Throat Blog — Just Add Water

After mulling that dramatic 5 lbs in 6 days weight loss, I realized that that could not have been body mass loss. I was eating some, if not enough. So, considered the other probability…hydration. I am not in a habit of drinking a lot of water in-between meals unless I’m doing physically active things.

Sitting at my desk. Driving to/from work. Sitting on the couch. Sleeping. Hmmm, none of those are really falling into the category of “physically active things.” And not eating as much also means (to me) skipping some meals entirely. Which means skipping my main time to drink fluids…mealtime.

So, yesterday I made it a point to keep sipping on water throughout the day. I probably put down a little over 2 liters of fluids. And, this morning, right out of the shower, I weighed a little over 3 lbs more than I did yesterday morning. So, instead of 5 lbs weight loss in 6 days, maybe 1-2 lbs, which is still not great, but also not alarming or entirely unreasonable.

My appetite yesterday was better, and today I also feel more like eating. So, I suspect that during the coming week I’ll be able to pack in more calories (and water!) in preparation for the 4th and final 3-week round.

Throat Blog — Chem-on Down!

Ok, I’m about 66% through treatment and it is starting to wear on me a bit. Pretty evident from my weight chart, above, which plots from beginning of treatment to today. Rounds 1 and 2 (each round is 3 weeks, starting w/a 3-drug combo the first week, then a single drug each of the next two weeks) I got by pretty good. Appetite was a little affected (especially during the first week of each round), but recovered by the end of the round.

The first round, just had a little queasiness for a couple of days, the rash from the Erbitux, but not much else. The second round, the rash was still pretty bad (especially on my head) and I did get pretty tired by the end of the day during the first week, but the 2nd and 3rd weeks I had plenty of energy. Well, round 3 and I still have the head rash (a bit on my chest and back, too, but it doesn’t itch there, so doesn’t really bother me). But the two things most affected now are my energy levels and my appetite.

Even in the 2nd week, my energy levels were pretty low. I went to work every day, but also left early every day. I got into the early afternoon and realized that if I hung around until 5 it would not be safe for me to be driving. So, early in the week I took off around 3. Later held on until about 4. Got home and crashed in front of the TV and tried not to go to sleep too early. On the plus side, I was able to catch some great documentaries (making of National Lampoon’s Vacation…I never knew that Lindsay Buckingham did the “Holiday Road” theme song…rockumentary on The Doobie Brothers, and another on Brian Wilson).

Appetite, though. That is the worst, as not eating also affects energy levels/fatigue. I’m not nauseous, but food is unappealing when I look at it, tasteless (mostly) when I eat it, and I quickly fill up…long before the plate is empty. I can feel my appetite slowly recovering (the week 1 combo is really what drags down my appetite), but not enough to keep my weight up. As you can see from the graph, the last two weeks my weight has fallen off the cliff. Overall, about 10 lbs lost, but 5 of that has been in the past week or two.

So, I am trying to pick higher calorie (even if it also means higher sugar) options. Instead of black iced coffee in the morning, grabbing a latte. Most sweets and coffee still taste OK (but potatoes taste like sawdust, as do many other foods). I was eating oatmeal for breakfast, but it tastes so bad, now, I’ve switched to yogurt. Lunch I’m trying out a variety of soups (Udon noodle is best, but Phó is also pretty good). Dinner is the toss-up. Sometimes just a smoothie (homemade from freeze-dried then powderized banana, strawberry, kale, and broccoli). Sometimes I can manage 1/2 of an entree like lasagna or other pasta.

Even typing the above makes me feel like I want to have nothing to do with food. Ugh. I’m not even going to re-read it for typo’s and grammar tweaks.

Anyway, I really don’t feel bad. Just get tired early and often. I’m able to mostly keep up at work. My guitar practicing has suffered. The couch looks so much better than my practice area. And, keeping up this blog has suffered, as well. But, I can tell that next week will be better. I’ve already warned my office that the week of the 30th will likely be my worst week (the beginning of my last round).

So, back to editing videos from the Nashville trip. Or, maybe a nap. Well, definitely a nap.

