Epiphany, Three Kings, Etc.

Hello everyone: we hope you made it through the holidays in one piece, deftly navigating the various obstacles thrown your way: blizzards? flight delays? fruit cake? family "togetherness?" I'm not saying any of you specifically experienced any of these things. I'm just saying, is all.

Aren't the holidays super?

Anyway, we're past all of that, heading inexorably to an Epiphany on Tuesday (a.k.a., Three Kings Day, Little Christmas, The Twelfth Night). My big epiphany is that the holiday break is over and it's back to the reality of running a nonprofit in the middle of the worst recession in 80 years come tomorrow. As my surgeon pointed out back in November, doing that may be more challenging than fighting cancer. I just finished reading the results of a Bridgespan survey of nonprofit leaders on how they're navigating the downturn. The news is the same all around: funding is down, demand for services is up, and all of us are trying to hold on to staff people who have sacrificed to get us where we are today. Something's got to give, and in the coming months, I think it certainly will for many organizations. How we navigate these moments by cutting smart rather than cutting in panic will tell the tale of our ability to have impact.

In the face of that, dealing with the effects of my "Maxi CHOP" treatments seems to be a passing annoyance. Seriously. OK, I will tell you that the aftermath of Round 2 was decidedly more difficult than Round 1. It's hard to say how much of that is due to the highly toxic ARA-C chemicals pumped intraveneously into my system over 48 hours and how much of it is due to getting just 3 or 4 hours sleep over the two days I was in the hospital. I suspect it was the latter, because even in good health, I'm a little past the time in my life when pulling back-to-back all-nighters was a good idea. At 45 and with a system already under duress, it took me like a week to get back to feeling normal.

After Round 1 with the R-CHOP, my white blood cell counts plunged to a dangerous low 7 or 8 days later only to come back to normal just before I started Round 2. This time, my WBC dropped but came back to normal by this week, thanks to my Neulasta shot. Unfortunately, my red blood cell counts dropped dramatically this week, which means that my blood cannot process oxygen well, so doing bike intervals with Coach Troy is much harder. I found my heart rate in the top of my zone during warm ups and had to ease back on some of the sprints. I got it done, but it's definitely a case of listening to my body. When it says no go, I don't go.

The more dramatic drop was in my platelets, which went from 271 on Dec. 26th to just 13 when I went in to the oncologists' a week later. A normal platelet count ranges from 150-400, and my lowest count before Friday was 174 (yes, I keep an excel spreadsheet on my phone with all of these stats which will surprise no one reading this I'm sure). If the count drops below 10, I will need a transfusion. As it is, I'm at risk of "spontaneous bleeding," which sounds lovely. It means that little blood dots may mysteriously appear inside my cheeks and my nose might bleed for no good reason. If anything bleeds and doesn't stop, I will have to go into the ER. Thankfully, that hasn't happened yet.

For any of you who are going to see me this week, please suspend our normal ritual greeting with swords. I am also giving up my chain saw for Lent a few weeks ahead of Ash Wednesday.

Lest you worry about me, let me assure you that my spirits are fine and I am continuing to do my best to live a boring life in a crazy world. My brother George and my boys spent the last week with me and we cooked pizza from scratch, made s'mores in the fireplace and had our annual Lord of the Rings film festival as we do every holiday season. Lucy and I went on a nice, four-mile walk this afternoon and I have been watching Alec Guinness playing George Smiley on DVD all weekend. Kathleen is back from Florida to take good care of me. Other than looking like the bald bad guy in every James Bond movie, I'm ready and eager to get back in the saddle tomorrow.

Here's hoping that all of you are just as ready for whatever awaits us in 2009. As I suggested in the poem I wrote today over on that other blog of mine, it's far better that we look skyward right now. I'd rather not think about what we're collectively stepping in at the moment.