Paul's Heart

Life As A Dad, And A Survivor

Archive for the category “Cancer”

Decision By Bagel


Could a baked good have the power and influence, in making a critical life and death decision? To be fair, the particular bagel I am making reference to, is a great bagel. It cannot be found in a Starbucks or in the frozen section of the grocery store. It is baked fresh every day. It is definitely a great bagel. And after this morning, I am one step closer to making one of the more important decisions of my life, whether to get the Covid19 vaccine or not.

What? What does a bagel have to do with the vaccine? Why not just flip a coin if I am that uncertain? I assure you, the decision is not as easy as a flip. First things first.

I am not an anti-vaxxer. And while my initial support of the vaccine process was suspect at best, because of the processes in time that were not followed, it is clear, the vaccines that have been approved or approved for emergency use authorization (EUA), do have an impact on getting of top of, and staying on top of the Covid19 crisis. Also, understanding that the vaccine is not about preventing infection from the virus, the vaccine is about preventing the extreme effects of the virus, those that result in a higher likelihood of hospitalization or death. This is the thought process of someone not treating this pandemic as political or conspiratorial. This is dealing with facts.

I am immunocompromised. My spleen was removed in 1989 as part of the staging for Hodgkin’s Lymphoma. I learned early on, way before Covid19, I was more susceptible to viruses and other illnesses. I check off most of the other boxes to the susceptibility of the Covid19 virus. I have cardiac and pulmonary issues related to my treatments for my cancer over 30 years ago. I am also diabetic, and overweight (though not obese).

So, when the warnings came out from the scientists, because of my exposure and medical knowledge, I knew I had to take the warnings and precautions seriously. I could not afford to be affected by the smoke and mirror of politics and false choices being hurled through the television and social media.

Lastly, the warnings from my doctors were clear. “Do not get Covid19.” One went as far as to say, “with your issues, it will kill you.” So to be clear, I have taking this crisis seriously from day one. I made decisions that were difficult, such as making arrangements whether to have my children visit, health care, and such, even participating in court proceedings in reference to the Covid19 crisis, all with the mitigation recommendations and warnings in mind.

But you know what I did not do? I did not make it political. I did not make it about vanity. I did not make it a false argument over loss of freedom and liberty. For me, the science was clear. The exploding statistics did not lie. And I did it without being “ordered to do it,” which made it a lot easier. More importantly, the decisions that I made, impacted only me, and my loved ones. Check that, it also impacted others that I might come in contact with, because the care I was taking for myself, was also going to benefit others.

A meme came across my news feed recently. I am not posting it here, because it really is stupid, inflammatory, and completely erroneous in its bravado. But the commentary reads, “444 days without a mask, never tested, with no vaccine, no social distancing and no fear… we are still alive and all our people are still alive too.” And then refers to everyone who did follow the mitigations as “suckers.” The person who posted this, I know personally, and yes, while I know and disagree with their position, the meme definitely does not apply to him. I know for a fact that several in his circle were diagnosed with Covid19, including one death. I do not know if he himself or his family have had it, nor do I think he would ever publicly admit it if he did. But for him to post that meme, is pure bullshit.

Off my soapbox. The vaccine. I believe the vaccine does what it has been studied to do. We are still waiting for other studies to be completed, but for the purposes of saving lives, it appears Pfizer, Moderna, and Johnson and Johnson have products that will do just that. Statistics of success are adding up exponentially. And yes, while the concerns over long term side effects, something I personally deal with from my cancer treatments, it will not matter if you get Covid19 and die just because you did not get the vaccine.

For me, my reluctance at this point has been simple, and based on a condition with my body that I was made aware of a decade ago. When it was discovered that my body was dealing with issues related to my cancer treatments over thirty years ago, one of the studies done, was on titers, in other words, the ability of my body to fight illnesses, especially through vaccines. Three of the illnesses tested were influenza, pneumonia, and menningitis. To be clear, there are three illnesses, but within those illnesses, there are multiple types and strains. So, in determining titers, in other words, how strong your antibody response is, the tests are divided by types and such. In my initial case, I showed no ability to fight most of the types and strains of all three. That was kind of expected. But this was not what was expected. When I was given the vaccines following that determination, and then followed up with titer testing, I still was not registering much response with antibodies for the flu, pneumonia, or menningitis. This was not good. Boosters, additional doses of the vaccines were given and followed up with titer testing. I finally had a response to the flu, and a minimal response for menningitis, and nothing yet for pneumonia. Finally, a third booster would give me the response necessary for menningitis, and finally, only minimally at least, a response for pneumonia. One more booster for pneumonia that year, and I finally achieved immunity with most types of pneumonia (ironically, I did end up with pneumonia later that year, but not caused by a virus, rather, aspirating reflux, a different post is needed to explain that one).

