#337: Short, Swift, and Saggy

Date	Time	Miles	MPH	Min/Mile
6/9/11	00:25:48	2.35	5.47	10:59

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I have a long run scheduled for the weekend, so I didn't want to wear myself down today. I also wanted to try to test my speed. I don't want to get involved in a lot of speed work, yet. My body and I still have plenty to learn about endurance, and it will be a long time before my time in a race is more important than finishing. Still, I have an ego, and would like to have a little more oomph... at least enough to keep up with the strollers and dog walkers. So today, I went as fast as I could, for as long as I could.

First of all, those are some shocking numbers for me. I don't think I've ever run that fast for that long in my life. I stuck with my Run/Walk intervals, running 2 minutes and walking 30 seconds. After that first mile, 2 minutes seemed like a very long time, but I kept pressing. I could really tell the difference between this and my usual runs.

There is still a difference between the distance I measure on MapMyRun.com and what my Nike+ gizmo indicates. I use the longer of the two distances here, because it's so much more impressive. I did mention my ego, didn't I? No matter how far it was, at the end of these miles, I was spent. I don't think running 8 miles on Sunday left me feeling this tired. I am definitely not a sprinter!

On the other hand, it felt good to seek my own limits for a little bit. My legs learned something about running at a faster cadence than they are used to. I won't try to duplicate this pace on my long run, but it will be interesting to see if this work allows me to cover a little more ground.

I've begun noticing some changes in my body. As my fat percentage continues going down, things are appearing. Hip bones. Ribs. Nurses can find the veins in my arms a little easier. I can feel separate muscles in my thighs. My face looks longer. There is one thing that bugs me, though. I have these pouches of flesh on me. 130 pounds ago, my skin got used to covering up a lot more stuff than is in there now. I can tell from the scale that I'm lighter. I can tell from my pants that I'm slimmer. But my belly is like this floppy, empty sack. Not blubbery, just baggy. The other day, I took a naked stroll into the living room and asked Mrs P if she thought my gut and thighs would eventually shrink down to normal.

"Oh, no," she answered with not enough sympathy and a little too much amusement. "You should probably get a tummy tuck."

Well, no one could fairly describe this vast expanse as a "tummy," and "tucking" it just seems inadequate. I'm thinking we may have to bundle up a couple of yards of the stuff off and donate it to science. I could probably provide grafts for several burn victims with the hide sagging from my torso. Of course, there would have to be some medical reason to do such a thing. The insurance folks won't be interested in paying for surgery just so I can have washboard abs and a tight butt. Not that any of that will matter since I'll need a zipper where my belly-button used to be.

Anybody know if looking like a half-inflated beach ball in swimming trunks is a life threatening situation?

Peace,
Pennsy

#170: Setbacks and Delays

I can't help smiling when I remember that night in the recovery room when I thought that Cancer had been awfully easy to lick. I half-expected them to pat me on the head and send me back to work. No such luck.

Just because the surgeons removed all that they could see doesn't mean that they got it all. There were cells outside of the main tumor, and it had reached the lymph nodes in my neck. I was going to need both radiation and chemotherapy to clean up what they might have missed.

The meeting with the radiotherapy oncologist was pretty jarring. She described the procedure to me, and told me about the side effects I should expect. Loss of taste. Sunburn like burns on my neck. Hair loss. Sores in my throat and mouth. Nausea. Lots of pain. For at least six to eight weeks. We scheduled my first appointment with the medical oncologist (the chemo doctor) and left the clinic on shaky knees.

The morning I was to meet the chemo doc for the first time, I got an urgent call from the Cancer center. Blue Cross had determined that my Cancer was a "pre-existing condition." My insurance would not be paying for any radiation or chemo. The lady at Lexington Clinic was very kind and assured me that they would find alternatives for me. Mrs P was working, but Mum was there in the room when I hung up the phone. She wept for my suffering. I wept for my humiliation. After a lifetime of hard work and playing "by the rules" I was being pawned off as a charity case. I blamed the insurance company. I blamed the man who fired me two years ago, costing me my life's savings and my comprehensive medical coverage. I blamed myself for trying to make a career in the arts where poverty was practically guaranteed. And I blamed God in whose image I had been made, reputedly.

Late that afternoon, the Clinic called to let me know that the University of Kentucky's Markey Cancer Center would accept me as a patient. They would be able to help me with the financial aid I needed. Actually, what she said was that they were big enough to absorb the loss of treating me. They had made an appointment for me. My treatment would be set back a week.

