Add a little Casino to the medicine...

I'm onboard a ship right now in the Tasman Sea, between Australia and New Zealand.  This cruise, onboard Holland America, was the prize for surviving cancer surgery.  I aimed to collect by surviving until the December disembarkation in Sydney, 2 weeks sailing around the islands of New Zealand, and I did.  I've been having a marvelous time...

Until now.  Seasickness has descended.

I took one tablet of bonine (I can't remember the name, it's something like that, although that name sounds suspiciously like Latin for "cow"), and one tablet of Aciphex, which seems to cure everything ever wrong with me.  The two together took the edge off the nausea, but I'm definitely not going to that Champagne tasting in an hour in the Pinnacle Lounge.

One other thing I did for the seasickness was distract myself in the ship's Casino.  I played a slot machine, maybe two, and that did take my mind off my troubles, at least until I ran out of money on the penny machine.

Being on a cruise ship is like being at Disneyland, but for foodies, it's better.  I joke about having 10 meals a day; while not completely true, it is certainly possible, and in my case, almost inevitable.  The trick for me is to stay away from sugar.  Ha.

I have had one Coke on this cruise -- which, if you know me, you'd think, Amazing! -- and that was only to get Wi-Fi at McDonald's in Auckland.  (The Wi-Fi didn't work.)  But there's so much white bread, desserts and alcohol on this ship that's it's a constant temptation.  I actually did pretty well for about 10 days on the 14 days' cruise, but have been paying for it the last few days.  My usual symptoms for overdoing it are feeling horrible, almost nauseous, and staying close to a bathroom.  I haven't experienced the former, except for the motion sickness, but certainly have the latter these last two days.

Tonight is New Year's Eve in the main dining room, and it should be quite a meal.  Our dinner mates are springing for the champagne.  Wish me luck.

Halloween is the Worst Holiday

I love Halloween. I always have. This year, I flew to Orlando with family and friends, just for a Walt Disney World holiday. As we did the last time we were there, we took in a night of Mickey's Not-So-Scary Halloween, which is just a barrelful of laughs and fun. Everybody dresses in costume, especially the kids, and we all go around collecting candy at different way stations through the Magic Kingdom.

And there it is. Candy. I am not obsessed by chocolate, which is what several friends claim. I'm addicted to sugar. Since I'm diabetic, it's not a cute thing any more.

I'm still trying to get rid of the Halloween candy because, of course, I bought too much candy. I usually get between 15 - 30 kids that night, but I buy just in case the entire contingent of grammar school kids in the Bay Area will show up. And I used to advise people with the same problem that you have to buy candy you don't like. Except that there is no candy I don't like.

My knee is perfect, by the way. No problems, no pain, not even a little stab if I get out of bed wrong. So, apparently, I get rid of one problem and move on to the next one. Diabetes, however, is always with me.

Cortisone Is a Wonder Drug

Not quite two full days after the cortisone shot to my right patella, my knee feels no pain at all. Whew.

Yesterday, almost all day, I felt little stabs of burning pain. I thought that actually might be from the shot itself, as I had never quite felt that kind of pain before. It was different. Or, the burning sensation might still by the xylocaine.

Whatever. My right knee, right now, feels FANTASTIC! Hopefully this will continue!

A Shot in the Knee

I got a shot in the knee this afternoon. When I reported for the treatment, the x-rays from Tuesday had still not arrived from NorCal Imaging. So she called before she gave me the shot, and their oral report was "advancing arthritis." Phew, that doesn't sound so good. But no other damage. So the shot was on.

She had Kristi with her (who works on Fridays), a med student, and told her about the "holy trinity," where you move the swab over the area three times with that horrible-looking brown stuff, to make sure it's cleansed. She then swiped an area where the syringe would go in, and we were ready.

She had mixed a vial of Xylocaine in with the Cortisone and placed it in the syringe. She felt for the patella, and slipped the needle in just to the left of the bone. Then she moved the needle for two other angles to release the steroid into that portion of the knee.

It hurt a little, but not nearly as much as I remember it hurting the first time I received a cortisone shot in the knee. She told me the xylocaine would create a burning sensation, and then would numb the area. I only felt pain, but perhaps that was the burning.

I have to say that my knee felt fabulous within minutes. However, three hours later, the xylocaine has worn off and I feel some pain in the knee. That's to be expected, I understand.

Dr. Miller told me that the limit for cortisone shots is 3 times per year per knee. That's a lot better than I had previously thought.

It might take a few days, but I have no doubt my knee will feel a lot better. Yay for modern medicine and the deft touch of Dr. Laura Miller!

It's Isn't All About Cancer, You Know...

My knee gave me a fit at Disney World. We walked something like an average of 5 miles a day. My knee constantly hurt, especially when I climbed up (and fell from) the train steps. And the three blisters didn't help, either.

I made an appointment with Dr. Miller as soon as I got back. I couldn't feel it, but she felt some grating and some warmth from swelling. Today -- this afternoon -- I am scheduled for a cortisone shot. It helped last time.

For the life of me, though, I can't remember whether it was the left knee or right knee that got the cortisone shot last time. This was maybe 4-5 years ago. It does matter, because you're only supposed to get a maximum of 2 shots per body area. After that, cortisone does bad things. Actually, cortisone can do bad things to you anyway. I have a few friends for which that's true.

The stupid thing is, today the knee feels pretty good. It's felt pretty good the last two days. So, instead of the 8 pain level I reported last week, it's about a 3.

But I think I'll shut up about that unless directly asked. I still want that shot.

I Get Most of My Injuries at the Ballpark

I've read many times that most accidents occur in the home. (Which is always a warning to clear your passageways, etc.) And I've also read that most car accidents occur within a mile or less of your home.

In my case, my accidents occur outside the home. The latest is a bruise I picked up yesterday. I had just driven to the game at 3pm, got out of my car, walked in the parking lot and turned the corner, and a car door opened and hit me in the right forearm. It stung momentarily, but I knew it would grow into a big, honking bruise. Because I bruise quite easily these days.

I will watch the bruise turn different colors before it disappears in about two weeks. But it's nothing to what happened to me last July when a foul ball at the Oakland Coliseum hit me in the right breast. That took months to fade away.

And the biggest injury in my life was when I took a fall at night on a speed bump across the street from Disneyland. That was two years ago. My left leg still has lingering problems from that, but nothing serious. And I had the chipped tooth replaced.

I am well aware -- well, I became well aware after that fall, which took place two years ago -- that falls will be my worst enemy. My partner is currently checking on an elderly couple who live in Alameda. When she discovered that one of them had fallen multiple times the previous night, she rushed him to the emergency ward. Falls are no joke. In this case, however, it isn't the result of the fall(s) that she worried about. It was the cause.

So, from these experiences, I can only conclude that (1) I am getting older, and (2) getting older is no fun. I can't do much about opening car doors or foul balls unless I just stay home. My son says I should wear a rubber suit when I go out. Do you think that would help?

Back to Dr. Miller

A few days, a robot called me to ask me if Friday was a good day for an appointment. I pressed "1" to confirm. What a strange way to get a doctor's appointment. I had no idea who the doctor was or why I was scheduled. But it turned out to be business as usual. It was indeed Dr. Laura Miller of Lifelong in Oakland, and it was a follow-up to my blood test in July. Dr. Miller had warned me that the last CT scan I had -- the one that showed I no longer had any sign of cancer -- had a dye in its preparation that reacted negatively sometimes to Metformin, a diabetes drug that I take. The blood test was a precaution. And everything looks fine. My A1C, as measured in May, is 6.1. Stellar. My blood pressure today was 116/63. Couldn't ask for better. My weight is up (hey, I was in Las Vegas all last week!), but we didn't talk about that. We did talk about the fact that Dr. Stern wanted me to have frequent follow-up pelvic exams (PAP smears?), as 5% of uterine cancer patients see recurrence of the cancer within the first five years. We agreed that I would see Dr. Poddatoori and discuss how we would go about this. Dr. P. is on maternity leave presently, so I told Dr. Miller I'd try to make an appointment with Dr. P. in December. And so we left, agreeing that I would come back to see Dr. Miller in either November or December. Curiously, she told me that Lifelong is going to electronic medical records. And that meant, the fall-out, was that doctors would see fewer patients as they learn the system. Interesting, but a positive note that my records could be viewed by any medical staff anywhere, provided, I hope, I give permission.