But now you can see my dilemma. I know how my body reacts, or rather, does not react to vaccines. And there are many other fellow long term survivors in similar shoes as me. And up til this point, I have delayed getting the vaccine, on the simple fact, there have been no studies on boosters, which I am 99% certain I will need, no protocol on how/when to administer them and will they be safe.

One odd thing I do not give much weight to, is the fact, that if I would proceed with the vaccine, I would not allow it to give me the false sense of security that it worked. In other words, I would still follow all the mitigation precautions. The vaccine in just the two doses will not give me the ability to do as so many others are able to do now, walk around confidently that they will not get sick enough from Covid19 to end up hospitalized or dead. Keep in mind, with the vaccine, you can still contract Covid19 as many are finding out. The vaccine simply prevents the extreme situations of hospitalizations and deaths. I now know several people, who have had Covid19, had antibodies, got vaccinated, and then tested positive again. But the vaccine has done its job, preventing the extreme effects.

So, what does this have to do with a bagel? For several months now, I have been easing back into exposure, still following mitigation recommendations, masks and distancing. And one of the things I have been doing, is going to the bagel shop on Saturdays. And I have been noticing as time goes on, people and their behaviors as they have changed over the months, as our country gets a grip on Covid19. Plastic barriers between workers and customers are now gone, and so is mask wearing, probably close to 95%. In fairness, I live in Florida, where there has been much controversy over the willingness to cooperate with mitigation and collections of actual statistics, and massive amounts of denial of reality.

So while nationally, Covid19 numbers had gone down, they are starting to creep back up. We have seen this pattern before at least twice, and definitely through other countries. And living in a state that probably 65% of the residents deny or refuse to accept precautions, and a highly more contagious and lethal strain of Covid19 increasing cases nationally, this is a concern. It is not a concern for those who have been vaccinated as it has been determined the vaccine does protect against the variants just as it does the original strain.

But while we live in an “honor system,” people not wearing masks assumed to be vaccinated (you know what happens when you “assume”, you make an “ass out of u and me), and worse, those who still deny or treat the situation as political. And as I cannot tell at least by just looking at someone if I am safe around them, I have two choices I can make. I am already doing so, and plan on continuing to do so, follow the recommendations. I do not care about the stares and glares I get. Not one of those looking at me gives two shits about me living or dying. I have to do what I have to do, and the decisions I make, affect no one. Even better, for the ones who claim they lose their freedoms and liberties, I call bullshit on that too. Because with the exception of going to a movie, and long distance travel, I am doing everything I was doing before Covid19. I am still free. I still have my liberties.

The other choice, I am one step closer to making, and yes, it was because of this morning’s bagel. Years ago, when I first met with my doctor and we talked about my “luck” with not getting the vaccines, he compared my streak with that of someone in a casino. At the time, I was 18 years out from my cancer, so that meant 18 years I had not gotten a flu vaccine. That is when I got this speech. “So, you are familiar with a casino. And it does not matter if you are playing slots or cards or whatever. Let’s say you win 18 straight. Do you really know for sure that your luck is going to continue, especially letting it ride? How many more hands do you think you can get before you bust?”

Well, I am at that stage again. All of the facts are there in front of me. The vaccine works. In Florida, there are two types of people and they react differently to the facts. And then the state itself is not exactly transparent with its facts and statistics. There is an expression when it comes to Casinos, the games favor the house. The odds are not in the favor of the player. I know that, which is one reason I can be in a casino, and not have one itch to play. But with as much as I have on the line, finally getting to a stage in my life, I never thought I would get the chance to see, my daughters grow up, this decision continues to grow in importance.

