I just haven’t had any luck with food this trip. I had reservations for 6 pm at The Dining Room and I checked in with the hostess at 5:57 pm. She said my table would ready in a moment. Four other couples checked in after I did and they were all seated first. The restaurant was busy but when I was eventually seated at 6:20, there were plenty of empty tables that could have sat me. Maybe they were paying me back for not meeting my reservation on Wednesday night.
When I looked at the menu, absolutely nothing attracted me, particularly not the dishes I already sampled. The prices were ridiculous. I got up and left and headed into historic Snoqualmie.
I ended up at Buckshot Honey, a BBQ place. I ordered pulled pork sandwich with collard greens and baked beans with the day’s lager. All for only $44 + tip. It was pretty tasteless and I ended up eating the pork and a few sips of the beer.
Hopefully, Seattle will offer better fare.
The lodge has certainly picked up in traffic and guests. The valet parking was backed up and it looks like there are a lot of people spending the weekend. The lodge is nice but I probably would not stay here again if the opportunity arose. The staff are helpful for the most part, The Dining Room experience tonight notwithstanding, but it’s not worth the money.
I checked out of the lodge around 8 am and headed west to Seattle. Amazingly, traffic was light and I zipped into the city without any traffic snarls. I valet parked at the Paramount and left my luggage (too early for the room) and sat out to explore Seattle.
The hotel was built in 1996 so it’s 27 years old and even though it was renovated in 2008, it’s showing its age 15 years later. However, it’s clean and the staff are nice and it’s a place to rest before my red eye.
The desk clerk pointed me in the direction of the public market, often called Pikes Market even though Pikes is just one of many, many shops in the market. The place was packed.
Pikes Place Fish
I did eventually find Pikes and I had just walked away to buy some donuts for breakfast when someone, from the roar of the crowd, must have thrown a fish.
From the market, I headed down to the pier area and saw saw Seattle’s version of the “eye” and saw the Norwegian Bliss, a massive cruise ship.
From there I walked up Bell Street to 4th Ave and headed to the Space Needle. On the way there I saw the reflection of the needle in the windows of a building.
It didn’t look too busy so I walked up to the ticket window and asked if I could go in even though I had 2 pm reservations. She changed the ticket and into line I went. It was longer than I anticipated but they moved you through very efficiently. They certainly have learned how to do this over the years.
The needle was completed in April 21, 1962, 6 months after breaking ground. It’s 605 feet high and was renovated in 2018. A view of Elliott Bay from the needle.
One up on the observation deck, I took a few photos and then went down one level and had lunch. You could order “bites” and a cocktail and sit while the revolving part of the needle changed the scenes for you.
This is a Lunar Calendar: smoked pineapple, jalapeño infused tequila, lime, with agave. Only $22!
What was neat was sitting at the table and watching the “restaurant” turn.
At first, you think you are sitting still and the glass wall is turning to the left.
In reality, when you look through the glass floor below you, you see the needle is turning to the right.
From the needle, I headed down to the Chihuly museum. I’ve seen his exhibits at Fairchild (twice) and his museum in St. Pete (once) and now the museum in his home base of Seattle. These were some of his most impressive pieces I’ve seen. All the better since I got $10 off my ticket with my Space Needle ticket.
I left Chihuly and looked for the entrance to the monorail.
I remember when the monorail was built and it was one of the first of its kind in the states. It opened on March 24, 1962, one month before the Seattle Worlds. Fair. Disney was first with their monorail in July 14, 1959 and it was the first in the U.S. Senior tickets in Seattle are $1.75 and it has only one – stop in downtown Seattle.
Monorail arriving at the station.
Seattle reminds me a lot of San Francisco in both temperature and walkability. I did over 3 miles today and it seemed much less.
Certain neighborhoods around the needle remind me of some of the broad boulevards of Paris.
Look at the width of this sidewalk!
One year in Paris I somehow found myself on Rue Lauriston, southwest of the Arc de Triomphe. They had unbelievably wide sidewalks along each side of the street with very cute apartments lining the street.
Once I got back to the hotel, a little after noon, I checked to see if my room was ready and it was. I will shower, rest, read, and then around 9 or 10 head to SeaTac for my red eye home.
Other than poor, expensive food, it’s been a great trip. I loved the hiking and the waterfalls. I can see myself coming back to this area for more hikes and more waterfalls.
It seems you can’t escape your oncological team by flying to Washington. I got a call yesterday morning where the scheduler for Dr. Arnaout wanted to set the date for the first infusion of chemo for May 22nd. I told her I wasn’t a fan of that idea since the port surgery was scheduled for May 25th. She then suggested May 26th and I suggested I wanted the surgery to heal before the first infusion. We settled on June 5th. She anticipates it’ll take 4 or 5 hours for the first infusion. They administer it slowly to see if you have any side effects to the cocktail.
Then some good news. I had an email from Invitae this morning telling me that the first series of genetic tests came back negative. I still have an outstanding series that will probably be ready in a couple of weeks but at least I’m in the clear on the first set.