Those Tests Are Out to Get Me...

This is a continuation of the last blog entry, in which Dr. Stern's Stephanie told me that, although all the tests to detect cancer were negative, I need follow-up Pap smears for the next several years.

My initial thought was, "No, no way." That's still my thought. When I said to Stephanie, "I don't think I'll do that," I was waiting for counterargument. Is there something else you could recommend, could I be sedated, etc. She didn't answer with any other recourse.

The pelvic exams that were ordered by my doctor, Dr. Miller, were the reason I put off any exams for a year. Just as I had suspected, the 30-year separation from having any pelvic exams have not lessened the pain, and the ultrasound was unbearable and could not be performed. So, I just stopped mentioning it to my doctor. She didn't follow up on that issue until she wanted a full-blown physical, and at that point I talked with her about it. As it turned out, I had cancer, and that delay gave the disease further chance to spread.

Dr. Stern did warn me this morning that if I were to show any signs of bleeding, I should come back to his office immediately.

It was at that point that I figured out that he was telling me that I could make my own medical decisions -- fine -- but that there were certain warning signs to which I should pay attention. And he apparently figured out that I might be more willing to talk with Dr. Poddatoori about such things, or that she could figure out some sort of compromise, like sedation, etc.

In fact, Ruth and I made a pact: any signs of bleeding returning and I have to submit myself to Pap tests. I agreed begrudgingly. I can't figure out what's worse sometimes -- the cancer or the actual tests. I realize that's cavalier on my part, but please forgive me. I have never felt the ravages of cancer, even though I've had it twice. I've been rescued, both times, by surgery.

While my luck has continued along those lines, I don't feel that lucky. My purgatory involves a sharp instrument stuck up my vagina. Ouch.

Follow-Up to Cancer Surgery: The Good, the Bad, and the Ugly

I've been hoping and dreading this moment -- all at the same time -- where I walked into my oncologist's office, and he tells me the results of the post-surgery tests, tests which determine whether I still have cancer. Those tests are negative, thank goodness.

The CA-125 blood test, which is a unique test for cancer, was 18 prior to the surgery. It's now 7, a considerable drop, and in a very good place. The CT scan was negative. Dr. Stern told me that I shouldn't need either test again (at least at this point).

However, there are follow-up tests. Stephanie told me that because I had endometrial cancer, there is a risk that the cancer could occur. Therefore, I should have Pap smears every 3-6 months after surgery for the first two years, and then every six months for 3-5 years.

I was in shock. I had been told by Dr. Poddatoori, my gynecologist, that I would never have to have a Pap test ever again. The uterus is gone, the ovaries are gone, but there's still risk. Dr. Stern told me there's a 5% chance the cancer could recur. Then he paused and added, "Or greater."

I don't do Pap tests. In fact, when Dr. Poddatoori found out that I had had my last Pap test before she was born, her reaction made me trust her and like her so much more. She understands that I can't do a pelvic exam easily. Last time I had to be so sedated that the procedure was done in a hospital, and she performed it. (This was just prior to the surgery to remove the uterus, etc.) It's too painful.

I told Stephanie that I doubt if I would ever do that, and apparently she reported that to Dr. Stern, because when we got in to see him, he recommended that I go to see Dr. Poddatoori for follow-up instead of him. He suggested I see her after three months.

I'm still a bit freaked out. I don't feel like celebrating, like I thought I would. Still, I have a plan. And I think ice cream is definitely in my future. Because, damn it, life is too short.

Kidney Problems....?

I did get that phone call, yesterday, from Dr. Laura Miller, my general practitioner. Thankfully, my iPhone is working again. What a wonderful doctor.

She had called to say that she had seen the note from the people who did my CT Scan last week. I was to consult with her about resuming Metformin, my diabetes medication. When I told her I had already resumed the meds, she was fine with it, but told me to stop using it until after I had had a specific blood test.

The blood test will show whether there's increased creatinine in my bloodstream, and whether the kidneys are at risk. All because of the dye I consumed during the CT scan.

According to Medicine.Net, "Creatinine is a chemical waste molecule that is generated from muscle metabolism. Creatinine is produced from creatine, a molecule of major importance for energy production in muscles. Approximately 2% of the body's creatine is converted to creatinine every day. Creatinine is transported through the bloodstream to the kidneys. The kidneys filter out most of the creatinine and dispose of it in the urine."

So, what's the problem with a CT scan as it relates to kidneys? According to the University of Michigan Health System (www.med.umich.edu), "serious kidney damage... can be caused by the iodine-containing 'dyes' that doctors use to enhance the quality of such (CT) scans."

"People whose kidneys are already vulnerable, including many older people and those with diabetes or heart failure, are the most at risk from contrast agents..." The University of Michigan concluded from their study in 2008 that, "Mild to moderate kidney damage occurs in one in four high-risk people who have CT scans, and in as many as one in ten people with normal kidney function. In some cases, it causes acute kidney failure."

Dr. Miller looked at my last blood tests, and concluded that I have normally-working kidneys at this point, the point before the CT scan, that is. I swung by Lifelong this morning, picked up the lab paperwork she had prepared for me, and got to LabCorp by 9am. At midnight last night, as I was falling asleep, I remembered that I could make a LabCorp appointment, and so I did. The whole world shows up in that tiny little waiting room between 8am and 10am, because they're all fasting.

The photo shown is a CT scan of normal kidneys, top-down view.

So, the blood test is done. I am to resume Metformin this afternoon. Dr. Miller will call me if the lab results show there's a problem (probably in a couple of days). I tell you, if the cancer doesn't kill you, the tests will. Amazing.

My iPhone Has Fallen & It Can't Get Up

My iPhone hasn’t worked for the better part of two weeks now. That single event has changed my life.

It’s quiet now. It’s peaceful. I don’t automatically reach for the phone, looking to check to see if I got an email or a text message. Looking at Twitter to see what’s trending now. The iPhone is the epitome of instant gratification for a neurotic. And the lack of it is very freeing. I have to sit still, maybe read that book I’ve been saving. Actually sit down and talk to people.

Yeah. I hate it.

Seriously, though, what really bothers me is that the doctors' offices can't get hold of me, if need be. My instructions at the CT scan on Friday was, don't take metformin (diabetes medication) until 48 hours from now; then they gave me a piece of paper saying, don't take metformin 'til you contact your doctor. They told me they faxed this to the doctor's office. So it could very well be that Dr. Miller is trying to call me. (What I'm going to do is start taking the metformin on Monday. That is well past the 48 hours, and I'm not feeling any ill effects from the scan.)

I will keep trying to get my iPhone fixed. It's my third visit to the Apple Genius Bar tomorrow. However, I think that title is a misnomer...

Afterthoughts Re: CT Scan

My arms hurt today. I had to hold them over my head while I went in and out of the tube for the scan. Muscles I don't usually use, I guess.

And I didn't feel altogether great after the whole process. I mean, I drank a quart of chalky liquid, and then was injected with something that overheated in my body. They warned me I might experience some diarrhea. I didn't exactly have that, but my body felt uneasy as if it was swamped in something unpleasant, something it didn't understand.

Today, as you can imagine, I have a big bruise where he stuck me for the injection. That's the orifice where the blood freely flowed afterwards. It's not surprising that it's painful today, with a lump of purple flesh surrounding the pricked hole.

Someone asked me the other day how I was doing, how I was feeling, with a concerned look on their face. Frankly, I had, in that moment -- actually, most of the time now -- had forgotten about the cancer and the resultant surgery. I hope to continue on that fact, hoping the whole early 2012 scene becomes a distant vista in my mind's rear-view mirror.

A Different Kind of CT Scan

Today I had a CT scan taken of my abdomen to see if any cancer remained after the removal of the cancerous uterus.

It was done at the Hettrick Campus in the Alta Bates Women's Cancer Center over in Berkeley. First I had to find my way to the basement. But then there were two radiology departments, so I had to figure that one out. Then I checked in.

His first question to me was, "What flavor do you want for your Barium Sulfate?" The choices were banana, mocha and berry. I chose berry because I don't like coffee, and I had chosen banana for the colonoscopy liquid, which turned out to be a mistake. As it turned out, I think all answers are wrong. There was a slight hint of berry, but mostly it was fairly-hard-to-swallow gunk. And I had to drink the size of two medium-sized Cokes in half an hour. "Coke," as in what's Linda's favorite drink, was a wrong choice of words.

