The painkillers are doing their thing. And being doped up allowed me to enjoy a laughter filled afternoon with my friends Kit and John Standridge.

The theme of this blog is supposedly “laughing my way through cancer, AVN, and other things.” I admit we’ve been a quart low on laughs around here. I’ll try to remedy that soon.

It’s good to be alive. It’s even better that I’ll be back home by Friday afternoon. Good night, friends.

I was the first person to show up at the pre-op center and was remarkably relaxed through the whole thing (blood pressure 115/76). My biggest concern was getting another MRI. As it turned out the insurance company nixed the MRI so that made it all simpler.

I finally got to meet my surgeon Dr. Einhorn face to face and he was everything you want a surgeon to be — smart, older but not elderly, confident. He also had those surgeon hands — soft, firm…skilled. In fact he reminded me a lot of Dr. Jahrsdorfer, the surgeon who operated on my daughter’s ear and made her an ear canal where there wasn’t one.

I told him that many, many people were praying for him tomorrow and he smiled. Speaking of prayer, I have felt very humbled by all the kind notes of support where so many friends have let me know they are praying for us. I’ve rarely felt so supported and encouraged my whole life. Thank you from the bottom of my heart to everyone who has been praying.

Tonight I had the requisite “cup a chowda” as well as some mahi mahi at a place called Legal Sea Foods (sounded a lot better than Contraband Sea Food in the dodgy end of town). Then we walked through the Boston Common and had dessert (Boston cream pie of course ) at Cheers. Since it gets dark at 4:45 pm that’s about all we had time to do. That 4 am wake up call comes early tomorrow.

Thanks again for all the prayers. I’ll see you on the other side.

I hope to blog a little and update Facebook a lot to keep friends and family up to date with what’s going on all along the way. Here’s the agenda right now:

Sunday – Leave Knoxville early and fly to Atlanta, then Boston. Check in to the hotel which is right on Boston Harbor. Maybe have a slice of Boston Cream Pie.

Monday – Show up at Boston Medical Center early for an MRI, pre-op visit with the surgeon, Dr. Einhorn, and perhaps some other medical stuff. Perhaps see something interesting around town, then get to bed early.

Tuesday – Another early arrival at the hospital for the surgery itself. It’s supposed to last an hour and half, give or take, and I will be spending the night in the hospital. Hello embarrassing hospital gown.

Wednesday – Hope to be discharged early in the day and spend the rest of the day resting at the hotel.

Thursday – More rest at the hotel and I hope a visit from some friends who live in Boston.

Friday – Leave early for Logan International and fly back home (with the required layover in Atlanta again).

Thanks everyone who has been praying already and will be praying me through this week. I’ll be back soon.

I'm a survivor.

It’s been an eventful two years, and while I would never choose to have cancer of my own accord, I’m very thankful to have grown in so many ways since that day. Mostly, I have gained a deep gratitude for the life God has given me – an amazing wife and kids; great, supportive friends; a church where I’m challenged to grow spiritually every week; a job where I can use my talents; a home in one of the prettiest places to live in the world. I’m blessed beyond my ability to fully understand. But I am more in tune with those blessings now than I ever was before cancer.

As the great Wes King (a fellow cancer survivor) says, It’s Good to be Alive.

It’s good to kiss my wife
It’s good to hug my kids
What a magic tale this life in God
I said it’s good to be alive.

Well the pain has left a mark
But it’s given me a spark
So that I can light a fire
Now maybe I’ll inspire
Maybe I can right some wrongs
And sing a few more songs
Live the way I know I should
And say that Life Is Good!

I had the unique privilege to talk with Wes recently, and it’s a real gift have a bond with him as a fellow survivor. And Wes is just one of the many people I have connected with as fellow members of the C-Club. Those others of course begin with my mom (lymphoma), my church friend Karen (breast cancer), my coworker Allen (bladder cancer), my VFL brother Chris Lofton (testicular cancer), my college classmate Marshall (melanoma), and my high school classmate John (lymphoma) who I chatted with at my 25th class reunion earlier this month, just to name a few.

While I’m deeply grateful to be alive, I’m also much more keenly aware of the plight of so many others who are going through much more difficult circumstances than I dealt with 730 days ago.