Instead of adjusting to the time change, I seem to be getting worse. After the hike yesterday I came back and napped. This morning, I was up again at 4:30 am. That could be because I went to bed at 6 pm. Can’t wait to see how I do on the red eye flight back home on Saturday.
Dinner last night was at The Attic again. The martini was good. So far this trip, the best meal I’ve had has been as McDonalds and it was a damn sight cheaper. Later, I’ll load up and travel to North Bend again for the Twin Falls trailhead. It’s 17 minutes from the lodge and is a 2.5 mile out and back hike with an elevation gain of 636 feet. That’s about double of the gain for my last two hikes, so it should be a challenge. It’s rated moderate but I find that term has a wide leeway as to meaning.
10:30 am
OK, I don’t how it is possible I’ve survived this long in the woods. I’m surprised some hiker hasn’t come upon my decayed body on some trail. I generally consider myself good with directions and knowing where I am but somehow I always seemed to get turned around on trails. It’s happened too many times to count. At least today, I didn’t get turned around. More about this later.
I drove to Twin Falls trailhead and got started on my hike at 8:20 am. I read up on this hike and I knew that I would follow the south fork of the Snoqualmie River for the first little bit of the hike. I started out with a knit cap and my jacket. The temperature was 55°F. I soon shed both the jacket and the cap.
You can see just a sliver of the river to the right. A lot of the canopy of the forest reminded me of a rain forest, fairly common in western Washington.
I also knew that I would make an approximate 400 foot climb up to get my first view of the falls.
It’s this view that give the falls their name. However, it probably is more accurate to call them quintuplet falls.
At the upper part of the falls, there are four smaller falls. The first is 45 feet, the second series is 20 feet, the third is 30 feet and then another 20 foot section. The main portion is 135 feet. None of the individual falls look alike, so there is no twining here.
Then I knew that you walked another section of the trail, steadily upward to view the 135 foot section from below. It’s called the lower falls view. I chose not to do that and instead decided to walk to the upper part first. That was another 500 feet in elevation. There is a bridge across the river at that point.
What I didn’t pay attention to is that the trail doesn’t end there. The Twin Falls trail goes for miles and miles. It eventually merges into the John Wayne Trail and the Homestead trailhead. I started up along the trail and dumbly kept climbing. In my defense, the park has only one sign – at the trailhead that says falls. There was no signage for the lower observation deck nor for the upper observation deck nor a sign saying the trail continued to the John Wayne trail. In the prosecution’s case, I should have remembered the bridge was the terminus of the part I wanted to accomplish.
You can see a guy sitting on the bridge (red shirt). As I walked past him I said “I feel your pain.” He broke out into laughter – and sympathy.
The view from the bridge back down from the way I came was pretty nice.
You really can’t see where the 135 foot section of the falls but it starts just to the left of the big rock.Trust me, I’m more tired than I look in this photo!
Wildflower were abundant along the way. I added three to my lifetime list of plants.
Sweet-after-death/Vanilla leaf (Achlys triphylla) – a new species for me.Pacific Bleeding Heart (Dicentra formosa) -not a new species for me.Scouter’s corydalis or fumewort (Corydalis scouleri) – a new addition to my list.
It didn’t matter what part of the trail I was on – it was some of the steeper inclines I’ve hiked.
To my eyes, that looks like about a 30° incline from the switchback.
Then there were roots and steps. You know I hate steps.
In any case, I then decided to hike down to the lower part of the falls. After hiking a lot extra and turning around, I headed back down to the upper area and then down to the lower area. More stairs.
Most of the images I’ve seen of the falls show what is similar to a thin sheet of water coming over the rocks. This was gushing. Again with the spring melt. There is also a power plant at the very top of the series of falls but cannot be seen from the park.
Notice I used the belt on the pack to hold my gut in.
All in all, I hiked 3.69 miles (more than 1.2 miles than I needed to) with an elevation gain of 1001 feet. It took me 2.25 hours. Again, for perspective, AllTrails says the elevation gain is 636 feet to the top of the falls and the hike should only take a little over an hour. I added an additional 365 feet of elevation by overshooting the trail.
Regardless, the trails were beautiful.
I’ve hiked a lot all over the U.S. and I think this is one of the more beautiful hikes I’ve done notwithstanding the idiocy of hiking and extra mile or two.
When I pulled in at 8:20, there were five cars in the parking lot. As the morning went on, I saw more and more people on the trail, many with dogs. At one point I stood on the side of the trail and let some 25 people pass before I continued. Some knew to yield to those going uphill and some didn’t. I always said good morning and sometimes got into conversations with the hikers. I really like that part – sharing experiences along the trail. I knew I’d met a lot of people going up the mountain as I descended but when I got to the parking lot, I was a little taken aback.
The line of cars went all the way of the hill and almost to the connecting road.
Tomorrow I head to Seattle. I have reservations to visit the Space Needle and then a trip to Pikes Market. Then I’ll be staying at the Paramount Hotel in downtown Seattle until around 10 pm and then the drive to the rental car return and catch the shuttle to SeaTac. I’ll spend time in the United Lounge until my 11:41 pm flight to Houston.
