30.11.10

Thanksgiving Weekend 2010

The pain was sudden and severe.  The left foot, little toe and one next to it and the ball on that side, WOW, shebang, holy sh.., OMG, what the hell is this all about.  Pain again, bang, pow, whoa hoss, oh damn, yeoweee Abigail, oh kalamazoo, bam.  Neuropathy has reared its ugly head.  Now that is an equalizer if ever there was one.  Unable to bear any weight on the areas affected causes me to hobble.  A hint Thanksgiving, an attack Friday and a knock down Saturday and I am back to the prescribed 3/300 mg/gabapentin per day every day.  Now the condition lurks, close to the surface, rolling about.  Sometimes it hits like a hammer, raising one up with a start.  The drug taken as prescribed seems to manage the condition but does nothing to cure it.  My problem is I continue to live in this dream world where I can quit taking pain pills and gab and so on and I have to accept that ain’t gonna happen.  Whoa, don’t touch.  Don’t even get near.  You learn to walk in odd ways, on heels, balls, sides of your feet and sometimes you might not get to walk at all.  This is all the more reason to return to the gym as soon as possible as far as I am concerned.  And clearly I need to accept reality every day and stop living in that dream world that has kept me young all those years.  Is that another cost levied by the animal, the end of the Adonis Effect, or AE as it is known?  While everyone else sees an old fat guy I look in the mirror and see Adonis.  A God.  Why not this one indulgence to see me through? 
The animal will not give me peace.  I never know from day to day what is going to be thrown at me.  It makes life more interesting than ever when physical comfort is involved.  I shall not lay down to the beast.  Dr. Noah assures me we have a pill for everything. 
Saturday night we had our birthday for Vanessa.  She got her IPod with its camera and tuner, I’m so jealous but happy for her as she continues to stumble kicking and screaming into the 21st century.  As with all things she will soon be more advanced than I in the intricacies of the IPod world..  We had a great time, sharing small plates with wine at a wonderful venue along the canal in Indy and then to the brewhouse for desert and lots of laughs.  Jocelyn took pictures so evidence does exist.  It was a ton of fun and the finale to our great weekend holiday with the Family, oh how I miss them when they are gone.  Fortunately for me I will have a couple more opportunities in the coming month to spend time with both my Daughters and Wife. 
We are keeping the grand dog while J and J take a vacation for a few days starting Tuesday.  It appears I will be in pretty good shape for the puppy.  I will once again experience the joy of the dog inside and out and I need to be in shape for it.  Sunday was football day.  I did walk to the end of the cul de sac with no problem during a time when the neuropathy was toned down.  This is turning into a battle.  I take great care bringing weight to bear on my feet as I sometimes cannot tell where the pain is lurking if I have been sitting with my feet up.  So Sunday and Monday I stayed down for the most part.   
I appear to have overdone the walking and stairs etc. over the weekend.  Now Tuesday early and I am back to where I was last week about this time.  Vanessa suggested I have gotten worse over the past couple of weeks.  I can summarize my issues in two words, incision, gas.  These are my two constant pain generators and I am a wussy when it comes to pain.  The return of fire feet has been like hot fudge on vanilla bean, I mean if you are going to have the pain, let’s go all the way.  The bone ache in the left leg is also out there, from not taking walks several times a day.  I know, I know, suck it up. 
This morning since I am importing some CD’s into my I tunes library.  I have the program set up on Vanessa’s machine and loaded my LP collection into my library yesterday in anticipation of her use.  We went down to the gym yesterday and converted my membership from Senior Single to Senior Couple, Vanessa is now officially no longer a Curves member after all these years.  She has a couple of buddies to start with and was thrilled to get her bar code card and official membership.  ‘Now we can come to the gym together’ she gleefully proclaimed.  ‘Oh yeah.’ He replied, ‘to watch TV’.  ‘No’, he knew this was coming, ‘We can work out together!’ she was almost giddy in her tone.
‘Oh boy’ he deadpanned.  A game we play.  Actually I am thrilled that she has joined the gym.  As with all things she will go into this head strong and it will be a great success for her I am sure, not to mention another networking opportunity.  It’s only a matter of time before she takes up golf.  So we are 59, I am loading up my I Tune library, we are in the same gym and I am talking about golf in November, ah the modern couple.   
In keeping with the spirit my mantra today is ‘Quit Bitching and Take Pain Pills’ (as required).

