Category Archives: Cancer

Goodbye Jeffrey

Friends,

Last night Jeffrey passed away. As readers of his blog, you know about his zest for life. He had a passion for living and did it with reckless abandon. He gave so much of himself – to his family, to his friends, to his work – all because he loved his life and what he did.

We feel blessed to have shared his life and received his love. He has changed us in so many ways – helping us to love more deeply, be fearless and take risks. He was inspirational.

Jeffrey loved blogging and he loved reading your responses even more. He was awed by the comments people posted to his cancer blogging. He felt the love that reached out to him in every word you all wrote. Going in to his surgeries, he read the postings you wrote and it gave him strength.

Let’s give him strength again. I know that somehow, he will see your comments on this blog.

Tonight, drink a martini for Jeffrey – grey goose gibson, straight up with a twist. It’ll make him smile.

Love, Jessy, Brittany and Mac

Living with Cancer in Silicon Valley II: Survival Tips from a Hardened Cancer Dude

Although I have a reasonable excuse for not blogging since March, my Kids have become my conscience telling me to update people. Facebook and Twitter are for updates, so instead, here are my ways of surviving the ordeal of cancer.

Originally I blogged because I joined Atlassian. My Inner Writer Nerd also wanted to come out. Then I crossed the line from business topics with my Cancer 2.0: the Killer App blog. No surprise, a lot more people read this. Two lessons: 1) Speak from the Heart and it’s way more interesting. 2) Business colleagues accept one crossing the line from business to something as starkly personal as cancer.

I am on leave from Atlassian, so writing about work is less likely. My focus needs to be elsewhere. So Dear Readers, I am Leaning into It, and will write about personal matters.

How do I survive this Cancer Thing? What would I say to a Cancer support group, which I don’t go to it because I find them depressing? Here are my Seven Survival Tips.

#1: Focus

I have one focus: Get Healthy. Whip Cancer’s Sorry Ass. Everything that follows here is in service of this one Big Goal.

What is difficult about focus? For one, I love my work. I even lurve it, as Woody Allen said. When I had cancer in 2004, I re-evaluated my entire life. I realized that I live here in Silicon Valley and work in technology for a reason: I love it.

My cancer, however, is not a mild or known variation. My cancer is an aggressive, unknown (4 cases ever) beast that grows tumors in my kidney region and attaches to valuable stuff. I have lost one kidney already.

Time to focus, buddy. Taking a leave from Atlassian sucks. I am honored to work in such a special place, and letting go is not fun. But now a singular focus is critical: Health.

#2: Focus on Short-term Goals

I focus on getting through short-term wins or “gates” in the treatment. My 2004 treatment lasted 10 months. This one will be shorter, but when you add up my chemo, surgery, radiation, and the possibility of the treatment changing anytime, long-term goals feel elusive.

An example is chemo treatments. Each one is an accomplishment. I focus on the reward of eventually eating like a Pig, going out, enjoying life, once the toxic crap dissipates.

Now my short-term goal is getting ready for surgery. Nothing else matters. Screw radiation; that’s down the road. I am working out every day to be in shape for surgery.

Remember the precept of good project management: never have a task longer than two weeks? If you an Atlassian-type or engineer, think about some Agile Development principles. Two week goals are great things. Chemo cycles tend to be three unfortunately!. Think short-term; otherwise, the disease is more debilitating mentally.

#3: Don’t Look Like a Patient

“It’s not how you feel, it’s how you look”, goes the Billy Crystal line. If I look good, I feel more invincible. I absolutely hate looking like a patient. Even in the hospital, I wear jeans and t-shirt rather than Their Goddamned Pajamas.

At one point chemo drove my weight down to 175 pounds. I’m 6’ 1” and can easily carry 190, and started chemo at 200 pounds. What did I do? I shaved my head, put on some nice clothes, got out my sunglasses and took this photo for an internal Atlassian blog.

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Although I felt like shit, and could not wait to eat a meal, Ben Speakman, one of our developers at Atlassian commented back that I looked “Badass”.

Look like the healthy person you want to be. Be the change you seek.

#4: Follow Your Heart

Yes, my heart is in my work, but I can’t have that right now. My heart is also in my music, my art, reading, hanging with my family. I give these pursuits as much space as treatment allows.

I might call this “Re-Balancing” meaning: if you cannot pursue work, what pursuits can you fit in between hospital time, chemo infusions, treatments, countless doctors? For me, it meant making a project of my music and art. I finally set up a new iMac with all my art, photos, music, movies, and installed Protools for recording. I bought myself a keyboard, and transformed my home office into a real music room. Follow you heart.