Tonight is another dining experience at The Dining Room. Can’t wait!
In all my excitement in being back in the woods yesterday, I forgot to eat breakfast and lunch. That was probably a good thing after seeing some of the photos people took of me.
I even sucked my gut in on this one. This was taken around sunset. I wanted to see the falls at night since they spotlight them.
The Snoqualmie tribe runs Snoqualmie Park and gift shop and actually owns the Salish Lodge. The falls are a sacred site for the tribe and it’s now a part of their tribal land.
In exploring the area around the lodge, I asked about the wooden bridge across the very busy road next to the lodge. It’s overflow parking for the park. Over 1.5 million people visit the falls every year, second only to Mount Rainier. The desk clerk mentioned that at the upper end of the lot was the apiary for the lodge.
The lodge harvests the honey and uses it in their restaurants and sells it in the gift store. They plant specific flowering plants to influence the taste of the honey as well as help with the declining population of bees.
My massage was scheduled for 3 pm so I showed up in the Salish Lodge robe and slippers. After some quiet time in their meditation room, Jennifer took me back for a deep tissue massage. She did a decent job. It’s always interesting to see how different massage therapists perform. I’ve had many different massage therapists over the years with all my trips and each one does it slightly differently. No one seems to do a real deep tissue massage. I think they believe they will hurt you. I can easily tell them to ease up if they do, but they still don’t do real deep tissue.
I chose to eat at The Attic for dinner which keeps bankers hours. I think they want everyone to eat at the restaurant (higher prices). Actually, if you sit near the windows, you have an excellent view of the falls.
View from The Attic
I ordered the margarita pizza and a vodka martini. The martini was excellent and the pizza was pretty good except for the lack of basil. That’s kinda the definition of a margarita pizza – the basil – and there was only one tiny flake of basil and it was stuck to the side of the pan, not on the pizza. Again, the food critic!
In any case, I forgot I had reservations for The Dining Room last night. I remembered I made two reservations while planning the trip but I don’t remember booking the third. As I was on my way to view the falls at night, I stopped by the hostess stand and apologized. She was very understanding. I felt even more guilty since there seem to be more guests at the lodge tonight than last night. I even have a couple next door to my room and to the credit of the lodge, you can’t hear anything from one room to the other.
The lodge aims spot lights at the falls at night and I wanted to see what it would look like. The problem is the only camera I’m using this trip is my iPhone. This version allows you to take photos in total darkness and so I had to figure out how to keep from getting “daylight” shots in darkness. I finally figured it out and here’s one result.
You can barely see the effects of the spotlights at the very top of the falls.
As I waited for sunset and nightfall, numerous couples and families came down to the viewing point and I ended up being the photographer for them. It was fun trying to get the families and the falls in the view. One little girl kept turning away back to the falls every time I tried to snap the photo.
I’m still on Fort Lauderdale time which means I got out of bed at 4:30 am (PDT). I was hungry and decided on breakfast around 6:30 but The Dining Room didn’t open until 8. That’s when I decided to hike Franklin Falls.
The falls are near the Snoqualmie pass just off I-90 in the Mount Baker/Snoqualmie National Forest. It was about a 35 minute drive to the trailhead from the lodge. Just as I passed the town (the historic part) of Snoqualmie, I passed a herd of elk grazing in a meadow. I didn’t slow down to photograph the herd. Eh! When you’ve seen one elk, you’ve seen them all.
The parking lot at the trailhead to the falls requires either a Discovery pass (never heard of it) or one of the other passes for national parks and forests. I have the lifetime senior pass but when I went to fill out the form, there was none available. I simply left my senior pass on the dashboard of the car. I’d read where the rangers were very particular about parking and wrote tickets. As fortune would have it, I met a ranger while on my way back down the trail and she said at this time of year, parking wasn’t an issue and what I did was fine.
When I stepped out of the car and grabbed my pack and walking stick, I realized it was cold. The temperature was actually 60F but it felt colder. I got an indication of what was to come in the parking lot for the disabled.
AllTrails reported hikers suggested cleats for the snow on the trail but fortunately, I didn’t need them. Spring had sprung.
The trail is a round trip of two miles and unlike yesterday, this was all uphill for 1 mile and then all downhill for the turn around. The trail was well traveled and clearly delineated.
A lot of work has gone into this trail and other than a little mud from the melting snow and some actual snow on the trail, it was an easy walk.
There were not a lot of plants blooming but I did run into an old friend.
Western Skunk Cabbage (Lysichiton americium)
I’ve found two species of skunk cabbage in my travels over the years and they thrill every time I see them. Skunk cabbage, when it is ready to sprout in the spring, generates enough heat to melt the snow around it and is one of the first blooms of spring.
The trail follows the south fork of the Snoqualmie River. There are numerous cascades along the way.
It’s pretty much one cascade after another as you work your way to the falls.
