November 3, 2007: Again?

I went to the doctor on October sixteenth for a blood draw. That is always an experience. This time it was lucky Kathleen. She is 46 years old and experienced.

As always, that doesn't matter to me. I destroy them all. I told her where it doesn't work and that we often resort to my hands. She started with my right hand. My veins just don't pop-up. We had the talk about drinking a lot of water for at least twenty-four hours before the draw (I did) and double tourniquet, baby needles, butterflies and all of that. I hang my hand , I pump my fist and still no veins. She finally sees one that she will try behind the third finger of my right hand.

Drat! She could see it "just go turtle". Blood started to flow, but then the vein contracts and draws back. Well I have others.

She would like to try my right arm at the inside of the elbow. I told her that rarely works in spite of how prominent it looks. Kathleen put double tourniquets on my upper arm and gets another butterfly setup while my vein backs up with blood. Rather it should have been. Still it did look pretty good.

Kathleen looks for the direction the vein runs and lines up the needle. Slowly she pushes the needle in and there is a little burst of blood that just reaches the tube on the butterfly and quits. No amount of coaxing, pumping or wishing can get blood out of this turnip! At least not at this junction of the humerus with the ulna and radius.

She apologizes for putting me through this; I'll just have to wait until the doctor comes in. With tears welling in her eyes she says she ALWAYS get it by the second stick.

I told her, " The doctor won't do any better, if even as well as you. How often does the doctor draw blood? Let's just get another setup and find another one. I'm used to getting stuck four or five times. You'll just have to change that 'always' to usually."

She was real reluctant to keep sticking me. I assured her that it was no big deal to me. It is obviously much more traumatic to her than to me. We agreed we would just keep going until we got it done. She got another setup and looked on the left hand. She gave it a try but it was another dry hole. I encourage her to just poke it again. It actually got some in the vial but just a bit. She said it was only about two ml and not enough for the testing.

I offered my left bicep. There is a large vein running up the bicep toward the chest. Whew! That creeped her out.

"Oh, no! I could do that." she said. She made a face and turned her head. I guess there are somethings that just aren't done.

We put a bandage on sticks number three and four and went to my right hand again. I pointed out a couple on my fingers that had been used before. They are right on the knuckle of my index finger. They weren't real prominent and she couldn't tell which direction they ran. So while she referenced the veins of her hands and arms and looked for the corresponding vein on me we talked about how I used to get weak kneed and green on the first stick. But over the last few years I have grown accustomed to being stuck a lot. She found one on my thumb. It was excellent! Two vials full. To the very top. Just in case there was some other test they wanted to add on. The probem using the knuckles is that it stings the entire time.

I assured her this was not the worst I had endured. I expressed my thanks for her patience and effort. It's nice to get a half hour of time from someone in the medical profession.

I only had to wait a week to go to the urologist/surgeon/oncologist for my follow-up. The second three months has passed already! I am still cancer free! It seems anti-climatic after the effort of the blood draw. He said I'm perfect! Much to Sally's chagrin.

We talked about continued continence and function. All is well and the doctor said really early. So I guess I am a poster child for prostatectomy. Personally I think it is remarkable that they can do what they do; but ... It is not without it's problems. I still have issues with constipation and hemorrhoids I never had before. I have various abdominal pain every day.

Then I put ALL my experiences on the scale. The pains and problems post surgery weighed against the pains and problems of undiscovered or untreated prostate cancer are pretty insignificant.

He said there are no long term detrimental effects. The recovery is permanent. Once I regained contienence it won't go away. Dysfunction won't return as a result of the prostatectomy. Not having a prostate won't produce ill effects over time.

Another visist in three months, January! Then again in April! Then every April for four years.
If the results are all negative i will be considered cured.

August 28, 2007: As time goes by ...

Here it is, another month gone. April seems so far away. I feel just as guilty as ever; but I am looking forward to retirement in several months. This continued good luck just makes me anxious about the future.

None of us have any promises of a tomorrow. We are all given the ability to dream and hope that what we believe will come to be. I wonder how it is that I am so very lucky to have not suffered.

I think perhaps it is partly due to my belief and faith. Part due to just the way I am. I would have expected that I would have been shocked, angry and fearful. Since my heart attack I have been more emotional. Why not now? It just never occurred to me. It was as if I were told, "you have a wart and we are going to remove it."

My life is surreal. Things are so very different since the MI that I sometimes wonder if I died and this is the afterlife. I often don't feel connected to events in my life. I don't get concerned or worry about little things like I did before. Not even big things like I did before.

I suppose a large part of this is that I feel that I can't effect any change in the outcome of any event. I can't 'be' healthy. I can't change the situation at work. I can't change my personal life. I can't change my children's lives. I am really just an observer.

I'm riding this 'train' and don't need to waste my energies worrying about where it is going or where to turn. I just sit back, relax, look out the window and take-in the scenery. I don't interact with the environment, I just observe.

I wonder where the next station is. What awaits me at the next stop. Is there a next stop? I suppose at any moment the conductor can kick me off the train. Or the engineer could screw up and wreck the train. I just wonder ...

August 1, 2007: First Follow-up Results

Wow!! Three months already. I got to go talk to a cute 30 something young lady about my test results and "sex life".

In her words, "The PSA is perfect!" The continence is great! Really was early and has improved. The Viagra therapy is okay.

It can take months and months. Then she explained that the musculature heals pretty quickly. The Viagra will promote revascularization in a few months. Nerves can take a long time to recover. They suffered a pretty big insult. It is all attached to the prostate and had to be carefully separated before the prostate was removed. Even though they were very careful and had very good nerve sparing experience with me, nerves don't respond well to being disturbed. It was as if they really whacked my prostate 'funny bone' and it will take a lot of time for them to recover.

The good news was very outstanding, I thought. If this is my life, I can live with it. And what guy doesn't like the opportunity to talk to a cute 30 year old who really cares about his petty problems? And then I get to go home to my lovely lady who knows me like a book. Three great kids and their spouses and families all in the turmoil of busy, happy lives.

This is what makes the autumn bountiful! I am having a great harvest of what I sewed in the Spring of my youth and loved through the Summer of my life. I often wonder why I deserve such riches.

Another three months and I can do this again. Just to catch anything that might recur early.

July 30, 2007: First Follow-up

Well, we have been off-line for sometime now. We have been busy with the things of summer, family, vacation and of course friends.

Friends in need are friends in deed. Some have been having more than their share of problems, but we pray they see that they are healing and getting better everyday.

I took a trip for two weeks with my wife. We went 3,000 miles without a problem. The seed was a 50th Anniversary party for her uncle and aunt in South Carolina. The trip was planned for a week to get there and a week to come home. It had a few days of long drives and some sights we wanted to see along the trail.

We started with a long drive to southwest Missouri to see my sister and brother-in-law. It was just an over-night visit after a LONG drive. Next we went to Little Rock, Arkansas to see the William Jefferson Clinton Presidential Library and Museum. The building looks much better in life than I saw in the news. It has an amazing amount of information and is very well done.

We stayed the night and drove to Atlanta the next day. We toured the James Earl Carter, Jr. Center and Library. It covers his term and the center is dedicated to alleviating suffering, illness and oppression around the world after his presidency. He has done a lot of good works around the world. We also saw a lot of Atlanta. It is quite a metropolis in the south. Gray Line has a good tour option. We both can see the sights without traffic worries.