27.11.10

Thanksgiving...So Glad We Made It

Listening to the Kansas LP ‘Two for the Show’ as it plays through for digital conversion to MP3.  I still have a few albums to go to complete my project.  So far 267 LP’s are done.  Over the years I considered many times getting rid of this collection.  In my ‘do it as you can program’ over the past two years I have had the great pleasure to replay my collection.  Many albums were only played once to record to cassette.  I gave away the cassette collection last year, knowing I had the vinyl to back it up.  This collection has been the mainstay for my I Pod.  Picking songs at random from the files for the I Pod is my SOP.  Often times my play list sounds like Q 95’s when they are playing classic rock.  Interspersed with that is the easy listening collection, from Abba to Elgin John and beyond.  A few Kansas songs still get regular radio play.  Wow, what that must be like, to do a song decades ago and get a check for airtime.  Called Shirley Evelyn and Helen yesterday, my Dear Aunts to hear their voices and wish them a happy Turkey day.  I certainly hope I can get up to see them.  What a delight to hear those voices and I had a great visit with each one.
 Wednesday night we were at the Hay’s compound and dined on Cajun fare, fabulous, that was a carry in from a nearby Cajun chef.  I have come to look forward to dining with Jared and Jocelyn, it is always a real treat and many times a true adventure, whether dining in our out.  Jenny made it in late after a very long drive down.  Tough getting out of the city on the night before T day as it seems about a million others are getting out to go home and spend time with family or get out of the City for another diversion and we had only a few hours sleep going into Thursday.  
Thanksgiving Day 2010, 50’ish temps, rain, wind sometimes, definitely November in Indiana.  Of course we have had brutally cold T days and much warmer ones in the past, so I will gladly take this relatively mild one this year.  It was just the 5 of us.  Vanessa worked most of Wednesday and all Thursday morning.  Jocelyn brought yummy stuff, including the addictive mac and cheese dish and some continental cuisine.  It was a great day.  We ate like royalty, napped like satiated felines, played games, watched football, got a little tipsy and laughed a lot. What a great Thanksgiving we had together. 
I have been wearing my compression stocking on the left leg, and Inger reported this morning it looked pretty good.  I am still battling back pain and I am sporadically passing blood in my urine.  The seepage from the wound is at last slowing and I am getting around better today than yesterday.   Now 4 weeks since the surgery and I move slowly.  My movement is accentuated by pain at the suture and odd pains internally that are short lived and very sharp.  I cannot do a lot around the house yet.  Pushing the sweeper or standing for long periods is out of the question.  I have set a goal to be doing so good in the business a year from now that I can afford a Consuelo.  So I take a pill.
The girls stayed over and Jocelyn and I camped out in the recliners.  I caught about 2 hours of sleep but was not too uncomfortable through the night.  I took two pain pills at a 4 hour interval but they seemed to have no effect.    
We all put on a brave front when we are together but there is a pall that hangs over us, a dark shadow of the animal that lives inside me.  Jocelyn called it an ‘emotionally charged atmosphere’, an understatement to say the least in a household with 3 women who are ‘emotionally charged’ to the nth degree normally.  It certainly would not take much to reduce me to a sniveling mass that’s for sure.  I have only to look at my Girls and dwell for a moment on all that I will miss for the tears to well up.  Perhaps what we all need is a good group cry but it is not my way.  I cannot allow myself the luxury of such a lapse.  My battle demands I stay strong and positive and so I allow myself those moments of weakness when I am alone and apart, and only for a brief time.  Brief grief or BF as the two letter acronym for it would go.  BF allows me to vent.  I know behind my back the girls are tortured but they put up a strong front.  Vanessa seems to be bracing for whatever might happen whenever it might happen but I think the Daughters just cannot get their arms around it like that.  Only Jocelyn reads my journal here, and she says it is difficult for her, but she is drawn like a moth to the light to read my thoughts as I journey through the process.  I wonder if I should ask if we should have a group cry, but the thought of it makes me cry.  My battle plan says there is always time for cryin’ so why start it now. 
I took Friday off.  The Girls went south to Grandma’s and shopping.  I visited my extended family in Muncie in the morning, John G stopped by in the afternoon and we watched stupid television and tuned up for the evening.  Writing and some play with recent photos rounded out my day.  I got about 6 hours of good sleep in.  As Vanessa predicted I awoke Saturday late, had some cuddle time and Tucker time and find myself feeling much better with the exception of one thing.  Neuropathy struck my left foot with a vengeance leaving me hobbling.  I absolutely could put no weight on the left front side. I went back to a 6 hour interval on the medicine yesterday and this morning I have much improvement.  Still tender by not so debilitating that I cannot get around.  

24.11.10

So Much To Be Thankful For

Oh what a blessing technology is.  I sit with my Brothers as if we are in the same room on Skype.  Dan is at the cutting edge of research into cyber passing but we ain’t there yet.  We chat and laugh and share and vent.  While it certainly does not replace physical presence, it does enhance our long distance conversation significantly.  I have long wondered how video calling would work for a professional salesperson, most of who shudder at the thought I think.  I’ve had little sleep in spite of the pain medicine.  The wind chimes chiming in infinite harmonies as the wind of strong storms sweeps through.  Ah November and he stands on the porch looking to the northern sky and feeling the wind blow through him.  A new year for the business and we battle on in an economy that is ever changing.  Technology is a wonderful thing, but it is also a brutal task master.  For some professions where communications and response time is critical a job can be carved out and adapted to changing conditions. 
I once had a salesman who I could not get to go out and see a Customer, it was like pulling teeth.  He hovered over the office, sucked up resources indiscriminately and cherry picked incoming calls.  After he left the work load in the office dropped in half and it was a decidedly nicer place to work.
He was consistently a top salesman, although I never had a lot of respect for how he did it.  I can now appreciate his powers of persuasion and ability to use the technology available at the time to get orders.  The most remarkable thing to me was he posted great numbers for my business at a time when none of the technology we take for granted even existed, and made a decades long career of it. 
For me the business is more than numbers.  Producing billable hours for highly skilled artisans is an honor.  Placing very high quality equipment is fun, but does little for aftermarket service income, a conundrum but a good one to have.  Making sure you spend your Customer’s money wisely is a mandate.  Providing a service to a plant utility without which the doors could not stay open is a grave responsibility.   I never saw it as a long distance job, and I never got rich.  Throughout my career I have been blessed with being surrounded by very talented individuals, allowing me to apply the shared memories of a large and smart team to my job, making it easy to do.
However as I go through periods of limited or no travel and motoring about on foot I am forced to resort to alternatives to the face to face meeting.  I am still learning my way.  One thing for sure, work is work, no matter how you go at it.
Working at the Cancer Center was like work anywhere for us

I am just thankful I have the ability to continue and so many things to keep me busy.  It really is a gas.  Travelled today for some calls in Muncie and visited with my friend Gerald.  Still get worn down pretty easy.  Driving really seems to take a toll but I did wear regular pants and made it without major incident. 
Now Wednesday and 5:30 AM and I have been at it for a while.  Sleep continues to be evasive and painful urination is a periodic problem.  I am certainly abnormally frequent.  Cranberry juice now in the daily regimen.  Gerald suggested adding bee product as well to my intake.  Good or bad we have set keeping my immune system in boost mode as a worthy goal.  It is important to have goals.  This one encompasses diet and exercise and gives Vanessa aka Inger many ways to participate in my ongoing therapy.  Being blessed with such a caring soul, it would be cruel and do a great disservice to us both if I in any way excluded her.
She watches closely now, sometimes hovering and boy am I thrilled with it.  Nothing like having a beautiful woman hovering.  I see in her blue eyes the girl I met nearly 40 years ago.  It was love at first sight for me then and like a gold fish forever in orbit forgetting where he just was I rediscover that feeling in my gut and heart every time I look into those eyes.  It is without question a singular joy that could sustain me if no other joy entered my life.  On top of that we have two wonderful and beautiful Daughters who have held there childhood bonds to their Mother long distance.  When they get together it is just like having a bunch of teenagers in the house, ornery ones at that.  My Son by marriage is a caring soul of like humor who patiently took me golfing for the first time and who’s company I thoroughly enjoy.  His Wife is a rock with attention to the finest of details in patient and family care.  She brings stability to our situation.
A disease that put me in the hospital, long recoveries and extended treatments opened the door to more blessings than I can count.  They were often hidden and only came to the light of day through hardship.
These hidden blessings include the loving and caring family I have with my Brothers, Sisters, Nieces and their Husbands, Sons and Daughters.  Although we are the last Courtney to show our face in this crowd I am thankful we live so close and can share with them and hold them dear. 
My dear Neighbors who saw me on a stick and wondered but dared not asked and once told stepped forward without hesitation.  Dale mowing my lawn at a critical time in my recovery from the first surgery, Bob weed eating and cleaning up and all around ready to step in whenever called.  Vanessa’s Church Family, Phil trimming hedges for us and tilling the garden in the spring, food, caring and emotional support for Van is all a dream come true for me.  And her amazing circle of friends, with whom she can share the details of her feelings, so important to good mental health in stressful times.  My work team one and all would come at a moments notice if I called as would many of my Customers who are also friends and confidants.  Many in my home town and from high school pray for my recovery and wish me well.  My close friends and supporters John, Gerald, Peggy, Kathy and Joe.  My dear Aunts, three wonderful ladies, two of which I now have regular e mail contact with as a result of Mom's passing.  God's gift to me in my suffering, all of these people who are in my life and supporting me and my Wife and Daughters in so many ways.  More than I can list here. 
All the blessings that have come my way or still await I am most thankful for this year. 