As I gained elevation, there was more snow on the trail.
The forest was mostly spruce and western red cedar. One tree really stood out.
Western Red Cedar (Thuja plicata)
You really can understand how large this tree is so I put my walking stick next to it to give you some perspective.
The base of the tree stretches all the way across the frame of the photo.
To me, this compares with the giant redwoods! I can now understand how you can purchase cedar beams and boards. One tree this size would probably construct and entire house.
I finally got to the falls.
I met an older gentleman (my age, probably) at the base of the falls and we got to talking. He said he thought this was the greatest flow of water he’s seen.
Just to the left of the falls is I-90. They have a massive bridge that spans the area. I didn’t want to get the bridge in the shot.
The gentleman told me he comes all the time and he showed me photos of the fall completely frozen in winter. At certain times in the winter, they are completely frozen and he said he’s seen ice climbers on the falls. He recently stopped technical climbing but admitted to still repel occasionally but he didn’t let his wife know he did this. I told him I would keep his secret from his wife.
I had a couple of protein bars and offered him to join me for breakfast but he declined. He did get a photo of me, however.
Breakfast with a view.
After he left, I took a few more photos and then headed back. It’s funny how differently the trail looks returning. As I hiked up, I kept an eye out for wildflowers and did find one Western trillium.
Western Trillium (Trillium ovatum)
I first ran into this plant while in Redwoods National Park. What’s interesting about it is as the day goes on, the bloom turns from white to pink. On the way down, I noticed more and more of these in bloom that I missed on my way up.
I also didn’t notice another flower in bloom on the way up but saw it on the return.
White Marsh Marigold (Caltha leptosepala)
A few years ago, I found the yellow version of this (Caltha palustris) growing in a ditch on my way to connect with a seaplane to Isle Royale National Park. Both are fantastic and the white one is a new species for my list of plants. By my calculations, I now have three new species to add to my list on only two days of hiking.
Maybe I was too focused on bears. The woods have both grizzly and black bears. I sadly didn’t see either (yeah!).
I did see a couple of small waterfalls feeding into the cascades below.
Both on the way up and on the way back I saw cabins. Since this is national forest, I wondered if they were rented out by the U.S. Forest Service. The ranger I met informed me they were all privately owned. I assume they were grandfathered in to be allowed to be in the forest.
Some of the cabins were simple and some were quite large and a little out of place in their architecture.
I did find one peculiarity on the trail that was a puzzlement.
Someone with a little too much time on their hands whittled a pattern into a stump, trailside. I guess you could use it to clean the mud off your boots.
As I got back down the mountain, I again saw the older gentleman. He was looking at closed sign on the Denny Creek road that intersects the trailhead. He was photographing a sign that had a phone number on it to ask about opening. He then said they planned to keep this closed and one other. What he said next threw me. “At least it’ll keep the illegals out.” What illegals? Hikers? Illegal Mexican immigrants? Aren’t we a little far away from the Mexico/US border? However, we are very close to the Canadian border so perhaps he was interested in keeping out those sly illegal Canadian immigrants.
Overall, I hiked 2.54 miles and gained 387 feet in elevation. What has to be taken into account is the elevation at the falls is 2,580 feet above sea level. People tell me that when you get above 2,000 feet, you begin to feel the effects of the elevation and I started at 2,210 feet. I seemed to have faired well. I didn’t have to have any rest stops on the way up. Also, fortunately, my knees didn’t bother me on the way down. Win! Win!
On the return trip I had a McBreakfast at North Bend, WA. The protein bar didn’t last long.
Tomorrow, I may head to Twin River County Park and do some hiking. They have two waterfalls along the same trail. They can’t possibly be as spectacular as my first two on this trip.
As I sit on my patio typing this, the breeze wafts the aroma of the killer weed. I forget that marijuana is legal in Washington state and people seem to be pretty open about it.
Some of the luster came off the Salish Lodge last night, at least in the food aspect. I had 6:30 pm reservations at The Dining Room. They seated me at a table near the window although there wasn’t much of a view of anything but a closed off terrace.
The problem was not with the servers – they were very attentive. It was the food. I decided to go with the prix fixe menu.
I went with the wine pairings and started with the spring asparagus soup as the appetizer. It was just OK and you could, if you thought very hard about it, taste the asparagus. The cedar plank salmon was a total disappointment. I asked the waitress if it was wild caught and she said yes. I should have also asked if it was fresh. I swear it was from a previously frozen piece of fish. As far as the crème brûlée is concerned, I’ve had much better. My friend Holley hates crème brûlée and I can understand why with this dish. I have reservations again for this place on Thursday and I think I’ll cancel them and try their other restaurant, The Attic. Hopefully they can’t mess up a burger.
I will admit this is the quietest hotel I’ve ever stayed in. I usually complain unceasingly about noisy hotels but I think I must be the only guest on the lower (1st) floor. I don’t even hear anyone above me. Maybe no one stayed here last night other than me.