The Frederick Regional Health System website tells me that, "You may be asked to swallow baking-soda crystals (sometimes called fizzies), which will create gas in your stomach. Then, you will be given 20 ounces of liquid barium, which resembles a light-colored milkshake, to drink. The radiologist will note the passage of barium into your esophagus and stomach on the fluoroscopic monitor. Once the upper gastrointestinal tract is adequately coated with the barium, still radiographs are obtained.The examination is usually completed within 30 minutes."

And then I waited about an hour after chugging the liquid. After shucking my clothes in favor of two gowns, I lay down on the slab which would lead me into the scanner. Then he gave me an injection and warned me about the warmth. What he told me didn't begin to prepare me for what would happen about 15 minutes later.

Then there was the usual out-in-out-in stuff. When it came time to hold my breath, though, I was amused by the green face, amber face, the latter showing a balloon holding its breath. And then a timer telling me how many more seconds before I could breathe. All of those things helped, but it was no struggle this time to hold my breath.

Then he injected me, and I entered the tube again. This time, however, everything started getting really warm, fast. "Everything" included my groin area, which, for some reason, really startled me. Still, it wasn't terribly uncomfortable. But just when I knew we were almost at the end, I started getting nauseous. I felt like I was going to throw up at any moment, but I don't know why. I swallowed and swallowed, and was able to hold down the urge, until, finally, the guy said I was through.

He bandaged up my arm and I walked back to the storage locker to retrieve my clothes. As I pulled them out, I noticed blood amply dripping down my arm. The blood around the vein on my left arm had completely overwhelmed the bandage, so I went, in my two gowns and sock feet, to the reception area, and she told me to go back to the technician who promptly put gloves back on and asked, "Are you a bleeder?"

Well, no, not ordinarily. In fact, never. But he bandaged me up again, this time with one of those stretchy bandages, wound tightly, and problem was solved. However, there was blood all over my pants. We will see if the large spot will come out in the laundry.

It's not a pleasant experience, but at least for right now, it's over. I'll hear about the results in two weeks when I go back to the oncologist, Dr. Stern. I must admit, I am a bit anxious.

Put this gown on. And don't breathe...

I did finally hear from the Radiology department at the Cancer Center, about an hour later. My appointment for a CT scan is next Thursday. And, a little less than two weeks later, I'll be meeting with Dr. Stern to go over the results. The timing is very good.

The clerk told me this will be a barium scan, which means I'll have to drink the barium solution, then wait while it's being absorbed into my body. I won't be able to eat anything four hours beforehand. And the whole thing will take about 2 hours.

So, I made notes and will review them before I go to Berkeley.

I've never had a CT scan or anything like that which requires me to drink a solution. The last one, the PET CT scan, required an injection, and then we waited for an hour while I played "Angry Birds" on my iPhone. So this will be quite unusual.

Wikipedia says about the barium sulfate solution:

"Barium sulfate suspensions are provided by a radiologist in advance of a CT scan to allow for better computer tomography of the gastrointestinal tract. The patient is instructed to take nothing by mouth, which means to abstain from eating and drinking (fasting), with the exception of drinking the barium sulfate suspension.

"The amount of time for this fast may vary, depending on the instructions given by the imaging facility and the area of the body to be scanned, but generally lasts for several hours prior to the scan. The patient generally skips one meal, along with abstaining from all liquids, clear or otherwise, during this time. Consumption of the barium sulfate suspension begins 90 minutes to two hours prior to the CT scan, as instructed in the patient education provided. Consumption is paced, beginning two hours before the scan is to occur, with levels marked on the provided container indicating how much is to be consumed between each of the two hours prior to the test. A small portion of the suspension is reserved for the minutes just before the test, to ensure that as much of the gastrointestinal tract as possible is coated. After the scan is complete, the patient is encouraged to eat and drink normally, with special attention to plenty of fluids. The barium sulfate is excreted through defecation. Constipation is a possible side effect."

How pleasant. Time to put the gown back on!

Waiting for Godot

It's been three-and-a-half months since my surgery to eradicate cancer in the uterus. The plan was to have a few more tests in June, and see where I am.

I was told to go in early June to get my blood test, the same test that showed a negative result back in February. That was on June 1st, because, when it comes to this stuff, I don't fool around.

However, three weeks later, I'm still waiting to hear whether I have the go-ahead to do the CT scan. I called Dr. Stern's office today, and Shirley told me she had faxed over the insurance information to the scan place a floor below her. I called and they said they never got it, but gave me assurances that they would call me after they talked with Shirley.

That was 15 minutes ago, and I'm still waiting.

I have other appointments to make, phone calls to make, but those will have to wait because this appointment is and will be more important than having my home thermostat fixed, or figuring out when my next movie date will be.

In the meantime, my post-surgical status is excellent. There is only a little pain, and that happens only when I press on my stomach. Perhaps the only good thing that has come of that pain is that I stopped wearing a fanny pack. A stylish upgrade.

In the meantime, my phone goes with me everywhere. I have to get these tests in before I see Dr. Stern in early July, so that he can review them and tell me the results. If the tests come back negative from the blood test and the CT scan, I can breathe a sigh of relief with the knowledge that I am cancer-free.

It Itches

I am exactly 8 weeks and 2 days from my operation. In the first few days after I returned from the hospital (after spending 5 days therein), I couldn't sleep longer than 5 minutes at a time. I couldn't much focus on anything because of the vicodin and the pain. I couldn't drive anywhere. I was supposed to walk a little every hour (but we all know how that goes...). Today, I drive everywhere I want to go. I drink wine if I want to, because I'm not on painkillers, and haven't been for over a month now. But I have this 7.5-inch zipper from my navel down to where the sun don't shine. It isn't painful to touch any more, but it sure is red. And the vampire bite marks on either side of the surgical line are still there. It's a reminder of where I've come from. Not constant, but near enough. I have a slight bit of pain, right around the belt line. I pretty much don't pay any attention to it. It's not like even two weeks ago, when I knew the pain was there all the time. I have to be reminded now that I have any at all. I consider myself cured. What do I face now? I will walk unassisted into Lab Corp on June 1st and have my blood drawn for the first of two tests. I will then call the oncologist's office, and Shirley will apply for a PET CT scan one more time. I have to say I'm a little nervous about the latter, not because of the procedure, which is a piece o' cake, but because of what it might show. If it shows I'm free and clear of cancer, I'm home free. Well, pretty much, although the gynecologist will see me annually for five years. If not... well, I don't want to think about that. Oh, one further thing: the incision scar itches. It's the damnedest thing.

Searching for a Nutritious Diet

I have just finished my eighth week of recovery from the operation. If you don't know, I had surgery to remove cancer in my uterus on March 9, 2012. I am still recovering from that rather extensive surgery.

A medical student came to my house a few weeks ago to visit and interview me. This had nothing to do with the cancer or the surgery. In fact, I had seen her before several times at Lifelong Medical workshops on diabetes and stroke risk. She was required by her school, as part of her training, to do some in-home visits. After all, Dr. Miller explained to me as we were setting this up: you can learn a lot about a person by their home environment. Do they have a support system? What is their greatest worry or challenge?

My answer to that last question was: "I am recovering from cancer surgery -- my second cancer -- but that's not my worry. Diabetes kicks my butt daily." And so we talked about that. And that is the absolute truth.

I was talking to a friend the other day about what I would do differently 15, 20 years ago if I knew what I know now about how diabetes would affect me. Nothing, I replied. I don't think I could change a thing.

But that's not important, really. What's important is, what am I doing now? I'm taking my blood sugar levels every morning before breakfast, which tells m absolutely what path, what trend I'm on. I'm conscious every time I put something in my mouth, and now I write it down (in my new app in my phone). But I'm going one step further.

I'm ordering food from a local nutritionist. Yes, I've tried NutriSystem, and when the food was lousy and cardboard-like, I tried BistroMD. A little more upscale cardboard but still not tasty. And so I couldn't stick with it.

My nutritionist, Sandy Der, is making meals according to menus she puts together with my guidance. She will deliver the frozen goods to my door -- 20 of them -- and I'll eat them over the month. Then, next month we'll do the same thing. (Sandy has worked for year's with Oakland Women's Cancer Resource Center, teaching nutrition and helping people with cooking ideas.)