23.11.10

Days Passing

Saturday and I walked, pushing myself harder now.  I started some seeping on the wound again but I gained in my ability to walk with a more normal stride. I am having some pain and burning when I urinate and have passed some clots that nearly buckled my knees.  I am working on increasing my clear water intake to help this.  It is similar to previous post catheter difficulties.
Sunday and cuddle time first thing.  I am still healing and a lot of movement makes me sore below the navel in a horizontal line through the incision.  I remain sensitive to gastronomic pressure, which causes pain as that runs the circumference of my middle.  It is of course manageable and a reminder I need to mind my p’s and q’s as the healing process progresses. 
Inger now visits daily with glowing reports on my condition.  Her masterful touch I suspect is the difference as the lymph finds those alternative paths to circulate through.  She missed yesterday and this morning I had the keg leg so I put on the compression garments for the first time since the surgery without issue.  Going to church with Van this morning and we shall see how I do.  It certainly makes comfort station breaks more of a job to get down to business and covered up again but a small price to pay I think.  What is most discouraging is the swelling shows that no miracle is going on, the nodes are not getting better and neither am I.  Regardless, I continue without symptoms of the cancer itself and look forward to the coming short week and holiday.  I joined my Wife at her Church today and enjoyed a feast afterwards.  I thanked the church family for their prayers and support as it has meant a great deal to us and been a real boon to our situation and spirits.  Vanessa looked gorgeous and I wore workout pants and tennees with a fashionable sweater if I do say so myself.  We had to explain to a couple of folks that there was no treatment regimen for me now.  ‘Look Lady, would you quit, you don’t get it, you’re out of the loop.  Did they have to cut me?  Holy cow.  Oh alright I will give you the short version instead of my typical brush off.  Helloooo, you did not listen?  No chemo, no radiation, just regular check ups.  I see you have that deer in the headlights look.’  Finally there is nothing left to say.  
My mode within conventional health care is defensive to make the time I have left as good as possible.  This does not preclude me from cutting a chicken’s head off and sprinkling blood in a circle around my bed in hopes of deriving some benefit from it.  It is hard to tell people I am incurable and my time measured, yet when pressed I certainly get the point across I think.
The Colts lost to New England and life goes on.  Once again a cold wind blows from the south and west so it looks like the temps are going to tank soon.  I did not get the maintenance done on the house this year and pray for a mild winter so I will have minimal damage to deal with in the spring. The home seems right tonight, I in my office and Van in hers.  She’s tutoring and I am writing this among other things.  I have my pile to start in on tomorrow morning as I do not expect to be in the driving long distances and walking around mode.      
I have taken a pain pill, a 5 mg of oxycodone or the like and now find myself droopy eyed and ready to lay this quill down for a while.

Cancerpage.com sums up my situation as follows 'The last two decades have brought significant improvements in the treatment of metastatic bladder cancer with survival time nearly doubling to 12 months and the three-year survival rate improving from less than 5% to 15 to 20%.'  Let's drink to the 20%.

20.11.10

Routine And Reflections

Working until I can’t, resting short periods, working more through the day,
Restless shuffling, constant tightness, slowing me along the way,
Pain sometimes, sharp and hard, feeling like a burn,
I take extra care, I would not dare, to risk its return. 
Back pain from sitting too much I hope,
Cold outside that cuts through my coat,
Life is hard and can be cruel,
So I took a pain pill and a laxative to on both ends drool.
I know the drill,
If that don’t fix it nothing will.
Now the 17th, my 3 week anniversary since the surgery.  Another day where I am a little closer but not there yet.  Making calls and talking to nice folks, layed back and feeling no pressure, a blessing for sure for me.  The days are sunny but crisp now and these last few days I have spent most of my time inside.   It becomes more difficult for me to keep my spirits up as the days pass.  I am still sleeping in a chair.  I get a lower back ache that comes on every evening early and gets progressively worse as the evening goes on.  I take a pain pill late in the evening to sleep. 
The laxative is always a surprise.  I think I am working fine, straight through, out as much as in, etc. and I take the senna and a few hours later pow, where did all of this come from?  Just goes to show the importance of this with the pain killers.  I find it most curious that digestive tract pain brought on by pain killers and the resulting constipation is much different from what I would expect.  Long known for my ebm’s (explosive bowel movements) I am quite familiar with the rumblings and abdominal cramps that go along with abusing my GI tract.  This is quite different from the pain I now have that goes away almost immediately after the laxative hits the mark, punches the clock, turns the lever, opens the gate, etc. 
Now the 18th and I am marginally better in the recovery department.  Over 3 weeks since I have worn compression stockings and my left leg is looking pretty good.  I am up early getting some office work in and gathering stuff for a visit to the office later today.
A wonderful lunch with Jocelyn and Vanessa and a steady work load in the afternoon rounded out my day.  I wiled away the evening reviewing photographs, catching some TV and talking to Renee.  Only 3 hours of sleep or so and up at 4A, Friday is here again.  Odd how the days are so long with my lack of movement outside the office and family room and yet looking back on the week it seems to have flashed by.  Mornings are getting better for me and this one seems to be no exception.  My stomach feels better and I am motoring around a little more gracefully. 
Vanessa shared with me a little of her experience in the waiting room, the room of the big numbers, while I was in surgery.  I am not sure I would have held it together as well as she had our roles been reversed.  I laughed when she told how my entourage settled in, hospital professionals one and all.  The waiting room mode, I never got it until now.  The vigil, how blessed every patient is that has one. 
I suffered when Van told of getting the call to get back, she thought it would be an hour before the next report and slipped off for a break, the surgeon needed to talk to her.  How my stomach sank as she told of how the news was delivered, how she took hope from it.  I thought if how it must have pained my Daughters and got a bigger knot in the gut. 
And my Sisters and Jack were there as well, but being older they have heard such things a few times now.
And witness to it all was the stodgy receptionist.  The guardian of order, that assigned you a number for your area in the waiting room, would witness elation and desolation on an hourly basis every day.  I am not sure I could do even that job in this cancer center.