A good family friend, Jeannie, is undergoing chemotherapy for bladder cancer even as I write this…

I just learned a couple of days ago that the wife of a coworker of mine is being treated for ovarian cancer and having a very hard time right now…

the husband of another former coworker passed away this week after a long battle with leukemia…

and on and on.

It’s very encouraging that there are new cancer treatments that are showing great promise, and I’m so glad that organizations like Stand Up 2 Cancer are funding some of the best new research in the fight. And people like my friend Michael are at work all day coming up with new and creative ways to attack cancer. But the fight is bigger now than I ever realized before and claims so many lives. I know that God never promised a life free from pain, sickness, and suffering. Thankfully, He promised the gift of His presence through everything, including cancer. “In this world you will have trouble. But take heart! I have overcome the world.” John 16:33

On Wednesday, Sept. 28, I got a call from Dr. Thomas Einhorn, the orthopedic surgeon at Boston Medical Center who has pioneered the bone marrow aspirate concentrate (BMAC) procedure here in the United States after learning it in France. He told me what I already knew – I’ve got messed up hips. But he also said he believes his procedure could help me. By withdrawing bone marrow from my pelvis, putting the marrow in a centrifuge to separate the stem cells from the other cells, drilling into my femoral head(s) and then injecting the stem cells into the drilled out area, he believes he can relieve the pain I’ve been having. Decreasing pain is the main measure of success for the procedure. However, the additional hope is that the stem cells will begin growing new, healthy bone and either stop or (in a best case) reverse the progress of the avascular necrosis.

That gave me a lot to think about by itself. But he also said he recommended if I were to do the procedure that it should happen in the next 4 to 6 weeks. Yikes!

On Saturday, Oct. 1, I hobbled my way down to Latitude 35 in Market Square for the 25th reunion of my high school graduating class. I had a lot of fun catching up with folks most of whom I hadn’t seen for the whole 25 years. Since I grew another 3 inches after high school and I’m currently about 70 lbs heavier than when I graduated (yes, that’s 23 pounds per inch) I got a lot of looks like “what the **** happened to you?” The crutches also made for an instant, if unpleasant conversation starter. It’s also a challenge to give the full explanation of the hip problem which is long and complicated and then tell it over and over. I cut out a little early from the reunion so that I could get on the road to Nashville to see my best friend, Phil. We had planned a couple of months ago to run the Music City Half Marathon together to celebrate our birthdays. And even though I couldn’t run it, or walk it, I wanted to be there to cheer him on.

So on Sunday morning, Oct. 2, Phil and I along with his wife and his son headed to LP Field where the race started and finished. This would be the first race I had planned to run but couldn’t thanks to the hip problems. Still I had a great time as a spectator and got to see virtually the whole field pass by from my vantage point midway through the course.

On Tuesday, Oct. 4, I finally had my appointment with the Knoxville based hip specialist, Dr. Nadaud at Knoxville Orthopedic Clinic. The good news is he told me I could stop using the crutches and start trying to regain some mobility in my right hip and leg. The other news is that his reading of my scans shows that the AVN has affected 50 percent of my femoral heads, meaning my only surgical option in his opinion is total hip replacement. He did say that core decompression (drilling out the dead bone which is the first part of the BMAC procedure) wouldn’t pose any problems for doing a hip replacement down the road. So while there is no real problem with doing the BMAC, he said not to get my hopes up if I decided to pursue it.

While I was sitting in the KOC waiting room, I got a call from Dr. Einhorn’s office to talk about the specifics of doing the BMAC procedure including that pesky little detail of insurance. Well, as it turns out, my insurance will cover the procedure since Dr. Einhorn is in my company’s network. And because it’s considered an outpatient procedure, it will only cost me $100. That’s a great miracle and a large part of why I’ve decided to pursue this option.

So, I’m headed to Bean Town to get my hip (or hips) drilled and filled with my own stem cells. It’s a crazy world we live in.

Oh, and on Saturday I finish my 43rd trip around the sun.

The Sunday after the race I pretty much couldn’t walk because my right hip was in serious pain. For that reason I called the Knoxville Orthopedic Clinic first thing Monday morning and was fortunate enough to get an appointment that afternoon with one of the more well-known orthopedics in town, Dr. Bill Yeomans. I had to lock my right foot at about the 2 o’clock position all day just to be able to shuffle down the hall of work and the doctor’s office.

