I Robot – You Patient.

I am surrounded by five or six people who roll my bed towards the OR. Ceilings have never looked so fascinating. We roll into the operating room. It feels like a meat locker. Damn it’s cold! And the ceiling – all perforated steel, some filtration system. I am lifted from bed to operating table. Small supports are placed under my elbows. One of my beloved triangular pillows is placed below my knees.

Where’s the robot? Under a plastic cover. Over there. It stands about 4′ high by 3′ around. There are two components, the control unit and the cut, blood, splat bit.  I talk in non sequiturs. They get tired of my babble. The anaesthesiologist says something like “OK Les we’re going to start the aern frm gno joiy…”

Six hours later I awake in a bay in the ICU, scared and in pain. I have wires attached all over me, a drip into an IV on the back of my hand, a BP cuff on my right arm, an oxygen sensor on a finger, a catheter in my penis and worst of all a plastic tube going up my nose, down my throat and into my stomach. The technical term – Nasogastric Intubation. Care must be taken when inserting this device so that it is not passed through the larynx into the bronchi. That is bad.

I am, of course, dazed and confused. I try and sit up and am suddenly nauseous. A nurse plucks a sick bag from thin air and I barf up a load of foamy blood gunk. That is the medical term – FBG. It comes out in one fell splurge. There, done – feel better. They give me a suction tube I can use in my mouth to suck up saliva and spittle and the rest of the crud in my mouth.

Exhausted I lie back on the bed and start to feel the hurt. The worst is the top back of my mouth, you know that bit that you kind of suck on when you have gunk in your sinuses. I am constantly, and still am, drawn to try and clear that area of whatever I’m feeling back there. It’s painful, thankfully not much worse than strep throat. But strep throat hurts so bad you never want to swallow or even talk. Plain swallowing is brutal too, but I am so dry I’m not swallowing much. I’m just lying there trying to not move, breathe, think or feel.

Gradually they get me sorted out and roll me into my room in the ICU. They attach large blood pressure type cuffs to my legs at the shins. They inflate every few minutes and force blood from your legs to avoid the creation of blood clots. The cuffs alternate in their contraction. At first it feels like a large dog lying down on my legs. It’s really not bad. Your arm is also in an automatic blood pressure cuff which must sense the exact moment you have fallen asleep because it starts to compress like an anaconda around your bicep. You weren’t going to sssleep were you Lessss?

I hate the anaconda thing.
The nose sucky thing can go suck.
But mostly I hate the catheter in my dick.

A Foley catheter tube is inserted into the urethra through the penis. It is retained in the bladder by a little balloon which is filled with sterile water. The balloon is shaped like a poodle. Interestingly catheter diameters are sized in the French Catheter Scale, hence the poodle. Let us be grateful the great Danes did not decide to bring order to the chaos which was catheter sizing!

I feel like I constantly need to go pee-pee. I try and relax. Am I peeing? I can’t hear anything. Where is my pee going? I don’t know. I miss feeling my pee. My pee was my friend. And now I am denied it. Bye bye little pee…

Par-tay!

I’ll try and remember the chain of events on the day of the operation but, quite frankly, for six hours I was out of it! Oh har har.

Eva and I awoke after a fitful night of tossing and turning. We showered and dressed. No food or drink until after the surgery except for a small amount of water. Lots of waiting about as we are ready way too early.

I got checked into the hospital at about 10:00a.m. Not much later I am taken back to get ready for surgery. The prep area is very pleasant with high ceilings and skylights flooding in pretty sunlight. There are a number of quite large cubicles separated by curtains. An older, very kind nurse called Kat was there to help me get ready.

The usual questions are asked. Allergies, any pain, have I eaten etc etc. The reason they don’t want you to eat or drink before anesthesia is that you might vomit and get fluid in your lungs and then they have to aspirate you. Icky stomach juices in your lungs is very dangerous and can even be fatal. Kat leaves me with some blue socks with rubbery tracks on the bottom and a gown. I put my clothes in a plastic bag with my name on it.