17.11.10

Wierdness Hands Down

3rd hand, and if you believe this I have a bridge...
There are many unknowns when it comes to bladder cancer.  In a new twist I developed a third hand, doggone thing just popped up overnight out of the back of my neck.  Many times in the hospital nurses and patient care assistants offered to lend me a hand.  Since I generally shun credit I would normally respond with a no thank you and take my fine time doing what ever they perceived I needed a third hand for.  Often I wondered where the hand was coming from that they were lending.  A cadaver's hand?  An unwilling hand?  After all how do you get a hand's permission for anything if you don't know sign language?   No way the chemo could have done it I am told, so I must attribute it to all the CT scans and X rays done over the past 10 months.  As with all things I can adjust to this as well.  I can say it is comforting having the hand on my shoulder, almost urging me on.  I continue to find things I am handy with, and this condition should only enhance that phenomenon.  I do have some sweaters and shirts that will cover the condition as it seems to cause some people real concern when they see it for the first time.  Also I find I need to fit it with some sort of brace or glove to prevent the middle finger from popping up unexpectedly.  Next week we will consult with an appendageologist on the possibility of getting a hand job done.

16.11.10

Adventures And Thoughts As Recovery Wears On


Today recovery continues.  I have some blood passing at least once a day for the last few days, now 4 I think.  Usually but not always at the end of the stream I think it is a sign that the catheter in for a week beat the crap out of my bladder and related piping, not that I cared, I had an epidural through all accept the removal of it, which was done in fits and starts by a student under the supervision of a teaching Nurse.  Wow, just talking about it still makes by butt pucker a little. 
My left side is still markedly weak and I am very tired which I attribute to my body putting all available resources into the healing process. I talked at length with my Brothers in the morning and partied with Jared, Jocelyn and Maggie, the Hays family, in the afternoon and our beloved Colts won.  Vanessa was at a sorority function but called for a game update and had Jocelyn text the final score to her, hokey smokes, what a fan. 
It made me sad when they had to leave, but they have full weeks ahead and I understood.  I got to take a long walk for my present state, about a city block, this afternoon.  I have pulled a small section of my incision, the product of sneezing hard yesterday so I am taking yet another day very slowly and taking a minimal pain medication regimen. 
Now Monday Morning, and I am losing track.  Three weeks since the surgery?  I wake up to much improvement but I am still very delicate and prone to pulling in the same areas so I must continue with sitting, short walking and sitting.  Oh I am so tired of this regimen.  I am thinking that just about now I would be getting the catheter out if I my surgery had been successful and resulted in a new bladder.  The pain pills distort time and perspective and I hope the effects of what I took over the weekend in the interest of mobility wear off before I have to take any more.   
Skype is now second nature as I regularly visit with Rex and Dan.  For me this alone makes the computer worthwhile and would shorten Bill Gates sentence.  Video calls, what technology.  Just imagine, the telephone was invented around the same time as the gasoline engine.  Today the telephone in it’s infinite variations bears no resemblance to it’s original form, yet the gasoline engine is easily recognizable, having it’s last core improvement, hydraulic valve lifters, introduced in 1939.  While manufacturing techniques and materials of construction have changed, it’s still the same old technology.  Imagine if all technology was put on hold to support one industry, in this case oil.  Imagine if every generation we never said what if and every attempt to change was met with overwhelming resistance.  Many would feel very comfortable in such a world, saying we have all we need today and it will sustain us forever.  They will hold to this even as the world crumbles around them.  I wish I could experience such security by turning away from all but selected inputs. 
Video calls, what’s next, a wrist watch TV?  Holy Dick Tracy. 
4:30 AM and I am grateful for the morning.  I did not sleep fitfully.  I am continuing to pass blood sporadically in very light form or small clots.  Not sure what that means but will continue to monitor.  I still feel it is related to the catheter worn for a week while in the hospital.  Snickers demanded cuddle time so I set the computer aside and allowed her up.  I will be starting work early today as I have a lot to get out and several follow up calls to make.  Great to be busy.  Again today I can feel improvement in my incision but I am still not there yet.  Man I am ready to get back into walking normally, wearing real pants and going back to the gym.  Next week is my goal but I am fearful I might not make it.  Vanessa says probably two more weeks at least.  Perhaps they will come up with nanobots today to inject in me and go after my cancers like scrubbing bubbles, leaving me cured and able to once again drink 2 beers and write my name in the snow from the motel balcony.  Miracles happen every day. 

14.11.10

The c Word


November 13, 2010 and not even a year since my diagnosis.  What if the chemo continues to work?  Ah how we love the hypothetical.  What if there is a miracle, miracles do happen every day.  It’s well before dawn and I cannot sleep, not for the recovery, just restlessness.  This is more the norm for me and has been for years.  I rarely use an alarm clock and don’t need it when I do because I am a very early riser and early faller if you will.  Drives Vanessa crazy.  
I am feeling good and continue to heal.  The wound still seeps but less as time passes.  It is covered with a tape that will wear off.  It still slows me up and I cannot wear pants yet so I am in my sweats and feeling pretty good.  What a blessing it is to feel good.  I’m at the stage of sitting too much but not quite healed enough to get active. 
Controlling the lymphedema has been more challenging but Inger and basic exercises and walking as possible seem to be holding it at a level that is workable.  The neuropathy continues to lurk in my feet so I am trying to be careful to stay on the meds for it.  By the afternoon I found I had to take a pain pill to stay comfortable.  A couple of sneezes in the morning pulled something and I am so sick of this not healing up, although it looks like it will in time.  Clearly I will be on limited travel going into the next week. 
We went to the Methodists for a pancake breakfast this morning.  They do it annually as part of the Christmas in Pendleton event.  Standing in line the fellow in front, his red baseball cap, jacket and jeans, I would guess late sixties in age turned and noted me leaning on my stick.  In recovery my left leg has a deep muscle ache and is weak and the suture area is very sore, so I rely on the stick.  Frankly I don’t believe it is any one’s business why I would use a cane and often when asked my response is considered sharp.  For me it’s like swatting nosey flies.  He looked at me and asked ‘is your knee?’, ‘No’ I broke in, ‘I have cancer, the chemo caused me some problems with the left leg.’  With that crushing verbal swat at the nosey fly,  ‘Oh’ came the sheepish reply as he turned his back to us and no doubt contemplated asking a woman how far along she is in her pregnancy first chance he gets. We did not talk further and I lost him in the room after we were served.  I suppose if it was a knee we could have talked style, mechanics, issues, etc.  The c word has a dampening affect on conversation.
I do get a lot of compliments on the cane, cut from a vine by Dad so many years ago and still light and sturdy.  After all, if you have to be a hobbler might as well be a memorable one.

