Thursday, December 21, 2017

PCL22: Looking for Clarity

I’ve made many mistakes in life, but a recent one that sent me on a troubling downspin was yesterday afternoon. I opened my radiology report from my CT scan on the patient portal from my oncologist’s office. Seeing as the June report was very clear in saying, “No pathologically enlarged lymph nodes [and] no metastatic disease,” I figured I could sneak a peek at the report during a grade level meeting (sorry teammates) and move along with my day.

However, these words did not appear anywhere in the report. In fact, it stated that one lymph node was 1.3 centimeters in size. In June, all of my nodes were subcentimeter in size. This December report didn’t even mention the June one and only compared it to February, which was a remission scan, too. I decided to stop checking it and wait until I met with Dr. Maurer.

Still in remission
and taking care of the emotional healing
Later that evening, my body must have realized the best thing for me was to go to sleep, as I fell asleep during Die Hard around 7:45 pm. I woke up the next morning, raring to go for my 8:00 am appointment, on the first day of winter break.

I got to the office and checked in with the friendly receptionist team who greeted me every day last year. (Throughout the visit to the office, I also got to see all my old medical team, including nurse Jen and my pharmacist buddy. They all got ABSOT bracelets.) After being taken into the exam room and having my blood pressure checked (which wasn’t very high, surprisingly), I was told Dr. Maurer was coming from the hospital and would be a few minutes late. That was fine, as I needed time to collect myself.

As I waited, I noticed that the touch screen billboard in the office said, “Treating cancer doesn’t have to be stressful.” I agree. Treating it wasn’t too stressful. Surviving it is.

Eventually, Dr. Maurer came in, clad in a green shirt and red tie. His subtle holiday attire instantly earned more points with me, since I do love this holiday season. The first words out of his mouth were, “The scan looked good. You’re still in remission.” He must have known I needed to hear that.

I then asked about the 1.3 centimeter node indicated on the report. He pulled up my December, June, February, and November 2016 scans and placed them all side-by-side. Like I’ve always said, I’m not a doctor, so I didn’t quite get what I was looking at, but he did a good job showing and explaining it to me. The 1.3 centimeter node from my December scan did appear to be larger than it was in June. Interestingly enough, and I hope I understood this correctly, my original affected area was along the right side of my body and this node appeared to be on my left (or vice versa).

I asked him what that meant and he sent a message directly to the radiologist who read the report for further clarification. That’s the mark of a good doctor in my opinion. He didn’t say he would do it later; he physically pulled out his phone and did it right then and there. Hopefully it's nothing, and I should have more answers in a week.

He did maintain that I can still be considered as in remission, but we’ll keep an eye on this particular node. My next scan will be in June, as I’m on a six-month scan rotation for the next few years. Six months is a long way off, and I really hope that node doesn't continue to increase in size in that time.

The results of the scan was only one of the main reasons I was anxiously awaiting the meeting. While my physical healing has more or less completely ended, my emotional healing still has a long way to go.

If I'm really honest with myself, a feeling of darkness began less than six months after chemo was over. Ever since the Stranger Things episode and all the recent anniversaries of the beginnings of my cancer journey, it's become more pronounced. I know this darkness well, as it’s not the first time this has happened in my life.

I’ve mentioned it in a few posts, but I suffered from severe clinical depression in high school. The extent was pretty brutal, but I ignored the signs and let it progress to a stage I wish I hadn’t. Recently, I realized I was experiencing many of those same feelings now:

General feelings of “flatness”

Irritability and random outbursts of anger

Difficulty sleeping

Loss of interest in activities


And many more signs that have come and gone throughout the past few months. Since I am almost 10 years older than I was in high school (holy cow I feel old typing that), I realized the warnings and knew I didn’t want to get to the point I was at when I was a teenager.

Some people are into positive thinking, holistic medicine, healing crystals, exercise (or shopping), or whatever else seems to be the flavor of the week as therapy. I go to the gym regularly, and I do find that helps, but I can’t live in the gym 24/7. I tried traditional therapy in the spring, to no real effect. The eTC program helped while I was in the course, but I needed something more. I try to maintain a positive outlook, but staring your mortality in the face derails that slightly. Writing is an outlet for me, but it’s not enough alone.

So I asked Dr. Maurer for antidepressants.

I’m not beneath asking for help and this is the help I need. I know from previous experience that I respond well to these medicines and they help balance me. On my drive home, I asked myself, “Is taking these pills a cop out?” Honestly, I didn’t have an answer at the time.

A few hours later, I was doing a Facebook Live video (watch below) with Nora McMahon of Cancer Grad, and I found my answer. It’s not a cop out. The pills are not going to be the only way I find happiness. Writing helps me process. The gym keeps me healthy, inside and out. These pills will just be another tool in my toolbox for helping me to maintain a positive outlook, which is something I have struggled with since the end of chemo.

