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Notes from Recovery-ville

May 27, 2013 1 comment

Takes a Village

I don’t mean to turn this blog into a personal medical site, but God apparently did, so….

We’re just past the halfway point of the short side of the theoretical recovery period after most of my stomach, a piece of my liver and my gall bladder all sacrificed themselves in an effort to annihilate a 5cm tumor that turned up in my stomach 14 years after receiving unnecessary radiation in that vicinity following a bout with testicular cancer.

OK, with the background out of the way, what’s it like to recover from major gastro-intestinal surgery?  Meh.  Some days are better than others.  Some days are high energy, some days are low energy.  What is a constant is sleep.  This is the magic potion of healing.  I can drop a 2-hour nap in a New York minute (I know- that sentence must be a gross metaphorical violation of some sort).   The trick is getting 10-12 hours of sleep a day but not turn into a piece of the living room furniture.  You have to get out.  You have to walk.  You have to get in the sun.  You have to breathe the air.  Sometimes easier said then done.

A few days ago, I made my first distant foray from home besides the hospital to take in a Nationals game that reliever, Drew Storen tried to ruin for me but it’s not really his fault- he didn’t know I was sick.  The point is that when I mentioned my outing on Facebook, a friend noted “great you should be feeling so well to get out and about.”  In fact, without going into any detail, I will tell you categorically that was the single worst day of my recovery that I have had.  And that is precisely why I pushed on and decided it was imperative to get out and get TO the ballgame.   And it worked.  The field, the wind, the night air, the best game ever invented in the history of mankind- all conspired to make me feel vibrant and alive.  It did wonders.  Thanks to Drew, I got to leave after the bottom of the 8th and beat a lot of the subway crowd so even the Metro experience was pleasant.

This is about pushing the limits of your physical and mental boundaries.

One of the things I’ve done mentally, is divorce myself from the news within reason.  I am in the news business so it goes against instinct.  But I’m sorry, there is just too much conflict, violence, blood, natural disaster, evil, ego, banality, superficiality, celebrity-worship and general bullshit out there for it to possibly be healthy in any way to consume in large quantities at this time.  I’ll catch up later.

One of the larger adjustments is in the area of nutrition, appetite, food.  After leading a life, like most others I think, in which meals are defined by their taste, all bets are off now.  Foods that I used to secretly crave (and which are advertised more than any other) like cheeseburgers, french fries, fried chicken, have lost their appeal.  Food just tastes different.  With a smaller stomach, I also eat much smaller amounts.  And my appetite is all over the place.  Sometime I have one, sometimes I don’t.

The trick now (and this is too funny for words) is keeping my weight up.  After years of trying to watch my weight, I am currently losing about 4 pounds a week.  Add it to the weight loss that occurred after surgery and a week of hospitalization and we’re talking nearly 30 pounds.  Eventually this has to stop but right now, it feels great to be lighter.

In a couple of weeks I begin a discussion with my doctors about chemotherapy.  They seem to be all gung-ho about the poisonous little cocktails they want to give me to prevent any return of cancer.  They are going to have to convince me with science, research and logic.  The white coats and air of authority will not be enough.  Don’t get me wrong.  I love my doctors.  They have saved my life.  I just don’t want a repeat of 14 years ago when the prevailing medical orthodoxy was to radiate the crap out of people.  It’s one of my own doctors who tells me he is now constantly running into patients with tumors who received radiation 15 and 20 years ago.  A debate for another day.  For now, a few more weeks for healing from the sharp, steely knives.

They say God works in mysterious ways.  I do believe the dude has tried to kill me several times in order to make me stronger and healthier.  Eventually, this time, I think it’s going to take.

 

The World from a Hospital Bed

Here I am with my temporary, dapper walking stick, a brand new Hoyas T-shirt courtesy of a co-worker, and sitting in front of a Chinese symbol for Serenity with my Faith, Hope, Love cancer bracelet...ready to take on BEAR.

