The Depresh

Depression, or as Nancy’s Mom – Gobby – used to call it “The Depresh.”  You are likely going to have to deal with it at some point, or several points, in your diagnosis, treatments and recovery.

It can hit you in many ways, starting with the obvious “holy crap, I’ve got cancer” to the general Depresh that creeps in as you wage your daily fight to try to feel better and not succeeding at it.  Then there’s the great one about going back to work fifteen years ago after you have recovered sufficiently from your stem cell transplant and the President of the Board takes you out to lunch to tell you they will not be renewing your contract.  Also, it would be best if you don’t return to the office because it will make everyone feel uncomfortable knowing that your work decisions don’t matter since you won’t be continuing with the company at the end of your contract.    I learned they had decided they “couldn’t afford to have an Executive Director that was going to die on them.”  Nice!

I saw that when Robin Roberts returned to her job at Good Morning America after her stem cell transplant, they had all of the Muppets come on the show and welcome her back.  Unfortunately it doesn’t work like that for everyone. 

Including when I was diagnosed with Leukemia and began my year and a half of treatments, my employer had to let me go because they needed to have a fundraiser on staff, and I couldn’t do it.  Not that I blame them, but it was still pretty crushing losing a job with an organization that I loved.

Then there’s the Depresh that follows the joy of “hey, I am still alive” with looking at your one hundred thirty-five pound self in the mirror.  You look like an escapee from a prison camp!

So, not only are you fighting to regain some normalcy with your health, but you also have to find a new job to help support your family.  And we all know how much fun that can be as you get older.  We also know that you have to keep a positive outlook when you are doing the job search.  Good luck with that!  But the truth is you’ve simply got to do it.

You HAVE to share these feelings with your doctor.  They see this all the time with their patients and they have a great range of drugs that can help lighten up the Depresh.  And there is no shame in taking these drugs!  Let’s be crystal clear on this – there is no shame in taking these drugs!  They are mostly mild, you won’t get addicted and you won’t be on them forever.  But you won’t be able to move forward without them.  Trust me, I know.

Multiple Myeloma Diagnosis

Unfortunately, for a lot of people their Multiple Myeloma can go un-diagnosed or misdiagnosed for a long time.  A lot of doctors just don’t think about it when they are presented with the symptoms.  These aren’t the only symptoms, but they can include:

  • wacky blood counts (red and white blood cells and platelets)
  • an excessive amount of calcium in your system messing up your kidneys
  • deteriorating bone and cartilage damage, especially in your spinal column

But once it is suspected, a bone marrow biopsy – where they drill into your hip and pull out some of your bone marrow for analysis in the lab – will quickly and definitively tell your doctor and you what is going on.  Once they get that information, your oncologist will lay out your treatment options and plan your course of action.  Here is where it is usually a good idea to get a second opinion on treatment options.  Your doctor should not be insulted by this and if he/she is, that doesn’t say a lot about your doctor.

My Multiple Myeloma diagnosis came in a little bit of a roundabout way.  At the time I was in a very stressful situation with someone I was working with.  Normally I am the calm person in the room, but this guy really knew how to push my buttons.  One day I noticed I had burst a blood vessel in the white of my eye.  Normally that is not a big deal, it just looks terrible.  A few days after it went down I popped one in my other eye.  That was enough for Nancy to make me go to my doctor for a blood pressure test.

Of course my GP couldn’t see me for several weeks, so I went in to see his Physician’s Assistant.  She said my pressure looked ok and she drew some blood for tests.  She called me the next day and told me I needed to come back to her office that day so she could draw some more blood. Hmmmmmm!  As I was sitting there and she was drawing more blood, she was talking about blood this and proteins that.  I was busy thinking about the company’s annual budget and our upcoming Board meeting.  To me she sounded like the Charlie Brown teacher “wah-wah wah-wah.”

But then she said she had made an appointment for me with another doctor for the next morning.  That instantly made me start paying attention – doctors usually don’t make appointments for you, much less without asking about it.  She said the appointment was with a hematologist.  When I asked what that was she said an oncologist.  That was when the truck hit me right between the eyes.