I hope by sharing that I’m going on antidepressants, others will find that it’s ok to ask for this type of help. I compare it to needing chemo for cancer or a cast for a broken arm. You wouldn’t say no to either of those, but why are people hesitant to try medication for mental health? In my opinion, it is foolish to suffer due to the stigma that if you need medicine to help be happy, something is wrong with you.

I’m not broken. I’m not weak. I’m not a lesser person for taking these.

If I’ve ever felt brave along this journey, it’s now. I’m asking for help and advocating for my own needs. It’s a step in the right direction to putting me back onto a path of happiness.

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Sunday, December 17, 2017

PCL21: How to Help a Cancer Patient During the Holidays

Have you checked your Christmas balls?
As I said last year, I absolutely love the holiday season. This year, I’m able to focus solely on embracing the joy and merriment, but that wasn’t necessarily the case last year. Despite the grueling days of chemo and all its side effects, I did my best to maintain my Christmas spirit. As I look back, I realized that there were certain things that helped me a lot during the holidays. The following list details ways loved ones can support a cancer patient during this time of year.

Do things for them

Cancer treatments take a lot out of you, both physically and mentally. I didn’t always have the strength to do things or the mental fortitude to carry out traditional holiday tasks. I needed help, but I didn’t necessarily want to admit defeat and ask.

My brother, Kyle, was still at my house after Thanksgiving, which is the only acceptable time to begin setting up for Christmas. Since I was still recovering from my orchiectomy, I physically couldn’t put up our wooden reindeer in my front yard. Kyle noticed this and asked if he could put them up for me. Unfortunately, I didn’t have an excuse for making him do it again this year.

Similarly, my ABSOT partner, Katie, knows that I watch a different Christmas movie (including Die Hard, Iron Man 3, and Lethal Weapon) leading up to the big day. Usually, I spent hours arranging the movies and making sure it made sense (Home Alone 2 can’t be watched before Home Alone). Knowing that my mind was focused elsewhere, Katie asked if she could make the list for me this year. She ended up creating a really cool digital advent calendar, complete with GIFs to represent movies each day. (This year, I wrapped the DVDs so it’s a surprise every day!)

In both cases, I appreciated that they asked me before doing it. In my post “How to Talk to a Cancer Patient,” I shared that it’s important to offer specific help, but I did appreciate having the final say on what was done for me. Furthermore, both of them accepted input on what I wanted. Kyle asked where I wanted the reindeer, while Katie asked if I had specific requests for certain movies on certain days (the only two concrete days are Muppets Christmas Carol on Christmas Eve and Christmas Story on Christmas Day).

What can you do for the cancer patient in your life? Think about what they have done to celebrate on past holidays and ask them if you can help create the same amount of cheer this year.

Do things with them

One big thing I struggled with during treatment was the feeling of total dependence. I’m sure I’m not alone in this, so help the patient regain their sense of independence by doing holidays activities alongside them.

Last year's tree
The day after Kyle set up the reindeer, it was time to decorate the tree. Since I was going to be spending most of my time in my bedroom, I wanted my Avengers themed tree up there. I wanted to decorate it myself, but I knew I couldn’t carry a tree upstairs, open the ornament boxes, and so on and so forth without getting exhausted. My mom, knowing how important this was to me, stepped in to help and said, “Do you want to do this together?” She brought the tree upstairs, opened the boxes, and then handed me the ornaments. I got to put the ornaments where I chose, including placing Iron Man so he looks like he’s battling Captain America.

Whether it's decorating the tree, making cookies, or something else, be on the lookout for something that you know your cancer patient wants to do and can do, but may need help completing. It’s a small gesture, but it will mean the world to them.

Let them do things for you

Another favorite of my many holiday traditions is creating an ugly Christmas sweater. I’ve made some doozies in the past, and last year I was determined to do the same. Mallory told me that her school was hosting a competition and asked if I wanted to help make hers. I told her that not only would I help, I wanted to do it myself.

Over the course of a few days, I designed and built a fireplace sweater, complete with a three-dimensional mantle, battery-operated lights, and fake candles. Spoiler - she won the competition.

A small gesture, like this or the time I made pizza from scratch for my mom and Mal, are moments I look back on as major wins. Cancer patients don’t always need everyone doing everything for them, so let them do something nice for you when they offer.

Bring on the presents

Last year's sweater
Chestnut roasting on an open fire
It wouldn’t be a Christmas post without the mention of presents. Small things can help brighten a patient’s whole day.

The gift that made me laugh most came from my friend Quinn. Along with a Kylo Ren care package, he sent what appeared to be a coin purse. Upon closer inspection, it was a dried kangaroo’s scrotum from Australia.

But not all gifts need to be cancer related. Another friend got me a memory foam body pillow upon hearing I had difficulty sleeping. Listen to what the cancer patient needs. We don’t all need another “Cancer Sucks” shirt, but there may be something else that we can use to help make life a little easier during chemo.

Be the cheer

I take Christmas cheer to insane levels, but not all cancer patients feel the same. Help them find the sense of joy. There are plenty of holiday song playlists to choose from, or maybe you can drive them through the neighborhood of lights.