The anesthesia intern comes in to ask some questions. Am I allergic to anesthesia, have I had anesthesia before, did I drink or eat etc etc. He’s a handsome young man, reminds me of Paul Rudd, who EG really fancies. Eva arrives and admires the handsome intern. “Oh get a room!” I snap at them. He leaves us.

Then Dr. Myers’ intern arrives, his first name is Maten, can’t remember his last. He’s from Azerbaijan and looks surprised when I say “Of course I’ve heard of it.” Azerbaijan was the first Muslim country to have a cinema, I bet he doesn’t know that. He studied for three months at The Royal Infirmary in Aberdeen, my home town. My mother worked there in the forties. In Aberdeen he drank a lot of Tennant’s lager and put on 10lbs eating good Scottish fare at his B&B. He is nice in a brusque Eastern European way. I hypothesize that they feel Americans are weak and don’t know how hard life can be. I don’t know what it is. I’ve met grumbly Polish people like that. Eastern Europeans seem to have a chip on their shoulder. Azerbaijan is not in Eastern Europe it is in the Caucasus.

Suddenly, to my great surprise, our friend Stephanie makes a totally unexpected visit. She couldn’t help herself, but its nice to have her upbeat spirit in the room. She stays for about half an hour.

The nurses that will be part of the operating team come in and introduce themselves and ask if I have any allergies or if I’ve drunk anything.

Then the janitor who will clean the operating room after surgery comes in and asks if I have any allergies or if I’ve drunk anything.

A cook from the cafeteria comes in, introduces herself and asks if I have any allergies or if I’ve drunk anything.

A guy I had seen picking his nose in the waiting room comes in asks if I have any allergies or if I’ve drunk anything.

All of a sudden there seems to be a whole bunch of people in there and it’s really noisy and the wine is flowing and the anesthesiologist intern wants to get an IV in me . So party over everyone! I hug Eva and tell her I love her and will see her later.

As the anesthesiologist comes in I stand, offer my hand and say “Dr. Klein.” He says “You’re Dr. Klein?” And I say “Drink doctor. Eat Sister. Cook Mr. Burtenshaw. Nurse me.” Much hilarity ensues and we slap each other on the back. A medical Who’s On First.

I lie on the bed and Klein sits down and very deftly inserts an IV into the back of my left hand as Paul Rudd looks on in wonder. Kelin then removes the IV. Now the intern gets to have a go. I forgot this is a teaching hospital. Finally they are all agreed that it is correctly placed and it gets taped off. Paul Rudd injects some Margarita, as he likes to call it, and I start to feel all loosey goosey. Soon they are rolling me down the corridor to the O.R.

Did I say I have a gossamer thin blue hat on? I do and I am lovely.

Really?

Today I went for my pre-op screening. First person you get to meet is the woman who says “So you have a balance of $X,XXX how would you like to take care of that?”

Eva and I work as a couple. She deals with everything like gelt and I deal with stuff like, um, er, not gelt. “Our insurance said we shouldn’t pay anything till it’s all over!”

“Hmm. Let me get some person to dissuade you of that fact…..”

“Hello Mr. Hall, my name is Angela. Many insurance companies say that you should not pay before it’s all over, but we need money up front.”

“We are not trying to avoid paying. It’s just that we were advised to not give anything until everything is finished.”

“You could pay a portion of it.”

Lightning calculation – “OK I would be happy to pay half.”

“Let me see.”

Quick call to EG. Lady comes back in room and asks for about 1/4 of what we currently owe. I look at the print out. For surgery alone it is $100,000+ Not including radiation, use of toilet paper, air I breathe etc etc. We pay $x,xxx.xx

I pass muster. Before I leave – “This orange card shows that you have satisfied our financial requirements and tomorrow you will just go straight to admissions.”

Up to the second floor I go and am questioned and blood tested and blood pressured by two nice black nurses. One is American and the other is Nigerian. The Nigerian calls me Miss Hall which is a bad fucking start. Have I ever said before that upon landing in the USA I hated my fucking name?

I really do. Less fucking Hall. What a prat.