Lucky for me the Physician’s Assistant was as sharp as she was and suspected Multiple Myeloma.  It turned out I had a very advanced case where the cancer cells had taken over eighty-five percent of my bone marrow.  Not good!  But her detection of it literally saved my life.  I was also incredibly lucky to have been set up with the best hematologist in southeastern Virginia – Dr. Dean McGaughey at Virginia Oncology.

Killing Time in the Hospital

What can you expect to be able to do while you are in the hospital receiving chemo prior to your stem cell transplant?  Mostly likely, not much that requires any concentration or focus.  Those are hard to come by once the process starts.  You will be lucky to be able to remember what you had for lunch the day before!  Unfortunately that’s why you will not be able read and stay with any books.  And I just couldn’t stay focused on the TV or my cell phone.

But this doesn’t mean you should throw in the towel and lay there like a vegetable.  A very good friend who visited me early in my stay at the hospital was kind enough to bring me a word search puzzle magazine.  For me it was perfect! It wasn’t too hard, but it did require me to concentrate to find the words and circle them.  And I could easily put it down or pick it up as I felt like it.  I think that magazine helped keep me as mentally sharp as was possible and it certainly helped pass the time.

Nancy got into the adult coloring books, complete with a full set of colored marking pens.  I know that helped her keep her sanity during all those hours when she was sitting there next to my bed.

And as I have said in another post, you HAVE to make yourself get up and walk some every day.  This really is important.  But just keep focused on getting through one day at a time and before you know it, your strength will be coming back and you will be well on the road to your recovery.

There’s No Business Like Show Business

People are always asking me how I got started in show business.  First I stage managed the musicals at our high school for two years with my good friend Jeff Stehly (more about that in another post!).  Then at nineteen years old I stumbled into working in a costume shop owned by a classic theater character named Chuck Schulte.

One day shortly after I started working for Chuck, he asked me if I wanted to drive with him to Las Vegas to see the show he was running at the time.  The show was Juliet Prowse at the Desert Inn.  Coming from an all-boys Catholic high school in Anaheim, CA, I had never been to Las Vegas before, much less heard of Juliet Prowse.  So of course I said “sure!” and off we went to Las Vegas.

That evening we pulled up to the loading dock at the Desert Inn and went into the backstage of the theater.  We went straight to the backstage right wings where Chuck put on his headset to run the show and instructed me to stand off to the side and watch the show.

Like I said, I had never heard of Juliet Prowse before, so I didn’t know what to expect.  As the show started I could tell from the wings that she was a majorly talented dancer/singer complete with a full cast of dancers and big orchestra on stage.  And beautiful – she had legs that went on for days!

About ten minutes into the show Juliet runs off stage, comes right past me and says “oh, hello” and promptly goes into a full costume change right there next to me.  I later learned that she was claustrophobic and hated quick change dressing rooms.  She also figured that if you were backstage at a show, this was nothing you hadn’t seen before.  And when I say a full costume change, I mean everything!  There was nothing left to the imagination.  I just stood there like a statue trying to pretend like this was no big deal.  I think it was at that moment that I decided show business was for me.

Soon after that I became the stage manager for Juliet’s show for about the next six years.  We played Vegas, Reno, Atlantic City and we toured to Johannesburg and Cape Town in South Africa, Sydney, Melbourne and Adelaide in Australia and we even played the Palladium in London!  That was all such a GREAT time!  She was the nicest person you would ever want to know, much less work for.  During that time I made several great friends who I am still close with today.

I still get such a laugh out of the times we were playing at the Desert Inn and the show would start with a big, loud orchestra intro which led into a drum roll and then nineteen year-old me on a backstage microphone sounding like Joe Vegas saying “Ladies and Gentlemen, the Crystal Room at the Desert Inn is proud to present, Miss… Juliet… Prowse!!”  I love show business!

These Boots Are Made For Walking

If you are going to have a stem cell transplant – either using your own or donated stem cells – I personally think the best thing you can do to insure a positive outcome and speedy recovery is to get in as good a physical shape as possible pre-transplant.  Then, after the transplant you need to start walking as soon as possible and for as much as possible.