12.11.10

Past The Point Of What If

We waited about an hour and the Doctor came in.  He looked at the stitches and approved removing the staples.  A large knot has formed in my navel area but he was not too concerned, it heals or we heal it was his attitude. To my surprise he explained to his nurse that my case was the first time he had encountered severe edema as a result of chemo.  He explained in greater detail to me than previous what he found in surgery and the reasoning for stopping the procedure midstream.  The staples were plucked out carefully but not without stinging pain.  I breathed through it without any difficulty.  Dr. K released me without restriction. 
We did not wait near as long for Dr. H.  I was first examined by his fellow and a med student.  The student did an impromptu comedy skit dropping a pen and when picking it up another fell from his coat pocket and when picking it up down went a third.  Jocelyn showed some mercy on the embarrassed fellow and I noted Dr. H kept his collection in is side pocket, experience pays. 
Dr. H explained that there is nothing to do at this juncture.  Jocelyn put up a valiant protest but the Doctor’s reasoning was compelling.  In essence there is nothing left to do.  At present the cancer is not growing, but it is there and in a large area in my left abdomen.  Even with the surgery removing my digestive tract, bladder and lymph nodes some cancer would have been left so they stopped when they did.  We will watch and wait.  It will start to spread again at some point and at that point we will decide what to do.  Jocelyn cried facing the reality that her Dad was just not going to find that magic pill or definitive treatment to cure him.  Mercifully she left the room, sparing me starting at that point.  As she left Nurse Marietta gave her quiet comforting words.  She told us all to pray, and not discount the importance of it.
Dr. H’s analysis was nothing new to me. This had all been carefully explained to me at the hospital by both Ologists.  Given my good health and lack of symptoms the quality of my life each day I have left takes precedent in deciding my course of treatment. On this we all agree.  He offered some hope, pointing out things that may be done once the disease begins its inevitable onslaught.  Nothing is without great risk of complication at this stage so we must take care in deciding when the time comes how much suffering will come with any extension of my time here.  Once again the reality hit home on me as I sat in that exam room, that I may very well pass as my Mom did, in hospice and in great pain.  Somehow I do not fear this outcome, having gone through it with Mom, but I am a long way from there yet.  Every hour is the battle, every day another day in the war.   
We put the entire episode behind us for a lunch at a fashionable place in Broadripple.  We dined outside on gourmet sandwiches and celebrated Vanessa’s day.  Jocelyn made it so special for her Mom.  On the way home we found our way to a German bakery, where Vanessa procured a piece of genuine German chocolate cake and later in the evening we celebrated with her cake and a brownie for me.
Now in the early morning I look back on something I pondered a few years back, which ironically seems so relevant to my present state.

Thursday, November 16, 2006 

If there were no more hypothetical questions

I must ponder, as I sometimes do, at a question hypothetical, false or true?
What if, I say, in a hypothetical way, if there were no hypothetical questions asked today?
What would I do?  What could I say?  How could I work? 
Would fun run from play?
There would only be IS, as it IS what it IS.
No coulda’ woulda’ or shoulda’ here. 
No hypothetical questions to fear.
And there would be no ifs or what ifs if you will.
Only the is, from far to near.
There would be no progress on this faithful day, People would stop, and the earth would be still.
Where then without the hypothetical will fantasy flee? 
To the back of my mind under lock and key?
Imagining the possibilities, impossible though they may be.
This too will be lost to me.
I will lose my curiosity and the gleam in my eye, when a beautiful woman brings on a ‘what if’ high.
But wait, no what if means no regret, ahh, a lining of silver in the dark cloud.
No looking back, on what coulda’, woulda’ or shoulda’ been, no more for crying out loud.
So in the IS there is content.
No what if's, no pressure, no need to vent.
I see what you mean, and I mean what I say, there will be no what ifs in my life today.
No hypotheticals will come into play, and I will ponder nothing on this faithful day.
It will be what it is, no more no less.
I will end the day, and be sure to feel blessed.
But, what if it isn't any fun?


By Michael Courtney




11.11.10

Two Weeks After Surgery

SnickersWatchcat and Danderbomb

Now the darkness settles in.  Deep shadows, cat on the TV tray, alert and eyes dilated.  Black holes now, ears perked, off the tray onto the table, the reassuring picture of Vanessa at rest with her cat standing guard.  What does she see?  I see nothing there, yet her eyes follow and track, left to right and back again.  The cat, only one paw from the wild I think returns to the tray, her self appointed station a couple of times a day.  Sometimes animals save us from ourselves.  I shall rest easy knowing the walking dander bomb is on guard and protecting me from the unseen.
Now Thursday in the dark of the early morning, watching pundits interview pundits on PBS discussing the economy I find myself disappointed with the length of time it has taken me to come back.  Perhaps it’s the flair of carpel tunnel in my left hand sending excruciating pain up the arm and persisting long after.  I just registered where my brace is in general terms.  Not enough energy to get up and get it.  Not enough energy has been my hallmark this week, now down to a pain pill every 12 hours or so I hope to be done with them. 
Today is see the Ologists and get the staples out day.  More importantly it is Vanessa’s Birthday.  I hate the cancer for keeping me from my appointed rounds on her birthday.  I cannot imagine a gift worthy of her love and sacrifice for me during this past year of hardship.  I shall try to make her day a jolly one, despite the hospital meetings this morning.  We will have Jocelyn with us for these consultations, our secret weapon. I cannot tell where my Women are on my condition.  I find in my readings in such publications as the Journal of Urology that various studies have been done on post chemo therapy different from the what I have recieved.  Dr. K felt I might be a candidate for radiation which will put me in the care of the team Radiation Oncologist. After all if I can add a couple of years without it killing me it seems to him I should.  Now from Oncologist to Urologist to Radiation Oncologist my graduation to being a possible candidate for radiation takes me to a new ologist and a new fat file to be created.  Dr. Hahn was not so enthused about radiation so today we meet with them and get the skinny.  No sense second guessing what’s next I think I will just let the day unfold as it will, remembering all day first and foremost it is Van’s day. As I sit here and the PBS news hour takes time to show me the pictures of the most recent killed in our ill fated military forays.  Ten children, ten sons, ten friends gone and all the lineage that may have come from them.  Ironic I should see this at this time, but I am glad I did.  One more Vicodin this morning, I hope it’s the last one I have to take.    

