My two year anniversary as a glioblastoma multiforme (GBM) survivor is coming up on 10/29/17.  I no longer count my survival in months.  Just like a toddler, once you hit two, you can go by years.  Well, I’m two. October 29, 2015 was just the date of my diagnosis.  I had the cancer in 2015 in September, August, July, maybe June.  Certainly the seeds of abnormalities way before that.  Somewhere along the line, I had an insult to the glial cells of my brain, and their growth became unregulated.

Those insults, or risk factors, are not well defined for GBM.  One is brain radiation.  Never had that.  Well, maybe a little in the cath lab as a cardiology fellow, but pretty trivial overall.  Of course, my brain was fried daily for 6 weeks after the diagnosis, but not before my cancer.  A risk reducer is seasonal allergies.  The thought is that your heightened immune system will prevent any brain cancer from developing.  Never had that, either, but Staci does.  If I could do it all over again, I would chose mild allergies.  Maybe allergic rhinitis patients are suffering more than I can imagine. I just don’t have enough empathy, I guess.

Shawn Hervey-Jumper, my neurosurgeon, tweeted a link to an informative discussion about GBM on the National Institute of Health website.  It is easy to read, realistic, but also hopeful.  Of course, it starts with the usual ‘poor prognosis.’  No article on GBM article starts without that statement.  In the 1990s, the median survival was 8 – 10 months.  It is about 15 – 18 months now, with 15% of the patients surviving 5 years. Not great, but at least it is improving.  15% sounds better than a Mega Millions lottery ticket.  More like winning an NCAA basketball tournament pool (not at Spectrum, of course, since gambling is illegal).  I have won those before, but that’s when I lived in Ann Arbor amongst a bunch of Michigan fans and MSU went to 3 straight Final Fours.  Easy money.

Other than that, I still rarely read about GBM.  When I first was diagnosed, I did a cursory review in UpToDate, a resource for physicians to quickly read about some obscure condition and sound informed 1 minute later.  That was enough.  I got the idea.  GBM is bad and locally aggressive.  I do glance at immunotherapy clinical trials for various cancers in the New England Journal of Medicine.  This is easier because it is other cancers, and other people’s problems. Immunotherapy, and specifically Keytruda, is certainly not a panacea, nor do I know if it is actually helping me. Fortunately, it is not slowing me down.

Googling Myself

I googled my name the other day to see what comes up. After I got through Craig Alg, the first Google suggestion was Craig Alguire obituary. What? I can understand Craig Alguire cancer, Craig Alguire brain tumor, or Craig Alguire doctor, but who is looking for my obituary? Here you go: “Loving husband and father of 4 kids. Cardiologist. Gave generously, but always keep it anonymous. Tried to live as healthy as his recommendations to his patients. He is survived by his wife, 4 kids, and himself. In lieu of donations to some charitable organization (he has already given so much), you can write checks directly to Craig Alguire.” Maybe I’ll go to every computer in the hospital and Google “Craig Alguire sexiest man alive” until that comes up as the first suggestion. Spectrum computers will probably block that search. Never mind.

Once in a while, I do ask my elderly patients the secret of growing old. A 90 year old told me the secret to living until 90 was “No browsing or carousing.” I just wish I made a follow-up question, like ‘what do you mean, exactly?’  And, ‘why isn’t your husband here?’  Probably healthy advice, but not that fun for 90 years.  Maybe 80 years with some carousing would be better. I’ll need to define ‘browsing’ a little better before I commit.

Alguires in Grand Rapids Update

Staci and I went back to Chicago in late August for another short term follow-up MRI. After the good news, the night was suddenly more fun.  We stayed near the hospital, and kept our car in the hospital lot with a validated ticket.  We saved about $40 on parking #cancerhasitsbenefts.  We walked to a restaurant based on social media and my doctor’s suggestion at Girl and the Goat. Nothing against the fabulous restaurants in Chicago, but restaurants in Grand Rapids compare well.

