Monday, Monday...(#16)

YAWN!!!!

Monday, Monday…. 

Mondays.  Mondays are go to the doctor day.  Each Monday has a slight variation from the others in a three week span of mostly repetitive Mondays..

Today, for example, three Monday events that do not happen on the other Mondays but that do happen every third Monday..

At 9 a.m., I go to the South Texas Radiology Clinic (STRIC) on Sonterra Boulevard for a CTscan of my lungs and abdomen.  There is, as far as I know nothing wrong with my stomach, but they check everything.  This CT is with and without contrast.  So, 30 minutes in the belly of the beast, get pulled out, get shot with iodine of some kind and back in the beast’s belly again.  “Breathe In!”  “Hold!”  “Exhale!”  Repeat ad nauseam.  

11:30.  Upstairs in the same building.  I have had breakfast in the interval…had to fast for the CTscan earlier.  This time, I get punctured once more.  EVERY Monday, without fail, I go through a series of blood tests to check my white and red blood cells and my platelets and whatever else the doc wants to check.  This is always in the START Center.

2:30 p.m.  The STRIC Center on Hardy Oak for an MRI.  I love MRIs:  they take me right back to Vietnam with what sounds like fifty caliber bullets being fired from machine guns, strange sounds, Charlie creeping through the wires, a think blue line above my nose, claustrophobia setting in.  After the MRI, I go home.  I will learn nothing until next Monday.  Then I will sit down with Doc Onc1 and he will go over the results.  So far, that’s all been positive…except when we went over the first MRI and the only, so far PetScan.

Back to work tomorrow.

Actually, next med day will be on Sept. 6, a Tuesday.  That’s thanks to a federal holiday.  That day, I will also get my third Monday dripping of chemo into my veins (Alimpta and Carboplatin).  So, I will be fine on Wednesday for deans’ council and then will be depleted on Thursday and Friday, but good on Sunday for my golf foursome.

Monday, Monday…sometimes it just turns out that way…and sometimes, it’s Tuesday.

Apologies for the boring blog entry, but this kind of thing is much like war (as my Vietnam veteran on-line friend Bob Streck says).  And in war, most of the days are boring and repetitive.  What I'm counting on is that something this boring will seem much longer.  Think about Catch-22 (another book I teach in my anti-hero class some years), fifty years old this year, and, was it, Yardley's whore? and the theory that if we are bored, life is longer.

Oooops! You mean you cured that? Even temporarily??? #15

A singular fringe benefit of chemotherapy

OR:  Two for One is Twice as Fun

My oncologist is also a dermatologist!

One does learn something new every day…if not, one has wasted the day.  When a person has Stage Four cancer, even at a ridiculously early stage of stage fourness, that person gets up to date in things never before considered.

Take this, for example, and I can make this a ridiculously brief blog entry:

I have been suffering from what we once blithely called “the heartbreak of psoriasis” since I was in high school—long before most of you were born.  I have visited several dermatologists, a peaceful group of medical people who rarely deal with heartaches greater than psoriasis.  Now this is fairly unfair since many of them do work in burn centers, in children’s surgeries and elsewhere.  Still, our pervasive impression is that dermatology is a less intensive kind of specialty than, say, oncology or cardiology. I saw an episode of “Gray’s Anatomy” once when the youngish interns stumbled onto the dermatology ward:  soft music, skin ointments, make-up clinics and so on.  It reinforced the stereotype I already had of dermatology.

When I first consulted a dermatologist about my psoriasis (and I will get to the point soon), said dermatologist recommended a kind of tar compound.  I rubbed it on my scalp every day for months and nothing happened except my hair kind of stuck together.  It reminded me very much of the gummy residue I used to pick from the bark of pine trees in the Big Thicket and chew like gum, but in a liquid format.

The tarry compound helped a little, but never did as much as I had hoped.  I combined it, on the advice of the dermatologist with Neutrogena^tm  T-Gel, a shampoo that is supposed to help with psoriasis.  I continued to use T-Gel for years and, a few years ago, combined it with something called Clobetasol Propionate^tm (5mg), an ointment used on the bits of psoriasis on my body and combined with a scalp oil to rub on the psoriasis on my scalp.