8.11.10

The Other C Card


The pain came from some where, middle, back, low, high.  It crossed, from left to right and again, and then it passed.  Now in the middle it rolls and I feel the brick forming down below.  Suddenly it is there, pushing at the door and not caring I exhale.  With the ring echoing off the walls I had a hard time getting it out, ‘Gabrial’s trumpets’ I declared.
Vanessa, sitting before me showed no reaction, but I knew she heard the comment.  As she turned the bible to John and today’s scripture ‘very funny’ she dead panned.  I am pulling the C card, in this case colon card.  The organ is relearning how to do stuff.  I guess my colon brain was somewhere near the tumor.  In any event it get’s an A for gas passing.
We had a party yesterday for football with beer, sloppy joe, fries and pastries with Jared, Jocelyn and Renee.  Jocelyn did the work and we had a great time.  I was still pretty uncomfortable and taking one pain pill at a six hour interval so probably not much fun, but I sure tried and I sure had fun.  We lost to Philly in a tough one but it didn’t matter. 
Today there is a duck following me around the house.  Every time it quacks it smells like baby took a dump.  Ahhh, the C card, a dream come true, plus a hidden benefit, running from the duck to evade the smell is good for me. 
November and it will get into the 70’s this week. 

7.11.10

It Hurts To Laugh

Look at the fun in…feeling terminal, la da da da da da da da, feelin’ terminal to parody Simon and Garfunkle.  I noted in Van’s notes she made note of my breakdown after my visit with Dr. H.  She had asked me what he said about chemo and I broke down in tears for a moment.  Every time I do that the absurdity of it all seems to overwhelm the tears.  If ever their was a font of humor at a funeral it is I (I have done some of my best work at them as Family will testify), so the disease and the visits with the doctors and the acronyms and the terms and the questions by the Women are intrinsically part of the process that Dr. E talked about in the beginning. 
I wondered if the ologists were reading the same Google stuff that I had been reading.  I remember saying boy I hope I don’t get to that point when I was doing my initial research, and here I am.  I never had pain from the cancer, just from the treatments and unintended consequences.  I asked the surgeon where the pain would come from when it did..  ‘Left leg’ he replied, ‘of course we will give you what ever you need.’  ‘Of course’ I replied.  Sometimes the weight of it hits bottom and comes back up.  Of course I do not want to leave, although I am not afraid for my family, for their strength and bond would see them through my passing and they will all continue to thrive.  I just don’t want to miss out on the show as it goes. Since all of my Women reached adulthood I am surrounded by very beautiful and gracious Ladies.  It is every Father and Husband’s dream.  Who wouldn’t want to hang around as long as possible to be part of it. 
Feeling sorry for me is a luxury I cannot afford and feeling terminal equates to that so I put those feelings aside.  I am staying on the job, keeping my calendar full and taking advantage of my good health and increasing mobility.  Now 10 days since my surgery and I am healing pretty much on schedule I think.  Most of the time I am like an old dog, laying around here and there all day long every day, eating and doing that other thing.  I am still taking the generic vicodin so I do not have to worry about overwhelming ambition to do anything. I am content to just sit in my drug induced haze and heal.    
Freedom of flagellation is a totally unique experience for me.  Mostly gas passing is frowned upon in my life.  Beyond sitting around with the boys there is no appropriate venue for cutting loose.  A delightful unintended consequence to that recovery from surgery was the amazing level of support and encouragement given me to let em’ rip, so to speak.  Farting was a coveted sign of recovery in the hospital, and encouraged by Family and Staff I did my best to work one up and once started proudly ripped whenever I could.  So now these days later we still celebrate the gas although I sense Vanessa’s enthusiasm is waning in this regard.  It is impossible to minimize the miracle of medicine and that we are so advanced that I can have my colon cut in two and reattached and be near normal only a few days later.  I know it won’t last.  Already there are hints that I will have to return to civilization, where farts and belches are socially unacceptable sooner rather than later.  No matter, I shall toot proudly and hopefully often for the time I have to do so. 
Sunday and the clocks are turned back in that peculiar Hoosier ritual whereby we reset our clocks.  Long after Vanessa retired I found her standing at the foot of the bed with that self satisfied look of accomplishment.  ‘There’ she declared, ‘I think I have reset every clock in the house except this hall one (it’s atomic and will)'.  I checked my solar powered atomic wrist watch and it had reset as well.  No small feat resetting the clocks since we are surrounded by them.  As I write I see one lower right, a phone with one next to me, a small decorative thing on Vanessa’s side table, and very large and intimidating round one on the wall behind me, time. 
I am not sure why Hoosiers feel compelled to force themselves by law to give or take an hour.  The entire concept of any typical Hoosier to have such power is a downright scary.
Vanessa makes a fun ritual of the rite twice a year, and I must say I look forward to it as well.  This is not the first time she worked through a part of her process with this ritual in the middle of the night.  I went out for a paper this morning, still pretty sore.  Gerald stopped by yesterday.  When I met him at the door I just felt relief, he and Joe are family now, if you define it as the ability to sync up upon meeting each other and mutual love and respect as you do.  Seeing him for the first time since surgery helped me sense the magnitude of the accomplishment.  Under the knife and back again, as they say, or maybe just I said that, not sure.  I enjoy his stories and projects and we often brainstorm in the classic sense through some homeowner hell issue and the like.  Sometimes he patiently allows me to ramble as I do and more often than not we laugh until the tears flow in our meetings. 
It hurts to laugh, literally, but I just can’t help it. 