#5: Exercise

No matter how feeble you are, get your Sorry Ass to a gym, go for a walk, anything to fight it. I started with a 12×8 centimeter tumor planted on my Psoas muscle. I was in so much pain, I couldn’t sit in a chair. Every day I was taking 160 mg Morphine, 900 mg Neuronton, and 50-60 Oxycodone/Percoet…

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Once my tumor shrank from the chemo, I worked off the morphine. Then I started walking. Now I have zero pain and run at least 2 miles almost every day. I am on a Mission for God, and the God is My Health. Working out helps me mentally get through the agony of chemo, and I am certain, prepares me better for surgery.

#6: Live

That’s right: live. As a cancer patient, you are closer to death. It is trying to kill you. With some cancers, perhaps death is a long way off. With mine this time, the docs gave me a few months if I was not treated aggressively.

So I aim to live during this pain-in-the-ass treatment. Living, to me, means enjoying things you might now ordinarily do as a beaten-down patient. In 2004 during chemo, I flew my son to the Baseball Hall of Fame in Cooperstown, Yankee Stadium, and Fenway Park. I was told not to be in large public places while my immune system was weak. Sorry pal, I had to live while I could, and it was a trip my son will never forget.

During chemo this time, I played guitar at a local Stanford University Relay for Life. Here’s one of the tunes I played…

I love playing outdoors, and witnesses will tell you I was rather loud. Live, Baby.

#7: Be Positive

This could easily be my first tip, but I already blogged about the mental game in 2007, and recently when my cancer returned. Also, I am a natural optimist, so I really don’t do anything, I just am this way.

I also cannot say this to a patient after options have run out. I have had frightening diagnoses, but not that tough. I do know that every medical professional with whom I have discussed the power of positive thinking, strongly advocates it.

Focus on the positive. Tell cancer to “Piss off”

Living with Cancer in Silicon Valley

Enso, a symbol of Zen Buddhism

Enso, a symbol of Zen Buddhism

My cancer returned Monday. In not exactly a subtle way. I have two tumors, one of which is 11×8 centimeters. They are messing with my left psoas muscle which explains all the back and leg pain I have been having.

Being the occasional idiot I am about ignoring pain, I waited too long to get medication. Now I am on an intense mixture: the morphine is the platform, the percocet dulls the spikes, and the neurontin is nothing less than a bomb going off, so thankfully it’s reserved for sleep, something I have not had for weeks.

This is my life. I am living with cancer, I have had three major operations — here comes #4, I have had a frightening amount of chemo, and I lost a year of my life right before joining Atlassian. I can struggle or I can embrace it. Those of you who know me understand I have only one option. Not because I consciously choose. I am just innately positive.

Lean into it. A shrink once gave me this wonderful Zen advice about facing challenges and problems: they aren’t going away, so you can choose to fight them or embrace them. Embracing them means finding the positive, and turning the badness into goodness. Cancer is an opportunity.

I sincerely believe cancer has been more positive than negative. Thanks to my first battle, I had time to focus on my son, who was struggling with teenage issues, and help him make a remarkable turnaround to a focused young man. It was in him, but I learned how to be a better parent thanks to cancer.

I learned how much love there is in this world. All you have to do is get in touch with it, and it’s everywhere. Even out here in the social-2.0-blogging-weird-o-sphere, the connections can humble you. People may be conversing in Seemingly Strange Ways like Twitter, but there are humans behind those electronic bits and the messages and meaning can lift my spirits. That was the lesson I learned about blogging about cancer and seeing the love come back. My blog inspired people, and the Awesome Karma came back inspiring me through a major surgery.

A friend reminded me: I have a blueprint for this journey. Getting the news Monday about the two tumors sucked. I was upset to say the least. I love my life. Four years ago, I married the most Incredible Woman on the Earth, I bought a new house, and I met this incredible little company called Atlassian. I just love my work. I love living here in California. I am the luckiest guy in the world. My blueprint starts with reminding myself that I do all these things — the ritual Sunday night family dinner, the sandwiches my daughter Brittany brings me while I am sitting here waiting for surgery… the list is long — because I love them. And yes, it includes the work I love.

The first priority on the blueprint is of course getting the right treatment and recovering. But the blueprint includes trying to work when you can. I called a customer Tuesday morning, just 20 hours after getting the news. Willie Doyle had read my blog and wanted to share their agile development story. I love talking to customers and learning what they’re doing. The point is: cancer is not going to stop me from learning new, cool things like this.

Surely I will have to cycle down and let things go during surgery. Right now my biggest challenge is managing this intense concoction of drugs so I can still do the little things I love: like blogging.