I’m still on Fort Lauderdale time. I went to bed at 8:30 pm PDT (11:30 pm EDT) and got up at 4:30 am PDT (7:30 EDT). I decided to go look at the falls at sunrise. You really couldn’t see much. A mist hung in the air below the falls.
There was so much mist that some areas of the walkway literally ran with rivulets of water. You can feel the mist from the falls, even outside my hotel room. The falls are 270 feet in height.
Of course, the falls are part of an hydroelectric power plant. A dream of Charles Baker, the plant was completed in 1899. It was the first completely underground power plant constructed in the world. In 1910, a subsequent power plant was constructed down river from the first.
Part of the intake valves and part of the underground power plant above the falls.
Today I plan to hike the Snoqualmie Falls Trail, a 1.4 mile trail to the river level. Coming back up is the equivalent of walking upstairs to the top of a 30 story building. Pray for me.
9:20 am
God, it’s good to get back into the woods!
At the bottom of the trail with a view of the falls from river level. I’ve got to do something about that gut!
I made it! Even better, I made it all the way back up to the top without stopping. The total hike down and back was 1.9 miles with a 371 foot elevation gain. It took me 1 hour and 23 minutes but that was because I was stopping every few minutes to take wildflower photos.
This trail is pretty much all downhill. That worked for me since any lengthy hiking I do downhill hurts my knees. Getting this over first and then hiking back up was easy on the joints.
The trail down is steep. There are a lot of 5% grades and even steeper in some areas.
You really can’t tell from this photo but it is really steep going down. Mostly Western Red Cedar and Douglas Fir provided a shaded canopy.
Along the trail was a profusion of wildflowers and I even got to add two to my lifetime list that I had never seen in the wild before.
Fringe Cups (Tellima grandiflora) – a new recording for me. These pretty much lined the trail all the way to the river.Pacific Waterleaf (Hydrophyllum tenuipes) – again, pretty much lined the trail.Youth on Age (Tolmiea menziesii) – a new recording.Thimbleberry (Rubus parviflorus)
Once at the bottom of the trail, you could hear the Snoqualmie River roaring. At the edge of the water was the hydroelectric facility built in 1901. It has undergone several expansions and additions, the latest in 1957 and 2010.
Feeding the hydroelectric plant is water from above through two huge penstocks (pipelines).
The source of the water through these penstocks is actually above Snoqualmie Falls through underground tunnels.
The Snoqualmie River has a lot of rapids on it and there is a boat launch near the parking lot of Snoqualmie Falls Park for people who wish to run the rapids.
There’s a long set of stairs and walkway to the observation point of the falls.
Walkway to the observation point.
I stopped at the entrance to Snoqualmie Falls Park on my way back up. I’ve been noticing an unusual feature in the signage. In Canada, signs are in English and French. Here at the lodge and the park, signs are in English and Snoqualmie. The Snoqualmie are a federally recognized tribe of the Snoqualmie Valley and part of the Coast Salish people.
English/Snoqualmie translations.
On the way back to my room, I stopped at the registration desk and got some information about trails in the area, the tourist/historic town of Snoqualmie, and also some more waterfalls. One highly recommended falls was Franklin Falls at Snoqualmie Pass. Apparently, three days ago there was snow and some people have reported on AllTrails that it’s icy. It’s only two miles out and back to the falls. I may try that tomorrow. It means I’ll leave the lodge area and explore new terrain!
Lunch, sadly, was at The Dining Room, a buttermilk fried chicken sandwich. It was buried under an aioli, pickles and cheese so I assume it was a chicken sandwich. They were very proud of their biscuits with butter and jam and served them as a compliment to your meal but I found the biscuits hard and dry. My next calling is as a food critic.
I have a massage scheduled for 3 pm today at the lodge spa.
Forget breast cancer, forget chemotherapy, forget mastectomy, it’s time for a little escape!
Several years ago, Michel and Nancy were returning from an Alaska trip and made a detour to the Salish Lodge and Snoqualmie Falls. Michel showed me some photos and I immediately put it on my bucket list. Trust me when I say the trouble (and expense!) is worth it.
My morning started at 4 am. Just to be sure I waked in time, I set my alarm. I usually always wake up well before the alarm goes off but for some reason it startled me out of my sleep. After a token cup of coffee, shower, shave, and final pack, Joel picked me up and delivered me to Fort Lauderdale International Airport for a 7:46 am departure. I admit, I splurged for this trip and purchased first class tickets. About the only benefit is more leg room, more room to store your baggage, and a free meal – such as they are. Oh yea, one more benefit – you can board before most of the others. But you are still cattle being pushed through a chute.
It turned into a seven and a half hour flight, more likely eight with delays. They couldn’t get the fuel truck to fuel the plane in my Denver stop over. We still made it to SeaTac at the designated 1:30 pm time line. From there it was an airport bus to the rental car facility. Seattle puts all rental cars under one roof and I have to admit it was convenient. After an upgrade, I braved Seattle’s I-405. The speed limit was 60 mph and I was doing 16 mph. There wasn’t anything wrong. It just seems Seattlites don’t know how to drive any more than south Floridians.