On to Savannah. We were told in Atlanta, "In Savannah, everything they talk about is the 'oldest' or the 'first'." They hit the nail on the head there. The citizens of Savannah are VERY proud of their city. Maybe more than they should be. I expected to see an OLD city of the south, one spared by Sherman, truly antebellum. It couldn't live up to the hype. It reminded me very much of Springfield, Illinois. Not in good repair and getting around was not easy. And it was 101 F but felt like 108F. Another Gray Line tour, in an open trolley, and on to Walterboro.

It too was a small southern town with most of the really nice places out of town in newer developments. The South Carolina Artisan and Craft Center is located in Walterboro. We just looked. There were some pieces I liked; but, I would have needed to buy the room, cases and surrounding works because they looked 'right in the context of the display'. They would not look right in my house. The party was very nice and it was fun to watch the folks interact.

Next stop Charleston or "Chalstun" as they say. Our tour guide was very entertaining. Will was a native who had left and been a bit of a way faring man before returning to settle in Charleston. We toured the city and out to Magnolia Plantation and Drayton Hall. This was not an antebellum plantation. It was destroyed , rebuilt , burned, rebuilt then expanded. The gardens were not as I expected but it was interesting to see the slave quarters the home and get a sense of the way of life there.

Next to Asheville, North Carolina to tour the Biltmore Estate. The sin of wealth! 125,000 acres! Forty some bedrooms! Thirty some bathrooms! Thirty staff when the Vanderbilts were NOT there. All built at the end of the 1800's. And still family owned! Not given or sold to the state. Just one of their homes. They had "The Breakers" in Connecticut and a "Cottage" on the Hudson. It took all day to tour and we only saw 60 rooms.

How much Tennessee looks like home after being in the Deep South. Just passing through to Kentucky. We were staying at Mammoth Cave lodge and had to drive from the Biltmore. The lodge is like stepping back in time to the sixties. The room had a real key with the green plastic fob with the room number stamped on it. The walls were paneled, there were swag lamps with painted glass cylinders for shades. The place was immaculate! It was a wonderful place to stay. The restaurant was in the same building and a short walk from the park's visitor center. We sat on our patio and watched the bats at sunset. The next morning we took a "old man" tour of the cavern. Not too many stairs and no narrow passages. It was hot and humid when we came out of the 54 degree cave.

Then a long day's drive home. The number of trucks on the highway is incredible! The economy must be flourishing. There is too much commerce for it not to be thriving. We went 3,000 miles with out an accident! Vehicular or biological. We saw a lot of rest areas across the country. Fortunately there was no Minnesota on this trip; every state had all the rest areas open.

When we arrived home I had an appointment to get blood work done for my first follow-up visit with my oncologist. As usual, it took two people and three needles and four sticks to get three little vials of blood. It's not easy, even for the pros, to draw blood from me. I was finally holding the vial on the end of the butterfly-needle while he used both hands to steady the needle and the vein. When he got a flush of blood I'd push the vial onto the outlet and watch it slowly fill. When it would stop he would have to pump the needle in and out to find the vein again. He apologized for blowing the vein but we got it. Now I wait until Wednesday to go get the results. I am hoping (and pretty confident) for a near zero PSA. That will be an 'all clear' for the first 90 days. Four years and nine months to go to a 'declaration' of cured.

I've had some pains. Occasional abdominal wall searing pains. And if I can't get to the toilet in time it gets real painful. I think I am sooo good at controlling the flow that the muscles start to spasm. When I do get to the bathroom I can barely get the flow going. Then I have to relax a few minutes and go again. It really is no big deal when one compares it to having cancer. I would bet if anyone who has cancer that is terminal were given the choice, they would take this in trade.

Well, I will be back with an update on the results soon.

June 23, 2007: Another Week Gone

This is how I get OLD; time just flies by. I have gotten much better health wise. I rarely have any leakage now and rarely have a twinge of pain. Even then it is not a sharp or searing pain; but more of a low grade achy pain.

The short term disability insurance company has finally received sufficient information to make a decision on my claim. I am covered through the 3rd of June and can return to work on the 4th. Since they made that decision, the FMLA unit of my company also decided that my time off is covered under FMLA. Any further incidents in the twelve month period will have to come out of the remaining 95 days of eligible time. Whoopee!

Now they just need to get the adjustment made to my earned time off. Lord knows how long it will take for them to give that back to me. That is just small stuff.

I am again getting used to the daily grind of working. The folks I work with are really very nice. They are also a lot of fun.

June 18, 2007: This seems to be whipped!

Boy do I feel too lucky. It seems that this thing is whipped already. I am afraid to think that.

IF IT IS, this has been one more lucky star, blessing, etc. It could be my personality flaw; but, I feel like this has not been a big deal. As bad as I felt from the start I feel good about it now. I'm almost guilt-ridden that I've had a result this good.

The continence has continued to improve. I don't 'weep' when I step to the side like getting out of the car or mow. I can sleep six hours now. I can hardly wait for my next PSA test. I am pretty confident that it will be a virtual '0'. But that is reinforcing evidence that I am cured. That will be August first.

Any man or for that matter any woman who knows a man should insist on an annual prostate exam as part of his physical. (She won't need one)

I have heard that there are tests for ovarian cancer very similar to the DRE that combined with a good history at her physical can detect it early. The history should include the following from the website, http://www.baymoon.com/~gyncancer/library/weekly/aa011001a.htm :

WARNING SYMPTOMS OF OVARIAN CANCER
Contact your MD if you develop one or more of these symptoms and they persist for 2-3 weeks:
-Abdominal Swelling/Bloating/Clothes Too Tight
-Abdominal/Pelvic Pain or Pressure or Feeling "Full"
-Gastrointestinal Symptoms (such as gas, indigestion, nausea, or changes in bowel movements)
-Vaginal Bleeding or Discharge
-Urinary Problems
-Urgency, Burning, or Spasms
-Fatigue and/or Fever
-Pain During Intercourse
-Back Pain
-Difficulty Breathing

Remember, the vast majority of the time, these will not be due to cancer, but you owe it to yourself to get them checked out.

What should you expect from your doctor at your appointment?
In addition to testing for other causes for your symptoms, your doctor should perform a pelvic examination, including the rectovaginal component. A prompt pelvic exam has been shown to be one of the best predictors of timely diagnosis. The other non-invasive tests used to detect ovarian cancer are the CA-125 blood test, and transvaginal ultrasound. These three tests together will alert the doctor to whether there is a danger of ovarian cancer.

I love all of you and hope you take care of yourselves.

June 07, 2007: End of Week One Back At Work

Well, I must say it has been pretty good this week. Monday was wading through over 1200 e-mail. That was a trip because I couldn't respond to any until I deleted or moved many of them. I was way over the 90K of storage I am allowed. I had 120K. The result is they don't allow you to send e-mail until you remedy the usage. That took most of the day.

Actually talking to folks took MOST of the day. I mean the e-mail work took most of my "work day". But then I came home to find a letter in my mail box from the FMLA Unit (Family Medical Leave Act) at my work. They stated that they sent me the forms on May 3rd and as of the May 28 they had not received them. I have 2 days after returning to work to submit the form or my time off may not be protected. That sounds pretty dire.

