Paul's Heart

Life As A Dad, And A Survivor

Archive for the category “Education”

15 Years…This Crept Up On Me Real Quick


If my story ended when I mention that I am a 33-year survivor of cancer, Hodgkin’s Lymphoma, that would be enough of a conversation about me, an impressive fact by itself, to live in my fourth decade after cancer. When I started that journey, I knew of only one other cancer survivor who had beaten it, albeit only by a few years before me, my grandmother.

But if you have followed “Paul’s Heart” long enough, you know I am about anniversaries and milestones. And boy do I have a lot of them.

If a conversation with me only talked about the fact that I had to have open heart surgery fifteen years ago, no mention of anything else, again, it would probably involve amazement, and shock at the age when it happened, forty-two years old. Unlike my cancer survivorship, I did not know anyone personally who had gone through this surgery.

This time of year hits me very differently than all of the others because this anniversary is what I call a “dark” anniversary. And this year, it seems to be hitting me a lot harder than I am prepared for.

Once a patient reaches remission, and in my case, as long as I have, your really do not expect to hear anything more about “cancer,” or at least the cancer originally dealt with. In my case, so far, that has been my situation. Sadly, many of my fellow long term Hodgkin’s survivors have been diagnosed with a secondary cancer, or even multiple cancers. In full disclosure, and I know I have shared this info before, back when I was treated, I was warned of the potential for a secondary cancer or maybe some “blip” pertaining to my heart. But the truth was, there were no long term studies done of the potential late side effects that could and would develop. Medicine would soon learn, through us survivors, there was a lot more to long term survivors of cancer, than just reaching remission.

As to how I ended up writing this post, please refer to the page “CABBAGE – Not Just A Green Leafy Vegetable,” which tells the beginning of my journey as a heart patient. It was at that time, that I began to learn, there was a lot more things that needed to be followed up on in my survivorship. And honestly, it answered a lot of questions as to why I felt certain ways, and not always good. But because of my age and conditioning, my complaints and symptoms just did not match my demographic. Again, the plethora of issues I have faced are well documented in “Paul’s Heart.” To be clear, the situations between all of us long term survivors are different, though we do share some similarities.

Fifteen years ago, I was told I was about to die. Shockingly, this would not be the first time I would hear this sentence, and it does not get easier hearing it again and again. My “widow maker” blockage, was caught on a hunch, only because I got tired of the way I felt over the prior four months of symptoms and ignored (I am not a complainer), but because my primary care doctor interceded on my behalf, getting me an appointment to have a particular test done sooner than if I had tried to schedule it on my own, not normally done on someone my age at the time. If either of us had not done our part, I was going to die. As my cardiologist put it, “not a question of if, but when.” So, as I call it, a “dark” anniversary, one of seven I have, this is one of my top three.

The picture shown, occurred a week later, upon arrival home from the hospital. My daughters, aged three and five at the time, were glad to have me home. Behind my younger daughter’s head, a heart-shaped pillow that I used normally to stabilize my chest area, if I had to sneeze or cough. But it also served as a barrier for comfort for my daughters to give me their healing love.

The procedure itself, while quite common, bypass surgery, is a bit more complicated when it comes to patients who have been exposed to radiation and chemotherapies. There is all kinds of internal issues such as scarring, calcifications, hardenings and more, that complicate not just the actual procedure, but the recovery and healing process as well. A long term survivor recovering from this surgery, is actually more difficult than the recovery from the cancer and treatments it was caused by.

It is hard for me to believe it has been fifteen years already. It is not a case of “time flying when you are having fun.” Time has definitely flown though, for sure. With the discovery of my heart blockage, and its cause, soon would reveal many other issues that would require interventions, including two more heart surgeries, and a surgery on one of my carotids, all related to my treatment past. Those surgeries all occurred in the last four years. On top of that, during these fifteen years, I lost my father to lung cancer, went through divorce, lost my job and the health coverage that covered me being able to see the doctors that I needed to be seen by. And this was all without the concerns for what a Covid infection had the potential to do to me if infected.