In any case, I finally found the lodge. The outside is pretty nondescript and you think “Oh boy! This place is a dump!” It’s not. I don’t know when I’ve had a nicer room.
My bedroom with my own fireplace!
It’s called the Salish Lodge and Spa for a reason.
My patio with my own private fire pit.
The lobby is pretty ordinary. So’s the reception desk.
The Salish Lodge and Spa Lobby
But they really pay attention to details. When you check in you are offered either champagne or a slushy (with vodka) or wine. In the room they provide gourmet coffee and for the fire pit outside, a little surprise.
S’mores anyone?
After all that sitting (four hours to Denver), walking a million miles in the Denver airport from C terminal to get to the subway to A terminal and three hours from Denver to SeaTac, I needed some fresh air.
Right next to the lodge is Snoqualmie Falls Park with an overlook of the falls. It’s breathtaking!
You can see the lodge in upper left. Just to the right of the lodge is the power plant. The reason for a May trip is that the spring thaw is on and the falls are at their peak flow.Long Exposure of the FallsYou can get a sense of the power of the falls from the movie.
Tonight, I dine at the lodge in their aptly named The Dining Room. It looks to be delicious and maybe I’ll get the taste of airline food out of my tastebuds. There may be a glass of wine or two after my arduous journey. Or three.
I haven’t decided about tomorrow. I may just vegetate or I may try to visit some other falls in the area.
The oncological team really throws a lot your way in one morning’s time. Both Michel and I were a bit overwhelmed but I’ve had time to cogitate on what was said – and more importantly what was not said.
The average life expectancy for the American male is 74.2 years according to an August 31, 2022 reporting by the Center for Disease Control (CDC), down from 74.5 and 77.28 in previous years. I’m 74.
Based on the stage of cancer (mine is stage 1), age (a negative for me), general health (a plus for me) and the treatment (mine seems to be the most current – for females) the five year survival rate is 82%. If the cancer is restricted to the breast and hasn’t spread, then the five year survival rate is 95%. If it has spread to a distant part of the body (through the lymph nodes), the five year survival rate is 19%. For some reason, cancer organizations and government agencies don’t seem to quote 10 year survival rates or greater.
You think you know what things mean until you start to ruminate over terms. For example, on May 25th, I’ll go in for a chest port (actually more like upper chest near the neck port). I’ve heard of ports before but didn’t really think about the procedure or how they work. In essence, they allow an easy access to draw blood or provide chemo infusions without having to undergo continuous needle sticks. Remember, I’ll have infusions every three weeks for six sessions. Then after a potential mastectomy, then I’ll have a year of additional infusions every three weeks. I’d look like a pin cushion if they did needle sticks. Chemo often degrades the veins in the arms and can cause collapse. A port can be accessed again and again for several years.
The hard part, of course, is in installing the portal. That’s a surgical procedure and depending on where you have it done, it’s either a local anesthetic at the site of insertion or they put you under. I’m hoping for the “putting you under.“ You can get a pretty good idea of the procedure from a YouTube video. I caution you that it’s pretty graphic.
The video above is a local anesthetic. There’s a good deal of bleeding and apparently, it’s become routine for those doing the procedures. I hope they are not as lackadaisical as it seems in the video.
One section of the video was interesting to me and recalled some situations with students dissecting specimens in my lab. At one point in the video, they need to make a pocket under the skin to place the port. You see the surgeon stick their (gloved) finger into the incision and begin the push and sweep, much like you do when you try to put seasonings under the skin of a chicken you are roasting.
When we would dissect specimens in my biology lab, students were very timid and reticent to be aggressive with their dissections. Of course, this can lead to disaster in a dissection but there are times you need to be bold. Students failed to realize how tough some of the tissues are in a specimen and I would have to show them they were not going to destroy tissue by being aggressive. You can really pull and tear and rip on the human body and it’ll survive quite nicely.
To understand how to use a port, there’s another YouTube video.
As I was swimming laps yesterday (I better get that in while I can) it came to me I hadn’t thought about insurance. You hear horror stories how families go bankrupt from cancer treatments.
The chemo for me will require a drug cocktail of four very powerful and toxic drugs: Taxotere, Carboplatin, Herceptin and Petuzumab. Fortunately, my Medicare will cover 75-80% of the costs associated with these drugs. That leaves me on the hook for the other 15-20%. One estimate is that for the initial sessions of chemo, the out-of-pocket costs could be $6000. I have an AARP, United Health Care supplemental plan and I called yesterday to see if they would pick up the other 15-20%. I was informed that as long as Medicare covered the 80%, they would cover the rest. The drugs do not fall under the Medicare Part D plan for drugs, thankfully.
The other big concern was the long term Tamoxifen costs. I’ll probably be on that pill for 5 years or longer. The good news is that 60 tablets of 10 mg runs around $18.37 with insurance.