This month's menu items include:

Fish of the Day with sun dried tomato pesto. Side of wheat berry pilaf and broccoli.

Grilled lime and garlic marinated chicken. Side of cut corn and roasted sweet potatoes.

Beef stew with carrots. Side of egg noodles and sugar snap peas.

Hoisin glazed roast chicken breast with stir fried green beans and brown jasmine rice.

Turkey bolognese sauce. Side of whole wheat spaghetti and broccolini.

The whole idea is not to diet. The idea is to make better choices. I start May 12th. Wish me luck.

Reviewing the D Buddy App

I've been using the D Buddy app for two days now. I like it, although I find some of it difficult.

It's very convenient. I was able to enter what I was eating right at the ballpark last night. I couldn't exactly find "lemonade" like they were selling at the ballpark, so I estimated, extrapolating from a store-bought version of lemonade.

This morning I ate some Kellogg's Frosted Mini Wheats, Bite-Size. I was able to find Kellogg's Frosted Mini Wheats in their database, but not the bite-size kind. Still, I was able to guess.

What I don't like about adding the food is that I can't, say, eat half a banana. So I have to enter an extremely small banana. And I can't add a quarter cup of milk. I can only add a cup (which is a lot of milk). But, when I've entered everything, it tells me how many grams of carbs I've consumed (103.4g this morning), how many are remaining since I'm diabetic, which is what the "D" stands for (171.6g), 540.1 calories, 12.3g fiber, 31.3g sugar, and 16.7g protein.

I'm not sure what all the numbers mean. How many grams of sugar should I limit myself to? Calories I understand more about -- and I'm trying to limit myself to 2,000 a day.

This app is already helping. Nutritionists have always told me to write my food down. You're more aware of what you're eating, what you should be avoiding. If you don't want to write it down, don't eat it! So now that I have to do that electronically -- it's much more fun this way -- I really am paying attention.

And I also have a calendar method of marking my weight and glucose level, as long as I remember to enter the data.

There Must Be an App for That...

I received a call the other day from my GP, Dr. Laura Miller of Lifelong, telling me that Caitlin, someone who used to intern with Lifelong, wanted to do an in-house visit with me. Caitlin was with Lifelong for a couple of years as sort of a health assistant. She set up the workshops, like diabetes and stroke, which I would attend. She was very competent, had a good sense of humor, was engaging, and seemed to have a lot of knowledge about general health matters. Caitlin is now in medical school at USF. She told me today that medical school is now emphasizing much more the patient end of health care. So, she shadows Dr. Miller a couple of times a month, and is now doing these in-house visits. She asked me after we sat down, "What would you like to talk about? Your cancer surgery, your diabetes, your support system?" I started out by telling her about the uterine cancer, how it was diagnosed, about the surgery at Alta Bates. When she asked me the question at the end, "What would you change?" I replied that there's nothing about the Alta Bates hospital care, the care I received at the hands of my oncologist or gynecologist, or even Dr. Miller. They are very caring, extremely competent doctors, with great caregivers in each of their practices. (That last statement doesn't apply to my GP; Lifelong doesn't have the resources.) For instance, Dr. Poddatoori has a scheduling person, a surgery scheduling person, someone who helps me in the examining room, etc. Dr. Stern, the oncologist, has his own assistant physician, Dr. Stephanie Summers, a scheduling person, an insurance person, ad infinitum, it seemed. I told Caitlin that I have had two cancers, I have had two surgeries, and it's gone. Twice. But diabetes beats my butt every day. I don't have a hold on diabetes, and haven't for a good, what, 20 years? I have all the information, but I can't seem to make the right choices. It doesn't help that I feel I'm addicted to sugar, and sugar snacks are the easy way to go. As are potatoes and bread. I wished -- well, almost -- I was back in the hospital. When the dietitian came by, he gave me a menu from which to choose my next three meals. After I kept checking everything -- I was hungry after having not eaten in three days! -- so he stopped me and pointed out that I was allowed only so many glucose points because I'm diabetic. Once I learned that, I could choose more optimally, and end up with a glucose-balanced meal. Ruth suggested that, just like there's a Weight Watcher's app on her cell phone, there's probably one or two good apps for diabetics. Sure enough, I just found one and bought it: Diabetics Buddy (shortened version is "D Buddy.") I have yet to use it. I hope I can figure it out and use it to my advantage.

Checking In with the GYN: My Go-To Doc

I kept my appointment today with Dr. Vineela Poddatoori, who checked on my incision today. Everything looks good. She told me the line would smooth out over time, fade, and the puncture marks on each side of that line would disappear, eventually.

She noted that I was still swollen a bit around the lower part of the incision, and that that's normal. She said it would probably disappear within the next two to three weeks.

She also gave me a lecture. It somehow came out in the conversation -- I think when she asked if I had been lifting things -- that I had been carrying the recycle and garbage out. Well, of course, I said. Who else would do it? She went on for a good 10 minutes about how I could easily hernia. And gave me examples, like a cousin who had a baby but then everything ruptured, and now, well, her intestines won't stay inside where they should be. Horrible stuff. She said it's harder to treat a hernia than my initial surgery, as the hernia never seems to completely heal. She made me promise to be more careful over the next couple of weeks until I'm completely healed, and not lift.

We noted that she looked like she was well along the pregnancy path, and she acknowledged that her due date is in August. I made a note to myself that I won't be able to see her until maybe Christmas, if necessary. Still, in the same breath, she suggested I call her if I had any concerns.

An important note: She said either she or Dr. Stern should be my check-off against recurring cancer. If Dr. Stern sees the June tests and pronounces me good, signs off on me, then I should come back to her. She said annual visits to one of them is important during the next five years.

Which made me think: where was my go-to doctor during the first five years after my colon surgery (also cancer) back in 2002? I didn't have one. I kept wondering whether my GP doc would know what to look for. I was just lucky: nothing recurred.

But now I have a back-up plan. I'm very happy about that.

One Month Update

It's been exactly one month since my surgery, so I thought I'd check in.

Pain. Yes, there is still pain. Pain when I walk, pain when I sleep, pain when I move. If I sit very still, I don't feel it, and can actually forget about it. Until I stand up. I'm using Aleve right now, every 6 hours. No Vicodin. The pain is certainly less than even a week ago. But according to doctors, I probably have another month to go before I feel almost normal again.

My son's grandmother wrote me to tell me that it will take me a year to get over this. "I can say confidently that it will take you longer than you think it will." She lost her uterus some years ago, and "I never missed it." Well, I know the last part is true.

As to what the area feels like, it's still a swollen mass right behind the suture line, right where the uterus used to be, and a little behind every inch of the vertical line itself. The "line" of the incision is much smoother than it has been, and doesn't hurt. It's the area where the uterus was that hurts, close to my navel, where the incision was started.

Fatigue. I still get tired quickly. I can go out for a few hours now, but when I come back I'm pretty tired. But every day brings new stamina.

Exercise. I walk quite a bit, I think, most days, but not on a flat line. I don't go for walks, normally. I need to build that into my schedule, a little bit more each day.

Diet. It's Passover now, so I'm not eating bread, which is a good thing. More salads, fresh fruit. I slipped back to some of my old habits because, hey, when you're hungry, you reach for whatever's convenient. Chips, ice cream. I try not to keep such things in the house normally, but I have slipped in the past two weeks. I am still holding at 10 pounds lost since the surgery, and I hope to improve upon that in the next few weeks.

All in all, things are going well. I have had a few set-backs in recovery (notably, nausea, bleeding from the clamps being removed, recovery from getting off Vicodin), but each of those only lasted a few days. I'm on a roll now.

Passover Challenges

I was finally able to find the time and patience to take my new glucose meter out of the package, plug in the key code wand, and get it going. It's not like the old days, when this used to be simple.

This morning, my blood sugar level was at 113, the best it's been since, well, I don't remember when. Right before the surgery, I was averaging in the 130's, which I thought was pretty bad, as before that spell, I was averaging in the mid-120's. I'm thrilled. That means that my eating regime is paying off.

Thanks to a dear friend, we have a first-night Passover seder to attend tonight. I'm not sure how long I'll last. Seders are usually looong, somewhere between 3 - 5 hours. I still get tired easily. And walking up the long, steep driveway to her house will take a lot out of me.