Once I was able to see the doctor, he looked over my history and tested my pain points with some guided leg movements and kept making faces I didn’t really like. He ordered an x-ray which he said didn’t really show him anything so he said he wanted me to get an MRI and then see one of his colleagues for the results. The reason I had an existing chart with KOC was because in 2009 I went there to be checked out for a condition called Avascular Necrosis or AVN, aka osteonecrosis (google them up; it’s not pretty). The reason I thought I might have AVN in 2009 was because I had been given an overdose of prednisone which was prescribed by a dermatologist for a nasty skin rash I had all over my body. High doses of prednisone are known to cause AVN and I had experienced a sudden onset of major hip pain while taking the prednisone.

The x-rays that KOC took in 2009 were negative, but the doctor I saw back then told me to stay in touch if I ever had problems with my hips. I had just begun to put that possibility out of my mind when a  couple of months later I found out I had testicular cancer. At that point, AVN was the least of my worries and since I had no hip problems over the next two years, I had more or less not thought about it again.

Then in July of this year, I started having hip pain each time I ran. The pain would go away as I warmed up but would really flare up after I cooled down from  each run. I thought I was managing the problem OK until my 8 mile run the weekend before the Hotter ‘n Hell race. After that run the hip started hurting all the time, so I took it easy leading up to the race, but I knew the pain had crossed a threshold and was afraid the injury was more serious than just a muscle pull or soft tissue tear.

The diagnosis

So on Monday,  Aug. 22, I had my MRI which was a strange experience in and of itself. If you’ve never had one, you probably think like I did that it’s nothing more than a lengthy x-ray with a fancier machine. It’s actually more like a cross between being lodged in a sensory deprivation chamber and being buried alive…by jackhammers.

The results of the MRI didn’t come until the next Friday, Aug. 26. After waiting on pins and needles for the whole week–plus another hour in the waiting room–I finally saw Dr. Betcher late in the day. In my mind I had prepared myself to hear him tell me it was either a labrum tear or a stress fracture. Turns out it was three things:

1. a stress reaction, which is a lot like a stress fracture without the break but with all the pain, in the right hip,
2. cam impingement, which is a condition where the femoral head (the top of your femur which forms the ball of the ball and socket hip joint) is enlarged and interferes with the normal motion of the hip, in both hips,
3. Avascular Necrosis. Both hips.

So what is AVN?

AVN occurs when something interrupts the flow of blood in the veins located in your femoral heads. The result of that interruption is that the blood vessels die, and the result of that is that the bone itself begins to die. Once the bone begins dying that ultimately leads to the collapse of the bone. And once the condition reaches that point, the only option is to have total hip replacement.

I had read plenty about AVN in 2009 and again the week before the MRI results just to be braced for the worst case scenario. I didn’t really think there was any way I had AVN. But unfortunately I was wrong.

I was pretty shell shocked right at that moment he gave me the news thinking I might actually never run again. That was the hardest part of this at first. I’ve run my whole life but in the last year and a half running has come to mean so much more to me than just exercise. Running helps me feel alive. When I’m outside running and see the mountains or the moon, or a sunset or a grove of trees turning colors in the fall, or small animals zipping around me, I feel like I’m part of God’s creation doing what I was made to do. You don’t have to be fast to enjoy running. But you do need two good hips and now I don’t even have one.

Dealing with it

So once Dr. Betcher had dropped the bomb on me and shown me the very ugly MRIs, I barely heard what he said other than he would see me in 3 weeks for follow-up and also refer me to a colleague who specialized in total hip replacement. He also told me no running for 6 weeks (ha! as if I could), but that I could do whatever didn’t cause me pain, e.g. ellipticals, swimming, biking, etc.

Based on that, a few days later I got the bright idea that I would try riding the stationary bike at the gym. After that bike ride I went almost completely lame again and actually had to stay home from work for the next few days. After Labor Day I called KOC to report that I was doing worse and the physician’s assistant I spoke to recommended I get crutches and try to keep all weight off the right hip. Fortunately, a good friend had a set of crutches in the closet and loaned them to me. It took a few days to get the hang of it, but it’s like riding a bike. I had spent several weeks on crutches during college for a broken foot so I knew how to use them somewhere in the deep recesses of my brain.