You certainly don’t need to be running a marathon, just be walking at least a mile a day.  As you recover and get stronger, you can gradually increase the distances of your daily walks.  At first, your walks will really wipe you out; but don’t let that stop you!  Keep at it and you will get better and stronger.  Your doctors and nurses will also be encouraging you to do this.  I believe daily walking also reduces the chances of some side effects and infections from your transplant.

At the Duke Cancer Institute and their Adult Bone Marrow Transplant Center where I had both of my stem cell transplants, they have measured that 17 laps up and down the hallway of the transplant wing in the hospital equals a mile.  Twenty days after I received my brother’s stem cells, I was going to be released from the hospital to move to an apartment and then visit the clinic every day for the next two months.  So the night before I was to be discharged from the hospital, they disconnected my IV tube from my catheter.  I was so thrilled at the prospect of getting out of the hospital I was wide awake at 3:00am.  Because it was quiet and I didn’t want to bother anyone, I went into the hallway and shuffled/jogged the mile distance.  Believe me, I could barely move after that, but it was so worth it because it was my way of saying “f*#% you, leukemia!! You are not going to beat me!!”  When my doctor and nurses learned what I did at just twenty days post-transplant, they didn’t know what to say.

Now that it has been fourteen months since my transplant, I have built up to a three mile loop through my neighborhood that I do every morning.  In fact I can now run about 2 ½ miles of it, and walk the rest.  I am certainly not setting any speed records and it really does tire me out, but I can do it!  And you can too!  Just do a little bit each day and keep at it and gradually build it up.  It really does wonders for your mental outlook on everything.

Immune System – Good! Infections – Bad!

Blood and bone marrow cancers and their treatments usually cause issues with your immune system.  Depending on what phase you are in with your treatments, you can have anything from a weakened immune system to literally no immune system at all.  So you have to be super vigilant about not getting infections because they can take off very quickly and before you know it you are in a ton of trouble.

And hospitals are notorious for being places where you can pick up all kinds of infections.  The good news is that most oncology wards in hospitals are very careful about this and take all kinds of preventative steps to keep you safe.

But sometimes we can our own worst enemy.  When I went to the Duke Cancer Institute sixteen years ago for an auto stem cell transplant (using my own stem cells), I never gave a second thought to the fact that I had an ingrown toenail.  Stupid man that I was (am) I had it for a while and I just never bothered to go to the doctor to have it looked at and taken care of.

Well, when I was going through my transplant and they killed off my bone marrow – and my immune system along with it – we couldn’t figure out why I was getting really sick.  I didn’t want to admit it at the time, but it was pretty serious.  Only after a couple of days did I think to ask the doctor if my toenail might have anything to do with it.  The look on his face told me that he would have smacked me, if he could have gotten away with it.  Needless to say they took care of it and my infections cleared up.

But then for several days when the doctors and their interns were making their rounds, I had to listen to the doctor talk about what I had been through so that the interns would learn from my stupidity.  Very embarrassing!

Hellllpppp!!!!!!

So you are diagnosed with Multiple Myeloma (bone marrow cancer) or Leukemia.  It is time for a crash course in cancer education.  Also, if you have lost your job due to your treatments, what the hell are you going to do to make ends meet in the bills department?

For information about Multiple Myeloma, you can’t beat:

International Myeloma Foundation: myeloma.org/ for information and emotional support, including area support groups.

Multiple Myeloma Foundation: themmrf.org/ for information including new drugs that are “in the pipeline.”

For information about Leukemia and Lymphoma, the best is:

The Leukemia and Lymphoma Society: lls.org/ for information and support.  They also have some financial assistance programs, which will be addressed below.

Of course, there is also The American Cancer Society: cancer.org/ for information and support.

