Paul's Heart

Life As A Dad, And A Survivor

Archive for the category “Cancer”

The Lesser Of The Two Evils


You can tell a decision that one does not want to make, when it is looked at as a decision between “the less of the two evils”.  This kinf of outlook is often given to political races as it is nearly impossible to find a candidate for a postition that meets 100% of your values.

Today is not a very good day for me health wise.  My back is acting up, and fatigue is kicking the crap out of me.  I knew this day would come.  I had a bone density scan last week and got the call Friday with the results.  As expected, my back has gotten worse, with my 9th vertebrae now suffering with osteopenia.  This is a change from the scan done four years ago, where osteopenia was diagnosed in L1-L4.  Last year my back also showed facet joint arthritis, perhaps the reason for the pain and shape.

Osteopenia is like the little sister to osteoperosis, bad enough to be called something, not bad enough to be called osteoperosis.  Osteopenia is still loss of bone density.  Translation, it is an increased chance of breaking a bone, especially in my hip, back, or legs.  From what I understand, the pain in my back does not come from the osteopenia, but rather facet joint arthritis which I am now just starting to read up on.

So, when you hear the word osteo, just like mentioning breast cancer, our assumptions go straight to a concern for women.  The truth is, men can develop both of these diseases.  In my case, there is a good likelihood that I could develop both due to cancer treatments.  The radiation therapy has increased my chances with breast cancer, and hi dose, extended use of prednisone is most likely the factor to the already diagnosed osteopenia.  So while treatments have their positive intended effects, there are side effects both short term and long term.  Now that I have a new diagnosis, that must be treated.

But the medication that I need to take, at the beginning level will only be equivalent to vitamin supplements.  Of course, that is possibly going to have side effects as I continue to alter the physiology of my body.  In this case, the two supplements, Vitamin D and OSCAL were to help boost calcium needed for bone support which I was now needing.  There is one major drawback with taking on all this calcium, kidney stones.  I’ve already told that story (see “Congratulations It’s A…” under the links at the top of the page), so this is going to be about the aftermath.

The hospital that helped me get rid of that pesky stone, screwed up, and did not test the remnants leaving it up to me to figure out what could have caused the stone.  All things considered, I blamed the supplements.  My dilemma?  I need to take those supplements to keep from being crippled by an increased chance of broken bones, but if I do, I can look forward to many more kidney stones.  To avoid the kidney stones,  I could end up incredibly hurt.

So following the release of my urologist, so too I made the decision.  There would be no more kidney stones.  I had to hope that my decision would be correct and there would be no further issue with my bones.  But a bone density scan to be compared with a scan done four years ago illustrate that I was wrong.  The osteopenia has continue to spread and worsen over recent years with the cessation of those supplements.  While I have not had any more kidney stones, it is clear what my doctor forewarned me, “it can be five years or twenty years.  It is a matter of your choices and how fast it progresses.”

This is not the first medical dilemma I have been caught in the middle of:

1)  treat and survive my cancer vs. potentially severe late effects even worse

2)  removal of spleen which was fully involved with my cancer vs. immune system permanently compromised with little certainty of protection

3)  carotid bypass due to conditions of carotids, risk of causing a stroke same as just allowing it to happen

4)  take calcium supplements to slow process of crippling or prevent the crippling pain of kidney stones

5)  to have a colonoscopy because it is my time vs. exposing an area of my body that has yet to be invaded and in 46 years, have not had an issue with.

The choice between the lesser of the two evils.  I have many more to make, some just as serious, and some a little on the lighter side.  But when it is looked at a between two choices we do not want to have, clearly it is something I would rather avoid all together.

Side effects of medications are perhaps the most confusing things we have to decide to follow through with.  Just watch a television commercial for a new drug and to cover the company’s ass you hear the following disclaimer, “may cause suicidal tendancies, high blood pressure, kidney failure, depression, stomach ulcers, and memory issues.”  But other than that, it is great.  You will not see me rush to the pharmacy counter I can tell you that.