This is not a test

Just got off the phone with the hospital. Surgery is planned for Friday but first I have to have pre-op testing. Hmm. This is really happening. Shit.

Pre-op testing checks to see if I am healthy enough to have surgery. Never saw this coming. Am I healthy enough? Not really – Hello! I have cancer. They go over any past surgeries and how you did under anesthetic. Take an EKG etc. Just remembered that I had the old colonoscopy last year. That was a pain in the arse! Oh har har. But I suppose I did have general anesthetic for that. So I have had general anesthetic three times and have been fine each time, well except that it knocked me out each time. What’s that all about?

Did not sleep well last night. Tossing and turning, trying to go to my happy, sleepy place. Instead, all I could think of was what it would be like when I wake up after surgery. I have had strep-throat before and it hurts like hell. I mean it really hurts. You have to emotionally prepare yourself for every swallow. Oh well, I’ll hopefully be doped up on painkillers so should be fine. Yeah right.

Apparently, after surgery you meet with some kind of speech therapist that ‘trains’ you how to swallow! WTF! I guess swallow with minimal pain. So much to look forward to.

I called my brother-in-law this morning. I haven’t told them about being ill because he is sick too. He has leukemia and on a recent test they discovered that he has some kind of infection. I think he said MRSA. These are the new infections that are surfacing because everybody has gone antibacterial crazy with soaps and washing up liquid and hand wipes etc etc. I blame the soccer Mums. I blame them for lots of things. I wish him all the best, he needs a bone-marrow transplant. I hope he finds a match. Know any Indian/Irish folk?

Not feeling very funny today 🙁 Balance I say. Balance.

Oh, on the recommendation of my old mucker Robert Hannant I ordered Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness by Jon Kabat-Zinn and Thich Nhat Hanh. It looks interesting.

Om.

 

I don’t like Monday

It’s been raining for two days. It hardly ever rains here in the summer. It’s depressing me.

Today we met with Dr. Myers. As we were waiting I received an alert – MyPET scan report was available on MyCharts. It’s all in medilingo.

Head and Neck: In the head and neck, there is a FDG-avid 2.8 cm right tonsillar mass with an SUV max of 20, consistent with the patient’s known history of tonsillar squamous cell carcinoma. Multiple associated level 2 cystic necrotic lymph nodes are seen with the largest and most FDG-avid being a 3.2 cm lymph node with an SUV max of 12. Physiologic activity is noted in the parapharyngeal lymphoid tissue, salivary glands, and muscles. No enlarged or FDG-avid cervical lymph nodes are identified.

Dr. Myers went over the results. In essence, I have cancer in my tonsils which has spread to the lymph nodes. But we knew that; what we know now is that it has not spread to other parts of my body. This is obviously good news.

And I think I’m going to start calling it neck cancer or maybe throat cancer. Tonsil cancer is so fey.

Eva had questions jotted down in her iPad. She was brilliant, asking all the stuff that you need to know but which I would have forgotten. Shit, I left home this morning without my wallet and then did it again this afternoon! I am not very focussed.

Up until now it has been a nebulous, abstract affair. I have a lump in my neck, it doesn’t really hurt, I can do anything I want, eat anything I want, cry at my party etc etc. But now we sit down and get into the nitty gritty of the operation and what I can expect afterwards.

It looks like I will have the surgery this Friday July 19th, probably in the morning. He has put aside five hours for the surgery. Five hours! I hope we have lunch half way thru because that strikes me as a lot of time to be under anesthetic with your cake-hole wide open and some dude, in another room, working a robot on your Billy goat.

I will have a feeding tube inserted whilst I’m under as it will be too painful to swallow. Not knowing I would have this happen, I happened to watch a video last week of Mos Deff getting a feeding tube shoved up his nose. Something I’ve wanted to do to him for a long time, hence my interest. He was demonstrating how awful the treatment of the Guantanamo Bay prisoners is. They get it for free, we will be paying thousands. They have lost all my sympathy.

