Tag Archive: Medical

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.”

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We Don’t Know

“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.

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I Fear the Process, Not the End

Extreme nausea announced itself around 9:00 PM Saturday. Granted, it’s not the visitor you want knocking at your door, but arrive it did. “Hey, there. Mind if I come to visit? I’m just gonna find a comfy spot in your brain and batter you for the next 9 hours and make your life a living hell. What ya’ say?” Beneath the sometimes wickedly sarcastic humor and laughter of this blog lay this writer’s mental awareness of the darkness and horror of dying. This past weekend reiterated that I fear the process more than the destination.

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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.’

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“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.”

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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***!”

Kamma! It Just Is.

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.

Lies We Believe

The two days post-Parkinson’s diagnosis was spent reflecting. Admittedly, I accomplished little. Yeah, 2019 taxes remain partially complete, but there’s laundry, mail, and several medical bills. Prima facially, I accomplished little, but inwardly, I accomplished much. 

Much like my tumor, I’ve told no one of my Parkinson’s diagnosis. If revealed, one would probably curse my doctors, tell me to sue or at least write a well-thought nasty letter. Sure, I could spit in my original neuro’s face. Yeah. That doctor who blatantly told me in April 2015 told me to see a psychiatrist. I could have done that. I didn’t.

I could have attempted an angle. As a former rescueman who risked his, I effectively calculated all aspects. I was known for quickly summarizing the best outcome, and often, beat back the face of death. Doing such was a lie I told myself and others.

Such lies bring comfort. If you’re dying, you want comfort God will dispatch angels to comfort and carry you. A young mother wants to believe doctors will heal their child or husband. If you lost your medical insurance, you’ll gladly listen to and swallow a politicians’ lure’ of free health care.

I could blame my neuro for all my ills. I could. I won’t. Why? Because I was the lie, I told myself. I’ve known for years my back was stiff, stiff leg muscles and pain, a left stiff arm, bad dreams, the nights I couldn’t sleep, and the ever so slight internal and left-hand tremor. I dropped more coffee cups and glasses than I could count. I just lied.

You need to see a neurologist,” She urged.

Ah, I don’t want to waste anyone’s time. They’ll tell me nothing’s wrong.”

I don’t know,” she frowned. “There’s something about your symptoms that don’t make sense.

I relied on my ability to elude danger. Like forty years prior, Celecoxib, Gabapentine, Tizanidine, Tylenol 1, and Tylenol 3 were my lies. Arthritis drugs killed the pain but didn’t treat the disease. The tumor forced me to address the pain. 

I didn’t have much choice. The surgeon who removed my tumor stated I required a neuro eval. And coming full-circle, I returned to the very clinic that ignored me years prior. In less than an hour, I went from viewing doctors’ confusion to hear, “We believe you have Parkinson’s.;” to hearing, “You have Parkinson’s;” to “I’m sorry.”

William Shakespeare said, “All the world’s a stage, and all the men and women merely players: they have their exits and their entrances; and one man in his time plays many parts, his acts being seven ages.What Shakespeare is referencing is the drama everyone lives throughout their lives. He reduces life to performance or acting. To which, oftentimes looks ridiculous.

Is there some connection between truthfulness and personal integrity? Possibly. Spiritual men and women often had a disdain for lies. In fact, “not lying” one of the fundamental training practices of his path of self-transformation. “Not lying” might raise some ethical issues. For instance, what if a Nazi guard asked if Anne Frank was in our attic? Would I have lied? Of course.

The practice of deceiving with myself of true inner healing via false medication was like a sailboat anchored to the shore. I had a role in my own lie. I lived to the act, and my decision making was ridiculous. All of us need to focus on good days – living as many good ones as possible. Tomorrow, I promise to have a good day. 

Promise me you’ll live only good days.


“It is in the nature of medicine that you are gonna screw up. You are gonna kill someone. If you can’t handle that reality, pick another profession. Or finish medical school and teach.”

~ Gregory House ~

Dr. House’s comment while substituting as a guest lecturer. Unfortunately, Dr. House’s statement to the interns occurs all too often. It happened to me this past Friday. I likened it to something out of Charles Dickinson’s Tale of Two Cities.

“It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity, it was the season of Light, it was the season of Darkness, it was the spring of hope, it was the winter of despair . . .”

I returned for my post-operation evaluation. Good News. The operation was successful. Bad News. The symptoms remained relatively the same. My neuro was positive that removing the tumor would make some positive impact.

Studying the medical history, a sharp, bright, neurological nurse looked at my medical history, then she squinted and studied further. Her first poke went unacknowledged. With careful forethought, she grabbed a piece of the neuro’s flesh, twisted slightly. Turning to look where she pointed, the neuro read. He read again. And again. He pulled up the MRI from 2015. And he read. Read again. And again.

They excused themselves.

Ten minutes later, several doctors, en mass, poked and prodded. They left, leaving the neurological nurse and me to kill time quietly. After eons of seconds, she sympathetically smiled me. “We believe you have Parkinson’s.”

Pause . . . Long pause. 

I must have had this WTF expression, but just as she was about to follow-up, the flock of physicians returned.

“In 2015, the MRI we performed indicated over seven supratentorial FLAIR hyperintense lesions or plaques. We should have noted these. We misread the MRI. While there is no one single test that can verify Parkinson’s, this finding and your symptoms demonstrate the diagnosis. Unfortunately, your Parkinson’s has been untreated for at least five years.”

“All this time I was told, ‘nothing to be done,’ we recommend a psychiatrist…”

“Was awful,” he interrupted. Soulfully searching for the right words, “I am sorry.”

The tumor still had to come out. The remaining portion of the tumor still residing in my neck still remains. All the while, physicians had either denied my symptoms or attributed to the tumor was wrong. All those years of pain and suffering. All it took was for a twenty-year veteran neurological nurse to read the chart and connect the dots. 

I am still processing, but I left in peace. “Why?” one would wonder. Well, I found some level of peace in the doctor’s words.

“Better than a thousand hollow words is one word that brings peace.”

~ Buddha ~