Med-Alert Bracelet


Just how important is the Med-Alert bracelets, bling that is meant to save your life?  I bought one four years ago, and of course its condition looks like I have had it that long.  I am not known for wearing bracelets or watches.  I really do not like anything around my wrist.  However, my investment of a little over $30 has already been counted on once.

A Med-Alert is a tag that can be worn on your wrist as a bracelet, or around your neck as a necklace.  Paramedics are trained to look for these identification tags as patients know this is the only way that they can communicate if unconcious.  My particular tag only measures about a half inch wide by an inch and a half long.

On the front side it shows my name, identifies three main medical issues with me, treatments I was exposed to and when, and then refer to the back side of the tag.  On the reverse side, it lists two of the main doctors I deal with, orders to call them immediately, and also a note to refer to my wallet for additional information.

My wallet contains two laminated information cards.  The first card lists all the things that my body has been through, or put through, a miniature medical file of diseases, wounds, treatments, etc.  It is amazing and overwhelming at the same time to see the abreviated version of my health history.  The second card deals with fevers and infections.  There is a special protocol that needs to be followed for me being asplenic (no spleen).  Actually it should be applied to anyone without a spleen.  A cocktail of antibiotics are to be started IV assuming I have an infection if I report to have a fever.  In the meantime, blood cultures need to be done immediately (to see what the infection might be) which is why they antibiotics need to be started right away, as cultures take time to grow.  A case of sepsis has close to an 80% chance of mortality after 24 hours of devloping.  There is no time to wait for test results.

My bracelet is pretty well scratched up as it has never left my wrist.  So it has been bumped and scratched, but it is still able to do the job it needs.  This past March, my personal system was put into play as Wendy called for an ambulance at 4am.  The EMT’s noticed that I had the bracelet, read the bracelet, and then asked Wendy about my wallet with the information cards.  Without me being able to speak, the EMT’s now knew my medical history and the extra care I would need.

Days later, I was told that my blood levels were so high for sepsis, that I had to be septic for at least 24 hours prior.  So I was already at risk.  Delays definitely would not have been in my favor.  The doctor was able to order care stat, that is medical lingo for “now”.

In this particular case, I believe my bracelet saved my life, and there is a good chance it will be needed again.  But there are so many others who would benefit from alerting an unsuspecting EMT:  diabetics, cancer history, high blood pressure, etc., any kind of condition that could affect emergency care with you not being able to communicate is crucial.

A Ghose Of Health Crisis Past


I had an aunt year ago who had taken a nasty fall.  In fact, eventually it will be what probably led to her death.  We had gotten a call that she had been admitted to the hospital, and things were not looking good for her.  Wendy and I had stopped by the hospital to either visit, or pay last respects.  We had no idea how things would turn out.  Our daughters were with us.  Our daughters were with us, but after visiting with my aunt, I decided it would not be a good idea for them to see her in her present condition.

You see, the hospital that she was in was the same hospital that I had my open heart surgery.  My daughters knew this.  They knew that I had survived.  I knew that it would not be the last time that I would find myself there.  If by chance, my aunt would pass away in that hospital, and that would be the last memory my daughters would have of their aunt, then there would be the chance that they would believe that I could face that same possibility any time that I would go to that hospital, perhaps any hospital.  The last image that we remember a particulare person or memory of a place can be powerful and overwhelming.  Sometimes a flashback can be just as traumatic as the painful incident itself.

Last week, I was focused on a loved one, in the hospital I was all to familiar with.  He was in for a procedure that many of those in the medical world, patients, family, and doctors call very routine, cleaning of the carotid artery.  Both are fairly blocked seriously at 85% on one side and 80% on the other.  A decade ago, he suffered a severe heart attack, so to me, this was going to be anything but routine.  I delivered him at 5am for his procedure and it would be several hours before they actually started. 

