Transitions

I realize it has been a month since I last posted on this Blog. I feel I am in transition, and so this posting will try to reflect that. The transition is both physical, and mental, with implications to my "identity".
To ease into this discussion I will begin by simply updating since the last posting which was Jan 30th.
Two Ferry crossings broke up our scenic journey from Port Angeles to Orcas Island the 31st of January. We spent three delightful days there with MC's cousin Julia, and Tom. Their home on a rocky promontory on Obstruction Pass is perfectly situated for experiencing the winter storms (rain and 38mph winds!) that came through, interspersed with some sunny weather during which we could watch the seals, otters, and eagles, or venture outside for a hike or a bicycle ride. There was also plenty of time for reading and relaxing between hearty meals of soup, stew, and rotisseried turkey and leg of lamb cooked over their open hearth. It was then something of a culture shock to return to Seattle on Friday the 3rd of February for dinner at a trendy downtown restaurant and two hours of comedienne Paula Poundstone, live at the historic Moore Theater.
Back in Sandpoint I had 4 days catching up before I headed East for a one day follow up at NIH in Bethesda. The news there was all good: thyroid tests almost back to normal (on thyroid medication), and, most importantly, Dr. Bishop asserted unequivocally that I remain in complete remission (dismissing the unsettling January bone marrow interpretation of the Pathologist that I mentioned in the last Blog posting.) I'm doing so well they don't plan to see me again until my 9 month check April 9-13th.
Four days after my return we were on the move again, this time to California! We flew to Sacramento rented a car, and over the next eight days visited some of our best friends from my Med School days: Steve & Claudia, in Chico, Marc & Lainey, joined by Mark Phelps and his fiancee Brooke at Point Reyes, and Peter and Patty in Berkeley. I won't even try to enumerate all the fun activities and great meals we shared. Enroute from Chico to Pt. Reyes we also got to spend some time in Marin with MC's brother Tom, and my cousin Tom Thorner and wife Brit.
We're actually staying put now, for two months anyway. I would love to fly off somewhere in the Comanche, but I'm still waiting to get my FAA Medical back. Usually the FAA bureaucracy is the major hurdle, but so far my biggest delay has been getting the requested documentation out of NIH.
So getting back to the aforementioned "transitions". With the last increase in my thyroid med I feel my energy level is approaching "normal", and I find I'm able to gradually increase my exercise. After that good news from Dr. Bishop I decided that there is really no point in worrying about recurrence, and that it is better to simply consider myself cured. I also feel much more confident that my sister's stem cells are indeed a "perfect match", and that I'm not going to experience any Graft vs. Host (GVH). This all leads to the frequently asked question of when am I returning to work, and the broader issue of "identity".
I don't see myself as a "cancer patient" anymore, and I'm even beginning to tire of primarily being seen as a "cancer survivor". I hanker for my former identity: "small town anesthesiologist-bicycling nut". However, I know things can never really be the same, I have certain insights from this experience, as well as an obligation to my family not to go back to my former stressful lifestyle. A sobering fact is that I am the only one out of the eight patients who have been through this NIH protocol that is still in complete remission (CR). The three other patients who initially achieved CR now have evidence of recurrence after receiving immunosuppressants to treat GVH. It would seem that avoiding GVH is critical. One patient's GVH occurred after contracting a virus soon after returning to work 6 months after her transplant. They really do not know what triggers GVH, but they do know that the longer you can go without GVH, the less likely it is to occur. I therefore made a promise to myself, prior to my transplant, that I would stay out of work for at least a full year. So at this point I'm taking some preliminary steps (ACLS recertification, renewing hospital credentials, getting additional CME)in preparation to do some supervised cases in June and then returning to work, part time, in September. In the meantime I plan to spend as much time as possible with family and friends,including two summer River trips, and trips to France in May, and Australia in August!