March 4, 2010 Pain and guilt. Is it all my fault?

Thursday March 4, 2010
3:30 AM-after sleeping in 60 minute intervals and racking up about 5 hours I give up. Here I am, another day in paradise. Mamashealth.com had a short article. I am suffering pelvic pain, painful and frequent urination and unfortunate urgency largely and daily, classic symptoms. Again, not to belabor the point and my friend John from up north did contract breast cancer and survive, but cancer in the drain, I mean come on.
Having reviewed this issue of my daily symptoms and compared to listed symptoms I must again conclude I have an irritated bladder due to the cancer and bladder liner damage. Just going to have to live with it. I shall let others drive me today. I know it is presumptuous, and a load, but after all I am the sick one and might as well act it when I am sometimes. The pain has slowed my gate to a totter. No more throw your toes out, John Wayne stride that always exuded my overly narcissist side. Now my short gate and no doubt occasional wince belie my condition. In a way mama’s article was a blow to me. I had been saying and praying that my pain and pains were somehow related to my surgery, being folded etc. Not so though, it is the cancer that has so negatively impacted my quality of life. So, 5:23A and getting ready to get cranked up, cleaned up, and stood up for another day in paradise. Took a lortab and logged same, 3.5 hours since last one, Vanessa will check on me and her strength and skill born of her love for this bum is a gift the Good Lord has given me in this troubled time.
Can you describe the pain? So let’s say you have (if you had one, if not try to imagine) to have a solid object shoved up the length of your one eyed trouser snake and suddenly by remote control it is enlarged to several times its diameter and heated to the temperature of the sun’s surface. Then it is returned to normal size and temperature, then without warning it expands and heats again. Now repeat the cycle with long expansion and short contractions the length of your dipstick for what seems like eternity but is only likely a few seconds, hard to time when you are ripping the arms off the chair. Follow that by the sense that willy has been invaded and stuff just keeps on hurtin’. So what number would you assign? Well, where do we put makes your knees weak and makes you swoony and a little sick? Is that a 5 or an 8? Can I see the chart? Well that is the top level of my discomfort at this juncture, and fortunately for a lot of the day I am getting along ok.
I googled around on the morbid side, wondering about stages of death. Appears the manual for my demise should it be so is the same as Mom’s last year.
Most painful day as I sit here and the sun sets that I have had. Five lortabs so far. Feeling out my providers, I made connection with the Nurse in charge of Dr. H. Although many patients perceive the doctors as the drivers, movers and shakers in medicine, they are but bit players. It is the nurses that make the wheels turn. Somewhere along the way I learned to be nice to the nurses, even when they are trying your patience (so to speak). Marietta will be one of my favorites, starting with her prompt and complete responses. I shall not be shy in following up and expediting my treatment as needed. I will temper my method understanding that my Family can easily turn into three flesh eating pit bull bitches and even on a good day my influence and authority over them is at best minimal. So with these new folks to us at IU I am working with my first nurse contact. I decided to try e mail instead of voice mail today, much faster, provides record of conversation and Marietta was johnny on the spot with her response. Dr. E had neither e mail nor fax and the facilities are about 50 minutes apart in Indiana. There seems to be some disparity here. I am grateful for Dr. E, and also have benefited from the care at Community in an indirect way. I have gained a deeper understanding of the health care providers I will be interfacing with from here on out.

In any event my back and forth with Marietta follows, in reverse order of course with most recent coming first.

Thanks ,,,,,,,,,,,,,,,,,,
Until today I took 2-3 per 24 hours in the night to help sleep. Today I have taken 4 so far, beginning at 2 am. They do not work very well for me. My pain level is about 75% of weak knee sick at stomach hurt level, with occasional peaks at the weak knee moan and groan level.

________________________________________
From: Marietta L
Sent: Thursday, March 04, 2010 3:02 PM
To: Mike Courtney
Subject: RE: Patient info
Hello Mr. Courtney

You are always welcome to email or call me. That's what I am here for. :) IF you do have problems after hours or the weekend and need to speak with the medical oncologist on call, please call 317-br549 and ask the operator to call the medical oncologist on call.
I spoke with the ultrasound dept just a few minutes ago and they are waiting on the radiologist to ok the bx and schedule a date and time.
Regarding your pain, are you taking 1-2 lortabs every 4-6 hours for the pain? How long does the lortab work and how many are you taking in a 24 hour period?
I will let you know ASAP when I get a date and time from radiology.

Take care,
Marietta
________________________________________
From: Mike Courtney
Sent: Thursday, March 04, 2010 2:42 PM
To: Marietta L
Subject: Patient info
Hi Marietta,
Could you advise the status of the radiologist review of my CT and when we can get the needle biopsy scheduled?
I am having a difficult week with a fair amount of mid section pain and discomfort and to be expected painful urinary symptoms and frequency. I am draining ok. I have not had visible blood this week. I have been prescribed lortabs for pain relief but wonder if that is the best medicine. Thanks for your help. Hope I am not too much of a bother, and hope you're having a great day.
Mike Courtney
Cell br549

Extremely important to be functional during the day. Work was hectic this week, with three deals floating. I was not physically up to working at my station or driving this afternoon, although I did for 2 hours and cleared most of my desk. I have decided that pain management is achievable to the degree I can be productive at work. Beautiful sunset, still, blue and purple, white patches of snow cling in the low ground, making a patch work pattern of clouds laid flat in two dimensions for as far as the eye can see. I tried to walk but could not so after a block I turned, rested and returned to my roost. Doing some filing on research and came across this article that I save a couple of weeks back. I saved it to remind myself that 40 years of smoking cigarettes likely brought on this scourge, so it was a self inflicted and maybe long term slow building suicide.


Bmj.com
Chemotherapy before surgery improves
Survival from bladder cancer
207
Patients who received chemotherapy before surgery for locally
advanced bladder cancer lived an average of 31 months longer than
patients treated with surgery alone, an 11 year study of 307 patients
has shown (New England Journal of Medicine 2003;349:859-66).
The principal investigator, Dr H Barton Grossman, professor of
urology at the M D Anderson Cancer Center, University of Texas,
Houston, said: “Treatment of this disease varies across the country,
but we believe neoadjuvant chemotherapy should be used more frequently
to treat patients with locally advanced bladder cancer.”
Patients in the study who were treated with surgery alone had a
66% greater chance of dying from bladder cancer than patients who
had both treatments.
Bladder cancer (cell shown above), is a worldwide problem related
to tobacco use. In the United States it is the fourth most common
cancer in men and the eighth most common in women. The American
Cancer Society says that about 57 000 people in the United (70,000 in 2010)
States are expected to be given a diagnosis of bladder cancer in 2003
and that an estimated 12 500 people will die of it.
David Spurgeon Quebec
Totally in your face. It’s your fault stupid, you did this to yourself. Now you might have robbed your family of who knows how many years of your company. Way to go douche bag. On the other hand I did love to smoke, and if I am terminal I might just pick up the habit again for one last time.
I am determined to improve my lot, so tonight I am trying to stand and avoid sitting in hopes of being able to recline when it is time to sleep without the through the middle ache that prevented me from any long sleep periods last night.