5.11.10

Standard Of Care Defined

Wireless and Ready

‘Can I tape this conversation?’ I asked.  Dr K was in at 8 am sharp.  He smiled and replied ‘what do you want me to say?’  ‘Well, it’s ok to say what you have to say, it’s just my Wife will kill me and this way she can be part of the meeting as well.’
So I hit the red button on the little recorder.  Our previous experience with my hospital stays included difficulty getting Vanessa in on the conversations with the key players.  It’s Monday morning at 6AM and I am digging the recorder out of my man bag (it’s not a purse) and making it accessible.  The nurse just came in and told me the urologists were running behind because they were entering their own medical orders.  I doubted that Dr. K or his resident would keep me in waiting until some late morning visit.  I just knew they would be in before Van.  Kudo’s to me on packing for this stay. 
‘Want to go home?’ Dr. K asked.  ‘I’m ready’ I replied.  After he left I hit the stop button and set it on the tray, grinning with the self satisfaction that can only come after decades of marriage that I did something really right for Vanessa.  In the quiet I hit the button and started to doze, only to wild click.  ‘This is Bea, may I help you?’  The question came in stereo from both sides of the bed and the hand held device that I could not find but obviously once again butt calling the nurse.  ‘Sorry Bea, wild click'  ‘OK’ she said cheerily. I must have wild clicked ten times a day.  Every time a patient and understanding reply.  I thought about my last few days, which in spite of my difficulty moving went by pretty fast.  Vanessa ever at my side and Jocelyn each day boosting our spirits and providing her Mother the kind of support only a loving Daughter can deliver.  My Surgeon or his Resident or both every morning, a check in from the chief nurse in charge on nursing care, housekeeping twice a day, ten to twenty IV alarms a day and visiting with my Nurse or her helper (PCA which I believe is Patient Care Assistant) plus the wonder of student nurses and frequent walks around the halls a veritable hiccup engine.  I shall always remember walking with Vanessa and the beautiful and graceful K (who was a masseuse and is now only a couple of semesters from becoming a great nurse according to another nurse that always volunteers more information than I really need.  Must be my inviting face is the only thing I can figure).  Students working very hard, strict protocols, nurse assistants and students walking 7 or 8 miles each shift, Nurses often called upon to change beds with workstations all about are hovered over their monitors if not their patients.   
Through it all an epidural in place and a happy button made it easy for me to greet every visitor with a smile and thank every visitor when they left.  Patient responsibilities begin with thankfulness and civility, period. 
I might be sick and helpless, but I have a responsibility to those who are caring for me to make their job as easy as possible.  The standard of care given me throughout my association with IU and Clarian has been nothing less than excellent.  My stay this time was marked by delays as new software was implemented.  No more post it notes or notes buried in charts.  Request for treatment and order for same will be digital.  Like any thing computer, the best way to learn it is to do it, which is like stepping of a cliff for a lot of people. 
With the hiccups throughout my stay except for sleep and brief periods during the day and of course the pain management I got to laugh a lot, they did not hurt but certainly made conversations challenging, and I am a talker.  When they started Dr. K dryly advised that the gas had to come out the other end before I would eat and I just laughed.  Wrong end, but it was a start.  I learned a lot about those who cared for me, their families, our shared interests, their work and life.  I shared freely with them as well.  We were all a smoothly operating team aimed at me firing out the door never to be seen again if the goal is met.  Smiling is an infectious thing and is easier than a frown, I checked it on snopes after Vanessa and I disagreed on the topic, she of course was right, so I tried to start it from wake up to the end of the day, another reason to just say yes to the epidural.  In the beginning Dr. E smiled and said it is part of the process as he explained the steps and order in which they will be taken.  He scrawled it out on a piece of scrap paper and gave it to me with a caring and sad look in his eyes.  The outcome is what it is and so we go on to the next step.  In spite of the long odds I got the chance to try for the cure and my caregivers put concern for me and my quality of life first every step of the way.  And that was how it was on this step in the process.

3.11.10

The Hospital Stay

Saturday night was the night of short staffing on the floor.  I am glad I was into my recovery.  My nurse made her appointed rounds on time and had time to walk me once, but I felt for her and really did not want to be a bother.    
Sunday and I sharted at 7:20 PM, my intestinal condition came back to life.  Nurse M and J were at the station at shift change.  I took a picture of it, left it and reported wearing a white cape since we all considered it another miracle.  Nurse M confirmed it and we all were pleased. I was allowed one ounce of clear liquid an hour as a reward, which I gladly accepted.  Rex showed up to cheer my day.  Carl was with him, but relatively quiet.  My Corona shirt was a gift, along with hats and a gadget.  As is a family tradition when you go to the hospital you get a bear, and Friday the Girls went down to the Colts shop and got me a genuine Colts bear for this visit.  Surrounded by gifts, flowers and loved ones, wow.
Monday, oh what a difference an epidural makes.  This Morning they pulled it.  Only hours before I had been kick dancing past the nurse’s station and singing between the hiccups.  ‘I think I am going to settle in here’ I told Van.  ‘Good idea’ came her reply.
They left me with the button in the IV, not knowing how I would respond.  Shoulder surgery a few years back gave me familiarity with incision pain so I settled in to see what this would bring me.  Within a couple of hours the answer came and I used the button.  A few hours later I started with pain pills.
This morning I learned I would be released tomorrow, and checking in with Aaron discovered he would as well.  We wished each other the best and he will always be in my heart.  I got approved for a liquid diet and knocked down some bullion, jello and juice in the morning and then cleared for regular diet in the afternoon.  I ordered a salmon sandwich and cottage cheese fruit plate.  The sandwich came microwaved to it’s plate and inedible.  My guess is it will survive for eons in it’s present state were ever it is.
Jocelyn came in the afternoon after devoting so much of the previous few days to me and her Mom.  Our lively conversations and humor shared make the hours fly by.  Monday night for the World Series final and Colts game Ken, Fonda and Loren came in. 
I think a measure of true friendship is the ability to start a conversation right were it left off.  I was delighted after 30 plus years of separation that Loren and I started up right where we left off.  Of course him and Ken had been warming up before hand over dinner.  Ken and Fonda are family for us, so it was a delightful evening, and later in the quiet as I looked at the picture I added up the hidden blessings I can add to the bank with this phase of my treatment, Aaron, sharing with my Nurses, Dr. K, Dr. I, the time with my Daughters and Wife, a visit from Rex, and just some sit down time with friends. 

