Monday, November 28, 2016

CC01: And So It Begins

My Testicular Cancer Treatment is BEP Chemo, and Today is My First Day

One month and eighteen days since this journey had begun, the first day of chemo finally arrived. I was oddly excited - partially because it meant that an end was in sight and also because I get weirdly fascinated with new experiences.

My appointment was supposed to start at 9 AM. The first thing I had to do was to numb my port with a cream the oncologist gave me. If you’re not familiar with the concept of a port, it’s a medical device that was implanted in my chest about a week and a half ago. A thin membrane on the opening allows them to administer the chemo drugs or draw blood. (Think of a sport water bottle that doesn’t have a lid and you need to squeeze it to get the water.) A catheter runs from the opening of the port and into a vein. The whole purpose of having it is so I don’t have to get stuck with a needle all 21 times I receive chemo. The port is on my upper right side of my chest and feels like a little bump. It’s not so much painful as it is just bothersome. Essentially, it is something that was surgically implanted and connected to my heart to help keep me alive. That’s right - I am Iron Man.

I had to apply the cream an hour ahead of time so it would numb the skin before I arrived. Once I was all done with that, I had to cover it with plastic wrap to keep the area clear. I wore a polo and a zip up hoodie so the nurse who would be administering my treatment could get to the port easily. No Magic Mike show for the other patients, unfortunately.

Mallory and I arrived (Mom would take me tomorrow) to the office and were directed to my own personal pod with the world’s most comfortable chair. One of the nurses came by and removed the plastic wrap. She also drew blood to run labs by accessing my port (and apparently the numbing cream worked, as I felt nothing when she stabbed me). She also took my vitals, which was a pretty customary practice for me by this point.

The labs came back, and they were clear.

It was time to hook me up to begin my chemotherapy.

First, Nurse Jenn (who would be my primary chemo nurse for all 21 treatments) administered Dexamethasone, a steroid that helps reduce the risk of reaction, increase the effectiveness of anti nausea medications, and increase appetite. It also would increase my glucose levels and possibly cause slight insomnia, in which case they could prescribe sleeping medicines.

Next up was Aloxi, which was an anti-nausea drug that would last for 48 hours. We also briefly reviewed which medicines I should be taking at home. She stressed the importance of keeping up with nausea meds because if I started vomiting, oral medicines wouldn’t help. After that was complete, I was given Emend, which was an anti-nausea medicine that would last for 72 hours.

At one point during the morning, I went to use the restroom, which meant I had to bring my “medical tree” with me. The “tree” is where my drugs hang and pump into a machine. The machine pushes them through the lines and into my port. I made friends along the way to the restroom because I am determined to raise the level of holiday cheer while I’m here.

After the anti-nausea meds and steroids were complete, the chemotherapy drugs were slowly started. My treatment started with the Bleomycin, which would only take about ten minutes. This was followed by clearing my lines, and then an hour long dose of Etoposide. After that was finished, a nurse cleared my lines yet again.

Throughout all of this, we chatted with Nurse Jenn and some of the other nurses. Somehow, the concept of “making yourself throw up before your body chose to” was brought up, which led to us sharing college stories. What a great way to make a first impression.

The final chemo med, Cisplatin, would really drain my body of electrolytes so they had to prep me with a whole liter of Magnesium. (For those of you unfamiliar with the metric system, go buy a two-liter of Pepsi. Drink half of it in an hour. That’s how much liquid ran through my veins. Now buy another two-liter and drink the whole thing within four hours. That’s how much liquid was in me total.)

Throughout the day-long chemotherapy infusion, I entertained myself in a number of ways. 

In addition to reminiscing with the nurses about college, I read How Google Works, ate granola bars, wrote to my students on Google Classroom, and annoyed Mallory. Overall, the atmosphere of the chemo area was calm, with lots of beeping from the machines, gentle pop rock playing from the radio, and conversation between patients and families. My pod was a little more isolated than some of the other ones, so I didn’t have other patients to talk with during my treatment. Tomorrow, I would choose a different seat. I’d be spending 21 days receiving chemo; I wanted to make friends (and also spread holiday cheer!). I did get a chance to talk to one older man as he passed by me with his “tree.” He asked how many treatments I had and shared that he was on his second to last. He recommended taking some anti-nausea meds as soon as I got home because “that’s always worked for me.” A few moments later, a bell rang out. This signified an elderly woman had completed all of her treatments. Talk about duality - a young man begins his treatments as an older lady finishes hers.