Of course the office is closed when I get home so I took the letter to work with me on Tuesday. The SECOND DAY I am back at work. I called the number listed and pressed option 7 as told to. "That don't work." They tell me I'm an idiot and to just stay on the line and a representative will be with me soon. It really was soon, only about two minutes. She asked for my identifying information like social security number and birth date and address and full name, etc. And then the pleasant, "How may I help you today?"

I explained that I had received the FMLA request form and the cover page stated that I can file it as soon as possible but no later than 15 days after returning to work. She said, "That's correct."

I proceeded to explain that Monday I received a letter from the FMLA Unit stating, correctly, that I had been sent the form on May 3rd and as of may 28 they had not been filed. That letter also stated that I must file within 2 DAYS of returning to work or I might not be protected. She said, "That's correct."

I started to get a little steamed and said I don't understand how both can be correct since they state two totally different times. Why do we have to always do illogical things? She said, "The government makes us say that."

I still don't know which government, federal or state, makes her say 'that'. Nor do I know whether 'that' is '2 days' or '15 days'. But I realized that she too is ignorant and unable to do anything about it, even if I could convince her that they BOTH cannot be correct.

So, I printed out another copy of the form sent to me via e-mail several weeks ago and left work early to take the new form to the doctors office in Barrington. The receptionist checked and there were no forms waiting for action so they must have been sent. I left the new copy and requested it be sent again. No wonder doctors used to charge per form to fill out for insurance.

That done, I had it downhill from there. I am starting to catch up on my work and recall what it is I do and how I do it. I don't know what I will put on my time sheet this week. But I will put something down.

June 2, 2007: A Good Week

I am just amazed that I have progressed so much. It has been a stellar week!

I am dry with the exception of sudden moves that cause me to step or lean to the side without thinking about those kegel contractions. Most of the time I make the moves automatically.

If something is falling over and I jump to catch it, I can have a bit of a problem. They call these stress incontinence. It may require a few months to control these. They are not heavy leakage, but more of what I call 'weeping'. It is just some dampness usually.

There has been another kind of stress this week also. Liberty Mutual Insurance (read as hired thugs) administers the short term disability claims for my employer. I have yet to experience administration on their part. They call and write me requesting I get the information for them to evaluate 'my claim'.

It started on the 9th of May when they sent me a letter stating that they contacted my doctor on the 9th of May and had not received the requested information from him. They proceeded to inform me that it is my responsibility to get that information for them. Seems that they should do their job and get what they need from my doctor. Oh well!

I went to Virden, Illinois on Friday. My sister's mother-in-law died this week and I thought we had to go the wake or funeral since my brother-in-law has been such a great guy. he did a lot for my mother. Sally had to work Saturday, which precluded our attending the funeral so I drove us down for the wake on Friday. Had a good visit and saw my mother's brother.

Bruce is going through the prostate treatment too. He is having the external beam radiation and hormone treatments. That's a shot every couple months and radiation five days a week for eight weeks. He is handling this real well. Gets tired but other wise feels fine. He has already had a PSA test that was .04. That is equivalent to zero but a lab won't say 'zero'. He and I talk regularly now. It is good to have someone to share this with. I think this is a pretty big coincidence that my uncle and I are both being treated for prostate cancer at the same time.

Wow! I'm still angry at the insurance company! Better let that go. At worst it will cost me a weeks pay and all my vacation time this year. I can't do anything until Monday anyway.

May 30, 2007: A Qualified Success!!

This was a milestone day! I had an appointment with my urologist/oncologist/surgeon. I had news for him.

I have worked diligently on my exercises. As I said last time, I can see some progress each day. I had only a spot on my pad when I showered on Monday. I decided to try a day without pads. I always was able to work under pressure. You know the "write the report the night before it was due" syndrome. It is common to all us procrastinators. I thought the pressure would keep me cognizant of my requirements. It worked! I was dry all day!

Tuesday I decided to push my luck and go another day. I was astounded again. So Wednesday morning I took a pad with me; but, I didn't wear one. We sat in the reception area for about a half hour. Then Barb called my name and Sally and I went to room two. We waited there about fifteen minutes.

Becky came in to update my chart with the usual. Same medications, how you doing? stuff. I told her of my leg pains and some blood in my stool, but that this is the third day I have gone without a pad. Becky was pretty excited and said she was going to put an exclamation mark in her notes. She said the doctor would be in since I hadn't really seen him since surgery and left the room.

It was just a few minutes until the doctor came in asking, "How are you?"

I said, "Better!" I'm cancer free and this is my third day without a pad. He was pretty amazed too. He had a big smile on his face and said how great this surgery is. We talked about my leg pain and he thinks it is probably back related, not related to my surgery. I thought as much. The blood is hemorrhoids. They should resolve themselves. I told him I had worked pretty hard on the exercises and was amazed that I could see daily improvement.

He asked if I'd had an erection yet. I would call it one. Doctor Goldrath asked if I thought I was capable of intercourse. I said no it wasn't that good. Maybe 60%. He said it is just one month today. That is very early! It is encouraging and will improve. To have this much function this early is very encouraging. All the nerves and muscles are inter-related. They take time after surgery to heal and resume normal senses.

There are some studies that show improved results when treated with a regimen of Viagra. The sooner it is started the better the results. He prescribed a quarter tablet everyday for six days and a whole tablet once a week. This promotes revascularization and enhanced blood flow. The instructions were difficult for the pharmacy to translate to their system for insurance billing. They came up with 10 tablets as a seventy day supply which cost me two co pays.

I came home to figure out what they were doing and to call the insurance company. It seems that they thought it was a quarter tablet daily upto 1 tablet per week. So that would be 1 tablet every 7 days so 10 tablets equals 70 days. The pharmacy wouldn't call the insurance, but they called the doctor for explanation. They then under stood .25 tablets each day for six days. (1.5 tablets) and 1 tablet on the seventh day. (2.5 tablets per week) Repeat. That is ten tablets for 28 days or four weeks. That is one (1) copay. Half price to me. That took four trips to the pharmacy and we didn't finish until 4 pm.

But who cares! I have made three days without leaking. I'm set to return to work Monday the 4th of June 2007. Cancer FREE!! And almost as important to me, with dignity and dry!

May 13 thru 26, 2007: The Work of Recovery

I certainly need to work on this continence thing constantly. It has improved daily. At first it was all I could do to limit the volume. Each passing day of exercise has reduced volume. But I can't count on eliminating leakage for any single action. I can almost hold it by clinching before I rise or sit; but, as soon as I relax there is a bit of leakage. Like all muscle contractions, I cannot maintain constant pressure indefinitely. Eventually the muscle gives out and leakage occurs.

Some times I start to feel discouraged. I feel like I will always leak. I will always wear pads. Worst of all I will always smell. I know me well enough to realize that I can't let myself become depressed. It is very hard for me to get up again if I let that happen. In this scenario I am not sure I will be able to get up if I let those feeling over take me. If I get down and don't conquer incontinence I would be better off dead.

The only thing to do is to maintain perspective. I may leak forever. Well, not forever but for the remainder of my life. However, the alternative to leaking was to suffer, actually SUFFER, a very long, slow, painful death. I can afford to change pads frequently to eliminate odor. I can do most things of life. I can't begin to control myself when I separate my knees for a side step, stumble, stairs, or standing. I can contract consciously, move and have just a little leakage. That is better than nothing. The pain is largely gone. Life is still pretty rich. There are possibly other procedures that can help with this now and maybe better solutions in the future.

