I had planned to tell people on my own terms. I had a whole timeline. There would be a right moment, a considered conversation, perhaps a tasteful announcement. I would control the narrative.
Instead, my bladder did it for me.
Tag Archive: Medical
I separated the curtains from my bed. From the 46th floor, I watched the rain drizzle down the window, winced, and rolled back into one of several comfortable positions. My body hurts. I spiritually hurt. I am mentally hurt. No longer able to pray kneeling, I offered today’s queloque from a fetal position. “God, will I die before my health insurance cancels me?”
When people receive a cancer diagnosis, they are stunned. I wasn’t. The clinician was direct and matter-of-fact. “We suspect cancer.” The calmness was amazing. Not my calmness. His. Thinking back on the exchange, I wish the clinician had hyped it a little more, like that old Dell commercial. “Dude. You’re getting a Dell.” Fist bump and smack, smack. Instead, just the standard textbook delivery that they suspect cancer, followed by a wave of the hand as if to say, “Now get the hell out of here. I am late for lunch.”
“We don’t know” comes in many forms. For example, the car mechanic quizzed about a part failure often states they don’t know why it failed. The heater-air conditioner technician told me two weeks ago that he did not know why the blower motor was leaking oil. “It’s old.” Children who spray-painted the car are asked why often retort with “I don’t know.” Then there are medical doctors.
“Doctor, I was cutting vegetables. My right wrist, elbow, and shoulder hurt painfully with each cut. So much so that I had to stop.” The doctor looked at his computer, “That’s a great question.” The comment ‘that’s a great question’ is like, “We don’t know.” Of course, the pain could be tendinitis, Carpal Tunnel Syndrome, or “You sleepwalk and play drums all night.” A lot of times, doctors don’t know.
The patient has to be proactive. May are not. Need an example? when the doctor seemed ready to breeze past initial blood results showing normal white blood cell counts, but red blood cells suddenly below normal, I forced her to opine. “Oh,” she mumbled while looking at the computer. “These results are way out whack. We need to run more through some more blood tests. I need to see if your results are iron-deficient anemia or something else. I don’t believe you have colon cancer, for the blood results are right for Colon Cancer. So, an Iron+TBIC+Ferritin blood test will be the first test.”Proactivity ensured doctors did not miss critical information, but I am unsure what ‘not right means.’
“It’s unusual for a person at your age,” the radiologist said. Hint. When a clinician claims you’re ‘unusual,’ that version of ‘unusual’ can infer many things, from good, bad, funny, ugly, or any combination thereof. “During your last scan, we detected something that requires a second look. Scans detected a 3-millimeter section under the left ulnar styloid bone. It could be nothing, could be something. Regardless, we’ll need to perform a Cat Scan or MRI, depending on your doctor’s request.”
I described the transient ischemic attack (TIA), arriving like a freight train and departing before dawn (see I Am Dying). Instinctively, I knew this was a warning shot, an enormous detonation. As a former medic, I knew of strokes. I now understand a lot about TIAs but knew nothing relatively several years ago. There are moments when I felt as though I am the only one taking it seriously. Getting medical professionals to understand a patient’s concern can be challenging. A Stroke Association survey concluded 16% of TIA victims didn’t feel taken seriously, and 25% reported that health professionals didn’t realize that they had had a TIA. If a TIA occurs, the patient is likely to be prescribed aspirin, receive a pat on the shoulder, and an escort out the door with a recommendation for a further clinical study.
Unlike my father, I consider my events with mixed emotions as my cognitive skills and memory were not affected during the October episode. Still, research suggests more TIAs are in my future. Some patients realize they had suffered a TIA when reading medical notes with no clinician confirmation of the diagnosis. My experience was similar, as I read my tumor diagnosis via an online patient visit summary posted 21 months ago. Only when pressed did I confirm ‘prognosis was poor.’
TIAs are hard to diagnose. Symptoms vary. Facial weakness, drooping mouth, arm or leg weakness, speech difficulty, blurred vision, and dizziness can occur. Each TIA tends to be specific to the individual, and not all symptoms arise. Initially, my neurologist kind of dismissed my concern. Should the TIA occur again, ‘… we’ll review.’ However, out of caution (since I kept asking inquisitive questions), ‘we’ll schedule an echocardiogram.’