I will get the vaccine, it is just a matter of when the time is best for me to do so. All I am asking for is one more detail, a booster protocol. In the meantime, I am doing what I have done with every other virus outbreak, learning to function with it. And if that means wearing a mask longer, social distancing, and washing my hands (seriously? We needed to be told to do this? Are people not going to do this anymore now that people are not following protocols? Ew!), I can do just that. And while it has no functional impact on you, it is to your benefit as well as my own that I do continue these protocols.

Adding An Insult To An Injury


I have to go back to 2007, for the last time that I visited a doctor for anything not related to my Hodgkin’s Lymphoma and treatment past. Since April of 2008, it seems that all of my appointments following my emergency heart surgery, have had some sort of tie to what I had been exposed to.

My health history prior to me having cancer back in 1988 and the time between the end of my treatments in 1990 and April of 2008 could not be any more simple. I had only three primary care doctors. One died still practicing in his eighties. Another retired. And then the current doctor I still have, now well over thirty years. The most challenging thing I usually gave them, was a seasonal allergy that resulted in a steroid injection to get through the Spring. Other than that, if they saw me in the office, it is if everyone was put on red alert, something had to be seriously wrong. Like the time I got into some poison sumac (I will spare you the pictures), way worse than dealing with poison ivy let me tell you. My medical record could not really be more than maybe a half an inch thick.

Even my battle with cancer did not change the size of my file too much with my personal physician. Cancer records would be kept with my oncologist. But once it was determined that I was dealing with issues related to my treatments, and that multiple disciplines of medicine would be followed, I needed to have a central advocate for my care, the main communicator between them all, and that was my primary care doctor.

It was not long before I would have more frequent communications and visits with her, coordinating everything from all the specialists that I would eventually see. Soon, my file grew to two inches thick, and then a second folder would be started. Today, with everything being digitalized, I am happy to see that a tree will no longer be sacrificed for my record keeping.

As I said, it has been a long time since I had a “normal” doctor visit, not related to my Hodgkin’s past. The last injury that I had to deal with was back in 2003, a tear of my left triangular fibro cartilage in my wrist.

Concern over carpel tunnel was eliminated because that would have occurred on the other side of the wrist. I was performing a function at work, that caused a “jerking” of the wrist, hence tearing that cartilage. The workers compensation process was a major thorn in the side as I was originally denied the claim, went through the legal process of appeal, and it was determined that this type of injury only occurs at someone’s employment.

With one caveat. Apparently, as you approach your middle ages, forty-ish, this cartilage begins to deteriorate until you have none according to my understanding. I was in my early thirties at the time, so this was not the issue. The injury was determined to be work related.

Seventeen years later, I found myself in need to seek medical help for the first time, something not related to my Hodgkin’s.

I had a huge pain in my foot. I tolerate pain fairly well, so it is often quite a time before I do anything about it. But with levels reaching between 7 and 9, and a well pronounced limp, and given my history of high dose prednisone during my chemo treatments, leading to one of my many late side effects, osteopenia, I have a higher risk of bone breakage. For the life of me, I could not recall when or where the pain first started, but I was concerned that I could have had some sort of stress fracture in my foot.

Now used to all of my medical appointments beginning with me explaining my cancer history and where I am healthwise today, I was cut short by the PA and I quickly realized, this was not an appointment having to do with my cancer past, well, as far as they were concerned. But because I did emphasize my osteopenia, to which I was immediately questioned how I knew, they opened the door, and I explained briefly, a word not often used with me, a DEXA scan confirmed it due to my chemo past. And with that, an x-ray was ordered. Fortunately, no break was found.

But as the PA ran her finger underneath my foot, from the ball of my heel, towards my large toe, my pain level shot through the roof.

I am not sure how, as I am not overly active, more than a daily walk, but I ended up with what is called Plantar Fasciitis. The tendons under my foot were angry, very angry. So, I was given a list of things to do to help the healing and recovery for a common ailment for many, concerned friends and family inquired to my diagnosis.