This picks my spirit up it seems and I carry on. I can't give up on the exercises. I didn't walk the first weeks or months of my life either. I am determined not to be an embarrassment to my family or myself. I have to get to a point that I can return to work and not be so embarrassed that I can't function. We are not yet rich enough to live without income.

As I said, each day brings improvement. I can wear a single pad all day most days. If I am doing predictable things such as just rising, sitting, walking, etc. I can hold it. If I stumble and have to move quickly I forget to clinch and of course leak. If I walk on uneven ground like the garden center or yard I have some leakage. But I keep working on the exercises and hope for the best.

May 6 thru 12, 2007: Let the healing begin in earnest

Monday was a day I longed for. My visit to the doctor's office at which I will hopefully lose the catheter and the staples. I am certain the staples will be removed because when preparing to shower I take the bandages off and they are clean. No fluids or sticking! I am less sure of the catheter because the urine still has blood in it as evidenced by looking like Lancers Rose in a bag.

Too bad I have to wait until 2:30 for the appointment. But the time does come. I get back to the room with Sally in tow. I am instructed to strip from the waist down, sit on the table and and put the paper sheet over my lap. I have often wondered why medical personnel seem so shy when we both know they will again see all I have.

The physicians assistant, Becky Luekens, knocks and comes back in. She gives me a choice of first action. Do I want to do the catheter or the staples first? Since the catheter has been the most uncomfortable I choose to have that removed first. If that is Okay?

Becky assures me that it is and has me lie back on the table. She folds back the paper sheet and uses a syringe to remove the liquid that inflates the bulb and hold the catheter in place. She then instructs me to exhale as much as I can before breathing in slowly as she pulls it out. I think they have you exhale so you don't cry out as they start to remove it. She pulls and pulls; 'til her hand is over her head. It is about two feet long (the catheter). She inspects the end for clots and detritus. Everything is goodness. WOW! That feels much more comfortable already.

Although the educational part of the visit is that first urination may be accompanied by pain or burning sensation. I don't look forward to that. In the long run, I have no problems with it. I am even amazed that my 'hemorrhoids' improve so quickly.

The staple puller is a four and half inch gadget that looks like a cuticle nipper or little scissor implement. I have six incisions. Four in a row across my waistline between my hip bones. They are horizontal and about a half inch each. The farthest on my left has no staples. It was sutured and held the abdominal drain. The other three have just a couple staples each and one has three. Then I have a vertical incision from my umbilicus (bellybutton) down. It has six or eight staples. Then there is another incision at about ten o'clock from the pivot of my umbilicus that has two. Apparently the implement causes the legs to spread as it is pulled and there is no pain for most of them. There were only two that seemed to pinch as she lifted them.

Becky daubed glue on next to the incisions and let it dry, much like contact cement. She then place steri-strips across the incisions. This takes the strain off the newly formed scar tissue. Becky said they will probably fall off in a day or two and that is fine. They can even fall off later the same day and it isn't a problem unless I pull one open. But I was healing fine and that should be no problem. No lifting of anything more than ten pounds for another week or two and do nothing strenuous. Basically I need to take it easy and do nothing more that walk.

Becky is a sweetheart. She is tall, blond and absolutely under thirty. She seems to have good training and a very pleasant bedside manor. I am again astounded at how young so many very skilled people are in the professions. I again have hope for the human race. We are not a dying breed. There are many young, bright people to carry on after us. They don't all skate board and do drugs.

While at the desk making my next appointment, my room mate Jerry was signing in. Coincidence that it is Jerry was next in surgery after me and here he is next in having his catheter and staples removed. We exchange greetings and joy at having this part done with.

My incontinence is immediately apparent to me. Every move that increases abdominal pressure cause a warm spot that is far from my heart. Moving either leg independently causes a squirt. Sitting or standing cause one. Turning into the car seat causes one. Thank goodness (not God) for Serenity pads. This is going to require some work.

Becky said that boys don't learn about their kegel muscles for some reason. She explained that little girls do at an early age. It's like they just always knew. And then she looked at Sally as if for a supporting nod or something. Basically, I should practice interrupting the flow without clinching my gluteous maximus. That is the pubocoxygeal muscle, muscle that is targeted by kegel exercises. At first practice in the mirror to see that the pelvis is not being tipped or thrust forward and the glutes are not being clinched. If done correctly there should be no visible evidence that I am contracting them. Contract them and hold for a five count. Do this five or six times. Repeat the set every hour or so. Over time this will strengthen the pc muscle and impact continence. We should all be doing these whether we had surgery or not. It is a part of continued good health.

May 5, 2007: Friends

Saturday evening and great friends are unbeatable. They brought everything for dinner; Italian beef, salads, etc. It could have been bologna as far as I was concerned. It was the nourishment of my spirit and hope that was most welcome.

The support from friends is incredibly healing. I had to get around before they arrived about 5:30, to get my shower and try some slacks. I have a pair of trail pants that the lower leg zips off. That was pretty good to accommodate the bag. I was up and down. Sit, stand, trips to the head, eat my dinner. It worked pretty well.

The only problems I had was a little bypass leakage and some pain. I can't seem to avoid either. I called the doctors office and was told that happens. I was foolish in wearing slacks that required a belt. The belt put a bind around my abdomen that at one point felt as if I was tearing something as I sat down. In my present condition I was in free-fall when I went to sit. That painful.

We talked and shared. I can't say enough about how good this has gone. I had not suffered with cancer! I had no symptoms. I was lucky enough to be regular about my annual physicals since my heart attack five years ago this month. The following year I had my first physical including PSA, DRE, colonoscopy.

Everything was good. The colonoscopy discovered a pre-cancerous polyp and a couple of routine polyps. They were removed and I needed to return in three years. Don't skip a colonoscopy! That is one screening test that can cure or prevent cancer. Snip and its gone.

The following year I had an elevated PSA. It was repeated and still elevated. That was my first encounter with Dr. Goldrath. I went through the history and examination with very little embarrassment. But I had to schedule a TRUS (Trans-Rectal Ultrasound Scan) and needle biopsy. Prep is similar to that for a colonoscopy. While lying on my side, the probe (about like a curling iron) is inserted and the image is viewed for evaluation. The doctor prints some images for my file and uses the view to guide the placement of the biopsy; a spring loaded needle jabs rapidly to collect a core. The needle is about an eighth of an inch wide and two inches long. They are so fast that there is virtually no pain. Especially when one considers that this is fighting cancer (maybe).

This was May, two years ago. My daughters wedding was just days before. I felt lucky; there was no cancer! It probably was something else like prostatitis.

That July I was diagnosed with Diabetes Type II. Oh well, I can live with that. It was certainly better that cancer!

And through it all, I have had great friends and family supporting me. Even though I let them down. I was the bad guy who smoked, who didn't take care of myself, who seemed to beat the odds. Now it was all catching up to me.

At my November physical I started with one thing and another. But over all I had no additional blockage in my coronary arteries. They did a Bilateral Carotid Doppler Ultrasound to check for blockage. That was good. No eminent stroke. Repeat the colonoscopy, a couple more polyps. And this oops. I sometimes find it hard to believe that I have battled three major killers and am still on top.