One thing to possibly avoid - making every conversation about cancer. Sometimes we just want to forget and enjoy the spirit of the season. Sure, it’s ok to ask about it and how they’re doing, but don’t dwell on their diagnosis.


Respect that they might not be so cheerful

The holidays can be tough for someone with cancer. Sometimes they have to be quarantined from from others due to germs, they may look differently than normal, or any number of reminders that life is anything but normal. These feelings are totally ok, and it’s also ok to not understand what a cancer patient is going through. Be cognizant of this and be the friend they need you to be. Don’t make a hard situation worse by demanding that they show Christmas cheer and positivity at all times.

Even though I love the Christmas season so much, I personally understand that it can be a trying time. I’m not currently in treatment, cancer is still never far from my mind. I’m about twelve days away from my twelve month scan, which is not as great of a gift as turtle doves or lords a-leapin’. I’m doing what I can to not dwell on these thoughts.

Nevertheless, Christmas is the most wonderful time of the year in my opinion and I hope these tips help others to find the same joy. I look forward to it all year round, and this year is no different. To be honest, I think it’s in my blood. I firmly believe that in a past life I truly believe I was a little drummer boy…

Pa rum pum pum pum

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Saturday, December 2, 2017

PCL20: An Open Letter to Tim Howard and Cremo

Dear Tim Howard and Cremo Company,

From what I understand, one of you is an athlete of some sort and the other is a hair care company. Seeing as I'm not into sports and my shampoo comes from a grocery store, our paths most likely would have never crossed.

Until November.

Since I have no idea who you two are, I'm going to assume the same goes for you knowing me. Allow me to introduce myself. My name is Justin Birckbichler. Many words describe me - teacher, husband, cat and dog dad, brother, son, and testicular cancer survivor. The last label brings us to the point of letter.

November is commonly known as No Shave November, a month for men to grow their beards freely. What's less well-known, but infinitely more important, is the why. It was originally designed as a month to spread awareness about men's cancers and health. The creators? A family who lost a father and a husband to colon cancer.

Unfortunately, on social media, it's become an excuse for men to skip shaving their beards and to instead post vain pictures for a month. We must do better, and in fact I have a few ideas on how to get the ball rolling. But this letter isn't about me. It's about you.

You are part of the problem.

Mr. Howard, in the middle of November, you posted a picture showing off your beard and hashtagged it with #NoShaveNovember. A further look revealed that this was a sponsored post by Cremo that advertised their products. No mention was made of the true intentions of No Shave November. Instead, the only purpose the post served was to highlight your beard and to earn some money for Cremo.

Since I had just written a post about using social media for the original purpose of No Shave November, I left the comment to the left. I also followed up with an email to Cremo. But again, this isn't about me. This is about you.

It would be one thing to ignore the comment. I get it. I'm one person with less than two thousand followers, while you're an athlete with almost a million followers. I would have chalked up no answer to never seeing it.

But you did see it.

How do I know this? Less than 24 hours later, my comment disappeared. Gone. Vanished. Someone, maybe not specifically you, had deleted my comment.

Why? Why did someone take the effort to eliminate this pushback? Why couldn't have there been a mea culpa moment? A course correction? A changing of the ways?

We're not so different, you and I. We both have facial hair. We both have passions that have opened up new doors for us. We're both men. We both spend a great deal of time dealing with balls.

I'm not angry… I'm disappointed. One in 250 men will be diagnosed with testicular cancer in their lives. Nearly 200,000 people will be newly diagnosed with colon or prostate cancer in 2017 alone, with about 75,000 dying from those two diseases.

This post, and others, could have been used for good. Raised awareness. Provided self exam tips. Shared risk factors. Anything about health.

But instead we got an ad.

You're not escaping the blame either, Cremo. You commissioned this ad. You paid for it. You've got plenty of posts on your own page using the hashtag, too. None of them mention men’s health.

It's now December. Nothing changed in the remainder of November, despite an email response from you, Cremo, saying that “upcoming posts will explicitly mention the awareness campaign.” To be exact, you posted ten more pictures after our emails, none of which held true to your promise. In fact, a handful of them just tried to push your product yet again.

Another one of your favorite hashtags is #BeardBoldly. You know what would be really bold? Standing up for men's health and following through on your word.

Like I said, I'm not angry, but I am disappointed. More than that, I'm ready to take action. There are 11 months until No Shave November begins again. Guess what I'll be doing on November 1st? Looking at both of your accounts. And I'll repeat it on the 2nd, and the 3rd, and so on and so forth.

I'm hoping this letter makes it to you and that your posts next year are more meaningful.

But if not, I certainly hope I don't see more ads with the hashtag misused again. You have a huge audience. Use it for good. Use it to make a difference in something (other than your bank accounts).

I'm sure you're not the only company and celebrity endorser who have done this. Frankly, I didn't want to look further. But I will be in the future.

Be the change.

Be the leader.

Be better.


Justin Birckbichler

Author's Note: Tim Howard has now blocked me on Instagram after posting this blog and tagging him. 

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