The weekend before school started, we had friends visit from Los Angeles and Holland (Michigan). We have updated pictures below.  When school finally began September 5th, Allison started 7th grade, Connor 4th, Queen Elizabeth 2nd, and Mia another year of preschool at Mayflower Church preschool. Allison left on the first day of school without much fanfare. She wouldn’t let me take a picture, so I just got her biking down the driveway. She has found her groove in middle school as much as anybody can in that terrible social stew.

The late summer and fall is full of family birthdays, starting with Mia on August 17 and capping off on October 22nd with mine. Everybody upped their age by one successfully. On my 40th birthday, we dissed the kids and sent them home with Staci’s parents and had an adult party at our house. This year, Queen Elizabeth planned the party. She suggested Craig’s Cruisers for my birthday party (because I’m Craig, I guess). For breakfast, she suggested Anna’s House. Sure. Why not. I woke up that morning with a little headache, so it was nice to have a slow start. I can’t really do 3 beers and stay up until 11:00 anymore. 1 beer and 10 o’clock bed time is the usual limit for this guy. That cuts down on browsing and carousing.

 

Figure: Upper left, Allison’s first day of school photo.  Upper right, friends from Los Angeles.   Middle right, waiting for our table on my birthday.  Bottom left, Mia is growing up so fast.  Bottom right, picking apples at the Walters.

Mia is progressing in the pool at Goldfish swim school. She is in a group wth kids that look Allison’s age. Being around her siblings and cousins, she is comfortable and overconfident in the water. She was the youngest in my family to swim the length of a 25 yard pool at 3, but a little older than my niece.  No, not that niece (Kathryn).  It was Rosie who looked like a fish at 3.

Let’s see.  I did the Reeds Lake Triathlon September 9th. No excuses, but (which is the usual introduction to an excuse) I was not able to do as well as I wanted due to a knee injury.  It felt great swimming around Reeds Lake, biking and running, albeit a little slower than usual. And then Connor played multiple soccer games and Alli started her swimming routine.

 

 

Figure: Left, finding my footing in the muck of Reeds Lake.  Middle left, my support crew at the Triathlon.  Allison photoshopped her way into the pic since she was still sleeping.  Middle right, Mia and her lane at Goldfish Swim School.  Right, Connor’s soccer team trying to stay cool in the ridiculous heat of late September.

 

The sports team we are most excited about is MSU men’s basketball. Connor and I went to the MSU Madness practice 10/20/2017.  When I promised him I would take him 6 months ago, it seemed more theoretical.  He has an obsession with autographs, but everyone knows MSU will be good this year, so it was very crowded.  We got there an hour before the doors opened, and were behind thousands of people.  By the time we made it through the metal detectors, the lines were too long to get any autographs before the cutoff time of 9:30 PM.  We didn’t exactly cut, but we were not passive, either.  Nick Ward got up from the table and walked down the line signing.  I pushed Connor forward and stood back.  Who can refuse a 9 year old with an MSU hat, shirt, shorts, and socks? Then, we stood by the ropes, near Miles Bridges’s table.  We must have looked desperate, since a random Breslin Center staff asked who we wanted.  All of them?  I did not push it. “Uh, Miles Bridges.”  She took Connor’s ball, handed it Miles, and brought it back with his signature.  Happy kid = happy dad.  He got MSU’s two best players.

On the way home, we discussed Halloween and carving pumpkins. I thought I was decent with the knife (for pumpkins). Connor said about our neighbors, “Their dad is super good at carving…not to be mean.” I didn’t think it was mean until he said, “not to be mean.” Oh well. Might as well learn early about your parents’ deficiencies.

 

 

Figure: Left, Connor finds Nick Ward.  Middle, the lady in the baseball gave Connor’s ball to Miles Bridges for an autography.  Right, Sparty.

In summary, I feel fine, GBM is slightly less terrible than it was in the 1990s, I could’ve done better in the Reeds Lake Tri, still working several days a week, kids are doing fine, and I cannot tolerate even a little bit of carousing. As always, I have an upcoming MRI. And I am grateful to start counting survival in years. Two.

 

Figure: Left, It isn’t browsing or carousing if it’s your wife.  Right, the family walking around ArtPrize in GR in late September.