But I'm leaving Egypt tonight. Exodus.

The Bills Are In

Most of the bills from the tests leading up to the hysterectomy are in, and the operating bills themselves. I don't think this is the end, however. But I think this is most of it.

The total? A whopping $128,000.


COST OF OPERATION MARCH 2012

Doctors:
Oncologist OP Visit, New PT, LVL 5 $453
Gynecologist OV New PT Lev 3 $329

Tests:
MRI Pelvis $2,770
PET CT Imaging Skull-Thigh $5,900
Radiology, Supplies, Injection

Hospital:
Alta Bates Outpatient (biopsy) $26,918
Alta Bates Outpatient $289
Alta Bates (hysterectomy) Inpatient, $91,548
Ancillary

TOTAL as of 4/5/12 $128,207

I am still getting co-pay demands, and I haven't seen any from Alta Bates, although I'm sure that's next. My share will be probably around 1% of the total cost. How does someone without good health insurance, without ANY health insurance DO this???!

I feel very grateful.

Weight and See

I did not go into this great surgery with the idea of losing weight. But, hey, if they take out a uterus with really abnormally thick walls, plus ovaries, wouldn't that give minus a few pounds? Of course, they had to put something back -- I don't know what that is, and really don't want to know.

As near as I can figure, the difference in weight was about 6 pounds, as I weighed myself on my first day back. I'm not sure if that's uterus or if that's mostly I was on a reduced diet while I was in there due to the fact that I was nauseous my first few days.

I do remember eating that big, orange popsicle they gave me on my second day. I promptly threw it up. But it sure tasted good for a few minutes. They then, I think, figured out I was diabetic, and I never saw a popsicle again. But everything, once I was able to eat again on the third day, tasted great. A little tin of fruit. Some chicken soup. I really didn't have an appetite and wasn't at all hungry while I was recovering from the nausea in the first few days of hospitalization, but then my appetite came roaring back. I almost wished I could have stayed to see what the evening meal was like on Tuesday. But I was discharged around 2pm.

I weighed myself this morning, and I've lost 11.2 pounds since I went into Alta Bates. I'd like to continue eating small, frequent meals, fewer carbs, more healthy choices. I don't know if I can keep it up, but I have so many reasons to try.

So, for the young adults out there contemplating surgery for one reason or another: don't go into the procedure thinking you're going to lose weight as a goal. But if you do happen to lose some pounds, maybe it's a new beginning for you to start on healthy habits.

A Miserable Day off Vicodin

I can't lie: the day I came off the Vicodin was a miserable day. I'm not even sure why.

Yes, I felt more pain but it wasn't unbearable. I think it might've been a matter of blood sugar. When I ate lunch -- an Asian salad -- at noon, things straightened out a little bit. But I still had a stomach ache and a bit of nausea. I felt so bad the rest of the early afternoon that I just sat in my chair even though our son was over visiting. I didn't feel like talking.

We ate dinner quite early, at about 4:30pm. I was actually able to drive for the first time, which was part thrill and part almost terrifying (the car was going too fast and I wasn't used to it). At the diner, I ordered a small dinner salad and a bowl of fruit. And I felt immensely better after that. Ruth suggested that my body needs frequent nourishment because it's still dealing with healing.

This morning when I woke up, I immediately noticed the lessening of the pain around my mid section. I have felt some of that same nausea this morning, but it appears to be lessening, especially after breakfast.

(A small interlude for the Jews among my readers. Friday night is the beginning of Passover. I was eating some of the last of my cereal for breakfast this morning at 9am, being careful to put the mini-wheats gently in the bowl and not spill any. After all, the cleaning crew had come yesterday, and I didn't want any of the forbidden chametz, or grains, over everything in the kitchen. Wouldn't you know, I sneezed -- and several pieces went everywhere. On my pants, on the chair, on the tiled floor. But, thankfully, I had a little toy poodle who likes to eat spilled chametz. So I think I'm safe.)

I was going to go to a movie this morning, but I'm a bit tired. Maybe tomorrow.

Off the Vicodin

I came off the Vicodin last night. Mainly it did it because I felt the pain was manageable. And I did it because I'm tired of being a prisoner -- unable to drive, go to lunch or dinner with friends, even pick up groceries. Tired of having to take naps after I take the next pill.

Yes, I have a little pain this morning, but it's not bad. I also have a stomach ache. I have no idea if it's because of the (lack of) Vicodin.

Just to recap, I went through surgery (hysterectomy with removal of the ovaries and a sampling of the lymph nodes because of cancer of the uterus) on March 9th. I have been recovering ever since. That's three weeks-and-a-half, almost three weeks since my release from the hospital.

They had me on a dilaudid pain drip, intravenously, while I was in the hospital, but that induced low-level nausea, and I couldn't eat, which delayed my release by a few days. Once they figured that out, they put me on morphine. Once I was released from the hospital, they gave me a prescription for Vicodin and Motrin (Motrin is just 600mg of Ibuprofen). I went in for a check-up and to have the stitches removed a week later, March 20th, and they gave me another prescription for Vicodin.

The pain is getting less and less each day. I was able to start really reducing the Vicodin about a week ago, going from two Vicodin tablets every six hours to one, and then one every seven hours, every eight hours, etc., until I got up to every 12 hours on Saturday. And then, on Sunday, I figured I could come off it that night.

I hope those days are over for me now. They told me initially it would take 6 to 8 weeks for everything to heal and for most of the pain to subside. When I think about it, I'm only half-way through that process. There is some more pain to come. But it's nothing compared to the first few days.

Cancer Breakthrough

Big, big article on the cover of the San Francisco Chronicle yesterday: "In a potential breakthrough for cancer research, Stanford immunologists discovered they can shrink or even get rid of a wide range of human cancers by treating them with a single antibody." You can see the article online here.

The researchers are understandably excited, saying that "the data is indeed exciting, and the effects are significant." What seems even more joyous is that the treatment doesn't cause "major toxicity," i.e., horrible side effects. Mild, temporary anemia is cited as the only one. And, perhaps more importantly, "the antibody offers hope as a weapon against a broad range of cancers -- breast, ovarian, colon, bladder, brain, liver and prostate."

Tests have only been in mice so far. Researchers are hoping to move it quickly to human trials.

It's called CD47, but more informally, the "don't eat me" molecule.

Press Conference

Hey, everyone, thank you for coming. Please keep it low on the flashbulbs. Let's get right to the questions.

Q: How do you feel after the cancer surgery?
A: Pretty good. I'm still on Vicodin, my new best friend, but I have reduced the dosage. Every day is a little bit better.

Q: Are you able to sleep on your side yet?
A: I did a little bit last night, but it's still pain-free to be on my back, so that's where I end up.

Q: I understand you're feeling a little bit bored. You've got to be buoyed by that, that you feel well enough to wonder what you should be doing.
A: Yes. This is a great opportunity to catch up on reading. Enjoy the dogs.

Q: Did this encounter with death produce any change?
A: Well, I don't think you can come this close and not think about what's important to you. You find that you take a few extra moments to appreciate your family members and friends, each and every one of them. The quiet moments are wonderful. I have many of those. And, you may find this strange, but I also find myself appreciating the level of care my doctors and staff have provided, inside the hospital and out. They were, and are, just amazing.

Q: What is this about an enlarged heart? What are you doing about this?
A: I just spoke to my GP, Dr. Laura Miller of Lifelong Medical, and she seemed to think it was no big deal. First of all, it was a chest x-ray taken while I was in the hospital, and not an ultrasound. I'll be seeing her in May, so we'll follow up on that, I'm sure. She reiterated that the main thing is for me to recover from the surgery.

Q: So, there's no chemo or radiation in your future?
A: Not now, baruch hashem. We'll do more tests in June just to make sure.

Q: What was with the morbid pictures? That was really gross.
A: Sorry about that. It seemed like a good idea at the time.

A New Problem

While I was visiting with Dr. Stern, he mentioned something that had shown up on the chest x-ray they had performed while I was still in the hospital on March 11th: the x-ray showed an enlarged heart.

What is curious is that I had the same chest x-ray done prior to the biopsy I had done by Dr. Poddatoori in December. These chest x-rays are requested every time you enter the hospital these days, just to make sure you're healthy enough to survive surgery. In this case, on December 13, 2011, the chest x-ray was clear.