Here I am with my temporary, dapper walking stick, a brand new Hoyas T-shirt courtesy of a co-worker, and sitting in front of a Chinese symbol for Serenity with my Faith, Hope, Love cancer bracelet on my left wrist…loaded for BEAR.

I last posted the night before major cancer surgery, expressing both confidence and alarm.  It’s now been about ten days and I am doing extraordinarily great, especially considering the circumstances.

Here’s kind of a blow-by-blow:

Pre-Op

Arrived at the Georgetown University Hospital Surgical Center Thursday, May 2nd at 6:30am.  Everyone and I mean everyone on Georgetown staff is so cheery and positive and kind.  Where do they find these people, I ask myself.  They are like cheerful mutants from a faraway galaxy where there is no such thing, for example, as road rage.

I pick up my bracelet with my name and birth date so from here on out, no one accidently removes wrong body parts or gives mistaken medications.  The bracelet also contains the bar code on which thousands of dollars of medications will be charged in the days ahead.

In the actual operating room I have a brief chat with the chief surgeon and crew.  The gentleman performing the operation is the Surgeon-in-Chief of the Lombardi Cancer Center, Dr. Waddah Al-Refaie.  I ask the doctor if he had a good night’s sleep and he confirms he is well rested and ready to rock and roll.  At this point the anesthesiologists  suggest that considering the length and complexity of an operation expected to result in the removal of 60% of my stomach, would I be up for an epidural?  Incredibly strong pain killing meds delivered right into the spine and nerves?   Yesireee, I would like that, gentlemen!

And that was the last thing I remembered.  They put a tube in me to do the breathing while I was gratefully and completely and totally out like a light for the next 7 hours, 6 of which were actual operating time.  Operations are like time travel.  Your loved ones get briefed once an hour on what’s happening but for those of us on the table there is only before and after.   There is no time in between.

Immediate Post-Op

I awake in post-op and my girlfriend, Millie is letting me know that while I was away, the surgeon did, indeed, take 60% of my stomach.  And, oh, an extra 10% of ye’ old liver.  Oh, and the gall bladder.  Gall bladder’s gone but they found nothing wrong with it and they put it back.   Still groggy, I make a mental note to revisit this analysis.  I would be correct.  Poor Millie had gotten lost in the fog of war.  They don’t put stuff back after they take it out.  But she was right that there was nothing wrong with it. They saw something they didn’t like that turned out to be benign.  Goodbye gall bladder.  Of questionable value as a mere bile creator to help the stomach handle fatty foods, I will not even miss the little guy.   “And so…” sums up Millie, “The operation was a great success!”

I smile to hear this; still slightly alarmed they took some liver.  But hey, it regenerates!

The next two days were mostly a sleepy haze.  The boys with the epidural did a masterful job.  Patients in hospitals are always being asked to gauge their pain on a 1 to 10 scale.  The first 48 hours after this big a surgery I had pain of 0 to 1.   That’s amazing.  For all the advances in medicine, the single most important has got to be anesthesia and the art of pain killing.

But, alas, Saturday came and they’d have to stop the epidural- can’t keep that going for long- off to the land of IV drugs!

I honestly didn’t even look at my sutures until day 3.   Nice job. Very handsomely done.  I counted about 36 staples from below the belly button to the solar plexus.  And they all hurt just a little bit!   Dilaudid into the veins helped.

All of this stuff, by the way, is measured in small hourly and daily victories.  The catheter comes out.  Yay!  Day 4, a day earlier than I thought, they pulled the NG tube.  This is a fiendish device that during surgery is put into your nose and way down into the stomach.  A kind of suctioning event is generated and bile and other bad things from the belly go into a vessel and the pressure also helps the stomach in some way no one adequately described to me.  The NG tube was an unwelcome addition to my head.  It also tethers you as much as an IV does.   It’s really fun when they pull it out too.  Oh, the laughs.

Run for your Lives- It’s Cable News!

