Adventures with the Medical Trade (#17); a new day

Went down to the corner just to ease my pain / it was just to ease my pain. I got drunk and. I got sick and. I came home again.  Hmmm, probably belongs more in my Vietnam Blog. Anyway:

A cool morning.  I put the top down on the MX-5, attach my “handicapped” (politically insensitive name though it is!) placard to my rear view and drive quickly to Stone Oak and the START Center. [Aside:  yesterday, a wildfire shot through parts of Stone Oak, but missed the new medical center there.]  When I get to the Start Center, office to Doc Onc1 when he is not at Stone Oak Methodist Hospital, I carefully put the top back up on my little convertible.  Why?  Because, last week, I left it down at my gym/club where I work out and some evil SOB stole the, WTH, disabled(!) placard.

Why I have a disabled placard:  The brain cancer:  the docs do not want the balding top of my head, yeh though I wear a baseball cap, getting too much heat during this hot spell in San Antonio.

You need to realize that I am feeling really good, quite healthy, asymptomatic for lung and brain cancer.  I go to work every day, except for day 2 and 3 after chemo when I simply feel very tired, play golf on the weekends, do minimally tortured workouts at the gym:  squats, abs work (crunches which look nothing like the crunches done by those younger people who do jeans commercials and appear in Men’s Health when they get out of their teens and can no longer pose near naked for Calvin Klein ads) ("Am I getting old?" sang Maurice Chevalier.  "Oh no, not you" Hermione Gingold sings back, (Fierst person to guess the show gets a free copy of my new book, Into the Thicket (on your honor not to use Google)), 10-20 presses and curls, treadmill (30-40 minutes at 3.6 mph)—all while listening to my iPod or watching MSNBC on one of the televisions mounted above the treadmills.  In other words, except for two days that occur two days after the chemodrip, I feel perfectly normal, perhaps even better than normal since I am eating more healthy food and have settled down at approximately 180 pounds instead of shooting up and down.

So, here’s what happened today:

After putting the top back up on my car, I run up the flight of stairs to the START Center (showing off to myself, no one else is in the area) and sign in, pay my co-pay, sit for a few minutes.  A cute phlebotomist calls me back to the “triage area”—I don’t know why they call it a triage area: “triage,’” since M*A*S*H, has always meant sorting out patients into categories to more efficiently treat them (a Hotlips Houlihan innovation left up to the nurses, as I recall).  But, that’s what they call their blood lab.  I’ll call it that, too.

In Triage, they weigh me, then draw blood from my left arm.  They take my “vitals.”  Another strange term for temperature and blood pressure.  Then I sit in a second “on-call” waiting area and check email on my iPad.  Most of my friends are not terribly active in the mornings.  That doesn’t take much time.  So, I switch to the iReader and continue reading The Six Ages of Paris, a fine book about Paris and its development over the centuries.  I just got rid of Napoleon and am coming up on Louis Napoleon and the great architect Haussman who really made the Champs Elysees, the Louvre, the Place de la Concorde, the Touilerie and much of what we consider the “City of Lights” what it is today.  I digress?  So, I digress.

I get moved to the batter’s box, next up.  This small room is filled with cute little Hallmark card (not Allen Hallmark) sayings.  It’s like a twelve-step program minus the first steps and most of them do invoke God while the rest are merely inspiring.  I don’t mind.  Doc Onc1 must have one of the most depressing jobs in the world.  Some of the patients I see there are very young:  women in their 30s and 40s with breast cancer; children with bald heads; young men wondering “why me?”; and others.  If the health insurance death panels approved them for the quite expensive chemo treatments, that means they have a chance of making it.  Many of them will not.  How awful the job must be to tell even one of them that their treatments have ended and that, no, they are not cured.  I would have preferred having one of Sarah Palin’s fictional Government Death Panel’s tell me that than to hear it from a greedy corporation.

Damn, I seem to be drifting.  Perhaps because I did have chemo today.

Doc Onc1 comes into the little room with his primary nurse.  He calls up my CT and MRI scans on his computer, looks quickly (to remind himself) at the reports and then looks at me.  Believe me when I say this: I am, at this time, incredibly nervous, even anxious, sitting on the edge of a chair not meant to have its edge sat upon.  I suspect anyone would be the same.  These are the results from the first scans I have had in the nine to ten weeks since I had the cyberknife procedure and the first week of chemotherapy.  A long wait.

You know, yesterday and today, were the only days San Antonio’s temperature has been under 100 since I got back from Paris and started all this.  Apologies for all the French allusions today.  I know some people fail to appreciate the French or Paris ("Freedom Fries" were a symptom of that!) Another digression: sorry.  But it’s almost allegorical and a story could be made of the long, hot summer and my cancer.  I am not, personally, up to that.  This blog will have to do.

Okay, okay, here are the results:

The tumors are much smaller.  The one in the brain shows no sign of activity.  The lung cancer has diminished tremendously.  Something called “cancer markers” (some oncologists disregard these) are down from 200+ to 75- (these markers are backed up by the CT and MRI).  I will continue the chemo once every three weeks, probably for a long time.  Every nine weeks, I will have new MRIs and CTs (can’t afford to retire!!!!!!!!!!!) and we will revisit whether I should move to quarterly and them semi-annual chemotherapy.  Whatever, for safety, I will be on maintenance treatments of Alimpta, probably for the rest of my life.  The alternative is far worse.  Plus, I do get 90 days of paid faculty sick leave each year.

After seeing the doctor, I almost run down to the Treatment Center (chemotherapy treatments).  I sit in my recliner, a nurse attaches my arm to an IV, Alimpta and then Carboplatin drip down into my vein.  It’s not unpleasant, and who cares?, it seems to be working.

 
More before too long.  I see my urologist again in two weeks to discuss what all this means for my prostate.  Probably good since chemo affects all organs, indiscriminately, except for the brain.

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.