Feb 6, 2015: Trip to Pittsburgh and Upcoming “POEM” Surgery

Kristina and I had a busy and eventful week.  I’m writing to give you a brief update.

We flew to Pittsburgh on Monday, February 2nd, and made it safe and sound despite a big storm in the Northeast that day.   On Tuesday morning, February 3rd, we had a very meaningful consultation with Dr. Hussein Tawbi, the director of the sarcoma program at the University of Pittsburgh’s Hillman Cancer Center.

Dr. Tawbi was wonderful.  He is an extremely bright, caring oncologist — and very knowledgable about and experienced in dealing with rare and challenging sarcomas like mine.

He had a lot to share. Of note, he carefully reviewed the results of a gene sequencing assay that was performed on my original tumor specimen about a year ago, which actually revealed three specific gene mutations.  Dr. Tawbi feels strongly that one the of the three mutations in particular is a potentially viable candidate for treatment with one of two new “targeted therapy” drugs. One of these drugs is FDA-approved (although for a different kind of cancer than I have), but could nonetheless potentially work for me.  The second drug is being studied in a clinical trial that is available in his program.  He asked me to return to see him in a month, after undergoing another series of MRI and CT scans.  Right now, I am very inclined to go.

Dr. Tawbi felt that — given how severely exhausted I am from my last cycles of chemotherapy — it would be reasonable for me to take this time as a break off treatment.

We returned home Tuesday evening, feeling very tired but glad that we had made the trip, and gratified to have Dr. Tawbi on our team.

Also of note, Dr. Tawbi recommended — as have several other of my doctors —  that I go ahead with the surgical procedure mentioned in my last blog post, to try and relieve the difficult swallowing/achalasia symptoms I’ve been struggling with for many weeks, before proceeding with any further systemic cancer treatment.  I’ve decided to go ahead with this procedure  — called a “POEM” procedure (which stands for “Per-Oral Endoscopic Myotomy”) — this coming Monday, Feb 9th.  This will be done by a terrific gastroenterologist at the University of Colorado, in Denver, Dr. Norio Fukami, who I saw for a consultation on January 22nd.

I admit that I am daunted about undergoing yet another surgery at this time, for a variety of reasons.  First, I still feel quite weak and exhausted from the last cycles of chemotherapy.  The procedure also requires general anesthesia, which I have found from significant personal experiences takes a toll on my system.  There are also risks involved — as with any surgical procedure.  I’m also not looking forward to a post-op recovery time that requires a liquid diet for a minimum of two before the surgery, and four days after the surgery — and it is unclear how long it will really take to fully heal from this and eat normally again.   Nonetheless, I am convinced that this procedure is the best option I have available right now.  And I feel certain it is important to try.  I want to keep doing all I can to keep moving forward, and being able to get adequate nutrition is essential.

The surgery will happen on Monday morning, in Denver, and I will be kept in the hospital overnight.  If all goes well, I’ll be discharged on Tuesday and return home to Boulder.

There is a lot more I could say about all that is going on — but these are the most pertinent details for now.  I wanted you to have a sense of the highlights.

Thanks as always for your love and support…

21 thoughts on “Feb 6, 2015: Trip to Pittsburgh and Upcoming “POEM” Surgery

  1. peter

    holy brother,
    my heart is with you, feeling you, surrounding you and kristina with the warm light of love and care

  2. Diane Nunn

    Monday will be Jeremy Geffen Day in my mind and heart. My prayers will center on you and your medical team and for Kristina who I know will need some anxiety relief.

    All best to you!


  3. Robin Temple

    Dearest Jeremy and Kristina,
    Thank you for letting us know what is unfolding! It’s wonderful that there are possibilities with the clinical trials and alternative drugs. I can only imagine how depleted you must be from the chemo. We will be enfolding you and your doctors and care-givers in prayer Monday!

  4. Diana Tripp

    Thank you so much or this report, Kabir. It all sounds and feels quite hopeful. Your apprehension is understandable because of your weakness – it it would appear that you body, can, in fact, take this on and that, in the long run, it will prove beneficial.

    Good luck on Monday and in the weeks to come. I feel you received very good news!