NOTE:  I teach a course fairly regularly called "The Antihero in American Literature."  I love it!!!  I start, usually, with The Red Badge of Courage and “The Bride Comes to Yellow Sky” by Stephen Crane (a true antihero hisownself); then move to Hemingway’s A Farewell to Arms, show the Henry Fonda film of Steinbeck’s The Grapes of Wrath, and then ZAP! Salinger’s Catcher in the Rye and Kerouac’s On the Road or The Dharma Bums.  We watch The Last Picture Show and Rebel Without a Cause (great material for the course) and I finish off with a fine novel by Bobbie Ann Mason called In Country or use her book Shiloh.  I did use Fear of Flying once, but my students weren’t fond of it.  Okay, I teach all that cool stuff and DAMN!  I can’t wear black!!!!  Why?  The heartbreak of psoriasis snowing over my shoulders.  Unsolved by medical science.

Did I say unsolved?  My psoriasis is totally gone!  How?  May I add, WTF!!!!!  I looked it up.  I Googled it.  Chemotherapy is the most effective treatment for psoriasis!!!!!!  I don’t have it anymore and I’m scheduled to teach my antihero course in spring, 2012.  I will wear nothing but black and I will be mostly bald.  Perhaps I’ll even appear threatening!!!  Doc Onc1 is the best dermatologist I’ve ever had.  And I don’t even have to pay him for that part of what he’s doing.  It’s a side effect, a mere bagatelle.  Please note that I do NOT recommend getting chemo for that disease!

More after Monday when I have a CTscan of the chest and an MRI of the brain.  And, as always, thanks for reading this far.

The routine sets in (#14)

Like a hamster on a treadmill

After the cyberknife experience, things begin to move a bit more slowly.  The following week, I am back at the START Center for a financial discussion (no problems) and to determine whether I need a mediport for the continuing series of chemo drips.  I do not; the veins are good.  So, a few weeks ago,  Susan and I go in for the first round of chemotherapy.

This, then, is the cancer ward.  Patients sit in recliners in a large room with teams of attending nurses and technicians.  Each patient is attached to an IV.  Some of the women who have lost their hair wear caps and knitted hats; others wear wigs.  A few of the men have obviously shaved their heads and taken to polishing the baldness.  I continue to have hair.

Wonder of wonders: the quite comfortable ward also has WiFi.  I am able to check email and surf the web from my iPad.  Susan is there for the first treatment just in case I need to be driven home, but the aftereffects on the day of chemo are quite mild.  She stays home subsequently.   

The Routine

I drive to the START Center in my little Mazda MX-5 with the top down, climb the stairs to the “treatment room” (not the “Cancer Ward,” I am informed).  I weigh myself (I have lost 20 pounds, most of that deliberately) and sir down in a recliner to wait for Maggie, my nurse, to plug me in.  Two hours later, the IV is disconnected and I walk downstairs.  The temperature is now at about 100 degrees; so, I put the top up and drive to work.  It has all become a routine.

Days after chemo

The day after chemo is always a good day.  I feel normal.  I go to work and am not tired.  The day after that, I am depleted.  I stay home, lie on the couch, read crap.  I don't feel up to poetry though I do enjoy reading brief segments from a Gray Snyder book my friend Will Hochman sent to me.  I feel heavy, not hungry.  My eyes burn (from the cyberknife treatment, I think, and not from the chemo); Doc Onc2, the man who wielded the cyberknife had warned me about that.  Food no longer tastes good.  The next day, I start to feel a bit better, but not good enough to go to work unless something important is happening.  The following day, I feel pretty good and go to work.