11 more weeks

That 3-week follow-up visit with Dr. Betcher came just a couple of days ago on Sept. 16, and he said that he wants me to stay on the crutches for a total of 12 weeks. Ouch, babe. So as I write this I have 10 and a half weeks left to go on crutches. When I see the hip replacement specialist on Oct. 4, he may decide to shorten that. But I’m planning in my mind on doing the whole 12 weeks. Ugh.

The good news is, walking on crutches appears to burn a lot of calories and my weight is down to the lowest it’s been since about 2007. Being on crutches really deters you from going somewhere to eat all the time as well. My arms are also getting stronger and I seem to be developing a sense of balance which is saying a lot for a highly uncoordinated white guy.

What does it mean?

I’m not about to feel sorry for myself or ask “why me?” All the running I’ve done in the last two years I hoped was something that could give glory to God as friends and family saw me coming back from cancer and doing things I didn’t even do before I was sick. Is that being taken away? I’m not sure yet and won’t know for a while. The AVN may well be something I live with for a really long time before I ever need surgery. But the purpose in life never changes — I’m still here to give glory to God. So if that’s done by handling another obstacle with Grace, so be it. If it’s overcoming that obstacle through God’s healing and strength, so be it.  For my praying friends, feel free to pray either way.

The other thing that came immediately to mind when I got the diagnosis was the fact that I already registered months ago for the Goofy Challenge in January of 2012. The Goofy consists of running both the Walt Disney World Half Marathon and WDW Marathon on back-to-back days. There’s no way I could  run both those races now as I won’t come off the crutches until  late November. But I’m still holding on to a glimmer of hope that I might be able to walk them. I’ll have a better idea about that possibility after I talk with the hip specialist on Oct. 4.

In the mean time, I’m going to try to stay healthy, eat right, and aggressively rest (there‘s an oxymoron) this right hip by keeping weight off of it as much as I can to give it space to heal from the stress reaction. I’ll also be getting another opinion or two and perhaps seeing a doctor in Boston who has developed a new treatment for AVN patients using your body’s own stem cells to help reverse the effects of AVN.

Stay tuned.

Despite the name of the race, the weather was really pleasant at starting time. I had warmed up enough and doped up enough (on Tylenol) that my hip wasn’t bothering too much as we headed out from Tyson Park near the skate park. I hadn’t run a 5K for speed in a really long time so I had to kind of feel my way out through the first half mile or so. But I settled in to a pace that felt fast but sustainable. As it turned out, it was slower than I hoped but maybe the best I could do under the circumstances.

It was an out and back course, and the turnaround came sooner than I was expecting which got me excited. The last mile of the race was quite a bit warmer than the first two, but I felt pretty strong and still passed people all the way to the finish (ok, one guy caught me in the last 20 feet but he was probably half my age).

As I crossed the line, my  time wasn’t what I hoped (25:11), but I still felt like I was ahead of most of the field which felt nice for once.

Since the race was in support of the American Cancer Society I chose to wear my StandUp2Cancer “Survivor” t-shirt. That got the attention of a guy named Jeffrey who approached me and asked if I was indeed a cancer survivor. When I told him I was, he handed me a coin encased in lucite that he said he gives to all fellow survivors he meets. We talked radiation, diagnoses, prognoses, etc. and he gave me the sobering news that he had been cancer free for 20 years but had a recurrence this past month. I was honored to meet him, accept the coin, and talk with him for a few minutes. But I couldn’t help but walk away thinking about that 1% (or less) chance that I might have a recurrence one day myself. It made me feel very thankful to have yet another day of life without cancer, and made me thank God that I was able to do something like run a 5K on a summer day.

At the after-race awards ceremony, I hung out with my friend Lola as we waited in vain to win a door prize. When they started handing out the actual trophies I held on to hope that I might have placed in the big guys division. As I said earlier, it was an out and back course, which allowed me to see everyone who was in front of me after they made the turn and ran back in my direction. I noticed several guys grayer than me, but not very many who were packing the pounds. And as it turns out, I got first place in the Clydesdale Division. My first running trophy ever! It’s worth less than the cash value of the Five Guys Burgers and Fries gift certificates they were giving away as door prizes, but it meant a lot to me. Again, very thankful to God to be alive another day and able to pick up a little trophy.

I really appreciated my friend Michael Holtz organizing this event, and his lovely wife Sarah (a former co-worker) for cheering me at the end and handing me my trophy.

