Thursday, September 29, 2011

It Might Get Messy

You know that scene in Johnny Mnemonic when J-Bone introduces Jones-the-hacker-dolphin saying “the Navy got him wired up for hard encryption”? Well, Dr. H got me wired up for bodily fluids. I got two drains “out” and one drain “in”. Oh, and when I woke up from the anesthesia, I was catheterized. And I’m thinking, “what the hell?!”


But let’s not start there. Let’s start with the overnight technician. In the GBMC hospital, the nurses and technicians write their name and 4 digit cell number on a big white board over your bed with every shift change. My tech was Maria, a tough, take-no-prisoners Cuban woman, early 60s, I’m guessing. I’m also guessing she could have hammered rum with Hemingway all night then gone out at dawn to wrestle 700 pound marlin without batting a dramamine. She came on around 8 o’clock, came in to look me over and introduce herself, and immediately decided I was “Pops”. Officially. For the whole night. I’m 58, BTW.


Back to that catheter. Doctor H, anticipating that it was going to make me crazy, left instructions that we could remove it at midnight, but apparently there was some sort of urine volume threshold involved. The nurses insisted we couldn’t pull the catheter until they had 300 ml. I was too fuzzy brained to ask, but, given that the basic plumbing—kidneys, bladder—is the same whether the urine is passing via catheter or penis, why would there be a volume delta?


Anyway. Via some desperate slurping of ice water and ice chips, I made my vigorish. Technician Maria comes in and prepares to remove the catheter. I say “this is gonna hurt, isn’t it?” And she says “no, no. I pull, you say ‘ouch’, and it’s over.”


Trust me. It hurt. 


After the catheter contretemps, my head cleared. And when the nurse came in to give me a heparin shot, I asked why—given that I was bleeding at the time rather profusely through massive incisions. She said—“oh. That’s a good question. It’s to prevent blood clots in your legs. But you’re not going to get blood clots in your legs, are you?” We skipped the heparin. 


Also worth introducing is the phlebotomist who came in to get my morning labs. She was seriously harried by 0930 hrs. But still smiling. “Man, they got me rockin’ and rollin’ this mornin’, Sugar” she says (obviously hadn’t met Maria). “Don’t tell anybody, but I’m thinkin’ of going and sittin’ in the bathroom for a while. How about that?!” I told her that’s where I usually hide. She liked that. 


Anyway, here’s the big finish for today.


It might get messy. But it probably won’t get messier. All the biopsies came back clean. I am, at the moment, cancer-free!


Check back here on the weekend. I’ll put some photos of the suture lines up. Those of you with weak stomachs will have to turn away!

Sunday, September 25, 2011

It Might Get Messy

Ok, fans, it’s crunch time. My long-awaited surgery is on for Tuesday morning. Arrive pre-op 0530 hrs, anesthetic around 0700, knives about 0730. 


To be blood honest, I am terrified of this procedure. Not at all sure why. I’ve had three surgeries in my life: vasectomy, back, and gall bladder. All were via small, polite incisions. Although the bruising pattern from the first suggested that the trained-in-the-Soviet Union doc from some Central Asian “country” was in there to his waist with his hands stretched over his head wielding a ballpeen hammer and a set of sheet metal shears. 


But still. I have every faith in young Doctor H. and his staff. I’m not afraid they’ll find more malignancy—I know that’s a real possibility and I’ll deal with it when the time comes. I think the main thing is the massive nature of the operation itself. If I understand correctly, he’s going to split me mid-lateral from chin to chest, rip the entire cylinder open, and poke around in there for a couple hours. 


He’ll biopsy the two areas of residual radiation uptake, but the oncologist was not concerned about those. He’ll also look for other suspicious tissue and I’m at least hoping clean up some of the dead stuff that is cosmetically problematic. 


No idea how this is gonna come out, except that by mid-day Tuesday I’m gonna be a veg. I’ll probably update this blog several times this week and let the others lie fallow, but I’ll keep you up to date when and where new material might be. Keep good wishes for me in your heads, my friends. And maybe an image of undergraduate anatomy lab of a throat with little pins with flags identifying organs and glands… . 

Monday, September 19, 2011

It Might Get Messy

It has NOT been a good week here in cancer survivor land. I’ve been too sick to make it to the office, which is fine for my own projects which mostly involve writing and reference books I have here at home, but is bad for other people relying on me to help them with shit. I managed to make it in for like two hours on Tuesday to not-so-much help Tim by scribbling a page of gibberish. Then I had to drive home in two stages because I hurt so much.