These fifteen years have definitely flown by and the reality is this. The surgeries that I have gone through are not permanent, they all have limited lifetime warranties. How long? It really depends on who you ask, but can range between 10 to 15 years. Having the surgery done, you need to be followed up, at least annually. And in cases like mine, it is not just for the patency of the bypass, but because the effects from my treatments also impact how long these repairs last. The other three repairs I had done, also have their time limits.

Now, if I did not have this Hodgkin’s treatment history, I would likely become a candidate for what actually needs to be done, a heart transplant. Just as my fellow survivors and I have waited for technology and medicine to catch up with the procedures we are now eligible for, the heart transplant is the one thing, none of us seem eligible for because of all the potential complications. I know of only one who had the closest of chances, only to pass away following complications during pre-op procedures.

At last look, my bypass is still holding up, well beyond the 10 year mark, but testing shows as of last year, it will loom in my future again. I do what I can to slow the process down from simple walks to limiting stress (something not easy to do during a divorce).

There is one factor in my survivorship, all-encompassing that drives me, and I believe protects me. And they are pictured with me.

I went from dying to getting to experience so much time with my daughters, that I otherwise would not have had. They are my world, my driving force, and there is just so much I want to experience with them yet. I do not have a say with my body and what it does, but I do know that my will and fight is as strong as it has ever been, definitely not to be underestimated. I have reached so many milestones since April of 2008. Their biggest events in life are yet to come, and I want to witness them.

My daughters were not around when I went through my cancer battle. And they were too young when I had my bypass. But they are both at the age now, where they understand my health is not the best and the issues I deal with are quite serious. They both have friends that have lost a parent from a health issue. I know many families of survivors who have endured losses at the passing of their parent from one of our issues. A parent always does what they can to protect their children from that kind of hurt, and I give all I can to never let my daughters feel that loss.

I know of other Hodgkin’s survivors who are in the 40’s and 50’s of years of survivorship. I hope to be included in those rare groups some day. But for now, I take my survivorship, just as I did my original cancer fight, one day at a time. I know my potential fate, but do not live in fear of it. I live in spite of it. I go to bed each night, with the plans of what I have in store for the next day. And that is how I have lived these last fifteen years, and hope to make another fifteen.

An Organization That Actually Makes An Impact


Over the last couple of weeks, I have shared two posts pertaining to cancer survivorship. One dealt with the acceptance of a shortened mortality. The other dealt with the realization that to survive cancer, and live after cancer, the survivor must learn to advocate for themselves. Well, here comes the third and final post in this series. And I want to stress, though the post clearly focuses on Hodgkin’s Lymphoma, as more and more cancers find cures, which will also mean new and different long term survivors, the strategies necessary to navigate the next several decades, are the same. So please, read on.

Several years ago, in 2016, an organization was created, to help Hodgkin’s patients survive, and live after cancer. Unlike the major cancer organizations, Hodgkin’s International focuses primarily on the Hodgkin’s Lymphoma community. However, like I said, in much of the information and guidance provided, it can be beneficial to other cancers as well. But for being one of the most successfully treated cancers, it hardly gets any attention or focus, and those who survive it, get even less. Which is where Hodgkin’s International comes in.

This meme is so powerful. Yes, it is from Michael J. Fox, who is courageously fighting Parkinson’s Disease, but the quote actually applies in many circumstances. When it comes to Hodgkin’s International, the organization is led 100% by the very experts who have survived Hodgkin’s Lymphoma. The seven board members and lone staff member, are all long term survivors of Hodgkin’s Lymphoma, like me, and like me, deal with various late developing side effects. Like me, at one time or another, there was struggle trying to find care and answers for unexplained health issues that were coming up. Like me, many face emotional struggles as the physical issues pile on. Who better to provide information and support, than those who have “BTDT” (been there, done that)?