For years, I told people I would not submit myself to chemotherapy for any cancer. You hear such horror stories. Treatments seem to have improved. Apparently, they give you anti-nausea medication before chemotherapy and provide you with a prescription for nausea after chemo sessions. They also check you white blood cell count and can give you medication to boost wbc’s. Otherwise, I would be susceptible to infections – not good in the age of COVID.
I’m willing to get started on chemo and see how it affects me. I certainly think I can manage the first six sessions over 18 weeks if I don’t have any adverse reactions. I’m more concerned about the additional 17 sessions over a year’s time. There is so much for me to consider. Can chemo shrink the tumor? Will I still need a mastectomy? Can I cope with chemo and for how long? You have to ask yourself the question that if you are already at the average life expectancy of the American male, how much you want to put up with for the potential (albeit excellent odds) for five more years of life. Yes, I know many people have survival rates much longer than five years. Five years is only the bookmark for cancer treatments. It boils down to a quality of life issue. For now, I’ll start the process.
Michel and I met with the Holy Cross Medical Group – Oncology team today. We saw, one at a time, Kathleen McTauge, the oncology nurse and office coordinator; Jessica Burgers the oncology surgeon; Alexandria Diego, genetics nurse; Karim Arnaout, hematology oncologist; Phil Fusca, oncology social worker; and Vivek Patel, radiation oncologist. It was a full morning with the addition of blood draws for genetic testing and additional blood work.
Both Michel and I were impressed with the members of the team and how they handled themselves and how they explained everything in detail to make sure we understood what was being said and what the options are.
Dr. Burgers first came in with news. The fluorescence in situ hybridization (FISH) test came back positive for HER2 (human epidermal growth factor receptor 2). HER2 is a gene that produces a protein on the surface of all breast cells. Sometimes, the HER2 mutates. When that happens, too much of the surface protein is produced and this makes cells grow too fast and divide too fast (the very definition of cancer).
I am HER2 positive which means my cancer grows faster than other types of cancers and therefore may spread faster. That’s the bad news. The good news is there are several drugs available that recognize the protein receptors and target them specifically. In a word, HER2 positive means my cancer cells respond well to chemotherapy.
You might know me, I’m a little peculiar. The cutoff point for decision of treatment for HER2 positive patients is if the tumor is greater than 2 cm in size. My tumor is pretty much dead on 2 cm. Most of the data of chemotherapy on HER2 proteins are based on women’s breast cancer. However, most oncologists think that the positive results of chemotherapy associated with HER2 proteins (greater than 50%) will also apply to males. Age also makes a difference. My age is against me but my physical condition is a mark in my favor.
The question for the oncology team is whether to go ahead with the mastectomy on 23 May and then do chemotherapy and/or radiation depending what is found in the sentinel lymph nodes during surgery or to do chemotherapy first to shrink the tumor and then surgically remove any tumor left after chemotherapy. They called me this afternoon and the oncology team agreed on chemo first.
As I undergo chemotherapy first, they will look for the response. A pathologically complete response would give ideas as to additional therapies that may be applied. An incomplete response opens me up to newer drugs for treatment.
The other good news is that the drugs that are used for HER2 proteins work very well on any cells found in the sentinel lymph nodes which means they may not have to remove a significantly larger portion of my breast and axillae area (under arm).
If surgery is required, it will be 3-5 months later, I’ll certainly be on tamoxifen for at least five years.
Alexandria Diego was next to counsel me on the benefits of genetic testing. The company they use accepts Medicare and so it should not cost me anything. She informed up that 5-10% of all cancers are genetically based and they test for 84 cancer causing genes. There are three possible outcomes of the genetics test: negative, positive, or variance of uncertain significance. The negative and positive are self explanatory. The third category is when there is a change in the gene but it is unknown what the change means.
The genetics test is by the Invitae company and it an RNA and hereditary cancer blood test. They did that later in the morning. It’ll take 5-10 days for some of the results to come back and 6-8 weeks for others.
Many of you have heard of the BRCA gene. There are actually two: BRCA1 and BRCA2. If these are positive then it may pay to get a double mastectomy. However both Dr. Burgers and Dr. Arnaout indicated data did not support a double mastectomy.
Next up was Phil Fusca, oncological social worker. He went over several support organizations for breast cancer both nationally and locally. There is a great likelihood that I will be recommended for home health care for wound care. He explained there are two categories of home care: skillable and custodial. Skillable is something that improves your condition (changing the dressing of the surgery) whereas custodial would be like bathing, cooking, and cleaning. Medicare pays for skillable and does not for custodial.
Dr. Arnaout, medical oncologist gave me an exam and then spent time dealing with the chemo first option. The treatment before surgery includes (1) blood work (2) echocardiogram and (3) placing a port into the chest for infusions.
During chemo, they will infuse me with four drugs (TCHP) all through the port: Taxotere, Carboplatin, Herceptin and Pertuzumab. These are apparently pretty powerful and pretty toxic. I can expect fatigue, nausea, vomiting, diarrhea, pancytopenia (lowered red and white blood cells – 24 hours after each infusion I have to return to boost my white blood cells), risk of infection, cardiac side effects, hair loss (ha!) neuropathy and infusion reaction. These are very nasty drugs but they seem to have a real good effect on HER2 surface proteins.