I was advised to get with my GP, Dr. Miller, to figure out what's going on about this, a condition generally known as "cardiomegaly." Causes usually involve high blood pressure, but can also involve stress to the body. Dr. Stern indicated in the hospital that it may be due to a temporary condition, the surgery itself.

The photo shows a normal heart, and an enlarged heart, side by side. Obviously not mine.

I'll be calling Dr. Miller tomorrow to see if we can follow up.

Feeling Much Better

I'm feeling much better, and the picture of the stitches tells you why. They almost look normal. (Pic was taken exactly two weeks and one day after the surgery.)

Sleeping longer now with less pain medication. Obviously I'm still stuck at home. But I'm feeling more normal now, so much so that I was bored yesterday and started looking for something to do. I watched some TV. I then watched the Seattle Mariners - Yomiuri Giants game in Japan at 9pm. Even though it wasn't telecast.

It'll be exciting to put on pants again and venture out. (Obviously I won't be driving, at least for the next few days, until I fully get off the Vicodin.) I am pretty sure pants won't fit because of the swelling, and that they will irritate because of the stitches. That's what I mean by "exciting." Still, it will be a major milestone in my recovery.

I don't think I mentioned that when I went to sleep under anesthesia two weeks ago Friday I thought there was a chance I wouldn't wake up. When I did wake up several hours later, I was very thankful.

Finally, a Corner to Turn

I felt like yesterday I turned a corner. I didn't feel as much of the pain, and my range of motion was better.

It took three days of bleeding from the stitches first, then the healing from that. I'm sleeping longer now. In fact, I missed my medication at 11pm, waking at 11:30pm, and took half the dose of Vicodin. I completely slept through the next dosage time of 5am, so at 8:30am, I gave myself another one pill.

I have to say, though, that I'm still feeling the pain, especially with this half-dosage amount of Vicodin. But I feel very encouraged by the signs.

Thanks to Jamie yesterday who ran some errands for me, including a pick-up at the pharmacy. There was no prescription, so it was a last-ditch effort to get the clinic to approve another prescription of some of my regular blood pressure meds, with a push from the pharmacy. As it turned out, the pharmacy (CVS in San Leandro) already had a prescription from November. Four months ago. That hadn't been filled. So he waited for that and brought it home. Again, that's a battle that I couldn't fight under current conditions.

I would like to extend some get-well-soon and heartfelt empathy wishes to two women from temple who have also wound up in the hospital over the past week: Frances Rotolo for a knee replacement, and Toby Berger, regarding breaking her arm in three places. I'm so sorry you have to go through this.

Up at 5AM for Pain Meds

Yep, here I am again, up at 5 am, and eating Fritos in advance of my pain meds. This pain has whipped my butt for two days now.

I had no idea that the pain would be so bad after the stitches. I bled a lot the first night, and several of those little bandages were either washed away, or ripped off my body. It's better tonight, but still terribly raw around the stitch sites. My memory of my colon surgery some 10 years ago is that it wasn't as bad then -- I had fewer stitches over a smaller area. And so I wasn't prepared.

So, thank goodness that Stephanie had given me a prescription for more Vicodin. I am still plowing through that. The plan is to take it fully for one more day. Then we'll see how I am, and try to cut back on Friday to one pill every three hours, then less and less.

We'll see how it goes.

My dream of being off the stuff and driving to fanciful lunches is still a dream. But, damn, these Fritos really taste good in the meantime.

The "C" Word + FREE

First thing going here, let me just toss out the "C" word with abandon: I AM CANCER FREE!!!!!!

Whew. Now that I've got that off my abdomen, let me tell you what else happened today. Today was the follow-up visit to Dr. Jeffrey Stern, my oncologist whose reputation has just grown with the addition of me as his patient.

Dr. Stephanie Sullivan, his assistant, took out my stitches today. While a little painful at the end, I was so glad to have those little suckers out that I smiled. She placed little bandages over each one, and told me they should stay on there for a week. If they fall off on their own, that's fine. WARNING: I am putting photos of these in here. They look rather raw at this point, and, believe me, they feel rather raw.

If I experience sharp gas pains, pains which are indeed playing on my system daily, I might look at GAS-X. Many people, however, say that it doesn't do them much good. I'm going to skip that. I've been fine so far with the gas; I expect it will get easier from here on out.

The inflammation that I feel -- and can touch -- in the lower part of my abdomen is normal. That will take about 4-6 weeks to finally calm down.

I was concerned about running about of pain meds. I have tried to cut down on meds, but yesterday was miserable. She didn't advise it, and so gave me another prescription for Vicodin. We love doctors and their little prescription pads. Stephanie suggested that, when I'm ready to wean myself off the Vicodin -- maybe in two to three days from now -- I might try one Vicodin tablet every 3 hours. That sounds like a good way to go.

I then walked into Dr. Stern's office, who went over the pathology report with me for all about five minutes. There was nothing to report. "Clear," "clear." He doesn't suggest radiation at this point, although he did note that some doctors do, as a conservative measure. He called it "prophylactic."

My appointment for a follow-up visit with Dr. Stern is June 21st, months from now. In the meantime, I will get labs done around the first of June. I will then call Shirley in his office, who will get the CT scan authorized through my insurance. By the end of that process, he should have results of both the blood tests and CT scan done before he sees me June 21st.

As I got up to walk out, I said to him, "You know, Dr. Stern, they say you're a genius. You certainly are to me. Thank you for the great work!"

And then he did something the usual taciturn Dr. Stern rarely does: He smiled.

The Hospital

Alta Bates hospital in Berkeley is its own little city. Even while I was doped up, I could tell the many layers of work that kept the place going, thriving. I was always amazed.

Every morning and every night someone would come in and write the name of the RN for that shift on the board in front of me. Simple math tells me that they probably had three registered nurses for each patient, but I can only remember the names of two, the same two I would see day after day. If there's sunlight, Kristi was coming in, followed by her nurse intern, Rachelle. If it was night, Sylvia would come in, print her name in big, bold letters on the erasable board, and give me a little lecture about what was to be expected of me. I began hoping I could avoid the next Sylvia shift as time went on.

Below the RN we had many types of nurses and physician assistants. Some did some things, while others did others. Although at night I noticed that fewer people were on staff. Maybe that's why I noticed Sylvia more.

And every shift had its responsibilities. My vital signs had to be taken four times a day. Blood had to be taken, but I'm not sure when -- maybe every couple of days? Nurses would write on my bandage as to when the last shunt or IV was put into my vein; every four days that had to be replaced.

When you're trying to get an hour's worth of sleep and someone is waking you up every 10 minutes (or so it seems), their health care seems counterintuitive. Still, I'm sure I was getting plenty of sleep, as much as I needed. I just didn't like to be awakened.

As Ruth tells me, though, she would see assistants turn around when they saw that I was asleep, promising to come back later.

I probably saw at least four doctors a day. This is quite different from when I had my colon re-sectioned 10 years ago; I only saw one doctor once that I remember, -- Dr. Wright, my surgeon -- and I'm sure I was wrong. There was probably another doctor or two who would check in on me, but I just didn't recognize them.
Dr. Poddatoori was there at least three times during my 5-day stay.
Stephanie, Dr. Stern's assistant, is also a doctor, and she was there about 3 times, maybe more.
Dr. Richter subbed for Dr. Laura Miller of Lifelong Medical, and she would fill me in on things, bringing the whole picture together for me as to where I was.
Dr. Stern was there twice. I was lucky that I was delayed checking out on Tuesday, as he was able to give me a summary of the pathologist's report.
I believe there was another hospital-based doctor in there somewhere as well.

I was taken care of so well. Even Sylvia, the one I was trying to avoid, was telling me exactly what I needed to do to get better and to check out of Hotel California Med: Walk, pass gas, eat solid food, breathe into the thingamabob so that I would eventually take deep breaths. I tried to be a very good patient. They were all very good health givers.

Babysitting After Surgery

Ruth is still a little nervous about leaving me alone even when today counts the seventh day from which I had surgery!

So, she's looking for people to look in on me. Today, our friend Dawn stepped up. Dawn even brought little tri-cornered hats of Hamentaschen - SUGAR FREE! Of course, they still had butter, so they were delicious! That's apricot filling. And the hamentaschen is one of our signposts that Passover is straight ahead.