Look, as I have said many times before, no one gets it more than someone who has dealt with cancer before, when you are told you are in remission, and you are declared in remission, and you complete enough follow-ups, you want to take off faster than the “roadrunner” racing off from Wile E. Coyote. While I understand this position, it does leave me concerned. I know, all anyone wants to do is get back to the life that they led before cancer. And you can for the most part, most likely. But there are things you have to realize, and though not guaranteed, the possibilities do exist, there could be things later in life that develop health-wise because of the treatments that gave you that “cure.”

So, regardless if you are a survivor who has had enough when you are given the “ok” sign, or someone who is already dealing with health issues, the point is, to be aware of, and remember, Hodgkin’s International. And for the record, why international? Because there are survivors of Hodgkin’s all over the world, and many of us are connected via social media peer groups. Many without the information that I want to share with you today.

So, without further adieu…

hodgkinsinternational.com

On this website, you will find a variety of resources. It should be noted, it is constantly being updated. The great thing about my fellow survivors, is we share information, whether it be diagnostics, late side effect information, which specialist to see, or how to find a survivorship clinic, because this part of survivorship is relatively unknown, it is taking those who know, those who have the personal experience, to build this website.

One of the unique things offered on the Hodgkin’s International website, are video presentations by patients, survivors, and medical professionals. There are personal testimonials of survivorship. There are explanations of the various health issues that are experienced, and many times, recommendations of what to do about them. Recently, in what was a “two for” presentation, we (survivors) got to hear from an oncologist who also happened to be a long term survivor of Hodgkin’s Lymphoma. Again, I want to stress, you can learn how to deal with other cancer treatments similarly by learning about the treatments used, and the need to understand how they can affect the body later on in life.

Then of course, there is the information that can be found on the website, from the various late effects possible, both physical and emotional, research articles, and other literature. The website continues to add the locations of known “survivorship clinics,” facilities that at least recognize late developing side effects from treatments. At the very least, you can find a “survivorship plan”, which includes research articles, and other helpful information for you to take to your primary care doctor, if that is your only option available. This is all verified and confirmed research information, by those who have studied late side effects as well as Hodgkin’s Lymphoma.

And Hodgkin’s International makes this all easy and convenient for you. You do not even have to just “bookmark” or save the website location. By signing up for the monthly email, you receive announcements about upcoming video conferences discussing topics like mentioned above. You will also be able to read stories from other survivors.

Again, like I said, if you are a patient of Hodgkin’s Lymphoma, any cancer really, and you are like I was, wanting just to move on, just remember, that if a time does come, and you find yourself, dealing with unexplained health issues, Hodgkin’s International is the place you want to begin looking for answers and support. I say this without reservation, there is no other organization out there, even the big ones, with the commitment to long term cancer survivorship as Hodgkin’s International. And why is that? “People living with the conditions are the experts.” Thank you Michael for pointing that out.

Delaying The Inevitable


This post was going to have a completely different direction when I started. But a tragic local headline served a stark and horrific reminder instead.

I wanted to talk about traffic and driving experiences. I am one of many parents who have children who have delayed getting their drivers licenses, a right of passage growing up. Where I live, the area seems to grapple with a loss of gravity, as the nearly daily accidents involve some sort of rollover of their vehicle, including from either a straightaway or pulling out in an intersection. No, when I originally came up with this filler piece, it was nowhere near as heavy as I write it today.

The picture is a screenshot from my phone, credited to local news agency, UC Breaking News – SWFL. The headline reads, “13-Year-Old Boy Killed In Crash.” Again, as I mentioned, daily car crashes here are not uncommon, and it seems that deaths or at least severe injuries occur nearly every day. There were not many details released. A car, driven by a 17-year-old girl, had three passengers, two aged 13 years of age, and a 10-year-old. She attempted to make a left turn, thinking she had the right of way, or at least enough distance, and instead was hit by another vehicle, being driven by a 30-year-old father, and his 3-year old child. This turn was attempted at night. The accident is being investigated. But one definite fact has been reported, a 13-year-old boy was killed in the accident.