Guitar Gathering 2018 — The Thursday Sessions

Ok, editing down the videos is taking me a bit longer than anticipated. But, I have now completed all of Thursday’s sessions. So, just a few left to go.

Thursday Morning started with another workout with Steve. But, unlike Wednesday’s workout, which strained our hands and muscles, Thursday’s workout was an exercise in stretching our minds. Steve has a great series of Fretboard Workouts available in the Mighty Oak Music store. Covering scales, agility, speed, and jazz chords, these make a great resource for inspiration in practicing methods.

Next up, Joe Robinson, who gave us such a great performance Wednesday night, walked us through many of his techniques for practicing, learning, songwriting, and performing. As I mentioned before, he has a new course at Truefire.com on fingerstyle techniques (Fingerstyle Synergy: Bass and Melody) worth checking out.

Our afternoon was filled with the music and accumulated wisdom of Musicians Hall of Famer and veteran session musician Will McFarlane. Will is funny, talented, and brings a wealth of practical experience to his master class. Although it is titled “Blues Guitar” this is actually a wide ranging master class that applies to blues, rock, country, and more. Note that this video is uploading as I publish this, so it could be a few hours before it is actually available to view.

So, that was Thursday Day. Hopefully, I’ll have time today or tomorrow to edit down the Thursday Night performance by the Blues Counsel f. Phil Keaggy and then start to work on the Friday sessions. Have a great weekend!

Guitar Gathering — Contemporary Fingerstyle Masterclass with Christie Lenee

Wednesday, Christie Lenee gave a great masterclass on Contemporary Fingerstyle Guitar. In addition to being an incredible guitarist and songwriter, Christie quite obviously knows what she’s doing, why she’s doing it, and when to do it…and is able to explain it all in terms that even I can understand.

Christie has quite a few videos on her own YouTube channel. You can also find CDs and  a link to her Fingerstyle Guitar for Songwriters Truefire course on her web page: www.ChristieLenee.com.

Guitar Gathering 2018 — Why does Steve Hate Us?

Well, that is what I asked him after the Wednesday Warmup. Wow. One of the most strenuous mornings my fingers have seen since…well…last years Guitar Gathering warmups. He replied that he didn’t hate us. It is just tough love.

There are some great tips in this video for improving finger strength and finger flexibility. Steve makes it painfully fun. If you find this helpful, you should check out his full Speed and Agility Workout video.


Guitar Gathering 2018 — Acoustic Night

As promised, GG2018 Acoustic Night with performances by Steve Krenz, Collin Hill, Joe Robinson, and Christie Lenee.

Steve Krenz was introduced to many of us through the Learn and Master Guitar course. Many others through weekly Live Lessons podcasts. You can connect with Steve and the rest of the GG community at www.guitargathering.com.

Collin Hill has been coming to Guitar Gatherings for several years. Originally from California, he and his family moved to Tennessee 3 months ago to put him closer to where the guitar action is. I’ve got a couple of other performances on my YouTube channel definitely worth checking out. You can also find his videos in his own YouTube channel. One of the youngest members of our gathering, he’s also one of the best players you’ll find in the group. Maybe Steve is better. For now.

Joe Robinson grew up serenading the cows on his family farm in Temagog, Australia. At 16 he won Australia’s got Talent and he moved to Nashville shortly after, at the invitation of Tommy Emmanuel. This is the first time he’s joined us for Guitar Gathering and, in addition to this incredible performance he also gave a great Master Class on Guitar Technique and Musicianship (look for that video in the coming days or weeks…). He frequently tours…if you see he’s going to be near you, definitely worth going. You will be wowed. He also has a courses on TrueFire.com covering Fingerstyle Guitar techniques (Fingerstyle Synergy: Bass & Melody).

Christie Lenee is the 2017 International Fingerstyle Guitar Champion. She is the May, 2018 Guitar Player Magazine centerfold, and her latest CD, Stay, was a finalist for “Best CD of 2016” for Best Lyrics (Indie Acoustic Project Awards). She plays intricate, percussive, emotional and unique original songs. Her performance at GG 2018 will leave you spellbound. This is also her first time to join us for a Gathering, and earlier in the day she discussed Contemporary Fingerstyle technique in her Master Class (video to come).