I have my scars. Figuratively as well as literally. I can't do what I could five years ago. On the other hand, I can do something I couldn't a month ago. I can get away with peeing my pants a tad. But, when I think of how this might have gone without the heart attack I am astounded.

I know that I wouldn't be getting physicals regularly. I had made an appointment and went in just because I was fifty and thought I ought to get a baseline. The doctor took a history and asked about complaints. I had a history; but, I had no complaint other that being over weight.

He listened to my lungs and heart, ordered no tests, suggested that I walk to lose some weight. I am pretty sure that due to my disappointment with that experience, I would not have gone again. I would have had colon cancer developing and it would probably have killed me before I knew that I had adenocarcenoma of the prostate.

This all adds up to being truly blessed. I have had really great luck and great friends.
Morning's at seven; The hill-side's dew-pearled; The lark's on the wing; The snail's on the thorn; God's in his Heaven - All's right with the world!

May 2, 2007: And the next few days

The drive home was like reading the seams of the highway via a stylus in my penis. Every stone and ripple seemed to be read by sensitive parts in the nether regions and telegraphed to each incision, stitch and staple holding me together.

By the time we got home I was ready to go to bed. I needed to figure out the logistics of going to bed with a catheter and bag that home beds just are not designed to accommodate. For that matter clothing is not practical either. Those awful hospital gowns are really well designed for their purpose. Lacking that, I have to settle for just the tee shirt and a foot of adhesive tape.

Tape placement becomes paramount over the next few days. The catheter can't be taped to the entry point. If it is taped anywhere else, the length is fixed but doesn't correlate to the foci of a flexing body. As the body bends the tube slides in to poke and the tube slides out to pull. All sense seems concentrated on a recently reconstructed bladder to urethra connection. Over the following week this would prove to be a major discomfort. It also caused major hemorrhoids. I looked up the anatomy and all systems seem pretty closely associated in the region. At least I can understand how they are all involved in the recovery.

On the brighter side of the pains and constant awareness I realize the skill of the surgeons in sparing the nerves in the area. I take this as a good sign for latter recovery of control. I will probably be able to pass remedial potty training 101.

Bowel movements are effected for five or six days by what I was given in the hospital . They were a dark green, viscous matter that lay in the water like a cold lava lamp. No matter what I ate, it was always what I thought BILE would look like. It was also probably the result of the erythromycin and neomycin changing the bacterial content of my system. Eliminating most if not all bacteria. The effect was much appreciated in my condition. There was absolutely no straining allowed or needed.

The pain was so intense getting into bed, that once I sat, I couldn't reposition myself at all. Sally had no more idea how to get me in the bed than I had. We were able to set me pretty well. Lying down was not good. Any leaning required me to use core muscles and they burned like hell; but I was afraid to take that leap of faith and just fall over to my side. Once on my side I couldn't lift my butt or shoulders to get further into the bed. I lay clinging to the whipcord trimmed edge to keep from falling out of bed, perched like a fledgling on twig, holding desperately to the thin branch of trim. What a night! Perhaps I should have stayed in the hospital.

After a few years of a nightly trip to the head interrupting a good nights sleep, I thought I would be able to sleep eight to ten hours straight as no pressure would build in my bladder and no people padding around to check things. Sleeping is no more possible at home than it was prior to the surgery or in the hospital. After a very few hours my hip and knees and shoulder were extremely painful without my Aleve for a week and my mobility to roll on to my other side. The hose is just long enough to lay on the one side, stretch out under the cover to the bag, which we hung on the low drawer of a small game cabinet placed by my bed side. A longer hose would help that, I think.

I wasn't feeling like a party; but Sally wanted the kids over on Wednesday evening. It went pretty good. Sally bought me a very nice robe and I was getting better by the hour. I learned to maneuver in and out of a chair and to the bathroom. The home toilet is much lower than the hospital version. The trick to sitting and rising on my own is to be able to position my feet under my center of gravity. That changes the muscles used to rise from the core of my body to the strength of my legs and arms. I was also starting to feel pretty well past my prime for bathing; but, I couldn't bath 'til Thursday.

May 1, 2007: Release!

The morning started with Harry, my day nurse, on duty from 7 to 7. He was a nice guy. My breakfast came as clear liquids, broth, gelatin, juice. Harry was right on top of it. He called the 'kitchen' told them to send a general diet tray up as per doctor's orders. So I had more than one breakfast. The food was pretty good.

Harry was just getting on my 'good side'. He came back later in the morning to get me out of bed. WOW! That was not good. First off when he moved the bag to the base of the IV pump he pulled my hose. That was a panic situation. I wasn't sure what would come off! I told him not to pull that. It wasn't taped down.

That was just the tip of the iceberg so to speak. When Harry took my hand and tried to pull me up I thought I was going to rip in two. It was all that both of us could do to sit me up on the edge of the bed. It felt like the row of incisions (my perforation line) wasn't going to stay together.

After a short rest for Harry and me, I stood up and held onto the IV pump to take a short walk. Out the door and down the hall to the left. Only about twenty feet then a right, another twenty-five feet to the parallel hall, another right and twenty feet back to the cross-over and straight into my Stepdown 2 bed. That was slow, but I was moving on my own power. And at the end of the walk, my arms were tired from supporting myself on the pole of the IV pump. Harry sat me in a chair in my room.

At least the next trip didn't require me to get out of bed. But it was still not possible to sit forward in the chair to get up. I had not been hooked up to the oxygen when I returned from the first walk; but, my O2 saturation was up at 99%. Now that my gut was rumbling, I needed help getting up and into the bathroom. I had no idea what to expect. But I had to take my third of the bathroom time. My room mate Jerry had already made a couple trips. The little old lady went everywhere. I had to get on the board. The things that I get competitive about!

I ordered lunch. It was a decent tuna salad sandwich. It punctuated my day. I was looking forward to the doctors visit to release us about 2 pm. So after lunch Harry got me unhooked from the monitor and out of the chair so I could walk again. This time we went down two blocks then over and back. I felt I had to do it faster than last time. In my mind Harry was charting my liquid intake and output, bathroom trips, and activity. I wanted to be sure that I was showing progress so the doctor would discharge me.

Jerry was really disappointed when they told us the doctor was tied up in surgery 'til two-thirty. I was kind of glad. I thought if the doctor came now I wasn't strong enough to be discharged. I needed more time to get more points on the board. I needed another trip to the head and another walk before he came up.

I finally had some measure of success with body functions and the third walk was left three blocks and back four blocks then to my chair. That was good. I was on a faster pace and went double the distance of my last walk. Harry pointed out his children on an employee bulletin board. They were cute kids just about school age. Harry was still in vacation mode. This was his first day after four weeks in the Philippines visiting family.

Now word is that the doctors are in surgery until 4 or 4:30. Jerry was upset and I was only a little less agitated. Jerry was having pain with his catheter; so he had his wife ask if I was experiencing pinching every time I moved. We compared notes and he was definitely having an issue that I didn't have. So he called his nurse and she checked it out and lubricated the tube. He was apparently experiencing the first signs of irritation and infection. The Bacitracin should help that. I heard her saying to make sure we put that on twice a day.