Obviously, being fed by a tube you do not taste anything. But this does not worry me as the radiation is going to take away my sense of taste for a long time. This is one of the reasons people lose weight when having cancer treatment. Of course, this is one of the silver linings to this whole ugly mess. I really like saying whole ugly mess. I will lose a lot of weight, at least ten pounds. I’m aiming for thirty! I know – it’s a heady goal, but I believe that if I can have as much radiation as possible I can feel nauseous enough for as long as it takes. I may have a hole in the side of my neck but I will be back in 30″ kecks! You can always wear a balaclava.

Hey what was that Vincent Price movie where he was feeding himself through the neck? He got a fish bone stuck in it! What a larf.

It gets better. I’m not sure how much radiation therapy I will have but the doc said that for every week you have radiation it takes a month to get over it. He said that I probably won’t be feeling good for anything till December. WTF! Now I see why people start thinking about crystals and orthopedic* food. One thing I do want to get is one of those crazy expensive blenders that they have in Starbucks. You can put a whole apple in and it reduces it to a pulpy juice. We have a regular juicer but you are forever cleaning the bloody thing. So I will be having a lot of yummy healthy juice. Mmmm yummy turnip juice.

Oooh another good thing! We were talking about post operation and I said I have sleep apnea, shall I bring my breathing machine? Doctor says you are not going to be snoring any more. That would be awesome.

*I know it’s macrobiotic. I thought it sounded funny. Having to do this so that people don’t whisper about how I’m mental and thought orthopedic was a kind of food, I know it’s to do with the eyes. Some people, cor blimey.

PET Sounds

I had a pet scan today. The technician took Izzy, Finn, Duffy, Gracie & George and placed them in a big cardboard box. Then he shaved little bar codes in their coats and put them on a conveyor belt where he finally got around to the scanning bit. He then put them all in a large paper bag and said “That’ll be Four & Sixpence please Mrs. Hall.” Oh goody! Today is the day I get to take one lousy Valium pill!

PET is the acronym for Positron Emission Tomography. It is a nuclear, medical, imaging technique that can be used to detect tumours in the body. Coupled with the CT scan I had last week, it can produce a very accurate picture of all the nasty, cancery blobs in your body.

You cannot eat or drink for four hours prior to the procedure. Or dance, or do anything physical. I had Eva carry me over her shoulder to the car where I did a very impressive jellyfish imitation. We drive to South Western and hand the car over to the valet. I did not know that a PET scan takes two hours to complete. Thankfully there is WiFi everywhere so EG could work. I am grateful for her support.

Adam, the nuclear imaging tech, escorted me to a room with a little bed and a TV. First he pricked my finger with one of those finger-pricking doo-hickeys that you prick fingers with. This generated a whole drop of blood which he smudged on a little strip of blotting paper. The strip was placed in a blood sugar measuring machine and after a few minutes I was declared sweet enough for scanning.

I then took my one lousy Valium with a little Boron chaser. I had a choice of banana, berry, chocolate & vanilla. I chose banana because it is my favourite and I love monkeys. It had a very ersatz taste, but had a pleasing cool, slimy mouth-feel – a bit like those yogurt drinks. Then Adam placed an IV in my arm and filled me up with some radioactive sugary solution that allows the PET scanner to image the nasty, cancery blobs.

Then I had to wait an hour and a half lying on the little bed, with the side rail slid up because – you know – I was really out of it on one lousy Valium. He turned the light off and I read for a wee while on my new Kindle. I am currently engrossed by Daybreak by Viktor Arnar Ingolfsson. Amazon describes it like this.

When the shotgun-blasted body of a goose hunter is discovered, the police believe they have a list of suspects who may have wanted the victim dead, from his young wife to the caretaker of his property. But then a second body, another hunter, is found with a similar fatal wound. And then a third. As the pattern emerges—all goose hunters, all shot at the break of dawn—Reykjavik policemen Gunnar and Birkir face the terrifying possibility that a serial killer is stalking the idyllic Icelandic countryside.

I nod off on my hard, little, hospital cot dreaming of Iceland and puffins and blondes.