For financial support, you should Google: cancer financial support.  Be prepared, you will get a ton of different listings.  Unfortunately, you will need to slog through each of them to determine if they apply to you.  Some are cancer type specific and some are geographic area specific, and most require proof of financial need.  You should also ask your oncologist if their office has a person on staff to help you find local sources for financial assistance.  All of this is really a difficult burden on top of dealing with your cancer treatments, but unless you are financially sound, we really don’t have much choice in the matter.  Just keep at it and chase them down.

Here are some of the organizations that I found who can help with grants and financial support.  Most of them are only able to offer support when they have funds “on hand” which is not always year-round.

The Leukemia and Lymphoma Society: lls.org/  They have a $500 travel assistance program.  They also have a separate support fund specifically for people with Multiple Myeloma.

Patient Advocate Foundation: copays.org/  They have a program that will help pay for your co-payment on your medicines.

Daniel’s Grace Foundation: danielsgrace.org/  They are a great, all-volunteer organization that serves the Hampton Roads, VA area.  Their mission is “to ease the financial burden of cancer.”  They also have a scholarship program to help student whose lives have been affected by cancer.

Mercy Medical Angelsmercymedical.org/  Their mission is “to ensure that no one in need is denied medical care because of a lack of transportation.”  In my case, they provided a round trip airfare for my stem cell donor.

Angel Wheels: angelwheels.org/  They are “dedicated to providing non-emergency, long-distance ground transportation to financially disadvantaged, ambulatory patients who are traveling for treatment. “  A typical trip supported by Angel Wheels does not exceed 300 miles (one-way), and they do not normally handle trips within a local area or community. Exceptions are made on a case-by-case basis, routinely for cancer patients traveling daily for treatment.  Angel Wheels to Healing utilizes the following resources for assisting patients: Gas cards (provided to help off-set fuel cost for patients), Bus Tickets (Greyhound, Trailways, etc.) and Train Tickets (Amtrak).

Family Reach: familyreach.org/  They are a national nonprofit dedicated to alleviating the financial burden of cancer.

The Bone Marrow Foundation: bonemarrow.org/   They provide financial assistance and resources for patients, caregivers and survivors.

Lee’s Friends: leesfriends.org/  They are a Hampton Roads, VA based organization whose primary mission is “To offer person to person help and needed emotional and practical support to cancer patients and their families who are facing the crisis of diagnosis and treatment of cancer.”

Good Days: mygooddays.org/  For support and financial assistance.

Patient Resource: patientresource.com/Financial_Resources.aspx  This is a lengthy, but VERY comprehensive list of organizations that provide support.  Again, you just need to ge through them one by one to determine if they are a “fit” for you.

The Actors Fund: actorsfund.org/  They can provide some short term support “for everyone in entertainment. “

Also, most pharmaceutical companies have financial assistance programs to help if you cannot afford their drugs.

Don’t despair.  You can do it and find help!  GOOD LUCK!!

Any Port in a Storm

For anyone fighting a blood or bone marrow cancer, your treatments will likely include having a port implanted into you.  In two of my cases, the doctors implanted a Hickman Catheter.  You can learn more about them from this good YouTube video: https://www.youtube.com/watch?v=z6dbV8vY1V8

Also: https://en.wikipedia.org/wiki/Hickman_line

It is a long plastic tube that is surgically implanted, usually in your upper chest, and runs into your jugular vein.  Typically it has three ports, or “lumens” that extend from your body and allows medical professionals to either administer medicine, drugs (like chemo) or blood products into you and/or draw blood samples from you.

In another instance for me, they implanted a version of that catheter in the bicep of my arm.

Trust me; you will develop a love-hate relationship with your catheter.  You will love the fact that you will not need to be stuck with needles every day.  That gets really old really fast!  But you will hate having these plastic tubes hanging out of your chest which are a constant reminder that you have freaking cancer and are fighting for your life.  The day they remove your catheter – which is a simple and painless process – is very much a milestone to be celebrated.

The nurses should always be checking your catheter – making sure it is flushed and clean.  In one of my cases, I had the Hickman Catheter in my chest for about seven months.  I guess that was a little long, because I started getting infections that they traced back to the catheter.  So they removed it and put a new one in my collar bone area for the balance of my treatments.  You can’t be too careful about this.  You do NOT want to be getting infections when you have little or no immune system!