And tonight, Jim and Marisa came over and made us dinner, a stir fried feast of chicken and vegetables. There were lots of wok jokes, including ones I haven't used since the seventies. Hey, this drug-addled memory is good for something!

Why I Stayed in the Hospital So Long

One note about why I stayed in 5 days and not the 2 days Dr. Poddatoori said I'd be experiencing.

1. She said "2 days" before the results of the PET CT Scan and the pathologist's report (during the actual surgery) were in. A small, laparoscopic surgical incision just wasn't in the cards for me.

2. One of the anesthesias was making me nauseous. It was either the stuff they gave me, a general anesthesia, during surgery, which took some time to work its way out of my system, or it was the drip they had me on in the hospital room. They put me on dilaudid instead of morphine for the first few days in the room. The RN and doctors figured out eventually that that choice made me nauseous. They had obviously made the choice to give me more pain relief after such heavy-duty surgery, as dialudid is seven times stronger than morphine.

I threw up on the 2nd day of hospitalization, and was in danger of doing so the next two days after that. Once the switch was made to morphine, it took a full day to bring me back. But that nausea meant I couldn't eat and I couldn't even have liquids or ice chips. That will certainly slow down the normalcy of your stomach and intestines.

It's alimentary, my dear Watson.

A Strong Dose of She's Right, I'm Wrong

We finally figured out what pain med dosage will work best for me. It's I listen to Ruth, who set up a system that actually works, and I stop trying to thwart her.

She has worked the Vicodin and Motrin so that I take it all at once during the time limits. We don't have to think about, okay, Motrin here during this two-hour time period when I was starting to hurt.

Why did I give her such a hard time about it? I think it's because I'm worried about running out. It's less to do with getting addicted. I'm certainly not close to that yet.

And one thing I suspect is working here is that I'm on medication, which makes it hard to think about what I should properly do about medication. I need a second party to help me monitor it.

The result of perfecting this system of how much to take and when means that I pretty much know when to take each dosage, because it never changes (it's just 6 hours in the future), and I feel so much better. I feel so much better at times that I have to remind myself that marathon running is not on the menu. Please understand that most of the time, I feel like there's this hot plate of spaghetti lying on my stomach. And that great fatigue can come swarming down upon me without warning.

My sleep time is better as well. I alternate between the living room blue chair and the bed. I am so worried the dogs are going to pummel my stomach, that I place a pillow on my stomach before I lie down. But there are other reasons the bed doesn't work as well: the transition between sitting and standing is rougher, it's harder to get comfortable, etc.

The blue chair gives me a little bit of the feel of a hospital bed. I hate the fact that I can't sleep on my side, but there's nothing to be done about that, and the chair ensures that I don't even bother to try. And at 2am, it's just the chair, me, my meds coming at 5, and Princess. Nice and quiet with a warm, woolen blanket over me.

Figuring out what the routine should be is what's helping. I'm beginning to relax a bit.

Tomorrow: I get a babysitter.

Counting the Minutes to the Vicodin

It's 4:30am on a Thursday morning. I'm due for Vicodin and a Motrin pill at 5am. If I can last until 6am, I'll be doing that much better by stretching my pain medication, making it last, and maybe eventually coming off the need for it.

But on the other hand, I don't want to be in pain. Research shows that (1) people heal more quickly if they're in less pain, and (2) I'm a bitch when I'm in pain.

So I think I will compromise and take a little less. But I will still take some at 5.

I was just reading about Kristen Johnston's new book about her addiction to Vicodin. She would take between 20 - 100 pills a day. Of Vicodin! Finally, she said, her stomach exploded. At the age of 36. Oh, we don't want to go there. And I certainly don't have residuals from 3rd Rock from the Sun to lean upon when something goes wrong.

It's good to have doctors' appointments (three different doctors) looming. To check on how you're doing. To check on other matters. (Other health matters have sprung up during the hospital stay; I'll get into that later.) And to keep you in check on the medication. This is serious stuff. Just ask

Staples Center

This photo of me lying in the hospital bed was taken on Saturday afternoon, I believe. Friday was the day of surgery, and is pretty much a blur. I have had a few people tell me that they stopped by and talked with me, and I have no memory. But thanks for doing that.

The images and language below may be upsetting to some people. If you are upset by the view of stitches, you may want to move on and visit another health blog. You know, something where they can do things by telekinesis, my preferred method of surgery. But if you have the stomach (!) for it, hang on in there.

I spent about five days in the hospital. Went in at 6:30am on Friday, and came out about 2pm on Tuesday afternoon. Thanks to major coordination and consolidation by Ruth and Jim, I was deposited in the middle of three lovesick poodles, who made me feel very loved. Ruth tried to keep their demonstrations to a minimum.

I haven't been able to sleep very well, and I guess I'm surprised that being home didn't make a difference. So, at about 3am, I moved my aching body out to the living room recliner, and slept there. Five minutes there, two minutes there, that kind of non-REM-producing sleep.

But today, the 6th day, I felt better. The belly still hurts, of course, but I'm able to sleep for 10 minutes, maybe 20, at a time.

I called today into Dr. Jeffrey Stern's office to make that appointment for next week. They could've brought me into his office in Berkeley this Thursday, but that would be tomorrow, and the thought of riding around, and then walking a lot, was very upsetting. So I was glad to get an appointment for next Tuesday morning, March 20th.

I'm hoping Dr. Stern will give me the full pathology report in which he says everything's clear, no radiation or chemo therapy needed. That's the short version I got as I was preparing to be discharged yesterday as he did his rounds.

And I am also hoping to get rid of these infernal staples.

A friend asked me on the phone what they were like. I didn't really want to look (although, frankly, that's the first thing I did when I got home: get in front of a full-length mirror), but I did. I thought they were nylon. Maybe plastic. They're metal! I would certainly set off a bevy of TSA x-ray machines right now! My hardware is kind of ominous.

The lengthy picture here is a section of my incision and the staples holding me back together. Believe me when I say "filet" is the operative word here. They fileted me like a fish. There is no other word for it. I am cut from around the pelvic bone up in a vertical slash to the belly button.

It only hurts when I move. It only really hurts when I don't use my oral medication, which is vicodin for the heavy-duty pain, and Motrin for the not-as-bad pain. I'm on a combination of both.

I have to go back to my reclining blue chair, as it's time for a nap, only because my body tells me so. More on the hospital visit -- which was fascinating -- later.

The other photo shows a close-up of one of the staples.

Getting Prepped Up

I just took my laxative. You know, this stuff is getting better. Oh, sure, it's no Grand Marnier, but this one was only 10 ounces and fizzy. I am to drink at least one glass of water after it, so that's what I'm doing right now. The surgery is tomorrow.

And, speaking of cleansing, I've been cleaning the outside of my abdomen with Hiblens daily. I had never heard of that before, where the patient is expected to get the area clean before the surgeons get their crack.

I would like to take the opportunity to thank everyone who has left a message for me on CaringBridge, wishing me well, sharing a private joke, giving me something in the future (like a trip to Disney World) to which to look forward. Thank you all very much. The outpouring is immensely helpful, and a little surprising. I mean, you don't know you have so many friends until you have to add them to a list for something.

I've been getting notes all week. Email. Facebook notes. Someone even sent me a note on the Words with Friends game we were sharing. I had three phone calls today. One from a dear friend, and two more from an ex girlfriend who wanted to leave a message in my mailbox that morning. While my mailbox should not be treated like the Western Wall, a depository for prayers, I will appreciate any and all that I get.

Back to drinking my water. I wish you all a good night.

Getting Ready for Friday

I'm feeling great. Thanks for asking.

Yesterday morning, we met with Kathleen, a nurse at Alta Bates hospital. Her job was to prepare me, verbally, for what's ahead on Friday. That, and send me to see Sam (again), who would take an ECG (electrocardiogram), a nasal swipe to look for staph infection, and four vials of blood.

Nobody took my blood pressure or A1C glucose level, but that will all take place Friday morning.

I signed a lot of paperwork: consent for hysterectomy, authorization for surgery (defined as "abdominal hysterectomy, bilateral salpungo orphorectomy, pelvic/aortic node dissection, possible pelvic reconstruction"), consent for blood transfusion (with two units ordered, just in case I need blood).