Upon arrival, the echocardiologist greeted, “You’re here today for an echocardiogram because your doctor diagnosed you experienced a TIA.” “Fantastic,” I quipped. Forty-six days later, it was the echocardiologist who stated the obvious, something I already knew but couldn’t receive confirmation. Undoubtedly someone will ask how I know when everyone else cannot. After completing the medical summary (discussed in the post Lists), my intrinsic gut feeling became clearer. My first TIA occurred in March 2019, with loss of vision, foggy sight. Although I improved throughout the following day, the impact lasted three days. My second TIA occurred in May 2019, with left side facial paralysis and mouth drooping. The effect lasted six days. During the third week in October 2020, my third TIA produced no coordinated functionality in arms or legs, no balance, could not stand, unable to lift myself, foggy. The impact was significant and lasted over six days. Should something in the heart be amiss, an echocardiogram will help detect cardiac sources of stroke or TIAs.
The echocardiologist performed a transthoracic echocardiography (TTE) using an ultrasound imaging technique that allows the heart structures to be seen. A hand-held wand placed on the chest provides pictures of the heart’s valves, chambers, and helps the clinician evaluate the heart’s pumping action. It was a ‘matter of fact’ test procedure. A ‘no biggie’ I’m told. ‘Good I thought. At least I didn’t hear, ‘I’m not used to this version of the software. Do you know what this message [Not Currently Recording] means?’ Results come in a week.
Wait another week? I envision doctors talking after my death, “He was in his usual state of humor — right up until his heart quit. Damn. That’s gotta suck.” But here I am. Two days post test, I am still alive. Still kicking. The Chinese Book of Changes (I Ching) states, ‘Waiting is not mere empty hoping. It has the inner certainty of reaching the goal.’ Goal? I have no plan. At this point in my life, if I had dreams, they were created by comedian George Carlin, “… get up, work eight hours, eat three meals, take one good shit and go back to bed.” The mind hates uncertainty, and living in a state of “not knowing” is intolerable.
To understand how inharmoniousness waiting is, I remember working in the emergency room one night listening to one friend comforting another. “You know, Mike; we give ourselves no credit for taking time to be present. The doctor’s said there’s just a few others ahead of you. How about if we pass the time thinking of things we can do in a week or two?” Horridly, Mike stares as if a flamethrower was pulverizing his friend, “F*** that s***.”
To counter such emotions, I become more aware of my feelings and come into the present moment, where everyday activities still take on a joyful, miraculous quality. If I am mindful or fully present in the here and now, anxiety disappears, and a sense of timelessness takes hold, allowing the best highest qualities, such as kindness and compassion, to emerge. And most of the time, it works. Other days, I want to say, “F*** that s***!”
I’ve been off radar recovering from ongoing medical conditions. A week ago, one of my eyes decided that going on the fritz was imperative, and for whatever reason, vision blurred. Being the alpha male of my home (Ok, the only male in said home), I decided it was nothing — that the visual part of my anatomy awoke to have a bad morning. Indeed, once I drop coffee down my throat, all will be well, sharp just like the night before. It turns out the alpha male of the home was completely wrong.
There is backdrop. February 2018, I woke up with primary open-angle glaucoma (POAG) — called open-angle glaucoma — which is the most common type of glaucoma. Open-angle glaucoma is particularly dangerous because those who have it don’t know anything is wrong until significant, irreparable vision loss occurs. Until all hell broke loose, I had no pain, no noticeable vision loss, or any other hint that something is amiss. Yet the “silent thief of sight” struck. Four eye surgeries later, I was a new man. “Go forth and procreate,” clinicians said. (I was told everything was ok.) Until this week.
“Ocular hypotony is usually defined as intraocular pressure (IOP) of 5–6 mmHg or less.” The doctor said. “So, instead of having too much pressure, you’re experiencing too little pressure. Also, the cornea in your eye looks like sandpaper. That’s why you’re experiencing blurred vision. The problem is, we don’t know why you’re experiencing low eye pressure. Every test we’ve performed is normal.” For the time being, blurred vision is my life, and the forecast reads like a weather forecast: partly cloudy to rainy.
Simultaneously, I’ve been listening to the news. Depending upon whom one hears, President Trump is either near post-COVID treatment and is ready to leave, requiring oxygen, has a long road to recovery, or has no clear path to recovery. Trump and I are alike in many ways. Both of us probably have “no clear path to recovery.” Each of us has received medical treatment not afforded to the average person living their life on Mainstreet, U.S.A. Trump received medication that neither you nor I will ever receive. Yet, both of us have avenues to better healthcare than most.