The surgeon came out to the waiting room just after noon, and told me that he was recovering.  Except for a slight blood pressure issue in the beginning, the surgery went well.  I would be able to see him briefly in a little while during recovery.  I was sure to find out all the things he would need to follow once discharged, hopefully in a day or two.  I also made it a point to inform the surgeon, just how stubborn my relative could be.  I told the surgeon to make sure that he got it across to him how crucial it was to follow discharge orders.  He was a caregiver for his spouse and it was imperative that he recovered fully to return to that role.  He would need to accept help, something a man with a whole lot of pride was not in the habit of accepting.  My point was made.

I got the page that I could go back and see my relative.  It was not an unfamliar sight for me seeing someone hooked up to all kinds of machines, tubes coming out of someone, and medical personnel buzzing all around.  My first experience in this environment came nearly thirty years ago with a dear friend who had been in a near fatal car accident.  I have been in this type of room many times, for myself, and for others.  I have made it a habit that I do not panic, cringe or show any other signs of being uncomfortable.  As of late, it has been important to retain my composure to ensure that my ability to make decisions in these time are the proper ones.

He obviously is not used to being a patient and looks quite uncomfortable.  The surgery has left him with an excruciating pain in his ear on the side of his head that had the carotid artery worked on.  The one thing I told him was that this was normal as the artery runs long his ear canal and if he had pain, he had to tell his nurses.  The nurses could manage this for him.  He was also not going to be pleased to find out why they told him before the surgery that he was not going to be able to wear his underwear.  I told him that he would be fine and that the surgeon said everything went well and I would see him again in his room.  I went back into the waiting room to wait to be told that he was being moved and to where.

Approximately at 2pm I had been given his room number and proceeded to take his belongings.  The wing of the hospital was a familiar building to me though it had not hit me emotionally.  As I continued to walk down the hallway from the elevator that I just took to the lower floor, it finally dawned on me.  The last time I had been in this hallway, I was in a wheelchair late April of 2008 being escorted to my wife waiting in the patient pickup following my heart surgery.  Suddenly my knees felt weak.  I turned the corner to head towards the Kasych Wing elevators.  I looked at the slip of paper with the room number on it, 3K25.

In a sudden rewind, my mind went back in time, going in reverse, getting out of the car, having been assisted from the wheel chair, rolled back from the hall, and back up the elevators of the Kasych building.  But back then, the building was not called that.  As I came out of the elevator, I was no longer in the present, there to care for my relative.  I was there reliving a time that I never would have thought I would ever go through, heart surgery.  Directly in front of the elevator, was the hallway that I spent so much time recovering.

I do not recall how long I was in intensive care following my surgery, and I have never asked.  There were no windows so I had no concept of time.  I know that I had three nursing shift changes between Jackie and Joe, and there was a visit from a nurse named Heather that I had the day before for the procedure that had originally been planned to save my life, a catheterization with stints.  However long after it was that I came to, and disconnected from some of the machines, I was given the challenging news.  I was being moved to the room where I would spend the rest of  my time recovering.  The bad news?  They expected me to walk there.  I went from exercising  nearly two hours a day, to being exhausted when I would blink my eyes.  There would be a wheel chair following me to sit and rest while I walked.

Like my relative, I am stubborn and do not like help.  Once I was removed from the bed, and on my feet, I began that journey, the wheel chair close behind.  From the second floor of the hospital of the cardiac intensive care unit, with my enterage, I got to the elevator.  I was strongly advised to sit down, but was afraid to because I had a goal to achieve to prove that I was going to get through this, because at that moment, I did not think I could.  As I got off the elevator, there was the hallway that I was standing in right at that moment currently.  I was warned that it was still going to be quite a distance to my room and it was my option to be wheeled the rest of the way.  They were pleased that I had gotten as far as I did.  But I needed to go the rest of the way.  I stood there staring down that long hall way then, and I did it again now.  Tears began to fall as I remember that time, the ghost of me standing right in front of me.  Telling me that I could get through this and so could my relative.  And I began to take those steps again. 

It is nearly a week since, and he is at home resting with his wife, anxiously waiting to return to his normal life and habits, go back to work, and be independent again.  He is glad to have had me by his side, but not nearly as glad as I am that he made it through this.

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