Finally, they administered the Cisplatin, which took about an hour. Dr. Maurer stopped by during this time to just check in, review side effects (fatigue and nausea by the end of the week; hair loss by end of next week), and chat about my baseline tests (which all looked good). He reiterated to Mallory that cheesy Hallmark and Lifetime holiday movies would be just about the worst thing for my recovery. I added that I heard Christmas movies made prior to 1960 were bad too, and he did remember new research supporting this. When everything was all said and done, I had received 5 hours and 46 minutes of chemotherapy today.

As I left the oncology office, I began feeling three separate but distinct side effects from the chemotherapy. 

Day 1 down... 20 to go
I felt very sluggish in my legs yet jittery in my upper body. All of this was underscored by a little bit of queasiness. As I arrived home, I took a round of Prochlorperazine to help quell the nausea. I then laid in bed for a while to try to regain some sense of normalcy. If this was just the beginning of nausea and fatigue, I couldn’t imagine what I would feel like at the end of the week, which was when Dr. Maurer had projected that those symptoms would be at their worst. As I recovered, I couldn’t help but drawing parallels between my situation and that of Cameron’s from Ferris Bueller’s Day Off. I had skipped school and was now lying catatonic in bed.

Two hours after stopping chemo, my nausea had subsided, but it was replaced with a slight headache. My skin was starting to feel dry, so I applied lotion. Another unpleasant side effect that was already showing up. As dinner time approached, I realized that smells were starting to trigger my nausea. A food delivery from one of the kind people who was keeping us fed over the next few months arrived, which included roasted broccoli and cauliflower. Under normal circumstances, I would have enjoyed eating both vegetables, but the smell was overwhelming. Instead of enjoying those along with the baked ziti, I decided to stick with soup and some Gatorade. After eating, I felt marginally better.

As the evening of my first day of chemo drew to a close, I found myself acutely aware of how my body was responding to the treatment. Though the hours spent hooked up and having a myriad of substances pumping through my veins were mostly uneventful (unless you call swapping college drinking stories with your nurses eventful), the evening after (and the subsequent symptoms) was less than thrilling. But underneath all of the discomfort I was feeling was a small sense of triumph: I was one step closer to being cancer-free.

I’m currently undergoing chemotherapy to cure my cancer. Each Monday, I’ll post my thoughts on this experience. These may be reflections on my prior week’s treatments, musings about my newly-altered life, or anything else that comes into my “chemo brain.” Follow along with my journey each week.

A self exam is how most cases of testicular cancer are detected early. Click the image for video directions or click here for a larger version

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Sunday, November 20, 2016

The Man Behind ABSOT

“You have cancer. The biopsy came back and confirmed it is cancer. After your CT scan, we’ll know what comes next.” 

Five days after surgery, I received this phone call from my urologist. Yes, I am 25 years old and I have urologist. Yes, that is an incredibly scary call to receive. How did it get to this point?

My name is Justin Birckbichler. I’m a pretty average guy who relocated to Virginia after living in Pennsylvania for 22 years. I’m white, 25 years old, slightly above average in height and weight, have brown, spiked hair and blue eyes, and have a tendency to wear sleeveless shirts and shorts year round. I’m a fourth grade teacher and have been for four years. I’m one of those cliche “I love teaching so much” people, although it’s unique that I’m a guy. This is my first year at a new school, and I absolutely love the transition I made.

2016 has been an amazing year. In January, I was accepted to the first Google for Education Certified Innovator Academy and got to actually visit the Googleplex in Mountain View, California the following month. February also was our engagement month! Two days shy of our two year anniversary, I proposed to Mallory, my then-girlfriend. In April, I left my old school and signed a contract with a school that was much more aligned to my views on education. We bought our first home in July and relocated to an absolutely incredible area of Virginia. Soon thereafter, we picked out a cute Yorkie puppy, who we would bring home in October.

In addition to having a great first ten months of 2016, I’ve had 25 years of having the most boring medical history ever. I had scoliosis for a few years, but it stabilized. I battled with depression in high school, but survived that. I’ve had some cavities filled and my wisdom teeth removed. I suffered a mild concussion once when I took a tumble on a snowboarding trip. I am colorblind, but that hasn’t changed at all in the past few years. I was the picture of health and always got the cheapest health insurance with the least amount of coverage in my old school district. I only upgraded it in my new district because it was cheaper.

With 2016 wrapping up, with many amazing experiences and memories and another year of no medical changes, things quickly did a 180.

A self exam is how most cases of testicular cancer are detected early. Click the image for video directions or click here for a larger version

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What is ABSOT?

