Alles Klar, Herr Kommissar

I just got a call from my oncologist's office - literally, like ten minutes ago.  The results of the CT and PET scans came in.  All clear.

So there are no tumors that were detectable by the scans.  Most likely I'll still undergo the next stage of chemotherapy, because (1) that's the standard protocol) and (2) I've wanted to treat this aggressively since day 1 and (to quote Tom Petty again) I won't back down.

I also had a follow-up with my surgeon, which was probably the last time I'll see him.  He wanted to know if the surgical wounds are healing on schedule (they are) and if I had any post-surgical complications (I don't). I did get a lovely parting gift, a new prescription for percocet.  Maybe I'll bring some to Lot 8 for a tailgate.  Opiates and beer, combination therapy.

Doctors

I had a follow-up with my primary oncologist at the end of last week.  My blood counts and vitals were normal and there wasn't much to discuss.  I also have twice weekly in-home nursing visits at which she checks my vitals, which are normal.  Not too long ago, colon cancer surgery required a two-week hospital stay, but someone figured out that it's cheaper to send patients home and have a nurse visit them.  I have no objections, because I couldn't spend another week in the hospital.  The food is OK, but the TV channels are very limited.

One of the nicer things about the hospital, though, was the morphine infusion.  The machine was set to give me a continuous supply, and I could get a bolus by using the on-demand button.  I could only get the bolus in ten minute intervals and the machine would chirp when it was delivered.  So I would press the button, listen for the chirp and then press it again every 30 seconds until the chirp sounded.  It was more entertaining than whatever was on TV.

My daily schedule is pretty simple. I wake up at 4 AM to take some percocet, try unsuccessfully to go back to sleep, and then spend the rest of the day reading, watching TV, occasionally eating, and going for a short walk.  I squeeze in a shower somewhere in that routine.  During this time, I started thinking about the number of physicians and surgeons I've seen since June.  The list doesn't include nurses, physician assistants, patient care techs, etc. So you can imagine just how many medical professionals I've met.  Here are the docs, roughly in order of appearance.

1. Primary Care Physician
2. Gastroenterologist I
   
3. Anesthesiologist I (colonoscopy)
4. Pathologist I (colonoscopy sample examination)
   
5. Primary Oncologist
6. Consulting Oncologist I (Mrs. 270's cousin)
7. Radiologist for PET and CT scans
8. Radiation Oncologist
9. Consulting Oncologist II (gastroinestinal oncologist)
10. Gastroenterologist II (endoscopic ultrasound)
11. Anesthesiologist II (endoscopic ultrasound)
    
12. Consulting Radiologist (friend from college)
13. Pediatric Infectious Disease Specialist (my picture of hope and her expertise iis useful because I'm so childish)
    
14. Colorectal Surgeon
15. Anesthesiologist III (surgery)
16. Pathologist II (surgical sample examination)
    
17. (and 18-20) Surgery Residents

Hooray for a good health care plan, although numbers 6, 12, and 13 are unpaid counselors.

Home

Thanks for the postive comments and good wishes.  I've been home since Sunday afternoon.  The surgical stuff seems to be healing, i.e. no bleeding, fever, unexpected pain.  I can't do much other than lie or sit aound.  Sleep still doesn't come easy and I have to get up a couple of times each night to take a Percocet.  I'm pretty much awake during the day.  So here's how it unfolded.

Saturday, January 2.  I knew that Saturday's dinner would be the last one I would enjoy for a long time.  So the family went out and I had a Caesar salad, a rib-eye (medium) with a loaded baked potato, and a Sam Adams.  I enjoyed all of it.

Sunday, January 3.  This was prep day and I couldn't eat or drink anything that wasn't prescribed.  Because I had to be admitted at 5 AM, we decided to spend the night at a hotel-like facility in the hospital complex rather than wake up really early and hope for no accidents on 270 or the beltway.  So, after dropping off the kids at their grandparents' house in the afternoon, we headed down to Washington Hospital Center.

Monday, January 4.  We arrived at the admissions office at 5 AM, about 20 minutes before any of the staff did.  When things settled down, they asked me a few standard questions to verify my name, DOB, address, and any drug allergies.  A short while later, I and a few other patients were escorted downstairs to a surgical waiting area.  After about two minutes, I was escorted to another surgical waiting area where they asked me a few standard questions to verify my name, DOB, address, and any drug allergies.  After that, they took me to the surgical prep area, when I dressed for surgery, had an IV inserted, and where they asked me a few standard questions to verify my name, DOB, address, and any drug allergies.  My surgeon came by to see how I was doing (or maybe to make sure I showed up).  We had a nice chat and then he left.  The anesthesiologist then came by and asked me a few standard questions to verify my name, DOB, address, and any drug allergies.  Then the OR nurse came by and, well you know what she asked.  They wheeled me into surgery and I really don't remember what happened after I got on the table.  The surgery lasted five hours and I woke up sometime after that.  I mean, I must have woken up because I'm writing this, but I don't remember much of anything from that day.

Tuesday January 4.  This and the next few days were OK.  I didn't feel much pain because of the morphine drip and the push-button boluses that I could self-administer every 10 minutes.  I didn't have much of an appetite during my hospital stay, which was to my benefit because the food - clear liquids, then full liquids, then solids - didn't taste at all like food.  I didn't sleep very soundly while in the hospital, and whenever I did seem to fall asleep, a nurse awakened me to administer drugs or check my vitals.