And now here was the part of the hospital visit that sucked the very most.  It wasn’t nurses and techs walking into your room at 4am to take your vitals or give you another blood-thinning injection.  No, it was no longer being groggy enough to sleep the day away and being awake and alert.  And ready to become the unsuspecting victim of CABLE TELEVISION.

This was the day Cleveland police officially arrested Ariel Castro and two of the three women the horrible little man tortured for a decade, returned to their homes.  This was the day America’s favorite villainess, Jodi Arias, was convicted in the gruesome stabbing death of her boyfriend.   This was the day of the Benghazi hearings.  In other words, this was the kind of day that was created for Cable News.  And, here I was, comfy in my hospital bed with my right trigger finger on the remote control.

Over on CNN, they covered everything in great detail, concentrating about 70% of their programming on the Cleveland House of Horrors.  Nice coverage- couldn’t complain about a thing.  They didn’t get any facts wrong.  They brought in solid contributors along with their own paid experts and personalities like Nancy Grace.  Over on Fox, no developing story of any magnitude could budge the network from its breathless coverage of the Benghazi hearings.   One guy at the witness table almost cried.  Another had triple the normal amount of emotion in his voice.  I didn’t see what else there was to it by way of red meat…or new facts.  And this is categorically not a political view on my part.  I was just a highly drugged-up guy in a hospital bed switching from cable channel to cable channel.

On one channel, live TV crews watching the Cleveland women arrive home, stunning police news conferences; bizarre, sick revelations about the nightmare decade for these poor women.  On the other channel, congressmen getting pissed or preening depending on their political persuasion and more white guys in suits at witness tables.  Every now and again, Fox News anchors went away from the hearings to Fox News reporters to explain to people the significance of something that just happened in case they couldn’t discern it for themselves.

And then….the Jodi Arias verdict!  This time, Headline News jumped into the fray, primed as they were positioning themselves as the Arias Verdict Network.  This hurt them early in the week as they went live to Phoenix repeatedly for two days before there was any verdict or news.   But now that the jury was back- Christmas for Headline News!

CNN adjusted and did a pretty darned good job covering both the Arias verdict and the House of Horrors.  Over to Fox; continued highlights and analysis of the Benghazi hearings.  By 6pm, even a Fox News anchor made reference to the fact there had been a lot of breaking news on this day but maybe tomorrow when it’s her birthday, they’ll let her cover all these other stories.

Then it was off to sports where I simultaneously monitored the Washington Nationals and Caps- the Nats on radio the Caps on the tube.   Nats won, Caps lost.  And they lost the next night too.  I came close, but would later dismiss notions of suing the Capitals for emotional distress.

I wrapped up my TV orgy day with the Science channel and three straight one-hour episodes of Stephan Hawking on space travel, space aliens and wonders of the cosmos.  It was an absolute pleasure to watch houses of horror, Benghazi hearings and murder verdicts shrink to their appropriate cosmological scale.

And I Thank You for Your Support!

Within two days I would be discharged.  And here we are, about four days at home.  I just got back from my first post-op consultation with the surgeon.  The tumor was larger and invaded a bit more territory than everyone first thought.  But no lymph node cancers.  And none to be found anywhere else in the body.  I am officially staged at stomach cancer 2b.  This gives me about a 65% chance of living through the next five years, odds I gladly accept.

I will likely get some chemotherapy this summer and fall but the all the cancer has been surgically removed.  We’re talking preventative measures.  Then after a few months of that loveliness it’s just a matter of monitoring until five years from now, we can all declare, “case closed.”

And I do not accept alternate outcomes.

To my friends:

I thank you for the books, the magazines, the musical play lists, the T-shirts, the kind sympathy cards, the wicked-funny cards, the thoughts, prayers, animal sacrifices and smudge ceremonies and as the three words on my blue left wristband say- for the love, the hope and the faith too.

We are beating this together.  Thank you for that.