I have known for nineteen (19) months that time is short. Specifically, my time is short. Maybe Trump and I are on a similar path, just different roads. I also affirm that this present life is only a part of the round of existence (samsara). This current life I am experiencing was conditioned by others who influenced me. In turn, my next existence will allow me to learn lessons in this life.
In COVID, there are usually some people who succumb while others escape, even though both are exposed to similar conditions. According to the Buddhist view, the difference between the former and the latter is inherited from the past. Other examples are the cases where though the treatment was given was successful, and the patient died, and wherein spite of ineffective treatment, the patient lived. There have also been cases of remarkable and unexpected recoveries when modern medicine has given up all hope for remission. Such cases strengthen the Buddhist belief that besides the physical cause of disease, illness can be the effect of lousy Kamma in past lives. An infection from Kammic cause cannot be cured until that Kammic result is exhausted. But the Kamma of every person is a mystery both to himself and others.
In reality, all of us know suffering is an inevitable part of life. Like old age and death, sickness is unavoidable. In other words, in this life, “it just is.” This does not mean that I will mitigate every ache and pain through available medical means, but I will accept and mindfully endure if suffering remains. Within the spiritual tradition, physical pain and illness can provide an occasion for the cultivation of healthy and desirable mental states, including forbearance and patience. Therefore, it is not an illness but rather our response to it that has spiritual value.
And maybe that’s my Kamma to learn.
On an early weekend morning, I rolled over to the edge of the bed and realized I couldn’t get up. (At least initially I couldn’t get up.) “F●●●,” my body groaned. I reached for my cane, pulled myself upright, steadied on the bed’s edge.” I am getting old. Quickly. There’s a sobering likelihood that I will be one of the seven 65-year-olds who will be disabled before death. I’m not looking forward to it, but I find myself continually negotiating with ‘Father Time’ for a snippet’s reprieve.
Nora Ephron wrote, “What I believe … is that at a certain point in life, whether or not you’ve been diagnosed with an illness, you enter into a conscious, ongoing … negotiation between the two … This negotiation often includes decisions as trivial as whether to eat the second piece of pie as important as whether to have medical treatment that may or may not prolong your life.” I’m at a point where second helpings are intolerable. I know it. My body knows it. Call it intuition. Call it the ‘sixth sense.’ Call it, ‘Joe.’ Call it whimsical. Doesn’t matter. Most dying can name the time, and date life shifted.
July 15th, my body shifted. My back, stomach, intestines, and right hip awoke pissed off, as if to say, “We’re in charge, Obiwan. And we decided to drive off that cliff in the near horizon.” My former sister-in-law described a similar feeling. She awoke one morning, feeling something wasn’t right. “It was an ominous feeling,’ she casually noted during an afternoon lunch. A little over a year later, cancer claimed her life. Therefore, any notion that “70 is the new 50” never occurred to me, as I never expected to get to 70. My physician will test whether ‘60’ is my never ‘70.’
Several tests, including complete blood count and tumor marker, have been ordered. I won’t stumble into the results. I won’t get to read it online before hearing from my doctor. Post-results, I will hit ‘pause’ to wait and see what happens. I’ll internalize everything until I know just how true this ‘intuition’ (my decline) turns out, for I do not want to claim to be a victim.
I never thought that anyone would be sorting through my life history 30 years ago. And at this point, there’s no optional editing that can be performed. History is written. I know how the scales of justice both God and man weigh each detail on trial. Afterward, everyone alive will understand I was no victim. It’s unavoidable. Accept it and move on.
Moving forward is an interesting concept. Buddhists believe most illnesses are primarily karma’s negative energy-consuming the sufferer. If so, I have acquired a s●●●load of it. Such karma stems from greed, anger, and stupidity, including eating pizza, beer, and onion rings. I suppose a lot of cancer is avoidable. Not smoking reduces lung cancer significantly. Avoiding red meat reduces other forms of cancer. Protection from sun exposure reduces skin cancer. For me, cancer is … cancer. Just is. It’s part of life (at least mine anyway). I will take this situation like others and make it part of the path. The path is exclusive. It’s not filled with only right situations, but any situation. Fortunately, I have time to prepare.
When told of the odds of my survival (a couple of good years), I instructed my physicians I was not interested in hearing about weird drug trials, new medications, or life-saving operations. What good would it do me? I decided to live until death. I refuse to get waylaid by the kind of emotional baggage that frequently accompanies others. Life is short. Admit your wrongs, make amends when you can, and live until death.