Jerry was finally ordering something to eat. I was skipping it because I was sure that I was being released soon. Even though it was after five, I was sure I was getting released today. Well, kinda sure. Now word was that they were in another surgery and would be up about seven o'clock. Sure, we've heard that before. Jerry was fit to be tied and I wasn't far behind him. Surely they could take a break between surgeries to come up and discharge us.

The hospital needed our beds since about two thirty. They had people coming out of surgery and needed to put them in monitored beds. We were past needing monitors but they had no where to move us to. They didn't want to put us in another room and then discharge us but we didn't want to be put in the hall. Good thing we didn't move to a hall; since they kept us another five hours and we would not have had nurse assignments or facilities to use.

About seven thirty, doctors Goldrath and Troy were talking to Jerry. Checking his chart and writing his orders. Giving him his directions and talking to his wife. He thought I was progressing faster and better than he and I thought Jerry was doing better than I.

Then Doctor Troy came to my bed followed by Doctor Goldrath. Sally asked him if they sold movies of the operation. She told them I had wanted to stay awake to watch because I was so fascinated by the robotic surgery. He said in fact they had a DVD that I get now. But then they had to find it. They left it in Jerry's area. We talked about my expectations in the coming week and to come to the office in one week to get the staples removed and the catheter. I felt pretty smug that I had an appointment already made for next Monday.

Doctor Troy checked the drain in my side and the drainage was slowed considerably. I'm pretty sure if he had looked at two o'clock I would have gone home with it in place. Harry had been emptying about a half cup, then a third of a cup, then a quarter cup, about every two hours. Now it only had a tablespoon or so. Doc clipped a stitch that tied it in and said, "Exhale and then slowly breathe in while I pull it out."

That was NOT pleasant! That was like a perforated drain tile a little over a foot long and was uncomfortable out almost as much as it was in. I guess he has you exhale before he pulls it out so you can't yell. That burned like fire and pulled my gut as it was coming out slowly. He tugged on the suture and put a dressing over it. I got my directions for the week. Don't bathe before Thursday. Resume medications immediately but no NSAIDs until after the office visit. We need to not start bleeding. Lift nothing over ten pounds, no driving, no chores, etc. Basically I can walk as much as I can tolerate and practice control. Stop mid-stream and hold it for a minute.

Harry worked an hour overtime to get me discharged just because he had started the day with me and wanted to see it through. He was really a very good nurse. All of the nurses were generous, courteous and good at their job. The techs were also very helpful. All things being even I'm still VERY glad to be going home.

April 30, 2007: OH MY GOD.

What? No recovery room?

I thought one always went to a recovery room and some beauty would stroke the brow and spoon ice chips in and shush softly.

Wrong! I missed that part. I first remember prying my eyelids up from the inside to see a dimly lit room with Cheri pulling a curtain across the foot of my bed saying, "Well, he's back with us now." At least that is what I remember.

Ah, there is my beauty. Sally was right there with the ice chips. I think it was between two and three in the afternoon of the thirtieth. It didn't matter to me. I felt like crap. I couldn't move; I must weight a thousand pounds! I am really, really, really tired. I'm going back to sleep.

I don't even know if I went to sleep. I was sooo out of it. I wasn't experiencing nausea. I was steadily come back to this world. And I was beginning to feel. Feel what? Ohhh. Don't ask. Just feel is enough.

I must have been drug through Hell. Somewhere in the process I either caught fire or was scratched up cause they smeared me with gel all over. It was in my eyes, in my ears, in my nose, in my hair, in my ... Let's just say in every orifice and some places in between. I thought that stuff was just put in your eyes to keep them moist. Apparently they used it to caulk around the cannula in my nose for oxygen (keep it up at 8!) and to keep my brain from falling out my ears. Hey! Some of the holes are new!

I think they use that silicone caulk so they can blow you up with a gas to about 90 psi. They continue to ask if I have gas or had gas. They know damn well they pumped me full of it. I am now a part of the National Strategic Reserve System. It was really so they could see during the operation.

And another thing. Is there no way they learn to settle someone in a bed? They pull flesh in every unusual direction and then lay me on top of it. As the feeling comes I begin to realize this just ain't right. But I can't move myself. I don't know if I am that weak or if it hurts too much.
It was hours before I understood that this pain wasn't from the surgery directly, but just because I was lying strangely in bed.

Sally kept filling me with ice chips and giving me sips of water like it was going to make me well. I don't remember if she fed me "dinner". I think it was clear liquids around 7 pm. The nurse kept looking for my heart in my stomach. She said it was all quiet. And I could have told her there was nothing going on down there. She said to be mindful that my bowel was put to sleep too. If nothing is happening there and we put too much in I will be nauseous and that is NOT good. The way my stomach hurts, I believe it would kill me to cough or vomit.

The old lady in bed three had a party. They mostly argued or conjured images in my head that made me wand to poke out my minds eye. Jerry, in bed one, had a party too. Wife, kids, who knows. They stepped in and asked if they could have the chairs in my area. I said, "Sure, as long as we can have it back for my party." I wasn't having a party. I didn't want the kids to come up or Sally's folks. There was nothing they could do and I knew I wasn't presentable. "Leave me alone; I'm fighting cancer!"

Sally couldn't stay in the room for the night because of the privacy rights of other patients. I guess privacy is guaranteed at night but not during the day. So the nurse got her a blanket and pillow and showed her the lounge. It was full of people so she got to come back for a while. I was glad to have her looking out for me. I am always concerned not having an advocate with the patient. And Sally is a great advocate.

Since both Sally and the nurse were there I thought I would remedy my problem. I couldn't stand it any longer. I asked the nurse if she thought that she and Sally could pull my sheets enough to roll me back and forth a couple times to relieve the pressure on my flesh. She assured me that she would do it but would go get a helper. She didn't want Sally to hurt herself.

Ah. That feels better. I can sleep the night now.

Well, technically I could if I were allowed to sleep. They come in and empty the Foley bag. They give me a shot of fire in my belly (that's heparin to prevent clotting). They check my breathing. The oxygen is still up around six litres per hour. My throat is so sore. The nurse listens to my stomach. It was just starting to come back. It was percolating. She also noted that the monitor kept going off because my respiration was six per minute; but, my O2 level was 100%. At one point while the nurse listened to my gut she looked at the monitors. Well your oxygen is at 100% and your respiration is back up around 12 but your heart stopped. I had rested my hands on my chest because I didn't want to put pressure on my stomach. That messed up a lead. Moved my and and voila! My heart was beating again.

It was a wonderful room on the fourth floor with a wall of windows facing East. I watched the dawn and eventual sunrise. To my right was a fellow who had followed me in the prostatectomy line. I felt like Jerry was recovering faster and better than me. Past the foot of my bed was an older woman who had bowel surgery a week before and was anxious to eat food. But she couldn't have food until her bowel was active again. That was entertaining conversation.

April 30, 2007: It's Show Time!

The day I have both dreaded and looked forward to is finally here. God, I hope I have made the right decision. 'What if...' is not an option now, the tiller is lashed, the sails are set, come Hell or high seas we are bound.

I had started the "bowl" lavage Sunday noon. Four litres of 'GoLytely' over the course of six hours and numerous visits to the head had proven very effective. On a less than musical note, my last 'movement' was 2:30 am. I can't sleep well so I get up at 4:30 or so. Take what may be my last pee in my control and shower and shave. Ironic to say I shaved, since I have a full beard and mustache.