Going Under the Knife with Equal Parts Grit and Fear

CT Scan of Garcia stomach

CT Scan of Garcia stomach

The following account includes details of human biology that could make normal people a little queasy.  It’s an honest account and, I might add, a therapeutic one for the author.

Last time somebody opened up my stomach and took a gander it was all quite spontaneous.  You see, the stomach is supposed to be a sterile environment.  But in my case last October, an undiagnosed ulcer perforated.   It was a mess.  Suffice to say I was en route to getting numerous rapid and intense infections that would make me, if left unattended- a dead man by morning.  But waking up that day not knowing I would later be taking an ambulance ride to the ER had its advantages.  At least I had no idea what was about to take place.

Now, some six months later, after an endoscopy performed to check on my progress from the perforated ulcer operation discovered- oops- a tumor- they’re going to open me up again.  Only this time I know exactly when; 8am, ET, Thursday, May 2nd, 2013.   They’ve blocked off 6 and half hours of operating room time to get a 1 to 2 centimeter superficial carcinoma out of my body and cure me.  I’m grateful for that.  It was caught early.  Stomach cancer is not curable in later stages. And, of course, to be on the safe side, cancer-fighting doctors are using an AK-47 to wipe out a gnat, so they’re also going to remove 60 to 70% of my stomach.

I am likely to be going from being an overweight former smoker, to being a perpetually slender and much healthier former smoker.   God works in mysterious ways.

But the knowing is not fun.  I am sentimentally enjoying meals I know I am not going to be having again for six months.  Even sipping from a water bottle is a luxury.  In less than 24 hours,  I will be lying in a Georgetown University hospital bed with a tube running from my nose into my stomach while an IV pushes saline solution, antibiotics and painkillers into my bloodstream.  No water or even crushed ice for at least 2 to 3 days.  You get nothing but a moist tooth brush type thing to keep your mouth sort of hydrated.  You know it’s bad when you start salivating at the mere thought of green Jell-O.  Forget solid food for 3 to 4 weeks.   Welcome to the wonderful world of nutritionists teaching you how to eat six small meals a day.

I generally have a very good attitude about these health things.  But only because I suspect I’m going to live to laugh about it.  I would not be this sanguine if the situation were dire.  Still, dark thoughts enter the mind from time to time.  Will this be the 5% of operations that have complications?  What happens if they mess up the anesthesia and you have a massive coronary or something?  Do you see the white light and the tunnel and everything if you’re knocked out on heavy drugs?  Who do I bitch to about a bad outcome if I’m, like, dead?  Will they get all of it so I can avoid post-operative chemotherapy?  What if it’s worse than they thought and I awake from the operation and they tell me the whole stomach or some other organ is gone?

But then I remember they have done about 3 bazillion tests on me so they have a pretty good idea of what they’re dealing with.  I have Dr. Waddah Al-Refaie, Surgeon-in-Chief (that’s his actual title) of the Vince Lombardi Cancer Center at Georgetown University performing the operation.  I also realize how fortunate I am to be alive in this day and time when there is so much knowledge about these terrible diseases that used to be death sentences.  Perhaps most importantly, I remember there are so many folks so worse off than me and my stupid stomach.

I have a health directive in place.  Finances are in order.  My peeps know who to call if stuff goes south.

To my many wonderful family, friends and co-workers with whom I have shared the cancer news in recent weeks and who have been so sweet and supportive- THANK YOU!   But just because it’s early stage cancer and an operation may cure me, doesn’t mean you can stop praying.  No siree.  Keep those going please.  Especially from 8am-2pm on Thursday, May 2nd.

Speaking of prayers- here’s an Irish joke somewhat appropriate for the occasion:

An Irishman is flustered not being able to find a parking space in a large mall’s parking lot.

“Lord,” he prays,” I can’t stand this. If you open a space up for me, I swear I’ll give up drinking me whiskey, and I promise to go to church every single Sunday.”

Suddenly, the clouds part and the sun shines on an empty parking spot. Without hesitation, the man says, “Never mind, found one!”