Just a quick aside:  I have, while all this has been going on, stopped reading manuscripts for Pecan Grove Press.  I have a large stock of accepted manuscripts and plan to complete all of those.  After that, assuming I feel up to it, I will start reading again.  I have managed to get a number of books out while going through the treatments:  books by David Starkey, Scott Wiggerman, Jessy Randall and Daniel Shapiro (at the printer), and Lisa Siedlarz (she has her proofs from the printer now).  More are in process.  But I simply cannot read new manuscripts at this time. I announced this on the press's website just above the link to the submission manager.  Sicne tnhen, I have received ten submissions

The chemococktails I am taking: 

Alimta:  the trade name of the generic drug Pemetrexed

and

Carboplatin:  also used for other forms of cancer

I get both on each visit plus flushing agents dripped through the IV.  I also have a two-page list of common side effects.  If my temperature goes above 100.4 degrees, I am supposed to call the doctor.

This is all terribly technical.  What happens is that they put gunk into my veins.  The gunk attacks virtually all cells in my body:  cancerous and non-cancerous.  I take other medicines to promote the development of white and red blood cells and platelets.  The good cells are supposed to win the war.

And oh, yes, I have started to lose hair.  It’s sort of like more advanced male pattern baldness than I already had, but I don’t think I’m going to lose all of it.  I feel good.  I’ll be playing golf on Thursday morning at Silverhorn.  I’m editing books and directing the library.  Both Doc Oncs continue to say the prognosis is good.

It’ll be a couple of weeks before I continue this.  I’ll still be doing chemo, but it’s all going to be just like this.   

I’ll get back to the blog after the next MRIs.

Thanks for reading.

Adventures in the Cyber Trade (#13): a nod to Ender Wiggins

Now Ain’t the Time for Your Tears (Dylan)

So, we rocked along.  Known:  lung cancer, really early.  Known unknowns: had it gone beyond the lungs.  Doc Onc1 sent me to the South Texas Radiology (and something with an I) Center [STRIC] for a PetScan…just to see what other evils might lurk in the bodily organs of men.  The new scan showed that the cancer had, in fact, spread to a central lymph node close to the pulmonary artery.

I met with Doc Onc1 again for a consultation.  He wrote on a yellow legal pad:  STAGE 3.  “But,” he said, “you’re asymptomatic and the prognosis remains excellent.”  Abdomen’s clear, liver’s clear, left kidney’s (if you’ve been reading this blog, you’ll know that I no longer have a right kidney) clear.  All that was good.  “So,” Doc Onc1 said, “So, now, we just need an MRI of the brain to make sure the cancer hasn’t metastasized to there.  That frequently happens; so, we want to be thorough.”  Back to STRIC.

A New MRI

When I got to STRIC, downstairs from the START [acronym irrelevant, actually, non-existent] Center where my Docs Onc hang out, I was punctured once more by a nurse…IV needed to shoot crap into my veins.  This one was with and without whatever the substance was.  The next day?  One more consult; one more piece of bad news:  yes, two small tumors existed in my brain.  That moved me from Stage 3 to Stage 4.  Doc Onc1 warned me to stay away from the Internet.  The dire warnings about Stage 4 did not, he said, apply to me because I was healthy, asymptomatic, and really early on all stages.  There’s some really scary stuff about Stage 4 out there; I suggest you not read it.

What the MRI did do was change the treatment protocols.  I would not start chemo immediately; instead, in DocSpeak “we” would take care of the brain cancer first.  The procedure would be “effectuated” by Doc Onc2.  Doc Onc1 made an appointment for me with Doc Onc2 for that same afternoon.  Both docs are part of the START Center, but the radiation therapy Doc Onc(2) floats to and from various locations while he is engaged in his trade.  I saw him that afternoon at the START office at Northeast Baptist (just around the corner from Doc Onc1’s office).

Some Really Cool Technology

All of my doctors plus the various centers are able to share data in the way President Obama wants all doctors to be able to do.   Each center, each individual doctor, can call up all my medical history and current labs and pics on the computers in their offices.   So, Doc Onc2 asked me to sit down and called up my MRI of the brain on his computer.  I saw the two small tumors immediately.  “Fortunately,” he said, they’re both small.  I can take care of them with two cyberknife procedures.”   