Now if I can just get this hip situation straightened out…

After that first lesson Natalie was hooked and said she wanted to start taking lessons. We reluctantly signed on for six months and started taking her two or three times a week. Every Tae Kwan Do class ends with the students reciting the tenets of Tae Kwan Do (sometimes quite loudly), one of which is “Indomitable Spirit.” She has embraced that value with both arms and I got a vivid picture of it on July 3.

That night was the annual Moonlight Fireball Classic 5K, a race held at the UT Ag campus every year on the eve of Independence Day. I’ve run the race each year since 2007, but for the first time ever this year, I registered all four Campbells for the race and my little Tae Kwan Do specialist asked if she could run with me while her sister and mom walked. She’s also a budding runner and I definitely want to encourage that interest so I happily agreed to run with her. We got in a couple of practice runs the week prior, but it had been months since her last middle school track meet and she was not in running shape, especially for the kind of heat we’re having this summer.

On the night of the race, I was doing my best to keep us at 10 minute miles which I really thought she could sustain for the whole distance. She did great for the first half of the race, but then started needing to walk in short stretches. She really wanted to run the whole race, but I reassured her it was OK to walk when she needed to.

A little past the 2 mile mark she was struggling again so I told her at the next refreshment station to get some Powerade to give her a little sugar boost. She drank a few gulps, but immediately she said she didn’t like the way it tasted or felt going down. That should have been my first clue that it would soon be coming back up.

Sure enough, with only about a half a mile left in the race she started struggling again and I heard her gag. She kept running though so I thought maybe it was just a momentary thing and she would fight through with the finish line so close on the horizon. But then a few steps later the gagging turn into a full blown barf and I looked on with amazement at her as she ran and threw up simultaneously.

“Stop, honey, stop!” I implored

“I can’t stop…I’m throwing up” she replied between yacks.

“If you’re throwing up then stop running!” I shouted.

Finally she stopped and got the rest out. She kept walking, and within a couple of dozen steps she said, “I’m fine. Let’s keep running.” And off she went.

We stayed at the same pace until she did see the actual finish line and at that point took off in full head of steam  and finished strong. I was amazed.

When I caught up with her I said, “Honey, why did you keep running when I said to stop?”

Her answer? “I thought you were telling me to stop throwing up. And I couldn’t.” She didn’t even consider that I meant to stop running.

But the indomitable spirit she has cultivated in Tae Kwan Do class was on full display as she redecorated Neyland Drive with her dinner and a splash of Powerade. She might never be the fastest kid, the strongest, or the first to cross the finish line. But she’ll never quit and never give up. Even when common sense–and her dad–tell her to stop.

I’ve got a lot to learn from that kid.

My mile 6 competitor.

This is right after he passed me.

I don’t remember everything about that day. What I do remember is:

• The night before graduation I spent camping out in a field with my friends Dave and Richard on a piece of property Dave’s family owned. We listened to U2 and Mr. Mister on somebody’s boom box with a cassette player. “Welcome to the Real World” was the name of the Mr. Mister album.
• The day of graduation I had to drive myself down to the University of Tennessee campus early and that made me pretty nervous as a new driver.
• The ceremony took place in Stokely Athletic Center which I thought was very cool having grown up going to UT basketball games and indoor track events there.
• One of my high school chums, Blake, showed up with a fake cast on his arm as one final show of rebellion against the school administration. I may or may not have been an accessory to some of his other pranks on the administration, which may or may not have included parking his car on the school’s front sidewalk, putting it up on blocks, removing the tires, painting it camouflage, and adorning it with brush.
• On graduation day was waaayyy too hot to be wearing a suit and tie underneath a cap and a gown.
• I was rocking the junior mullet.
• At the after party at my family’s house my graduation gifts included a Brother word processor (high tech!) and a compact stereo system…..that I still own and use all the time. It was another year before I got that treasured first Compact Disc player.

The class of ’86 is now planning a reunion for this fall and despite the fact that I skipped the 10th and 20th reunions, I’m looking forward to this one.

It’s funny how you see the same people almost every day for 12 of the most pivotal years of your life and then you don’t see them again for 25 years. But then Facebook comes along and brings everyone back together.

I guess I’ll have to put my 80s Faves playlist on the iPhone later during my evening jog. Here’s the payoff line from that Mr. Mister song:

Hey, it’s a human race, hey, it’s a brave new place
Hey, now you’re at the gate
Welcome to the real world, there’s so much to learn, welcome to the real world