Awhile ago I chose to write about personal things in this blog, and not just talk about software, business, Atlassian, and the expected. That’s also part of my blueprint: people have complex, interesting dimensions, and sharing these opens up opportunities.

Hang Tough and Live Strong

The community of inspiration I felt when I blogged about my cancer is still alive. Lance Armstrong just sent me this great note:
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My friend Fred Harman happens to be on the board of FRS [stands for Free Radical Scavenger — which would be a much cooler name — a great Health Energy drink] with Lance. Fred told Lance about my blog where I talked about telling my kids about my Plan to whip cancer, “The one difference between Lance and me is that I didn’t have to win the Tour de France. I only had to beat cancer.” All true, and one of those truly emotional moments.

Getting this is wonderful and inspirational for me. Lance was one of my attitude inspirations three years ago. When Lance writes “Hang Tough”, you know it’s coming from someone who defines Tough.

And I absolutely _love_ the last three words on the bottom of the card: Attitude is Everything. Check.

What I learned from Cancer 2.0

recovery.jpgSix days after surgery recovering in the California sunshine.

Last week was a Really Great Week. Everything went my way. When you’re a cancer survivor, you don’t forget weeks like this.

The pathology on the tumors they removed was 90% probability they are benign. I did not receive inter-operative radiation. Surgery took two hours and then while still open, the Docs evaluated the tissue for an hour. I could feel the difference when I woke up. My prior surgeries had been eight and fours hours. I knew this one was not as bad.

It was an intense emotional moment to have my wife Jessy tell me the news. When you have a one foot incision, it’s damn hard to laugh or cry. I wept.

Four days later I came home, and five days later I was off pain meds. I feel pretty good.

I learned something powerful when I blogged about my cancer. Although I have a number of incredible lessons from my one-year battle in 2004, this time I was the beneficiary of yet another.

I struggled with writing publicly about cancer. Originally I was only going to blog internally to my fellow Atlassians. It is easy to be inhibited about disclosing this disease to the business community. But everyone has either had cancer in their family or friends.

I wrote the blog last Monday when I found out my surgery was Wednesday. Tuesday, 1002 people viewed my blog thanks to:

The community was awesome. People I never even met wrote me passionate emails. I was touched.

Tuesday, the day before surgery, would not normally be a Real Groovy Day. You go onto a clear liquid diet and clean out your system for the surgery. Not a regimen I would recommend. Instead, it was an exhilarating day. Watching the comments, emails and views pour in from people I inspired turned out to be a massive inspiration to me.

What I learned is inspiration is circular: giving it is very inspiring back. The blog became this powerful therapeutic thing. Right before major surgery. I was psyched. I was so up I ran two miles at 6 A.M. before my surgery. I checked my blog stats one last time Wednesday before going under the knife. I could see I would touch 2,000 people before I was done.

Every time a nurse or resident or Doc talked to me at Stanford, I told them to go read my blog. I jokingly nagged the pre-op team to read my blog while they got me ready. They did! They loved it.

Everyone fundamentally wants to have a positive attitude. I am blessed with being a Pig-Headed Blind Optimist. Paul Herman sent me research that says optimists live longer. Brad Porteus also gave me the Norman Cousins book, Anatomy of an Illness that says a patient’s own powers – laughter, courage, and tenacity – are effective weapons against disease. That’s my strike zone. I guess it’s second nature for me.

Next month I hit the three-year milestone of being cancer free.

Cancer 2.0: the Killer App

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Watercolor, August 2004, of Bing Gardens at Stanford Hospital I drew during one of my in-patient chemo treatments.

Soon I’ll be going in for surgery for a re-occurrence of my cancer. I have a 2 centimeter tumor where my left kidney used to be.

I’m a cancer survivor. The year before I joined Atlassian I battled cancer for a year. It started with surgery to remove my left kidney, when they discovered a nasty tumor attached to various important things. They removed part of it. My initial stunning prognosis was 3-5 years to live.

My cancer was eventually diagnosed as an unknown cancer: sarcomatoid carcinoma. Which means it looks and acts like sarcoma [very rare bone, tissue cancer] but it may be a rare carcinoma [organ based], which means, “we have no idea.” This was exhilarating news: no statistics meant I was a data set of one, and any prognosis was bullshit.

Chemo for 4 months followed. Which was a lot of laughs. Because they didn’t know what I had, they experimented with different regimens. I had the pleasure of having Cisplatin amongst other drugs. Cisplatin is as bad as chemo gets. Chemo assaults the faster growing cells attempting to kill them. Your hair and your stomach lining are fast growing, so they can be killed by some chemo.