Friday's Diary


My tenured staff Nurses were quite different.  Nurse J was hovering and motherly not interested in anything I had to say.  She was on the night shift and taught the many student nurses on the floor.  She appeared to be a stern disciplinarian and likely one to play favorites.  Nurse M came on as my day nurse Friday.  Without the teaching approach she is a take no guff go by the rules gal.  I worked hard to satisfy both and understand their approach to nursing. 
There was a big difference.  For example, my IV’s were set in the back of my hands.  Due to there location they were easily bumped with normal activity.  An important part of my recovery is to be up and active.  I asked Nurse J if we could do something to protect them better because I was bumping up against stuff and it hurt.  Her response was simple, do not do it.  Nurse M came back with mesh fabric used for burn victims and fashioned glove to cover my hands.  It not only did the job making movement safer, it also had a stylish look about it.  Many folks prefer the conservative approach, but I want to move about as much as possible.  Staying stationary was not a reasonable option.  That night Nurse J noted the gloves and inquired about them.  I think she found it to be a good idea, although I am not sure she could admit it.  There two careers and experience show in their approach.  Both are pushers to make sure I do the physical part of recovery to the 110% level. 
The epidural left me with very little pain.  If I stressed the wound or had a bad gas pain it cut through and if it was too bad I had a button to push as much as once every 20 minutes.
Friday I got my laptop hooked up and e mail checked and processed, doing a little work as well. Moved to a private room I had much more space, more comfortable bed, more inviting surroundings and room for all the family and friends who have been there for me and coming to visit me.  Urologist in the morning and pain management in the afternoon,  student nurses with a year or two to go function as PCA’s (patient care assistants) and occasionally another med doctor.  No food ordered, so now the last time I had anything to eat was 5 days ago. 
The resident urologist, Dr. I, an outstanding clinician with a totally unurological bedside manner stopped by every day at the same time to check on my recovery.  This morning he told me the tube could come out of my nose today.  Later when I mentioned it to my nurse she said she would check.  The hose had repeatedly come disconnected from suction and since nothing was coming out was finally left disconnected.  When my nurse appeared later she advised me the resident said the hose had to remain in.  This was a female resident I am not sure I event met, however I felt another opinion was needed so I called Dr. K from my room.  Nurse D advised me at his office that the resident made that decision, and after some insistence agreed to have Dr. K call me.  Shortly there after two nurses appeared with smiles and pulled my hose.   We stopped by to check in on Aaron and he was on the heal. 
It happens that during my stay the medical order entry system was going digital.  As I have seen so often, the institution appears to have paid a pot load on the soft ware and then failed to train the Doctors first, putting the load on the nursing staff, undoubtedly at a cost to customer service.  I understood from my time with John G in the maintenance management software business and could be patient.  I am sure that it entered into the hose in the nose issue.  It seemed overall such a minor thing given the high standard of care I received every hour of the day. 

And Into The Bed

 I was exceedingly uncomfortable, learning from Jack the next day that my bed was improperly inflated and I was too drugged to complain and the Nurses missed it on their examinations.  Basically it put my lead butt in a bucket.  It was covered with an inflatable waffle.  Jack, who I practically had to talk a leg off to get a word out of him but found he had a lot to say, give me a sly look and said ‘be sure to take that home, that’s yours’, as he pumped it up.  As I jacked the bed and rolled about to get comfortable I did not want to run my TV, which was located in such a way to impact my roommate. 
At first with the curtain drawn between us I would call out to him without answer.  With the Daughters and Wife in the room we soon became rowdy.  Periodically the warnings on one or both of our IV pumps would go off, interrupting the melee.  Late in the evening I asked Aaron about pulling the curtain and we became introduced.  Aaron is 28, with spinal bifota a disease he was born with.  He is paralyzed.  He of course had to tell me twice, as I simply forgot that in our short time together repeatedly.  Both in bed hooked to tubes our handicaps never entered into that time.  He is here recovering from surgery for a pressure sore.  It is his 20th surgery.  Twenty surgeries in 28 years of life was a little hard for me to comprehend.  I pondered it for a while.  He could only lay on his right side and stomach, his neck was killing him and he was tired of looking at the curtain so we became one room before night’s end, a night that found us up as much as asleep.  With my epidural and pain button I was chatty and it turns out Aaron was as well.  We shared family stories and those of our own and when the Girls came Thursday I introduced them, although they had already met while I was out of it Wednesday early evening.  His endurance and desire to go on was without question and it humbled me. He had an infectious smile, a gleam in his eye and was easily brought to a laugh.  Physical strength seems such a trivial and shallow pursuit in the face of such courage. 
In the dark of the morning Thursday Dr. K appeared at the foot of my bed.  Dressed as a teacher to the nines I never realized how sharp he looked, although Jennifer had been telling me all along.  He asked if I understood what we had talked about after surgery.  I said ‘you mean did I understand that I still have a bladder, you found a bladder cancer tumor on my colon and cut a section of colon out with it in and I need to talk to Dr. H’?  ‘Yes’ came his reply.  The day passed as I shared with my roommate and he shared with me.  Primary care came from my nurse and her assistant Jack.  Jack gave me my first hospital bath, helped me walk a couple of times. For the day both daughters were on hand and the conversation was lively and broad ranging.  Friday Dr. K asked if Dr. H had been in?  I said he had not, but I met with one of his residents.  He wanted to know what he told me.  I said he only asked questions.  ‘What kind of questions?’  The resident wanted to know the some of the same old stuff.  What else was wrong with me, how life was at home.  ‘Why are they asking that?’  ‘I have no idea, maybe the want to know how viable I am as a candidate.’  Dr. K gave me a puzzled look.  I have always felt he thinks I know more about my condition than I do.  It does give me some cause for concern that I do not.  I feel vulnerable, always sensing that those chart books carry some terrible message nobody really wants to tell me.  He left as abruptly as he came, and an hour later as the morning light broke through the window and the pain I had to use my button a couple of times the entire encounter seemed supernatural in a way. 
During the surgery, when Dr. K had me opened up and found the cancer had metastasized beyond what was expected he stopped and consulted with Dr. H and the two concurred that removing the bladder held no chance of a cure at this time.  Dr. K shows great faith in his team mates oncological skill and abilities.  Late in the evening they moved me to a private room.  Dr. K seemed concerned that I would be stressed in a room where others can eat.

Happy Halloween

Just Three Crazy Guys November 2010
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