Wednesday January 5. Pretty much the same.  The excitement came that night when, along with the pain medication, I requested Ativan to help me sleep. It's what the chief resident suggested.  Well, Ativan - by itself or with other meds - can lead to some pretty interesting side effects. At some point that night I began to hallucinate and pulled out my IV and catheter.  Somehow, the nurse managed to subdue me, re-insert the tubes, and calm Mrs. 270.  I thought it would be like something on TV, where the patient gets really aggressive and six orderlies hold him down while the nurses kick him unconscious, but I was just stubborn and uncooperative.  Mrs. 270 would say that it's normal behavior.  After that, nothing exciting or interesting happened until I was discharged on Sunday, January 10.

Reading, Writing, and Recovery

Dr. Rumack: You'd better tell the Captain we've got to land as soon as we can. This woman has to be gotten to a hospital.
Elaine: A hospital? What is it?
Dr. Rumack: It's a big building with patients, but that's not important right now.

Airplane, 1980

I'm having surgery on January 4 and will be in the hospital for about six days.  I'll probably be doped up and unable to do much, and I'm not sure what TV channels the  hospital has.  So I may take a book or two, in case I'm alert enough to read. When I get out of the hospital, I'll be home for a couple of weeks, so I'll have time to catch up on my unread stack.

Over the years, I've accumulated a pile of books that I haven't yet read. Every time I enter a bookstore, I tell myself that I should finish the books I own before buying new ones. Nevertheless, I proceed to the sale table and look for good deals.  So why, you ask, am I in the bookstore in the first place?  Buying a latte, silly.

So I'm going through my pile of unread books to decide what to include in the:

Surgical Recovery Reading List
(in no particular order)

It's Not About the Bike. Several people have recommended Lance Armstrong's account of his experiences with and after cancer.  I figure that with all the LiveStrong gear I have, I should read the book too.

Band of Brothers:  Don't spoil the ending by telling me who won WWII (sag mir nicht, wer das Krieg gewonnen hat).  Speaking of Stephen Ambrose, I may add Undaunted Courage to the list, if I can find my copy.  Undaunted Courage is about two Virginians, Lewis and Clark, who travel west to spread their brand of right wing conservatism.  As a result, the midwest and the mountain west are made up of red states.

The Hobbit and the Lord of the Rings trilogy.  I read these in 1982, so it's about time to read them again.  I have some really fancy hardcover, boxed editions of the books.  But there's no way I'm getting those pages crinkled and the maps torn.  So I bought the paperbacks at a used book sale ($2 each).

The Twilight saga: No, this isn't on my list.  I just wanted to see if you're paying attention.  This series is popular among the kids who grew up with the Harry Potter books.  Apparently, witchcraft is the gateway occult practice to vampirism.

The Road.  I read Cormac McCarthy's No Country for Old Men before it became a MAJOR MOTION PICTURE!!!.  I can't get used to his refusal to use quotation marks and sometimes can't figure out whether the text is dialog or narrative.  But The Road was $3 at a used book sale, so I guess I can put up with the indignities of unorthodox punctuation.

Cold Mountain: I think this is a sequel to The Snows of Kilimanjaro in which the main character rebuilds his airplane and flies off the mountain. It's not? Anyway it was $1 at the Germantown library's "save them from the incinerator" sale.  Yes, we have a library in Germantown.  No, it's not just coloring books.

Sale table, used book sale, library sale. You get the theme here right?  I'm cheap.

Colorectal Surgeon Song

Training for surgery

I never played soccer at at high level.  I was on my high school's junior varsity team.  An ugly foot injury prevented me from spending my senior season on the varsity bench.  Of course, I didn't play at all in college or in grad school because (a) neither school had a soccer team and (b) what did you not understand about my lack of talent?  Only when I moved to MoCo, did I start playing again in a weekly pick-up match, with many foreign post-docs (and a gangly domestic one).  So I quickly developed a three-fold strategy:

1. pass to the Frenchman,
2. pass to the Spaniard (sorry, not you. The other Spaniard),
3) pass to the Brazilian

Early in my pick-up soccer career, I picked up a bad ankle injury.  Later on, I picked up a bad knee.  So nowadays, if I run for more than 1 minute, I have to wrap my knee and ankle and take ibuprofen.

But the doctors want me to get in better shape before surgery.  The surgeon says I should focus on cardio exercises and the oncologist says I should do some weight training to build muscle mass.  It's a good thing I didn't ask the gasteroenterologist and the radiation oncologist too, or I'd have to add pilates and jazzercise to the regimen. So now I'm resuming my pre-cancer exercise routine - OK, truthfully, I slacked off months before the diagnosis. 

Instead of actually running, I use an elliptical. It's not one of the fancy ones with many electronic controls and readouts.  It's a pretty simple one that displays the wrong speed and the wrong distance. That doesn't really matter, my goal is to get up to 20 minutes in the "green zone" of the display.  The yellow zone means I'm moving too slowly and the red zone means my ego thinks I'm a lot younger than my body is.  The lack of any lateral motion saves my ankle.  In addition to the joint-sparing, no impact workout, I can use the elliptical in any weather and, when I get tired, I don't have to worry about how far from home I am.  I also have a knock-off of the Total Gym - you know, that resistance machine advertised by Chuck Norris and Christie Brinkley.  I bought the knock-off because I'm cheap and because it's reasonable for a limited amount of upper and lower body exercise, but I'm not going to get buff with this.

So, If I keep to a rigorous schedule, I'll be in decent shape for surgery.  After surgery, of course, I'll lose weight and stamina again and have to start all over again.  If all goes well though, I will be in game form when the World Cup starts in June.  With the current injuries to our crucial players, the US will need a good bench warmer.  I hope the gangly guy gets in shape too.  We may need him on set pieces.