Ok, so this ended Day 1. I got back to my hotel exhausted and inspired.

Throat/Guitar Blog — Trip to Nashville

Well, Saturday week ago I headed to Nashville for an annual event I’ve been going to for several years. Guitar Gathering brings a group of beginner to advanced to performance-ready guitar players together for 4 days of intense guitar experience. Days are filled with master classes in music theory, fingerstyle, blues, rock, and more. Then, evenings feature a concert given by some fantastic talent. Watch here and on my Youtube page, as I take plenty of videos of the main events and post them as I get them edited.

But, not getting too far ahead of my self, first I have to get to Nashville. I normally take 1 or 2 days. It is about 9 hours of driving, which under normal circumstances, would not be a problem. But, as I headed out I was connected to what I lovingly refer to as my “poison pump” which gives me continuous doses of Effudex for 4 days. Effudex tends to knock me down a bit. So, first leg was to Hot Springs. By the time I got there, I was really having to fight off falling asleep. Got a hotel, got unloaded, took a nap.

In Mansfield, there is a restaurant I go to 2 or 3 times a week: La Gondola. It is a jewel of an Italian restaurant, serving up incredible Italian food hidden cleverly in a strip center. It was started by Sal, who had previously partnered with Jamal to run the Italian Villa in Arlington. When they sold Italian Villa, Sal started La Gondola, but Jamal moved to Hot Springs and opened J&S Italian Villa, there. So, while I was in Hot Springs, I decided to check it out. Jamal’s son, Sean, now runs the restaurant…I sent him regards from Texas and sat down to Pollo Rolotini (aka “Roly Poly Chicken”). Chicken breast wrapped around Italian sausage. Yummy.

Back on the road, I made it to Memphis on Sunday. It was a pretty short drive, but enough for one day. I wandered up and down Beale street, had lunch at B. B. King’s, and bought a hat (it matched 3 of the shirts I’d brought on the trip).  Beale street is a hopping place on a Saturday night…Sunday noon, not so much. Still, some live music, some good barbecue, a nice stroll, then I was ready for the hotel.

Monday I made it into Nashville and got checked in. Actually stayed down in Mt. Juliet…hotels closer in get really expensive. Didn’t do much on Monday other than rest and recover from the drive. Tuesday I got up and noticed that the bag of Effudex looked really flat. It wasn’t due to actually stop running until a little after noon, but I was pretty sure it had pumped all it could. I ready for a while, at the same time watching a few little bubbles that were in the IV line. When the pump hummed, they’d move about a quarter inch toward me, then immediately return to where they were. After watching this for an hour, so I was very certain that there wasn’t actually any drug still pumping, I disconnected everything, unplugged the line from my chest, and headed out to the meet and greet.

The event is primarily held in the music building at Trevecca Nazarene University. Said hi to some previous attendees, met some newcomers. At about 4pm, things broke up and I headed back to the hotel, intending to take a short nap then go to dinner. Well, the short nap ended up going from 5pm to 4am. So much for dinner.

Wednesday through Saturday were filled with all things guitar. I’ll talk a bit about each event as I post the videos.

Saturday we met at Columbia Studio A. This is where Marty Robbins, Patsy Cline, Elvis Pressley, and more recorded hit after hit in the 50’s and 60’s. Actually much of it was recorded in a studio called the Quonset Hut (which, oddly enough, was built in a Quonset hut). Got a great tour of the facility, which is now part of the Belmont University campus. Then student showcase, where 16 of the folks here for the event got to play and, in some cases, sing in the studio where magic had happened. I’ll be posting those videos, later (but some may be private, at the request of the performer).

Drove an uneventful drive home. Took two days…and I felt good enough that I could have probably made it farther each day than I actually did. Stopped overnight in Lonoke Arkansas then finished the trip on Sunday.

So, now, here I sit connected to yet another poison pump (just for a couple of hours, today). Then, into the office. I completely disconnected from work email on Wednesday…too busy during the day and really ready to crash after each night’s concert. So, I expect there to be a pile of emails to handle (well, I peeked and I have 90 unread work emails), a gazillion forum posts to read, plus whatever my bosses put off for “until Paul gets back from vacation.”