Side affects vary, but nausea is popular. A common cycle for chemo is once every 3 weeks. The reason is you need 3 weeks to recover from the bombing your system takes. I would lose 10 pounds in the first 5 days when I tried to eat a scone for breakfast or have a bite of a sandwich at lunch. Dinner was impossible. Smelling food was disgusting. Then on about the 6th day I would stroll down to this local French bistro and wolf down a steak and have a martini. Your taste buds get assaulted, so good wine was a waste on me. Then I would return to the clinic with my 10 pounds back.

One of the regimens required 3 days in the hospital because I had to be hydrated so my remaining kidney survived. I would gain 10 pounds of water weight in eight hours; Boy, was I attractive. They gave me a PICC line which is a tube inserted into the back of your bicep and then threaded close to your heart where the blood flow is strong. The reason is grim: the chemo is so toxic, it will burn your veins unless there’s good blood flow. Having a toxic warning to the nurses on my door was also a lot of laughs. God forbid they spilled the chemo on themselves.

Eventually my MRIs showed only modest shrinkage in my tumor, so I was sent to the largest cancer hospital in the world, MD Anderson in Houston, where a specialized team removed the remaining tumor. That surgery went extremely well as the contingent plans for a graft on my aorta and some other things-down-there-you-need never were invoked.

I was cancer free. That was a very wonderful moment after all the crap I had been through.

I then underwent 3 more months of chemo to make sure there were no bad guys hiding out. At least now I could count the weeks. December 18, 2004 was a Wonderful Day: my last treatment. I could eat on Christmas day.

The day I got my (wrong) prognosis of a few years left to live, I faced the biggest challenge of my life: not cancer, but what to tell my children? I got a copy of Lance Armstrong’s book and I remember setting it down on the table in front of Brittany and Mac and telling them the one difference between Lance and me is that I didn’t have to win the Tour de France. I only had to beat cancer.

Cancer never broke my positive attitude. Sure, for a few hours or a day I would be an emotional wreck. But I had an uber focus. I worked out almost every day. Chemo made me feeble compared to my old self but I was relentless about exercise.

I discovered I was an excellent surgery patient. I could withstand a lot of pain. I would be walking all over the hospital after surgery. I ran 2 miles 11 days after an 8 hour surgery. Slowly. I asked my surgeon when I could start lifting weights and he thought I was out of my mind. During my 3-day in-patient chemos, I asked Stanford Hospital if they had a gym. They looked at me like I was nuts: “Mr. Walker, this is a hospital.” They did get me a treadmill so I could run in my room while the chemicals dripped into me. I was on a mission. Get the fuck out of my way, thank you very much.

Prior to my second surgery, they had to stop chemo for several weeks, so I had full strength. I used this opportunity to bike the famous “loop” near Stanford University and my home. I biked every single day focused on going to Texas, getting through the surgery, and getting out of there as fast as possible.

At MD Anderson in Houston I snuck out of the hospital on the 4th night and went to my hotel across the street because I hate hospital beds. The nurses on my ward were really pissed. But they let me get on a plane home 5 days after a 4-hour surgery.

So where does that leave me now?

In preparation for this upcoming surgery, I’ll be working out every single day. I’ll be leaving work at a reasonable hour. I need to point my Type-A personality at Atlassian at something more important right now.

This re-occurrence is nowhere near as brutal as what I went through three years ago. Will I have to go through this again in 3 years? Perhaps. The way I look at it: I will certainly live 5 more years, based on currently available data. Will I live 15 more? I didn’t know the answer to that question one year ago, so nothing has really changed. In fact the behavior of the cancer is better known now: it seems to stay local.

I read fellow Atlassian Chris’ incredible blog the day before my MRI that detected this current tumor. These problems make you face your mortality. Everything gets put into play, up for grabs. Jump ball.

I have the same attitude from three years. I am Cancer Dude and I am going to kick it’s ass. Here’s my secret cancer-fighting outfit… :-)
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Supporting Cancer Research

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This weekend I’m supporting the American Cancer Society by participating in the Relay for Life at Stanford University. I’m a cancer survivor. I beat cancer right before joining Atlassian.

I’ll be playing music as with some friends to entertain the good people working there. My fund raising has been going great thanks to very, very generous friends and Atlassian colleagues. I _really_ appreciate it.

We named the band, “The Occasionals” due to our working only for benefits occasionally. :-) My buddy Bonnie Gemmell at Add2logo designed us a cool band shirt which we’ll be selling for last minute fund raising. Check it out…
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Last minute donations of any size are still appreciated. And I’m taking twitter orders for the T-shirts. Oh, OK, email too… sigh.