I am not a doctor and can only talk about my experiences.  PLEASE do not take my stories as facts for everyone.  Have an honest conversation with your doctor about all of this.

Father of the Year

My career in show business ensured that we never had a dull moment in raising our family.  After I went through twelve years of Catholic schools, we wanted to similarly curse our children so we sent our three kids to St. Norbert Elementary School in Orange, CA.   It is a great school and we are so glad our kids went through it.  I think the best part about the school was that it still had three nuns there: Sister Francis (the Principal), Sister Rose Mary (the First Grade teacher) and Sister Carmel (who I later heard our kids say was teaching them “Spirish” – that was Spanish in her Irish accent).

These were three of the really good nuns.  None of them was taller than four foot six inches or weighed more than ninety pounds.  But they really were lovely ladies who were GREAT with the kids.  How Sister Rose Mary was able to teach thirty first graders with no assistant, and keep them engaged and learning without a ruler to the knuckles is still a mystery to me.

One day when Ryan was in fourth grade and Neal was in first grade, I was in my car in the pickup line for the kids after school.  Well, Sister Rose Mary came hustling over to my passenger side window and very concerned told me in her Irish brogue “Mr. Stava, I need to talk with you.” After asking her what I could do for her she told me “Today Neal picked up a popsicle stick on the playground, rubbed it on the asphalt into a point and said ‘we’re going to have a rum-bull!!’” “What’s a rum-bull, Mr. Stava?”

I had to explain to her that I was producing a production of West Side Story and the kids had come to see it over the weekend and what a rumble was.  I then assured her that Neal would NOT be starting a dance-off gang war with the other first graders on the playground at St. Norbert.  To which she grudgingly replied “Well, alright then Mr. Stava; if you say so.”  Sigh!!

A couple weeks later I am in the pickup line and Sister Rose Mary again came hustling over and said “Mr. Stava, I need to talk with you.” “Today Neal called someone a ‘mensch’.” “What’s a ‘mensch’ Mr. Stava?”  I told her that ‘mensch’ was a Yiddish expression for a standup guy, a good guy.  Then I had to explain to her what “Yiddish” meant.  “Oh, alright then, Mr. Stava – if you say so.”  I don’t think poor Sister Rose Mary quite knew what to do about the Stava kids.

But I loved those nuns!  I don’t think I have ever met a priest who would pass up on a meal, but those nuns would go a week without eating if it was to help the kids.

Learning How to Accept Help

I have always been the kind of guy saying “what can I do for you?”  I always had an over-developed sense of responsibility.  Helping coach the high school football team the year after I graduated from high school myself.  Stage managing professional productions and being responsible for the operations of very expensive shows starting when I was twenty years old.  Managing and fundraising for several theater companies and helping keep them open (when some of them probably should have closed!) to ensure serving their communities and providing work for stage artists.  And of course for my family.

As a result, it was very, very hard for me to learn to accept another person’s offer to help me.  Maybe it is because I am a guy, or it was my ego, my pride or just my deep, practically crushing feelings of insecurity.  “If I accepted someone’s help, then maybe I was a lesser person and not worthy of their caring – or even their love??”  Ooouuch, it hurts to say that!

These issues came home to roost with me sixteen years ago when I started my fight with Multiple Myeloma.  There is nothing like a cancer diagnosis to make you realize you can’t do everything by yourself.  My initial step in dealing with this emotional roadblock was my rationalization that by accepting someone’s help, I was giving something back to them.  That sounds nice and might be true to some degree and it “worked” for a little while, but I came to realize the plain and simple fact that I needed help. And there was no getting around it and no shame in it.

Even things like being so wiped out that I couldn’t drive myself for many months at a time.  And believe me, being a Southern California guy where you practically get in the car just to drive to the bathroom; it is a big deal to learn to ride in the passenger seat.  Thank God for Nancy and my family and their patience with me while I came to learn my new reality.

And that is the simple truth – you can’t do it by yourself.  You need to accept and be grateful for help.