He explained that a cyberknife was a slight advancement from the gamma knife.  It was totally robotic and he had to take a couple of days to program the computer that would ruin the computer.  He sent me to STRIC at the main START Center in the Medical Center.  They, too, called up my MRI on their computers and turned me over to a couple of techies.

At the Big START Center (I get a neat new mask)

I had no earthly or unearthly idea of what they were doing when the strapped me into a CT platform and sent me sliding backward into the machine.  What they did:  part of cyberknife involves molding a mask to your face, not unlike the masks used, in some cases, to build death models for some famous people…in past centuries.  The CTscan would help map where the cyberknife would attack; the mask would hold my head perfectly still while the cyberknife worked.

NOTE, please:  the cyberknife is NOT a knife.  It is, instead, a metaphor for a little radiation box held by a robot’s artificial hand and maneuvered around the area of a person’s body that contains cancerous cells for the purpose of zapping them.  I had flashbacks, as I learned all this, to Orson Scott Card’s classic science fiction novel, Ender’s Game.  In that novel, Ender, a child genius, is taken from his parents to a special military academy for geniuses.  There, the kids learn a complex video game and have something very like rigorous military training.  Do excuse this digression.  Ender is the best of the lot.  We do not learn, until the end of the novel [SPOILER alert] that the videogame he and the other kids have been playing is not a game at all, but is weaponry aimed at a hive of enemies called “buggers.”  I had that impression early on and thought the START folks should hire a team of kids to operate the cyberknife.  But, there is no joystick, just a computer program.

I Get Cyberknifed (twice)

Six weeks ago, I was strapped onto a table in the cyberknife room at the Methodist Cancer Treatment Facility.  I would lie on the table, head immobilized for 72 minutes.  Around me, a robot wheeled itself, its arm (much like the arm on the now defunct space shuttles) positioned itself around my head, and zapped radiation into my brain at pre-targeted areas.  The same thing happened three days later for the other tumor.

Doc Onc2 is confident that the cyberknife and robot did their jobs well (he had programmed them) and that I was now, unofficially back to Stage 3.  But we won’t be sure until I have a follow-up MRI of the brain on a couple of weeks.

As I said at the beginning, quoting an old Dylan song, “Now ain’t the time for your tears.” (Bob Dylan, “The Lonseome Death of Hattie Carroll”).

 

Next:  the joys of chemotherapy

Rub-a-Dub-Dub, many docs in a.... (#12)

Here a Doc, there a Doc, Everywhere a Doc Doc

Susan and I were scheduled to go to Europe in June.  We would start in Dublin, fly on RyanAir (possibly the worst airline I have ever flown on) to London and then take the EuroStar (a great train ride!) through the Chunnel to Paris before flying back to Dublin for Bloomsday.  A grand trip:  no cares, no problems.  We worked on the itinerary together:  plays in Dublin (the Abbey Theatre for Pygmalion, the Gaiety for The Beauty Queen of Lehane, and the Gate for Cat on a hot Tin Roof) and in London (Wicked in the west end, Shakespeare at the Globe and School for Scandal).  Paris was all museums and dining.  And then, I went for a regularly-scheduled visit to see my PCP.  I made the mistake of coughing.

Dr. Atlas, noticing the cough, schedules me for a chest X-Ray to see if I have a bronchial problem.  That Friday, he calls me.  With many apologies, he tells me the X-Ray tech has called his attention to a small shadow on the X-Ray, on my right lung.  He has scheduled me, that day, to see a pulmonologist (new specialty for me!), Dr. Rafael Santiago.  The pulmonologist schedules me for an MRI (lungs to lower abdomen).  The MRI detects something (what we did not know) on the upper node of my right lung.  He shows it me on the film:  looks much like a jelly fish dripping down the lung.