At the Markey Center I met Dr. K. He and his team examined me much more thoroughly than they had at the Clinic. They discovered a loose tooth. We would need to see a dentist about that. He also explained to me that because of the damage the therapy would do to my throat, there was a good chance I wouldn't be able to swallow for most of the time I was getting radiation. If that happened, I would need a feeding tube. Rather than interrupt my therapy to put one in, Dr. K recommended that we install the tube before my first treatment. Now I had a dentist appointment and an outpatient surgery to complete before radiation could begin. I still hadn't met a chemo doc.

As we looked at the x-rays together, the dentist was very kind and to the point. I had advanced periodontal disease, a chronic infection of the tissue connecting my teeth to my head. Radiation would destroy my saliva glands and compromise my immune system. The infection in my gums would spread to my teeth, even my bones. I could wind up losing my lower jaw. All of which would interrupt my therapy and give the Cancer a chance to gain a new foothold.

My teeth were shot. They all had to come out. The next day, if possible.

Another office. Another kind administrator explaining that payment would be expected at the time of treatment. Yes she understood that I would die without the procedure. Yes, she was very sorry. If we could pay half up-front, they would bill us for the rest. Mrs P scrambled to find friends and relatives who would lend us the money for the down payment. The next day, all my teeth were gone. And my treatment had been delayed another two weeks while my mouth healed.

I finally got to meet Dr. Arnold, the medical oncologist. She asked why I had waited so long after my surgery to start chemo. I tried to tell her the story without cursing. She and her team examined me. I had developed "Thrush," a fungal infection on my tongue. Mrs P said it was from all the antibiotics I had been taking. They would need to get that under control before starting chemo. We also needed to schedule a morning to have my feeding tube put in. I expected this to take about five hours. I'm not sure why.

Two mornings ago, I reported to the hospital. They sedated me before I knew what was happening. I woke up feeling as if I had been shot in the belly. In theory, the idea of installing a hose through your skin and directly into your stomach is incredibly cool. I even found videos of the procedure on YouTube. In practice, having someone poke a hole through the muscles of your abdomen really, really hurts. You know all those exercises in the gym that are designed to develop your core? They're there because you use the muscles around your middle for almost everything you do from getting out of a chair, to drawing a breath, to using the bathroom. The surgeon poked a hole in my core, and left about 14 inches of rubber hose hanging out of it. Ouch. I spent the night in the hospital, eating Percocets like M&M's.

Today, I got the call from my medical oncologist, Dr Arnold. We're going to have to delay my treatment while I recover from this "minor" procedure. Chemo and radiation were scheduled to start tomorrow, now they will not begin until June 7. Ideally, radiation should start within four weeks of surgery. My operation was six weeks ago.

I'm really scared tonight. I'm afraid of what is happening inside my throat while we figure out which specialist gets the next crack at me, and who's going to pay for it. I'm afraid that the pain I'm feeling now is nothing compared to what I'll be feeling once therapy starts going full bore. I'm afraid that the steady hold I have kept on my emotional health so far could slip at any time turning me into an angry SOB lashing out at the people who love me so much. I'm afraid God has forgotten me and my family. I'm afraid that, as bad as it's been, we "ain't seen nothing yet."

I wish I had a glib little spiritual bonbon to throw in here. Some soothing bumper-sticker theological insight that would make us all feel better. But the truth is, I haven't got a thing. Tonight, I'm just scared. And that's going to have to be enough for me. There aren't any easy answers to be found. So I'll just have to sleep on the hard questions for a little while longer.

#169: Slow Fade

As I write today, I am heavily drugged. I had a feeding tube placed yesterday, and am really loaded up on pain killers. I'm kind of interested to see how this turns out.

As I remember the time around my surgery, I don't really have a linear narrative in my mind. More like a series of loosely connected episodes that fade in and out.

Arrive at the hospital, suitcase in hand. A very kind lady talks to us about how to get financial aid.

Ride the elevator to a large atrium/waiting area.

Follow a nurse through many, many doors after giving Mrs P my wedding ring.

Paper robe. Gurney.

Tim, our priest pops in to my pre-op cubicle. We don't really know one another very well, but I am very grateful for his company. He sits with me for a long time.

Doctors and nurses with clipboards ask me questions. They stick me with needles.

Groups of loved ones stick their heads through the curtain like farm hands welcoming Dorothy back from Oz. We laugh and pray. Mrs P is being brave.

I am in the operating room. There are lots of tables and instruments laid out along the walls. I remember thinking that these people are planning to be here for a while. I scoot off the gurney onto the operating table.

Mrs P is smiling at me. "You're finished." She tells me I was in surgery for six hours.

In a new room. Bigger. Dr Colin in scrubs. "Was it Cancer?" Yes, but they were able to get everything visible or palpable. He asks me to pucker my lips. The muscles around my mouth still work.