The orphorectomy indicates that the ovaries will be removed. (Oh, and I also had to sign paperwork which indicated that I knew I'd be sterile after this surgery. No kidding.) The pelvic mention is probably talking about the lymph nodes to be removed. And the "reconstruction" has to do with what Dr. Stern talked about, moving things around in the abdominal cavity to make sure that any future radiation treatments, if needed, will be successful.

Thankfully, my chest x-ray was cancelled after Kathleen confirmed that I had had one for the biopsy some two months ago.

Everybody was so nice. Kathleen was sympathetic that I couldn't bring a poodle into the OR. Damn rules.

The Soylent Green Connection

You may not remember the science fiction flick Soylent Green. There's a scene in the movie where Edward G. Robinson's character volunteers to die, and is "treated" to scenes of luscious green pastures and trees, what the Earth used to look like before we polluted our planet to death. Edward sees these scenes on the gigantic screen before him, and sobs.

I've been wondering what I would like to watch on Thursday night, the night before my surgery. And I think it's going to be Moneyball.

That scene where the Oakland A's can win their 20th game in a row and come back from the dead, where they're behind. 9th inning. 2 outs. And Scott Hatterberg steps to the plate. And hits a home run.

When I saw this in the theatre, tears of joy streamed down my face, because I had been there 10 years before, sitting in the stadium seat, but then jumping up, raising my arms, and cheering as loud as I could with 30,000 other rabid fans. Sheer happiness.

How Far the Cancer Has Spread

I had the PET CT Scan this morning. As Ruth suggested, the PET could've stood for Pretty Easy Test. It was much easier than the MRI.

First I met Pat, the nurse, who did a good job of explaining what would happen and what she needed from me. She stuck me and attached a gadget to control the flow, and started an IV; the water coming in would tell her whether the flow from my arm was good. She took some of the blood in the tube after the IV was established to test my blood glucose level. She said that, if it was 200 or over, we would say goodbye right then and there. Fortunately, it was 128.

Then she brought out the radioactive isotope (glucose), and put that into the IV tube. The only thing I had felt so far was the prick of the needle to start the IV. Then she left me for an hour, covering me with a heated blanket. "Don't talk on the phone," she told me, "but you can play games on your phone, anything like that." She then chatted with me about how she had gotten hooked on Angry Birds. During this long period of time left alone, I could've taken a nap, but she came back before I realized the time had gone by, and moved me to another room. I was urged to clear my bladder before I went in.

In the other room with the big, long MRI tube taking up most of it, I was told to partially undress (bra off, top still on, pants off, socks on) and slip into a gown. I then lay on the narrow plank, with my head on the pillow. She then placed a foam rubber pillow over my forehead, to keep it in place, I would guess.

"Your job," instructed Pat, "is to stay perfectly still. Don't hold your breath; breathe normally. This will take 21 minutes." This seemed easy enough until she placed my arms above my head, a most awkward way to relax.

And so I lay there as the machine moved me back and forth through one end and out the other, and back again. I noticed the whirring mechanism at one end, and so I assumed it was the business end.

This is the machine, the test, which will tell the doctors how much the cancer has spread. Whether it's reached the lymph nodes or not. Pretty important test. The insurance paper said the order was for "Pet Image with CT, Skull - Thigh." That's a pretty long scan.

20 minutes went by fairly quickly. I got out with her help, got dressed, saw the receptionist who offered me cookies. I don't turn down cookies, even for breakfast. Come to think of it, the radioactive isotope was breakfast. Helluva way to treat a diabetic, either way.

Telling the Relatives

I have dreaded making three phone calls. Two to nephews, one to my brother.

I talked with Ricky yesterday. Rick and I have always been close, although not as close in the last couple of years. He lives in Coronado, the beautiful island where I grew up. (I'd say "idyllic," except that the island population tends to go Republican.)

Rick took it well. He did say "oh, no" when I started the conversation. I think if I keep him informed, he'll be just fine.

Scott is a totally different nephew. The guy should have been a doctor. He knows so much about medicine. And I don't think it's "fake" knowledge, but some real knowledge there. He himself is flirting with lung cancer, as there's a tumor in one lung, but nothing more has developed about that. It looks like surgery at some point. If Scott had his way, he'd wield the scalpel himself.

So Scott was very understanding, very soothing. We talked a bit about medical procedures during the pre-Oscar festivities last night, and he seemed to think I was at an early stage (a diagnosis confirmed by my GYN this morning). I texted him this morning and he called me (he prefers the phone, which I do not), but I was having lunch with Jamie at that point.

I haven't worked myself up to calling my brother yet. I'm not quite sure how to predict what will happen there. When you're in a conversation with him, it's hard to get a word in. He will tell me where to go, what to do, I think. He's had some experience with cancer treatments, although I really don't think he ever had cancer. He was suddenly "cured" a couple of years ago, but that didn't save him from MRSA, the bacterial infection, from which he's still recovering.

It's sort of like Judaism. You can't be Jewish all by yourself. When you have cancer, you have to include everyone with whom you're close.

Good News about Cancer, If There Is Such a Thing

Dr. Poddatoori called me this morning. My gynecologist is back from vacation.

She doesn't seem to have access to all the medical records from the oncologist, but she did repeat that surgery is March 9th, and that she will be there for that.

She had some really good news for me. Mind you, this is before the results of the PET CT scan are in, and before the pathologist in Alta Bates takes a look at the uterus and lymph nodes he or she is handed. She said that an uncomplicated hysterectomy will mean that I will only be in the hospital for two or three days. Can you imagine that? So that's what we'll hope for.

If there's extraordinary bleeding, or, of course, more is found by the pathologist, the stay will be longer. She did state that it will take 6 to 8 weeks to recover.

She believes me to be in Stage 1B right now from uterine cancer, which means that recurrence is very low. Again, that's without knowing the whole story, which they will discover at the other end of the scalpel.

What wonderful, informative doctors I have. I couldn't wish for a better scenario.

Rabbinical Blessings

Two rabbis this weekend (not counting my sweetie) wished me well this weekend. Rabbi Straus, with whom I've had maybe two words so far, took me aside during Saturday's oneg to ask me how I was doing. We both had a bitter laugh over the fact that I feel just fine and that I'm going into the hospital to "feel shitty" (to use his words). He told me that he was going to offer me an aliyah today, but when he saw my name on the Mi Sheibarach list, he declined. I'm so glad he did not do that -- I would have panicked! But it's nice that he now knows who I am and said some wonderful words.

Rabbi Chester called me on the phone today to talk about my illness and the Oakland A's. Okay, both the A's and I have an illness. When I said, "But we now have Manny Ramirez!" he laughed, which is what most baseball fans are doing right about now. Manny can play on May 30th. I'm hoping I can play sooner than that. It was so nice for Rabbi Chester to call, even though he's in retirement. I guess you're still a mensch, if you are, even in retirement.

I'm mentally putting together a bag for Ruth to take to the hospital a couple of days after my surgery. My G-Slate tablet will be in it, plus my phone. I've talked to three people about smuggling in cupcakes; they're the perfect food, don't you think? I'm not much of a book reader (especially on morphine), but I think I will want that new book I just ordered about the teenaged Jewish photographer in World War II (A Partisan's Memoir: Woman of the Holocaust, written by Faye Schulman). Don't you think that the publisher added that second title?

I have to go now and prepare to watch the Oscars. It's not much preparation: just sit down in the chair with my bowl of popcorn and turn it on. But I have to watch the pre-Oscars stuff first, you know, where they dis the gowns, etc. My prediction for the winners are: George, Viola, Chris, and Octavia. As a non-paid semiprofessional movie reviewer, I'm on a first-name basis with them, you know.

Date for Surgery

I finally have a date for surgery: March 9th.

It's the day before Ruth's birthday, but neither of us feels like celebrating, early or otherwise. Funny how that works. But it's a good day as far as her schedule goes, and it's good to finally have it on the calendar.

In the meantime, my GP, Dr. Laura Miller wants to me to come in to discuss things. I'm not sure why. In fact, I will have 3 medical appointments before the surgery: my PET CT scan, which is still going on as planned on Tuesday, the meeting with Dr. Miller, and my pre-op appointment with Alta Bates.

I have to go now. We're having dinner at an ice cream parlor. Because, I guess, life is too precious to waste on real food.