It is one thing to have to deal with this injury, but as one of my “concerned” friends promptly pointed out, while this kind of thing is common, it is also associated with getting older. Thirty-one years out from my cancer, I have gotten to that stage in my life, I did not think I would see, getting older. But having done so, not only do I have my cancer issues to deal with, but now I get to add “getting older,” adding insult to injury.

Happy Father’s Day


If there is one thing in my life that I will say defines it, it is Fatherhood. All I have ever wanted to be, was a Dad. Along the way, I have been challenged in the most extreme ways from cancer to divorce, but nothing has stood in the way of the unconditional and never-ending love of my children. My daughters are the reasons behind every decision that I make, and the drive to keep moving forward.

Historically, prior to the arrival of my daughters, Father’s Day was just another day in June.

This is one of three photos that I possess with my father from childhood, none occurred on or around Father’s Day. In fact, I do not remember spending any time with my father for Father’s Day. To be clear, this was his decision, a result of the divorce from my mother. Another reason for my sadness of Father’s day, my grandmother passed away the week before Father’s Day in 1998. And then, my Father was memorialized on Father’s Day weekend in 2014 after passing from the effects of lung cancer. Admittedly, this was something that I requested.

Even with my daughters, Father’s Day seemed to take a back seat, as with other holidays, because I was expected to work. I had a 40-hour/week job, but if offered overtime, so I was expected to work it, even on Father’s Day, the one day that should have been about me with my daughters. I was supposed to just be grateful for the few hours I had to spend with them once I got home from work.

To be clear, there is no one more important to me, than my daughters. When faced with emergency open heart surgery back in 2008 due to late effects from the treatments that cured me of my Hodgkin’s Lymphoma, it was the fear of never seeing them again, them having the possibility of experiencing what one of their close friends experienced, losing a parent, that really pulled me through.

Unlike my father, I was there for my daughters for Father’s Day, with the exception of three, two of those were beyond my control, and the other was purely for everyone’s health and well being. A process with my divorce led me to miss two Father’s Days. And in 2020, Covid19 and all the uncertainties left me no other choice, than to keep my daughters safe, and that meant not having them travel to see me. Those three years, came and went, each time, leaving me with a broken heart, no other options available.

But just after the last time that I missed spending time with my daughters for Father’s Day, I made sure that they knew every Father’s Day, they are my priority. They are the reason I wake up every day. They are the reason I look forward to every tomorrow.

This Father’s Day is more than just having lost last year’s time together. For years, I have had friends prepare me for the time when my daughters would get older, and the likelihood that visits with them would be less frequent because they had their own things to do a la Harry Chapin’s “Cats In The Cradle”. In all honesty, for my one friend, he got much less years than I have in regard to that situation. My daughters know how important Father’s Day is to me, as important if not more than, our visit at Christmas. Father’s Day is the day, I get to celebrate and cherish all of the memories from the thousands of photos I have taken of my daughters over the years, opportunities that have lessened from the demands of the teenagers.

My daughters have a biological father, somewhere. But I am the only Father they know. And whether they are six, eighteen, or forty two, they know I will always expect this day to be ours, together.

Yes, their mother and I are divorced, and unlike my Father, I made the conscious decision, to stay in their lives, to be active in their school and interests, to be one of their two main role models, to guide them with their decisions toward their future. Each and every day, I make an attempt to reach them, through various means from phone, to Facetime, to text, a reminder that every day to them, that I am thinking about them. That I miss them. That I love them.

There are so many fathers that I do hear from, that for any reason, are not getting that opportunity this year, perhaps for several years now. For some, it is their first year without either their children, or their father. My heart breaks for them, because I understand the many different issues surrounding the emptiness of this holiday as an adult child of divorce, a divorced parent, as well as someone who lost their father.

The time with each other is only temporary. It can be a few years, or decades. But it is only temporary. That is why it is important every year, on this day, you celebrate if you are able to still do so with each other. And if you are in the unfortunate situation, having been alienated from your father or from your children, you DO NOT EVER give up! Time will heal. I got that chance to do that with my father before it was too late.

I do not know what Father’s Day will look like in 2022. But after having lost Father’s Day last year due to Covid19, this year will be more special than ever to me and my daughters.

Needless to say, as few photos there are of my father and I, my daughters will never have that problem.

Happy Father’s Day.

Post Navigation