Throat Blog — Round 2 Begins

Well, busy doctor week this week. First, I fired a doctor. He didn’t do anything wrong…its just that I don’t really need a cardiologist. He had checked me out to ensure that the clot I got in my small intestine last year didn’t start in my heart. It didn’t. So, I told him it was best if we parted ways. Seriously, we spent the entire visit talking about bicycling and guitars. Oh, and he confirmed no a-fib or other heart issue that needs constant followup. So, our breakup was amicable.

To keep the universe in balance, though, I’ve also taken on another doctor. During my visit with my ENT/Surgical Oncologist, I repeated a constant plea: Find a way to make my voice louder. As a reminder, the tumor in my neck last year destroyed the thyroid cartilage, which is what the front of your Adam’s Apple comprises. The vocal cords each have a tendon that connects to your thyroid cartilage, kind of like how guitar strings are anchored down by the bridge. In looking down my throat while I made pitiful mewling noises on command, he said that the side ligaments that are supposed to tighten and loosen my vocal cords to produce pitch and volume are working. But, since the “tensionors” aren’t in place, the vocal cords don’t come close enough together to vibrate properly.

Drawn in ascii, my vocal cords look like \ / instead of || when I try to talk. So, he’s sending me to a different ENT / Surgeon to have filler injected next to one of my vocal folds so that my vocal cords will be more like |/ all the time, pressing one cord over close to the other one. The hitch is that it will also mean that my airway will be half-closed all the time. So, will have to balance getting them close enough together without actually affecting my ability to breath.

Next up was a quick visit with my Medical Oncologist where we pondered 2B or not 2B. The cetuximab rash is graded on a 1-5 scale:

1: Less than 10% coverage over entire body.
2a: 10-30% coverage, but few or no pustules.
2b: 10-30% coverage, but mostly pustules.
3: 30-50% coverage w/pustules
4: >50% coverage typically with secondary infection
5: Death.

Each grade has its own treatment and I’m at 2b, which indicates either topical or oral antibiotics. Really want to stay away from 3 (3-week break from chemo) and definitely staying away from 5. So, started some antibiotics and either coincidentally (these rashes usually go away after about a month) or due to the antibiotics the rash immediately got better. No more itching in my head hear or back, so sleeping a lot better. Still looks bad, but feels so much better.

So, Friday I started Round 2: cetuximab and carboplatin infusions then fitted with the 4-day fluoruoricil pump and sent home. Well, actually I went to work. And, Saturday I headed out on my annual sojourn to Nashville for guitar, guitar, guitar. Expect my next few posts to be less health related and more guitar related. A relief for us all, I’m sure.


Throat Blog — Like a Teenager, again

So, I’m losing a bit of weight, but nothing alarming. I just can’t eat a full meal all at once. So, I set the rest aside or take it home to eat later. But, I’ve never really been one to hunt down food if I’m not actually hungry. So, while I could eat the rest, I never get around to it (well, in a day or two but not that day). So, down maybe 5 lbs. Going to work on keeping it to no more than 10 lbs (I’ve got a bit to spare).

Meanwhile, the side effects of the Cetuximab have hit with a vengance. I’ve broken out all across my chest, back, face, head, and arms. I’ve got some corticosteroid cream for the face and head, and they’ve actually gotten a bit better. But it still looks pretty bad. Fortunately most of it doesn’t itch. Only the area under my public hair (you know, the hair on my head) gives me any grief.

So, skinny and acne…just like when I was 16.

The other side effects (sore mouth, fearful flatulance) have subsided. They must be related to the other two drugs that I get only every 3 weeks. I’ll find out next week…Friday is the day I get all 3 meds, so those side effects should be kicking in somewhere around Memphis (I’m driving to Nashville starting out on Saturday). Maybe the weather will be cool and I can drive with the windows down.

Saturday my heart might have stopped. Not sure that it did, but I had a headache and took a pain pill, then fell asleep on the couch. I woke up and Rocky (the cat) was performing CPR. Up on my chest pumping left paw-right paw-left paw-right paw. Good thing he was there.