In about an hour and a half Adam returns to take me for my actual scan. The sled you lie on is even more narrow than the CT scanner. My arms, that want to flop down to the floor, are placed into a tube of fabric roughly 14″ wide by 16″ long. A triangular pillow is placed under my knees. I find these supports, I like to call them triangular pillows, very comfortable. Adam retires to his control room and the scan begins.

Imagine a machine about four foot deep. It stands about seven feet tall and about six feet wide. In the middle is a round hole about thirty inches across. The sled slowly glides you into the belly of the beast. The surface above your head looks to be made of plastic. It has the same lines and curves of the interior of an aircraft. Even the small orange light reminds me of the flight attendant call button. I imagine I am trapped in the overhead compartment of a Boeing 787 Dreamliner – how apt.

Unlike a piece of luggage you must not move. The scan takes about twenty minutes. It is not very loud, painless and non-claustrophobic – for me anyway. Another scan is made, this time with my hands above my head. I am ejected, the sled is lowered and I make my way to the waiting room. I pick up EG, we get the car from the valet and then head to East Dallas for Vietnamese food. I am hungry.

Marathon Meh

It’s been a quiet week cancer-wise, but eventful all the same. I had a dentist visit on Monday which was a ton of fun. It is suggested that you get any needed dental work done before they start de-cancering you. Apparently the radiation kind of messes up your mouth…

I normally get a bit goofy on Nitrous, but the last few times have been kind of meh. The same this time, even though I huffed away like a South American glue-boy.

I have an abscess on an old root canal. First he had to cut the crown in half. Crowns are normally made of a semi-precious, alloy base fused with porcelain. You can usually just ease off a crown with dental pliers. But this tooth had a root canal and was a bit too fragile to yank off. So Dr. R got busy with his little grindy thing, gradually cutting it in half so that he could remove it.

Then he cleaned the canal of all the gunk that had been stuffed in there 21 years ago. Root canal procedures involve removal of the pulp in the cementum of the tooth. The layers of a tooth comprise of Enamel – the hardest material in the human body, followed by Denton – a college town north of Dallas and then finally Cementum –  the daughter of Concretus, the hardest nut of all the Scottish Gods.

The root-canal that Frank was fixing had been executed by a cheapo dentist back in 1992 when I had no insurance and no money. He had used  A Boy’s First Root Canal Kit which came with a mask, drills, files, pins and gutta percha. Gutta Percha you may say! Why Les – isn’t that what they used to put in golf balls? Yes it is! I retort back. It is a natural latex material – it’s properties being perfect for replacing the pulp bored out of the tooth during a root canal.

But the pins. Oh the pins. Tiny little stainless steel pins about 1 cm long, that somehow had impacted into the canal like scaffolding. Phrank had to get out his best needle-nosed pliers and wiggle and twist and generally tug away much like you might remove a recalcitrant nail from a block of wood. Twisty, twisty – bendy, bendy – horrible squeaky, squeaky noise until all the pins came out. Clean up the canal with some little tiny files and then put in little wads of cotton wool that have an anti-biotic/anti-septic/anti-perspirant/anti-semitic/anti-bloodsports unguent on them.

Earlier, Cory, Phrank’s assistant, had made an impression of the crown and later Phrank made an impression of the stub of tooth. Then, using faery and elven technology, a temporary crown is grown in the nest of a hummingbird. Once the crown is ready it is cemented onto the tooth using glue made from the hooves of Unicorns. Dentistry is an arcane, magical art indeed.

Then I went to the reception area and handed over my Mastercard. They thought of a number between 2,500 and 3,000 added a $ in front and then using the latest dart-board technology came up with a final figure.

I shall go back to have the final crown installed after my surgery and radiation. I feel elated.

Everyday Object From An Unusual Angle

neck_7_7_13

 

The bruising is from the biopsy. Eva says it doesn’t look that bad, but I’m not convinced. Looks like I have mumps or maybe a tumour on the side of my neck! Wait a minute!

Too hot for scarves unfortunately, I can feel my tonsils pushing into the back of my throat. Just about to go out for our next anniversary dinner at Stephan Pyles’ Stampede 66.