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.