I roust Sally and she finishes her preparation for the day right on time. She doesn't eat yet because I can't. I wonder if she will quit peeing too.

We arrive at the hospital at five minutes before 7 am. I always like to be a little early. We got the closest parking spot in the 'Day Surgery' line and stop at the information desk. Sally gets her visitor pass and I'm on 'the list'. The guards direct us toward the area.

There is no one on the Day Surgery desk yet but directions on the wall instruct us to hit the button and enter. We advance and meet help inside. The 'hostess' escorts us to '3' and gives simple instructions to strip and put on the gown with the opening in back. Sally can have a seat in the chair and I on the gurney. I figure as long as there is a restroom right next to '3' I should avail myself of the facilities. Never pass an opportunity to use the facilities! Beside, I may not be able to for a long while or ever again.

It wasn't long before one of our servers arrives to take a history. She was a lovely lady in the prime of her life lets say. Old enough to have compassion for people at a dicey time in their lives. We covered what medications I am taking now. What does that mean? I was taking those listed when I called for pre-registration last Monday. Since then I have not taken any of those on the list; but, I have started taking Erythromycin and 'Neomycin' antibiotics.

She is stunned that I am not taking any meds for my heart or blood pressure. So I told her the tale of who had told me what not to take and why at each juncture, the surgeons scheduler, the surgeons nurse, the hospital pre-registrar, my primary care physician and the pharmacist. She said that was too confusing and agreed I wouldn't know what to do.

She explained the process we would go through today and that I get prepped, socked and booted. All that before I get cut. Sound too violent to me. I received, at no additional charge, a pair of shorty tube socks with little gripper treads on top and bottom. I don't know if that is so I can't put them on wrong or if it is so I can hang over the curtain rod by my toes. So I tried to put them on wrong and was equally comfortable with the treads running up both SIDES of my feet as I was with them bunching in front of my ankles.

Fortunately we didn't have a lot of traffic past my station, since '3' was pretty well the end of the line. Those gowns are nice for airing out ones business. When she came back to put my boots on she also gave me a blanket. That was the last time anyone could see what I pack. From now on they have to be looking on purpose.

The boots are lower leg wraps that are pumped up about four time a minute. They expand at the ankle and it spirals toward the knee. This forces the blood into the deep veins and prevents blood pooling in the legs causing a Deep Vein Thrombosis. DVT is what killed Bloom, the NBC reporter, in Iraq a couple years ago. A clot can break off and course through your circulatory system to some place that is devastating (like your brain, lung or heat). At first I thought the boots would be annoying. But by the time I came out of surgery they were very nice. I thought she looked very sweet and gave a terrific massage.

Then a nice lady came by and gave me a two bit hair cut. She reminded me of Eartha Kit with a clipper. She lay a pillow case beside me and tuck slightly under. she would run the clippers toward her and softly brush my stomach to that side. She switched to the other side and repeated the process. When she finished she rolled the pillowcases up and to hair and all to the laundry.

My in-laws showed up. Although we told them not to bother, they had to do something to show support. In just minutes it would not be a problem for me cause I'll be out of it all.

Doctor Toth and the surgical nurse came by to talk a bit about meds and history and the procedure I was expecting. We all seemed to be on the same page. The little nurse unlocked my ride and strained to push this overloaded cart toward the OR. She could have used the 100 pounds I could afford to give her. It would have made our masses closer to equal. She just kept saying, "Keep your hands inside the cart, please." It was like riding on a bumper boat. I had the urge to fend off. But to her credit, as close as we'd come, she never touched a wall, cart or piece of equipment.

The OR looks like a storage room! Big piles of junk covered with a sheet. Several of them. Looks like brooms or mops sticking up under the throws. All but the patient cart.

It was long and narrow. It looks about eight feet long and fifteen inches wide. In the middle is a red pad that looks like it is made from sorbothane. You know those gel shoe inserts that are kind of squishy. She wheeled the gurney up beside it and leveled them. "Slide your self over to the table, please. And use your hand to feel the other side. It's narrow and we don't want you to fall off the other side. Then pull your gown out from under yourself.", she said. Let me tell you, I covered that baby. When I pulled out my gown ... DAMN that's colder than a well diggers ass.

Then Dr. Toth came in and leaned over to tell me that they would have to stick me a couple times for the drugs they would administer during surgery but not to worry because I'll be out before that. He starts to look over my arms and is impressed by my right arm and the fine vein there. (here we go again)

I explained, "DON'T touch that one! Every fool falls for that, but it is not worth a shit." Sound familiar?

That's the last thing I remember. I don't recall the surgeons coming in. I don't remember the machines being uncovered. I don't remember them even asking me to count backwards.

April 29, 2007: The Great Fast

Sundays are usually our big breakfast day. Sally and I will have a breakfast meat and eggs, potato, biscuits and gravy, juices and coffee. This is one of two Sunday meals. But I am on a clear liquid diet this Sunday. Cranberry juice, apple juice, water. all day.

After the first few hours i am not really hungry. Somehow the body gives up hope of being fed. I am also off ALL medicine since Tuesday the seventeenth. That was one of the questions for the doctor. I hoped he could sort out which I continue and which are discontinued. When I picked up the pre-meds at the pharmacy they had gone over more that I could not take. For example Erythromycin and Lipitor combine to cause deafness. Holy crap! I was only left with Altace so I quit that too.

I feel bad for Sally, she is trying to not eat in front of me. I told her it doesn't matter to me but there is no dissuading her. She ran the store Sunday afternoon and stopped to get herself a meal. She shouldn't feel bad about doing that; I'm glad she ate. Tomorrow is looming on the near horizon.

What does that mean? Isn't there only one horizon?

April 20, 2007

The pre-admission physical is required by the hospital and no procedure will take place if it isn't done. Or so I was told by the scheduler. I dutifully scheduled it for April twenty, exactly ten days before the procedure just as I was told was the perfect timing.
We waited for a short while to get in. A man I had never before seen came to the waiting room in blue jeans, sneakers and a button down.

"Greg?", he asked rather tentatively.

I rose and walked toward him. Sally was right behind me. She comes along schlepping my note pad and documents and our new digital voice recorder. I always kid her about wanting to be there the minute they say anything that might let her file the life insurance claim. Anything to speed that process along. She knows I'm only kidding her. It's her way of showing that she cares.

As we walk down the hall to a patient room, he explains that he is Doctor Harris. He just comes in to keep them in line. He was head of some department at Condell Hospital until three years ago when he had some seizure malady, brain surgery, etc. He doesn't practice medicine but has kept his license up and just helps out around the office.

This is okay by me. He had some misfortune (like I don't) and they are taking care of him by letting him work up to his abilities. I see that as nice. He takes my blood pressure and updates my medicine list and leaves us for the doctor.

Kathy comes in with an EKG machine and a fist full of leads. He helps her hook me up to the twelve lead EKG and get a strip run. Sally and I sit and talk while waiting for the doctor. Sally has a list of questions we have for the doctor.

Doc comes in, sits down and starts to read my chart. Which is huge after five years of my history. He is apparently reading for the first time many of the test results and says nothing. Line by line following the text and occasionally underlining phrases. Like we did when we highlighted in school. He asked haltingly, "Did ... you ... maybe have ... just below... your... knee... on the left...some... damage?