We go to Europe

I ask if we should cancel the trip to Europe and he says no:  Early days, plenty of time.  Go, go, enjoy yourselves.  Dr. Atlas had said the same thing.  And so, we fly to Europe and have a great time for three weeks.  After Paris, we fly back to Dublin for Bloomsday and, the next morning, across the North Atlantic to Chicago and then home to San Antonio.   

Much activity with the medical profession await my return.  Among the first things I did was notify the English Department that I could not teach my graduate poetry class that was scheduled to begin in early July, nor my fall semester class.  I would have to miss too many classes, I assumed, rightly as it turned out, for that to be fair to my students.

Another Test

At 6 a.m., the Monday after we had returned from Europe, I checked into Stone Oak Methodist Hospital for a “fine needle aspiration biopsy.”  Because of the location of the suspicious “thing” growing in my lung, the doctor had to go in around my collar bone from the back and attempt to find whatever it was to extract a sample for biopsy.  I was in a CTscan machine the whole time he worked.  It took a week to get the results:  inconclusive.  Later, I have a lung function test that shows my lungs are working well.

The next step is a bronchoscopy.  Back at Stone Oak Methodist.  My pulmonologist does this one himself.  This one, I am asleep for.  He pushes an instrument down my throat and into my lung where he scoops out samples.  Results:  still not conclusive, but probably cancerous.

The next step?  a PetScan.  The PetScan, after the patient drinks some treated crap, lights up in areas where there is evidence of excessive sugar being used by “something.”  That “something” is almost always active cancer cells.  I have two such spots:  one in my right lung and one in the lymph node between the two lungs.  So, I finally have a concrete diagnosis:  lung cancer that has spread to the lymph node.  I had had two very good friends with that diagnosis:  Carla Saenz and Cynthia Harper.  Both had died within three months of the diagnosis.  So, I am more than a little bit frightened.

The Two ONC Docs

My pulmonologist, in consultation with my PCP, refers me to two oncologists at the START Center who will work as a team:  my chemotherapy oncologist (Doc Onc1) will be the lead oncologist for the treatments and my radiation oncologist (Doc Onc2) will take care of targeted radiation therapy.  Both of them have all of the tests (MRIs, X-Rays, CTscans, biopsies, PetScan) on their computer screens.  I am, as it turns out, a Stage 3 cancer patient because the bad ju-ju has spread to my lymph node.  BUT, and this is important, my prognosis is and remains positive.

More later.

Let us not to the marriage of true minds... (#11)

Internists (PCP), Urologists, urological surgeons, gastroenterologists, general surgeons, nephrologists, cardiologists, neurologists, neurological surgeons...so many specialists...there is no end to the making of specialists!

Very tired today, but thinking back to those days when Susan and I walked the neighborhood as part of recovery from heart surgery.  Outside my office, workers are replacing the wheelchair ramp for entrance to the library.  Reminds me of Vietnam:  the flukety-fluk-fluk of Hueys circling in, the drilling that sounds like machine gun fire.

One day, walking down to the mail box, about 4 weeks after the heart surgery, Susan notices that I am kind of dragging  my left foot.  I think it’s because the heart surgeon has nicked a nerve in the left leg while extracting the vein; Susan calls Dr. Atlas, my PCP.  Thirty minutes later, we are in her car headed to the Texas Neurological Center for a fast appointment with a local rock star neurological surgeon, Dr. Don Hilton.  Dr. Hilton invented this little shim-like titanium device that helps some patients with spinal cord injuries when it’s inserted between discs.  I don’t know how that sort of thing works.

The neurological surgeon

Within a very few minutes, I am in Dr. Hilton's office demonstrating my amazing ability to walk.  A young medical student who is “shadowing” him and looks at him with something akin to hero worship nods sagaciously whenever the surgeon tells him something about what he’s doing.  He sends me downstairs to get a CTscan of my brain and instructs me to hand carry it right back upstairs to his office.  He gives Susan a note instructing the techs to give the pix to me.

Perhaps the sounds outside my office remind me more of the CTscan than of Vietnam.  I am in the belly of that beast for 45 minutes, my nose an inch from a blue line running down the top of the tunnel, the CTscan machine making strange noises.  When they finally finish and the machine retracts me from its innards, I am shaking, claustrophobic (I had not known I was claustrophobic until then), can barely walk I am shaking so much.