I have no idea what’s going on. I’m still weak, but the pain is less, so I’ll have to get to the office to start cleaning up the messes (literally and figuratively) tomorrow. The big deal coming up is surgery. A week from Tuesday. Hospital at 0530, anesthesia by 0700, knives at 0730. Icky. He’s going to do a “bilateral neck dissection”. This means he’s gonna open me up like a specimen in an undergraduate anatomy class. I can see all those little pins…”thyroid gland”…”epiglottis”…”trachea”…etc. 


Anyway. I thought maybe my issues this week were dietary, but I’ve been good about getting more than maintenance calories every day and trying to eat something by mouth so my swallowing reflexes keep operating and my tongue exercises (!) don’t go to waste. To make sure, I even fired up my IV bag feeding pole apparatus. Takes frickin’ forever (well, a couple hours, anyway) to get 1000 mls in. But, you can read and write while you’re doing it. So it’s got its goods and bads. 




It is pretty cool. Here’s the bag, holding 750 mls of food and some water. The nurses like to put ice in there with the UN emergency rations, for reasons that are completely unclear. 




This is the primary control valve. It’s operation is, perhaps unsurprisingly, illogical, although simple enough to figure out.




Then there’s the coupler that links the IV bag to the tube inserted in my gut. 




Finally, the tube inserted in my gut. It’s been there for…1, 2, 3…7 months. Fresh as a daisy, near as I can tell. And I assume said figure of speech slash metaphor refers to a young, newly opened, daisy. As opposed to an old dried droopy one. 


Which latter is more how I feel. Many apologies for being such a whiner this week. In penitence, I have new material up around the horn, hit http://theresaturtleinmysoup.blogspot.com/ for some subbacultah (per The Pixies), http://sustainablebiospheredotnet.com/ for some bitchin’ lecturing on the environmental impacts of ancient Greek military engineering, and http://docviper.livejournal.com for some Bad Art By Dave. Thanks for stoppin’ by!


PS—on more health item. I purchased a cross bow this weekend. This is a serious weapon, 150 pound draw weight, battery-operated sighting scope, carbon fiber and titanium construction. It’s beautiful, I like to just pet it like Lucy the New Dog. But I also like to shoot it. It’s scoped within millimeters at the 10 yard range in my basement. Next up is the 20 yards at my carport. Eventually, this thing with a good broadhead and some insanely macho tactics, will drop a bison or a moose at 30 yards. Meantime, the main thing about crossbows (I laughed when my instructor reminded me of this) is to KEEP YOUR DAMNED LEFT HAND BELOW THE PLANE OF TRAVERSE OF THE BOW STRING. Laugh I may have. Stupid I am. See photo of my left ring finger below… .





Monday, September 12, 2011

It Might Get Messy

It’s not like there aren’t enough humiliations that come with cancer. Now I’ve got a big sheet of…get ready…tongue exercises. And not only that, I had to go in for an hour of tongue exercise coaching. A couple of otherwise cute speech therapists tortured me by making me practice the entire set of reps—6 exercises times 10 reps each = 60 reps @ 2 times per day—but by illustrating each of the exercises for me and doing them with me. Man, it doesn’t get any weirder than that. 


Plus, my tongue is now exhausted. Which can’t be a good thing, given that the one place there remains the possibility of malignant tissue is on my tongue. I’m thinking the poor thing really needs a nice long rest until the surgeon gets in there and can biopsy that tissue. The one thing this HAS done for me is convince me to call the surgeon’s shop and try to get an earlier slot. If that tissue IS malignant, I want to know sooner rather than later. I’ll try his scheduler this week and see if you’ll give anything that might open up between now and my surgery date, which is 27 September. 


Cancer brings out religious people like an open bag of flour brings beetles. Preacher’s secretaries call hospital rooms because the “padre would like to stop by and have a word with you.” Religious organizations send mailers looking for…well, opportunities to stop by to help you in your time of need, or offering to take your call when you are ready to talk. 


They called twice when I was in the hospital. Plus some odd in-house group of nonsectarian religious people that kept wanting to visit. Finally I told them that I didn’t need to talk. I needed somebody to run ice chips and fetch the nurse when the pain killer wore off. They said they’d go to the next person on the schedule.


Somewhere my Mom, whose last cogent “word” was a middle finger when she realized I was fending off a priest the day before she died—is smiling.


