Chip Chace’s Saga, 2018 September
Greetings friends,
Sorry for taking so long to respond to your missives.
As you may have heard, I’ve had a rather challenging summer culminating in a diagnosis of adenocarcinoma of the pancreas.
Those of you uninterested in the following back-story can skip this bit.
Back in April 2018, I trapped a testicle in my climbing harness and experienced a mild strain injury. The pain persisted and did not seem to improve. In late May, I had a colonoscopy, which was normal. Shortly thereafter, I developed symptoms of gastritis while teaching in Europe. I was unable to consume wine or eat like normal. I experienced persistent gastric upset accompanied by pain radiating between the left flank and both testicles.
I saw my Primary Care Doc at the end of June and we decided to treat for H. Pylori with a berberine-based formula and an iteration of Wen Dan Tang, a Chinese herbal formula. Things improved considerably on this regimen.
I left for Canada on July 8th on a return tip to Baffin Island, while continuing on my gut meds. I flew for two days followed by a one-day boat ride, then a two-day walk, including two sketchy river crossings only to discover that my gear cache had been stolen and that an attempt to solo Mt. Asgard would not be possible.
I made my way back to Boulder by July 20-21. I sought solace in the Wind River range in Wyoming. I’ve been soloing there for the past 40 years and its my home range. Ten miles west of Rollins, I was rear-ended by a semi trailer that was going 40 miles per hour faster than I was. I totaled my Toyota FJ, but was miraculously unscathed otherwise. Monika came up and got me so that I could regroup back in Boulder. I returned to the Winds with a rental car and spent another two weeks climbing. I still had to be very careful about caloric intake and continued on my meds. I did have a 17-hour moment of grace during which I soloed the 1800 west face of Mt. Helen. All the while, I was juggling the gut and testicular discomfort as best as I could.
Upon returning home the upper GI symptoms began to diminish, although the left flank pain persisted, as did the radiating pain into the pelvic floor. I continued working, but was doing very little else. The flank pain became increasingly prevalent and unresponsive to anything that I tried.
I was admitted to Boulder Community Hospital on Saturday 9/8 at midnight with left-sided flank pain that was unresponsive to pain relievers. They ruled out the possibility of a kidney stone via CT scan. This they followed with a CT scan with contrast dye, which identified pancreatic adenocarcinoma and hydronephrosis.
Presumably the tumor or an adjacent lymph node is compressing my left ureter and this is causing the pain.
I continued to have a difficult time with adequate pain control. I received morphine and dilaudid via IV every hour, plus oxycodone every two to three hours and atavan every three hours, which helped with sleep. They also put on a fentanyl patch since I was still getting inadequate pain control. This helped a great deal with the pain. They put in a nephrostomy tube on the left, which helped to decrease pain from the ureter. At some point, I developed intractable hiccoughs, which persisted for 5 days. None of the drugs for this were especially helpful.
I became less responsive to all the pain meds. At some point last night on Friday, 9/14, Monika worked on me while I was in the midst of my barely conscious delirium and this seems have mitigated the hiccoughs significantly but not entirely. The fentanyl made me delirious and I rapidly improved after the removal of the fentanyl patch. By Saturday afternoon, 9/15, I was alert and the pain briefly abated Though by the next day I was again began experiencing nocturnal pain that was off the charts. Two days ago that shifted to nearly severe pain accompanied by intensive wrenching and vomiting fatigue, weakness, and mental fogginess.
The Intensity Scale
Pain is often graded on a scale of 1-10 with 10 being unbearable. For me it’s useful to grade other experiences based on their raw intensity using a similar scale. Uncontrollable vomiting, retching, chills, weakness and muscle twitching may rate a 9 or even a 10 even though actual pain involved. In Baffin last year, I embodied the wild in the midst of a level-10 intensity experience and catalyzed a lasting moment of transformational grace. My death deserves no less than that.
Current Status
My diagnosis is adenocarcinoma of the pancreas and hydronephrosis in the left kidney. There is currently a tube draining that kidney. My biggest medical issue is extreme pain, followed by vomiting, nausea, and mental fogginess. They have not yet staged this extent of the cancer as this requires a PET scan, an outpatient procedure. I still need IV meds for the pain, which requires me to be inpatient. Catch-22. On the other hand, no one is in much of a hurry for me to get the PET scan as all other signs point to significant metastases.
Prognosis is poor. The immediate goal is palliative care - get me home and functional on oral pain meds. Now that I’m marginally lucid, I’ve begun doing Chinese medicine, acupuncture and osteopathy to help me recover whatever strength I can.
Goals
First and foremost, I want my death to be an act of creative transformation, that is to say, I want to die well. I’ve been training for this my entire life and I’m well prepared. I would have preferred to die in the mountains, and that is indeed what Monika and I had envisioned for me. I got this instead. Yet, here is precisely where I want to be. I cry from the raw wonder and intensity of the experience but never because I’m sad or afraid.
I’m grateful for every second of I’ve lived so far and for whatever moments I have left. When I’m writhing in pain I scream thank you. When I’m puking my guts out I retch thank you...and sometimes FUCK!!!!!. I’ve been practicing more or less this way for a long time.
I want to optimize my time with Monika and Djinni.
I also want to nudge my students along as best I can.
If possible, I want to finish up a couple of writing projects,
To achieve these goals, I need to ration my time carefully. We’ve set up this gmail email account: IamChipsPancreas at gmail dot com so that we can keep you updated in a manner that creates the least amount of hassle for everyone.
I’m not seeing visitors just now, but if you want to get together or talk on the phone then please email us back at this email address and we will contact you with information (but DO NOT REPLY ALL because there are about 300 people on this list). That way we can have meaningful conversation with as few interruptions as possible. Please do not just stop by, as virtually every hour of my day is schedule. I know many of you have already expressed interest in getting together. We’re just getting organized here so please write again now if you’re still interested.
A thousand thanks for your love and support Love, Power, Grace and Gratitude to you all.
Chip