Diagnosis

We get the pictures back upstairs and the doctor motions me into a nearby wheelchair.  Here’s what happened:  my neurologist had been correct.  The blood thinners used in open heart surgery and afterwards had caused more blood to spill into my brain pan.  The pressure on the brain is increasing and has caused the dragging of my left leg.  I am rushing headlong towards a major stroke.

The Texas Neurological Center has a long, air-conditioned, above-ground passageway that leads directly to the Southwest Methodist Hospital.  Within an hour of taking the pictures to Dr. Hilton, I have a wheelchair ride to Methodist and my hair is being judiciously shaved by a nurse while another nurse connects an IV to my right arm.  It is still not noon.  Susan noticed my limp at 8 a.m.; by noon, I am spread out:  a patient etherized upon a table.

I wake up...again

When I wake up, I have four new holes in my head and each is draining blood from my brain.  Dr. Hilton has won another one!  I do not stand up and leap for joy because I would have pulled the drain tubes out!

One month after my quadruple bypass surgery, I have brain surgery.  That’s a record, even for me.  A few days of walking hospital corridors, an open MRI, and then home again for another month of walking.  I do get a very short haircut just to even things out on my scalp. This is truly getting tedious.

Two months later, I am back at work and back on the golf course as if nothing had happened.

I think that’s all for now.  I may resume this blog in another month.

The Heart Is an Open Book (#10)

Or is it "the book is an open heart"?

I realize that I probably have more missing body parts than most people and also realize that much of that is my own fault.  The problem with my arteries happened over many years and the surgery happened almost a decade ago. But nothing, from my broken arm when I was a teenager and hormonally challenged to play football to my kidney tumor and its attendant ileus and to my way too clogged arteries wound up being without complications of some kind.  Fortunately, each of those events had what we could all call happy endings.

One morning early (why on earth do surgeons want to do their thing at dawn?!!  Tee times in the afternoon?) Susan drives me to the hospital where I am admitted and led to a Prep. Room.  Some non-qualified barber, disguised as a nurse, shaves my chest and does the old IV trick, poking around at my vein until she finds it.  What is waiting in OR is a competent cardiothoracic surgeon who will remove a vein from my left leg, cut off pieces of four arteries, and replace them with pieces of the vein he has earlier removed from my leg.  Piece of cake!

Once, I am told, doctors actually cut into your rib cage and used terrible things called “spreaders” to push people’s ribs apart to allow them to get at the heart.  Now, they have advanced technology:  an electric-powered, rotary saw.  Not unlike the one I have in the garage!  They cut down to your sternum with a scalpel and then saw your chest open.  I hope this isn’t all too gruesome, but remember:  I can’t actually see what they are doing to me.  I sleep like a baby through the whole thing.

The Surgery and After

When the doctor finishes replacing all of the arterial parts he has cut away with still living vein parts that he stitches to teh two ends of each now open artery, he staples my open chest closed.  I assume he is not using anything like my little office stapler or like the saddle stitch stapler I once used to create chapbooks, but some kind of incredibly expensive medical tool that, well, does much the same thing. Afterwards?  Neat stitches to tie the skin and muscle back together.  A very strong child could do it.  Very strong!  This kind of surgery requires muscles.

I wake up.  That’s a nice thing to be able to type.  Susan is there.  I’m grateful she took the “in sickness and in health” part of the ceremony seriously many years ago.  The doctor comes into the ICU and tells us that everything went well and that I might anticipate some bruising (I continue to have some bruises from that surgery...not psychological one, physical ones).  His recommendation is to walk a lot.  I fail to understand why I receive a prescription to get a handicapped placard for my car if I am supposed to walk a lot.  I don’t use it.  I walk.

Walking (I have written an essay called "Walking" before.  So has Henry David Thoreau!)

