifically EPA and DHA from food) help during chemo because they address what treatment stresses most after the drugs stop circulating. Used at the right time,…
My acupuncturist recommended this reading as background on Traditional Chinese Medicine (TCM) approaches to chemo side effects: Chemo Herb Support (PDF). I’m not taking anything based on theory alone. The goal here is simple: identify a short list of lower-risk herbs to review with my oncologist first, rather than sending a large formula with unknown interaction risks. MY MEDICAL CONSTRAINTS - Chemo regimen: FOLFIRI (irinotecan + 5-FU ± leucovorin) - Key metabolism issue: Irinotecan is…
How do you feel? How was the last chemo? I appreciate the care and concern, but answering those questions over and over is becoming overwhelming. It pulls energy away from healing. In general, chemo sucks. There’s always some level of inflammation or pain somewhere in my body. Here’s the routine: Tuesday (Day 0) Five-plus hours at the hospital getting the chemo drip. I’m sent home with a portable pump that delivers poison into my body for the next 48 hours. Wednesday (Day 1) The worst day.…
I’ve reached a chapter in my life I never imagined at 51. The Reaper isn’t a metaphor anymore. He’s scratching at the door. My odds of survival feel like two bullets in a revolver—maybe less. This can be a curse. It can also be a gift. Most people die suddenly and leave chaos behind—unanswered questions, emotional landmines, and impossible decisions dumped on the people they love most. I have something they don’t: time. Time to decide. Time to be explicit. Time to remove doubt. One of the most…
raig daniels