I was diagnosed with Stage IIB Nonseminoma cancer in November 2016. It's a form of testicular cancer that had spread to my lymph nodes. I had surgery to remove the original mass on October 28th, and will be beginning chemotherapy on November 28th to get rid of the remaining cancerous cells.

Naturally, my first priority after hearing my diagnosis was to tell my friends and family. However, after everyone in my life had taken care of when it came to knowing what was happening with my health, I wanted to keep going. I went semi-public with my diagnosis by sharing it on Instagram in early November. However, I had yet to share my news on Twitter. My Instagram account is private and largely comprised of friends from high school and college and distant family members. I only have about 100 followers, but on Twitter, I have more than six thousand. This is a huge reach and could have a real impact. I began thinking about using this reach to spread awareness about testicular cancer, a topic that is rarely discussed, as is men’s health in general.

The decision to potentially tell six thousand people is terrifying. While I have no problem Tweeting about my opinions on homework (it’s in how you use it), my stance on standardized testing (it’s too much), or my feeling on GSuite (I love it), letting people in personally would be a new order. I also didn’t want cancer to become my only identity. My handle is @Mr_B_Teacher, not @Mr_B_Has_Cancer. While I have shared some personal information, I still wanted the focus of my Twitter and blog to be educational. Author's Note: I eventually decided to split my handles into an educational one and a TC-related one. My teaching handle/blog is not used nearly as frequently as ABSOT's accounts. 

However, I couldn’t put the thought out of my head that I should do something more when sharing my diagnosis on Twitter - something beyond just mentioning that I had cancer once and then never bringing it up again. Six thousand people is a lot, and I was close with a number of people who had more followers than that. I decided to use my diagnosis and my Twitter handle to my advantage in a new way - to spread awareness about men’s health and testicular cancer.

In mid-November, nine days after learning that I had testicular cancer, I decided that I would begin this awareness campaign. The goal from the beginning has been to share my personal story and journey from discovery to being cured. My hopes are that this will bring more open discussion and a larger focus to men’s health in general. Knowing someone who is going through cancer can help make it more real. I would put my face where their balls are (which is a somewhat awkward turn of phrase).

Knowing this, I decided to start this blog, A Ballsy Sense of Tumor. The title was important to me. It had to convey it was about testicular cancer and that I would be talking about it in as much of a positive light and with as much humor as you can use when discussing cancer. While cancer is no laughing matter, my outlook on my story has to approach it with humor and positivity. I will beat this; there has never been doubt in my mind.

I knew I couldn’t do it alone. I first reached out to my friend, Katie Kraushaar, to help me produce and edit the pieces that will appear on this blog. These will be my words, but she helps me sound better. I also know that as I start chemo, I won’t be able to keep up with it by myself. Her support from the start of this journey has been invaluable.

Over the course of a few days, we worked together to brainstorm ideas for what ABSOT would look like. We decided to tackle three different aspects of my cancer journey:
  • Chemo Chronicles (CC), where I’ll be posting on Mondays about my present-day experiences with chemotherapy and general musings about life as a cancer patient.
  • Throwback Thursday (TBT) posts, will travel back to the beginning of my story from the initial discovery up until the beginning of chemotherapy.
  • Healthy But Aware (HBA), where, on Saturdays, my close friends and family will share how my diagnosis has affected them.
We decided to launch it in November because the month is supposed to be used to raise awareness for men’s health issues. I couldn’t have gotten cancer at a better time! Thinking on how to heighten the impact, I personally reached out to a number of men who I admired and respect to help me boost awareness. I wanted to use influential men to help underscore that this is a men’s issue and we need to highlight it as such. Thank you to Ben Brazeau, Ben Cogswell, Mark Wagner, Lee Aroaz, Doug Robertson, Quinn Rollins, Don Wettrick, Dave Burgess, Mark French, Jay Atwood, Steven Isaacs, Mark Bartmas, Matt Miller, James Sanders, Greg Bagby, Donnie Piercey, and Mark Barnes for helping spread awareness about an issue that affects all lives.

ABSOT was first mentioned on the “I Have Cancer: Telling My Students” post on my educational blog. This marked the bridge between my identity as a teacher and my newer identity as as cancer patient. On November 20th, I pressed publish. Finally, the whole world knew my diagnosis.

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A self exam is how most cases of testicular cancer are detected early. Click the image for video directions or click here for a larger version

Click the ABSOT logo below to subscribe to the mailing list for the new blog posts, latest testicular cancer information, and self exam reminders!

Don't forget to follow and share ABSOT on social media by clicking the icons below!