Well, Susan and I walk.  My first outing is half a block down the street to the mailbox.  When I get home, I’m exhausted.  Each day, a little bit farther.  Finally, I am strong enough to take a solo walk out of our neighborhood and all the way down the hill to Blanco Road.  I am able to look to the north and see the intersection with Bitters Road where I had my convergence of the twain with another car less than a month earlier.  Since then, I have passed out on Festival Hill, met with a neurologist, then a cardiologist, and had a quadruple by-pass.  One lousy month!  How time flies when you’re having fun!

I am scheduled to start back to work the next week, but Susan and I take one more walk.  She notices that I seem to be not exactly limping but that my left foot is dragging a little.  She loads me into the Honda Civic and takes me to see Dr. Atlas.

The next surgery happens very quickly, but more about that in the next blog entry.

When Doctors Collide (#9)

I Once Enjoyed Playing "HEARTS" (a simple game of cards)

So, what can I say?  I have never been as good to my body as I should have been…if it is a temple, it is a crumbled temple, like the piles of old stone and wood we sometimes find when poking around in abandoned towns out west.  But my temple has been the opposite:  over-fed, poorly maintained though I have never been obese, and suffering from the smoke I inhaled for way too many years.  Well, this is what the cardiologist found and how he found it:

My Angiogram and Other Examinations

Dr. C, my cardiologist, listens to my heart.  The part of the stethoscope that touches me is cold and hard though Dr. C is quite nice and affable.  He listens to my chest and to my carotid and other arteries.  He makes little noises like hmmm and mmm and even, damn, moves down to check the arteries in my ankle.  The conclusion is that I am ripe for an angiogram, the “gold standard” for checking my heart and arteries.

My angiogram is interesting.  Lying on a hospital OR bed, I am not fully asleep for the thing and can see the interior of the arteries and can see something like an image of my own heart pumping.  The room seems incredibly cold but that is largely an effect of the drugs. I confess that the half sleep reminds me much too much of the sixties as my eyes focus and refocus and my heart, visible on the crt keeps pumping with the iambic rhythms of systole and diastole.  Heart’s fine, says Dr. C, but the arteries…  The arteries, yes, the arteries.

How I Got This Way

My bad dining habits (only away from home, Susan has always prepared heart-healthy meals) have resulted in almost complete blockage of four different arteries, one of them at 98%.  In a week, I am supposed to have a quadruple bypass.  I really blame southern fried cooking but the blame is my own for eating it:  fried chicken, French fries, chicken fried steak, hamburgers, fried fish, shrimp and oysters with hushpuppies, so much more.  But…

Ooops!  We forgot about...

Well, there’s always a “but,” isn’t there?  The good news is that I have never, ever, had an actual heart attack.  My heart has continued beating healthily, blissfully unaware that the arteries have blockage.  But that’s not the “but” in question.  The “but” that faces us (my doctors and me) is that I also have a subdural hematoma that sits passively in my brain pan, slowly healing itself.

So, what’s wrong with that?  Open heart surgery is accompanied by massive quantities of blood thinners.  Blood thinners do what?  Right!  They make the blood thinner.  Making the blood thinner makes it easier for the blood to flow into my brain and settle into my brain pan.  So, should we have the heart surgery now?  Or should we wait for the subdural hematoma to heal itself.  The lady or the tiger?  Which door should we open?  Cindy and Carl Darnell, very nice people from Oregon, send me a T-shirt that says “Growing Old Isn’t for Sissies.”  I am convinced that living itself is not for sissies.

We Reach a Conclusion

In a few days, we (what is this “we” stuff, I mean the doctors.  “We” is doctor and nurse speak usually meaning “you.”  “How are we this morning?  Did we sleep well?”  In this case, the “we” means about five doctors conferring with each other and maybe even having harsh words.) have come to some kind of agreement:  I will have the heart surgery and we will monitor the subdural hematoma.  You must, by now, have come to some kind of understanding of how long-suffering and special Susan is.  I would probably have walked out on me years earlier!

 More soon:  The surgery its ownself