    Love to both you and Kristina.
    Love, Diana

  5. Amara Geffen

    Dear Rame – my one and only brother. It was so wonderful to see you and Kristina on Monday while you were in Pittsburgh….and more wonderful to hear that Dr. Tawbi was indeed able to open a hopeful option. Jed, Satchi and I will be thinking of you Monday and sending/beaming love your way. There’s a road to travel here for sure…but the plan is sound and so we will focus on renewed strength for you. When you return in early March I will come down again to see you if it makes sense. This time, I will buy the dinner! Love to you and Krissy! Amara

  6. Kathryn

    Dear Jeremy Thinking of you with much love; Sending prayers for peace’ strength courage and blessings. holding in the light of the healing lKay

  7. Cielo


    Thanks for this update. We are always with you in heart. It makes me happy to read about Dr. Tawbi and your good team caring for you. I hope your surgery fares well and will be thinking of you.


  8. Carla

    Yay! I love hearing good news! There were lots of it, you made the trip, no hassles, fantastic doctor, new drug, getting your swallowing fixed, and having the gorgeous goddess with you all the way, and some healing time. I am always with you in thought, spirit, and heart. Love you both. Doug and I have a few weeks open after this week. How can we help? Warm beaches anyone?

  9. Laura

    Dear Jeremy,
    My prayers are with you for this latest treatment plan and surgery tomorrow. Will keep you in my prayers. May God guide the surgeon’s hand and the procedure go smoothly and really help. Thank you Kristina for you devotion to Jeremy and may God bring you his peace and comfort. Blessings , Laura

  10. Logan Kline

    Dearest Jeremy and Kristina, I’ve been with you in Spirit and my loving embrace, since missing your email in Nov. switching to this blog. I’m now current, thankfully, and sending my sincere most focused love and light!! Great success for your surgery tomorrow and graceful recovery and as you prepare in body, mind and spirit for the next very hopeful step on this journey!!! Bless you dear friends, Logan

  11. Peggy Wrenn

    A POEM, to beloved Jeremy,

    Mary Magadele and every goddess, god, shaman, faeirie or anyone who can help,

    Thank you, from my heart to Jeremy’s heart…

  12. Amy Collins

    Dear Jeremy,
    Last night while lying on the couch reading, I suddenly thought of you and felt a strong urge to know something causing me to google your name. This is how I found this blog and learned of your illness and treatments over the last several years. While I am so very sorry that you are faced with this struggle, I am thankful to have the opportunity to reach out to you and let you know that my thoughts and prayers are with you, now and always.
    With love and healing thoughts,
    Amy Collins (Amy-la) xox

  13. Jack VanDervort

    Jeremy, What a beautiful tapestry of “Life” you are weaving by carding the wool of rudeness in this old world and turning it into the golden threads of this beautiful blog. Heal us brother with your Loving attention and observations The world is a better place for your presence in it. Love – Jack V.

  14. Gemma Wilcox

    Dear Jeremy,

    I am just catching up on all your posts, after feeling you strongly over past week and then discovering that I was not subscribed to these posts, so had a few to catch up on!

    I am sending you immense healing blessings and love and light as you rest and recover after surgery.

    I love and miss you and want you to know I am holding you very, very dear in my heart and prayers.

    Hope to have that tea when the time is right.

    Huge love to Kristina too!



  15. Bev

    How wonderful to know about this blog & to join my heart with all the others who love you. May the kind help you’ve provided to so many people (including me!) surround you with comfort & encouragement now. Continuous prayers from Tucson to you, dear Jeremy. You helped my quality of life today be such blessed miracle and I want to share that possibility for you as well. Sending much love & warm healing light.
    With love,

  16. Ani Samten

    Dear Jeremy,
    I was just sent a link to your blog and saddened to learn of your illness. Your book Journey Through Cancer was made such an impact on me when I read it 15 years ago. I have tried to draw on my own spiritual practice as a nun and to incorporate your vision into my practice as an oncology nurse ever since.

    Sending you prayers for healing and my deepest gratitude for the light that you have brought to the world.

    May we never forget those who have hopes of us,
    Ani Samten


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