Holy cow! I am peeing through a catheter!

I am in Intensive Care. Big room. Glass doors. Just like Princeton Plainsboro. A nurse removes an IV line from an artery in my hand. It takes a long time to get the bleeding to stop.

I fall asleep with a cup of ice water resting on my chest and spill it on my lap. I am awake.

Two voices are discussing my incision. Dr. Colin does such beautiful work.

Am I in pain? Yes, very much. Morphine into the IV line, chased by a little anti-nausea medicine. POOF! Pain's gone.

A hazy, angelic presence enters the room, approaches the bed, and very gently pulls about fifteen feet of rubber hose out of my privates.

Dr Colin is standing above me. It is early in the morning.

I eat a hearty breakfast of Jello, Cream of Wheat, and Ensure. The phone rings, and it is Mum. Yes, it was Cancer. They got it all. It's going to be OK. My voice sounds good. She'll be here in two days.

Mrs P brings me a book and my Rosary. She looks very tired and very beautiful.

In order to confirm that my kidneys are functioning, I have to pee in a bottle and call a nurse to contemplate it. They are pumping IV fluids into me. I have to pee a lot.

I am sitting in the chair, reading a book. Is this really all there is to Cancer? A couple of days in the hospital? What's the big deal?

I am in a wheelchair moving from ICU to a regular room. The person moving me says, "Well, at least now you'll have a male nurse." I try to think of a single way in which this is an advantage.

Is it easier to ask a man to help you empty your urinal? No.

Mrs P brings me my phone. I call the family and a couple of friends. I kind of wish there were room for two on this bed.

Restless night as I take stock. Voice? Check. Tonsil? Hideous scar, hurts like the devil. Neck? Huge incision from my ear to the middle of my throat where it meets my chest. Numb from my jaw to my collarbone. I have no sensation in my right ear. I can hear with it, I just can't feel it. There is a little rubber bottle attached to a hose in my neck. Fluid drains out of the incision site into this bottle and someone empties it every few hours. I doze from time to time, but am awake more than asleep. Can't quite figure out where to put my head.

Dr Colin comes in before the sun is up. I'm going home today, as soon as the little drain is removed. I call and get Mrs P out of bed.

One last pee in the bottle.

Wheelchair ride. Into the car. Back to the house. Into my own bed.

No bed ever felt so good.

#168: This is Happening to Us

The days between the PET scan and our next meeting with Dr. Colin were distracted. The nights were filled with unblinking stares at the blackness above our bed. Long fearful silences. "Denial" is as good a word as any.

Kammy was the first to notice at work. She is a young woman at work (nearly everyone is young at work) who pretends to be a silly girl to hide her intuitive compassion.

"You aren't as cheerful as usual today," she observed in that musical Congolese dialect of hers. "What's wrong?"

My candor took me by surprise. "I've been having some tests. The Doctor thinks I might have Cancer." It was the first time I'd said it out loud. Her response was honest and startling.

"I hope you don't. I don't want you to die."

And there it was, out in the air. Together, we had given my silent fear a voice. It was the first of many times I would realize how much I share my condition with the people who know and love me.

The day the Doctor gave us his opinion, Mrs P took it harder than I.

"I can't say for certain that it's Cancer, but if it walks like a duck... There is no time to lose with this. If you delay..."

I finished his thought, bad habit. "It will just keep growing."

The Doc corrected me sternly, "It will take your life." This was not a joke.

He described the surgery and the risks. Nerve Damage. Muscle removed. Loss of taste. Loss of hearing. We thanked him and moved across the hall to schedule the surgery, three days later. The treatment coordinator had strange news for us. My insurance was a strange, bare bones plan. Great for physician visits and prescriptions, but it did not cover inpatient procedures. Blue Cross would not be paying for my surgery.

It was a lot to take in. We rode the elevator down to the lobby and left. In the car, Mrs P started to cry. I was angry about the insurance. She was frightened about the diagnosis.

"I just don't understand why God is letting all this happen to you.."

I would deal with God later. "This isn't happening to me. This is happening to us."

What Kammy had taught me, what I wanted Mrs P to know was that I knew this was a burden we would share. I would not have the luxury of playing the victim. This was going to hurt everyone who cared about me, starting with her. We stopped by work. I picked up a prescription and told my supervisor that I probably had Cancer and would be missing a couple of weeks work after my surgery. I noticed his Livestrong bracelet.

"I may need to get myself one of these." I reached out and touched it, and he smiled sadly. I wondered why he wore one.

Mrs P and I walked out into the sunshine. It was a beautiful April Kentucky afternoon.

I wondered why God was letting this happen to my family.