I’ve always been concerned with having to undergo chemo because of the side effects. Katherine, when she informed me of the decision today, told me they have many ways to negate the side effects, particularly the vomiting and nausea. The biggest complaint is lack of energy or fatigue.
There will be one infusion of the four drugs every 3 weeks for 6 sessions. My math seems to come up with 18 weeks or almost five months. That would put my surgery off until around either the end of October or the beginning of November (happy birthday to me). Then I would continue to be infused with the four drugs every three weeks for 1 year. After that, I would be on tamoxifen for five years.
To facilitate the chemo, they’ll put in a venous port in my chest so I don’t have to have needle sticks every time. They’ve already scheduled the port placement on the 25th of May after I return from my trip. The first chemo session will last 4-5 hours. I’ll probably need someone to drop me off and then pick me up after the first chemo session because they’ll give me Benadryl to negate some of the effects of chemo. They do the infusion slowly at first in case I have allergic reactions to the drugs. After that, it’ll be 2-3 hours per infusion and I should be able to drive myself to and from.
Katherine is scheduling my echocardiogram to make sure my heart can take the therapy and then she’ll schedule a meeting with Dr. Arnaout’s nurse to go over “chemo education.”
Dr. Patel, the radiologist was last and the briefest consultation because the course of treatment (or lack of treatment) by radiation depends on the outcome of the surgery and the survey of the sentinel lymph nodes. He did go over some of the side effects of radiation which may include skin change, possible burn area around the breast and shortness of breath.
The only team member we did not see today was the dietitian. She was out but I was handed a packet of information. That was the second of two packets of materials for light reading I have to do.
I really appreciate all the support shown. Friends have been more than eager to volunteer to help me in any way possible. I don’t know what the outcome will be but knowing there are people out there who care about me gives me the confidence to go through this.
The team will call me as soon as they decide a treatment option – surgery first or surgery second to chemo. I’ll keep you posted.
I feel as though I am making progress on several fronts. I’ve finished my pre-op tests (x-ray, blood, EKG) and received final approval for the mastectomy. It was a little tense there for a while trying to get the oncologist’s office to send the request to the GP who then had to schedule the tests but couldn’t for several days because of a missing request. In any case, it got resolved.
The surgery is scheduled for 9 am on Tuesday, May 23rd. Actually, they want me there at 9 so that can pre-admit to the hospital in case that is needed. However, if all goes well, I should be home by the afternoon of the 23rd. If they have to do more surgery than anticipated, then it will be a two to three day stay at Holy Cross Hospital. I’m still waiting on the FISH (fluorescence in situ hybridization) report of the surface markers of the cancer cells to determine which treatment after surgery but they should be in before the surgeon operates.
I’m so lucky to have so many good friends. Michel will go with me on May 10th for a pre-op meeting, Barbara will take me to surgery, Tom will pick me up after surgery, and John will stay over two nights that I am home after the surgery. Many others have volunteered to help out during the 3-6 weeks for me to get back to my routine. When you start to think about it, mundane household chores become difficult – like changing sheets on the bed.
When I was a kid, there was no such thing as fitted sheets. You had two sheets, one you tucked into the mattress on three sides and one that sat on top and tucked in at the bottom. Fitted sheets are great until you get arthritis in your hands and try to put one on the bed. I can’t imagine trying to put a fitted sheet after a mastectomy. They don’t want me to even vacuum the floor after surgery.
Since I was able to complete the pre-op tests prior to my trip, I’ll be able to make the trip to Snoqualmie Falls after all. I fly out on United on the 16th of May at 7:46 am, stop at Denver for a short layover and then fly into SeaTac (Seattle/Tacoma) airport at 1:30 pm. From there, I get a rental car and drive 48 minutes to Snoqualmie Falls and check into the Salish Lodge. I have a 3 pm massage scheduled the next day to get over the flight and dinner reservations at 6:30 pm at The Dining Room. On the 18th, I intend to do Lower Snoqualmie Falls trail – all of 0.4 miles downhill from the lodge. After that, there are several waterfalls in the area I want to visit.
I’ll spend four nights at the lodge and then drive back to Seattle. I’ll be staying at the Paramount Hotel for one “night.” Actually, my flight leaves on the 20th at 11:41 pm. I have to be out of the lodge at 2 pm so I figured to leave early and tour Seattle, get a room, have a nap and then drive to the airport from the hotel. It’s a red-eye flight back through Houston to Fort Lauderdale and I land in Fort Lauderdale at 10:51 am on the 21st.
I splurged on the plane ticket and purchased first class seats for the entire trip. I’m getting too old to squeeze into economy and the difference between economy plus and first class isn’t too daunting to opt for first class.
That leaves me one day to recuperate from the trip before the surgery. I figure I’ll get plenty of sleep during the surgery.