I’ve been sick all weekend. Not sure what the problem is. I’m as tired as I was months ago right after treatment. And all my muscles are sore. I’ve slept 45 hours out of the last 60. I even took today off from work. Which was a bad thing. Shit is hitting the fan on multiple fronts at the office. I’m gonna have to fight my way in tomorrow no matter what. Oh well. They re-upped my Xanax prescription. A couple of those early and maybe I’ll get enough sleep to drive in safely… .


New material up around the horn. I’ve been sick, I apologize for being a day late with this stuff. Check http://sustainablebiospheredotnet.blogspot.com/ for the cancer diary, http://docviper.livejournal.com/ for photos and a little ecology, http://theresaturtleinmysoup.blogspot.com/ for the best in pop culture. And thanks again for stoppin’ by—every time you guys read this stuff, I feel a little more life come back to my battered frame!



Sunday, September 4, 2011

It Might Get Messy

When the universe peels apart, I can’t sleep. Last time this happened was in the hospital a couple months ago. Thirty hours after we stopped pounding my corpus with radiation and chemotherapeutics I ended up on the bathroom floor in a puddle of vomit and mucous, starting a week when I would be wide awake 24/7, much to the dismay of the nursing staff who like to have their patients slumbering for a third of every day. The cosmic split then was between the block of universes in which I actually dehydrated and died of treatment side effects including anemia over that weekend vs. this one where I made it to the ER and survived. It took a few days for the cosmos to sort itself out, and while it did, I was awake.


I’m awake now. Fourth night in a row. This time I think we’re losing the universes where I died of the tumors that were treated in that episode. It’s just about the time they would have finally closed up both my respiratory and gastrointestinal systems and shut me down absent drastic and effective treatment courtesy of Greater Baltimore Medical Center and their awesome throat cancer specialty shop. 


Good riddance. I’m happy to put up with a week’s lost sleep to have that whole slab of universes where I’m about to be mourned, or not, depending on the paths that got me to the point of death-by-throat-tumor, fall away into someone else’s existence. 


But that does leave us looking up at the enormous stack of universes that plod forward from here. 


Interesting things are stirring in the world of cancer therapy. This week, the University of Ottawa and a private biotech company published stunning research results. Patients with advanced liver cancer were given intravenous injections of a bioengineered virus derived from a now-archaic smallpox vaccine designed to trigger immune response. 87 percent of the recipients had viral replication in their tumors and none in their normal tissues. Six of eight patients in the highest dose group had their tumors stabilize or shrink. Side effects were minimal. Larger, more statistically valid trials, are planned.


Awesome. This is technology that bypasses the blunt trauma cascading from radiation and chemotherapy. Radiation and chemo work because there is a very, very slight tendency for tumorous tissue to be more susceptible to the destructive toxins than non-malignant tissues. The procedure is brutal, but often effective. If sufficient radiation and toxic chemotherapeutic drugs are administered to bring healthy tissue to the verge of collapse, then malignant tissue perishes slightly sooner and the patient can be saved at the last instant when that sensitivity delta has been exploited. Thus my trip to the hospital. The radiation and chemo slapped my otherwise healthy body to the edge of death by dehydration and anemia. Along the way, it burned down the mutated tumorous tissue.


This week I got the formal report from the imaging center. My preliminary assessment per last week’s entry was pretty much on target. The report documents that they gave me 19.2 millicuries (I assume that’s what mCi means) of fludeoxyglucose 67 minutes before they imaged me. They compared the images from this round with the pre-treatment imaging from 8 March. The “impression” is “resolved tongue mass and resolved adenopathy in level II region and right tonsil”. That means the tumors, both primary and secondary, are gone. More ominously, “there are two persistent areas of increased uptake, one in the right anterior mid tongue and one at the right anterior tongue base which are of undetermined significance. These could represent areas of post irradiation change although recurrent or residual malignancy cannot be excluded...the scan is otherwise unremarkable…”. I believe that Doctor Z, the radiation oncologist, thinks the “persistent areas of increased uptake” are unhealed devastation from the radiation, not residual malignancy. But I think this is what the surgery is for. 


The docs didn’t call about the surgery last week. I’ll have to call them next week. Got a busy autumn coming up. Major technical report due, plus SETAC in November, then it’s Thanksgiving, then the winter holidays.


Damn, it’s great to be alive!


New stuff up around the weblog horn this week. Be sure, if you have a few minutes, to visit http://sustainablebiospheredotnet.blogspot.com/ for an essay on environmental consequences of armed conflict, http://docviper.livejournal.com/ for the natural world, and http://theresaturtleinmysoup.blogspot.com/ for the best in modern culture. Thanks for stopping by!