I said, "Yes. I fell down a flight of stairs when I was a kid. They called it a 'green stick break'."

"That would explain that. We need some blood drawn, go with doctor Harris." And I followed to the lab room just down the hall.

He started on the left arm and asked if that was where they usually drew from. I said no that has not worked for many years. They usually get it from my right forearm or hands. He moved around to my right and said, "Oh yea! That looks good."

I quickly informed him that what he saw was really like a rubber band stretched through my arm. I know it looks good; but it isn't worth a shit. Even I would think that I could get blood there; but that well is dry. He insisted that he was the MASTER and could get blood where no others could. He taught others to draw blood.

So I watched as he pricked my arm and proceeded to slide it in and out. Maybe a little higher angle. No, maybe if he held it from from the side so it wouldn't roll. No, maybe if he pushed a little further in. DAMN that 1 1/2 inch needle is just too short. Oh well just push harder.

He had the needle in all the way and the syringe was pushing in a big dimple. Finally, blood! Glorious blood. He had to pump the little vial to draw any. The flow was almost imperceptible. Ever so slowly we got about half of each of three vials in ten minutes. Of course there was also blood coming out around the syringe too. That blood has been exposed to air and is contaminated. We can't suck that up to inject in the vials.

I went back to the patient room and Sally was still waiting for me. I asked if she had asked the doctor about our questions; but he had not come back after I left the room. Kathy came by and said she thought we were done; she would ask doctor. He had moved on and was a with another patient we were free to go. Kathy gave me a big hug and wished us good luck.

April 9, 2007: The Longest Week

Well it has been a long wait for action to start. I tested on April fourth and won't get results until I go to my primary care physician on the twentieth for a pre-admission physical.

The hospital requires that I be healthy enough to be admitted? They are rather persnickety. The physical should be ten days before the planned procedure. That is close enough to be relevant. Too many things can change if it were twelve days, for example. Ten days allows time for additional lab results to return and be evaluated. I suppose if I were not healthy enough they would have to give me a death sentence by slow torture. I don't want to even ask about the possibilities. Why should that surprise us? After all, we have to prove to a financial institution that we have money before they will lend to us.

It isn't as though I am sitting around with nothing to do. I am going to work every day. Well, I show up most days. I haven't mentioned before how great my boss has been about this. She has not assigned any additional projects and allows me to go any time I need to for appointments. She has made this a lot less stressful than it could be. I have great co-workers who are taking over my projects when I leave. (one more stroke of good luck in my life)

I have had a couple strange phone calls to make. I had to call the urologists scheduler to set a date. The conversation, like most calls for an appointment, starts with, "When would you like to do the procedure?" No suggested available dates? Should I know what lead time is?

I suggest, "A couple weeks?"

And she sets me straight, "The doctors are famous for this da Vinci operation and people come from all over the country to have it done. We couldn't hope to have it done before middle of May. There is a possibility of April thirtieth if Dr. Troy changes his schedule. He is supposed to go out of town but may not go."

Well that changed my perspective and I kindly asked for the first available slot in mid May. I really don't want to wait that long.

I also took note of how important her role is to me. She has to work with her two doctor's schedules and the hospital schedule for the da Vinci surgical robot. And the only days they can use the robot are every Monday and the first, third and fifth Tuesday. She recited the rules to me about only clear liquids the day before. That would be water, apple juice, cranberry juice, NO orange juice or tomato juice because they aren't clear you see. And no caffeine, no carbonated drinks and no dairy. She will of course detail all this in a letter to me confirming my appointment. These rule must be very important because we covered them more than once in the conversation.

I should also stop taking my medications the week before, that are not for my heart . (You know the MI that was the first stroke of luck) Stop synthroid, Folbic, nuproxen, aspirin, Metformin, all herbals and supplements, Lipitor, zetia, tricor. Only take my Toprol XL, for heart rate, and Altace, for blood pressure. I don't want these in my system at the time of the procedure because they will react with what they need to administer then. This too will all be in the letter.

I commiserated with her on the difficulty of her role and thanked her profusely. Hoping for preferential treatment her lady. Please don't sentence me to death!

April 4, 2007: Testing

Ready for my close-up, Mr. DeMille ...

Well I am way behind in keeping this updated. But, here goes the flood of events.
Sally and I started on April 4th at 6:00 am in Lake Zurich, I was at the High Tech Medical Imaging office for a body scan. They injected 25.4 mCi of Tc-99 MDP (another flavor of glow-in-the-dark crap). And we waited two hours for it to be taken up in my skeleton. It should show up on the scan in areas of unusual celluar activity. The staff was nice; but, as always with me, they had some challenge getting a vein for the injection. When my turn came I lay on a table about 12 to 14 inches wide with my arms over my head and waited as the machine passed over me, humming monotonously, for twenty-five minutes.
End of test 1; go dress and leave for the next imaging center.
We had some time bfore we were due at Bright Light Radiology in Elk Grove Village so Sally and I went shopping at a Staples. We wanted to get a digital voice recorder so we could get everything the doctors would be saying to us. We skipped lunch because we weren't sure that we could be done in time for my appointment.
Once at Bright Light, about 1:00 pm they took me in and did a front and side Chest x-ray or Chest PAL. I returned to the lobby to wait further directions.
A nice young lady came out with a big plasic cup of water for me. Sally didn't get any. The young lady directed me to drink it and informed me that I would receive another 16 oz. every 30 minutes. Nice of them to keep me hydrated.
I was actually ingesting some kind of contrast agent that need to fill my bowel. It wasn't 'horrible', more like a bicarb. But drinking a half gallon was a bit much.
They took me back about 3:00 pm and tried to find a vein. I felt so sorry for the girl. She was very frustrated and so apologetic for sticking me six times.
I told her, "It's not you. It's just me. You can't help the way I am."
She went to get the doctor to do it. I know one should NEVER profer a guess at a lady's age; but, she was about my age. We had a nice conversation while she tried to find new ground to stick. And more than stick, she needed a big, good vein that could take 3 ml per second of the die.
I learned that she has a husband my age who also had a heart attack. She can't keep him on his diet or exercise. Amid the many appologies she did get a vein in my right forearm and I was set for my abdominal and pelvic CT scan. This is where I find out if my older sister is crazy or not; but more on that latter.
A scan before the injection takes about 1 minute while I hold my breath. Then the girl comes in and holds my hand while the machine pumps me up. Actually she was there to verify that the 100 cc of Isoview370 IV was going IV and not subcutaneously. The idea was to get the contrast agent into the abdomen not my arm.
Wait five minutes and through the imaging machine again holding my breath.
The tech checked the images and said they were good. I could get dressed.
So we left about 4:00 pm.
Sally was so kind that she didn't eat because I couldn't eat. So we decided to go out for dinner and enjoy ourselves. Now we wait for the results.

April 3, 2007: A visit with Doctor

We did talk to another doctor who consulted with an oncologist and they agree the da Vinci procedure is an excellent option. I am scheduled for a chest x-ray, bone scan and pelvic CT scan Wednesday 4/4. These are precautionary to verify that I have no other cancer and this one has not escaped the prostate. There will be some additional blood tests, EKG, etc. and then into surgery either April 30 or May 14.