Of course, social media does not disappoint, with all the know-it-alls and just plain assholes, offering their commentary and disrespectful, hurtful comments. A lot of discussion needs to be had about this accident for sure, regardless of anything that comes out of the investigation. One thing that was confirmed, all passengers and drivers in both vehicles were wearing seatbelts, or this would have been much worse.

As a teenager, all I wanted to do was drive. The day I turned 15-years-old, I could not wait to rush out and get my learner’s permit. With a birthday occurring in the wickedest time of the year weather-wise, Winter, I would learn to drive in extreme conditions not experienced by my friends born in April or July. The furthest thing from my mind, was ever getting into a car accident, a clear case of the “it will never happen to me.” And for over 35 years, I kept that record in tact. That is right, that record came to an end, five years ago.

In a scene reminiscent to the story written above, only I know my details accurately, I had a left turn arrow, and was actually following behind a police cruiser who was also turning. But a young woman driving a Challenger in the opposite direction, was approaching, clearly without a green light, through the intersection. The police officer had just completed his turn. She was coming straight at me. A last-second maneuver, a hard turn left, turned my eventual collision from head-on, to her hitting my right passenger side. I do not recall much of the accident other than the sound of the impact. I remember the officer, who had turned around, witnessing the impact in his rear view mirror, asking me if I was okay. I was a little woozy, but I did not seem injured.

I deal with flashbacks when I have to drive that intersection, but otherwise, I had begun my accident-free streak again from that point on.

Having two teenage daughters, I knew there would come a day, that each would want to get their driving licenses. And why shouldn’t they? As I said, it is a right of passage. The fact that it was something that should happen, did not take away the many memories that haunt me of others that I knew, or had heard about, involved in car accidents. Admittedly, my memories really only hold on to those killed in car accidents. As a teenager myself, there were so many.

The first occurred during my senior year, a friend was killed driving across a bridge known for being hazardous, especially during inclement weather. Another friend, killed just after graduation in a vehicle purchased by his parents as a gift. The most personal for me occurred when my first ex-wife was hit head-on, on a dark two lane road. Driving a Geo Storm, she was hit by a Ford Crown Victoria. Somehow, she survived, hurt badly, but survived.

But these personal memories definitely impacted my motivation, rather, lack of motivation to encourage my daughters to seek their drivers licenses. I used all kinds of rationale from not necessary, to expense, and even relied a bit on their own lack of impulse to pursue the process. I would tell my daughters, “you know, by getting a license, you will be asked to run errands all the time,” capitalizing on how they often did not like being interrupted or, “if you want to borrow the car you will need to do this,” blackmail, the exchange simply not worth the inconvenience.

I have driven all over the country. And as I have, I constantly changed my opinion of which places were the worst to drive, whether road conditions or drivers. Along the way, Florida held that title for me once before and has regained my opinion of worst place to drive again. As my picture above shows an intersection in China, the photo was taken by me, that was what I thought was the worst place for traffic. Having witnessed all types of transportation, from tractor trailers and buses, to cars, to motorcycles and mopeds, to bicycles and pedestrians, it was clearly a “circle of life” situation with the strongest surviving. I had even witnessed an accident with someone opening a car door into a cyclist who had been trapped in her lane of travel. It was a sickening thud.

Here where I now live, in south Florida, there is not a day that goes by, there are at least two or three accidents, one of them severe, at least every other day involving a death. If it involves a car, there is likely a rollover involved, which does not make any sense from the lack of curves in the roads, and in most cases, traffic does not move that fast because of the amount of cars tying up traffic. Then, just as in China, you have all of these other vehicles on the road, not just trucks and buses, but because this is a tourist area, there are these funky vehicles, three wheelers, electric rickshaws, vespas, all risking their lives having less physical protection around them in the event of an eventual crash. And of course, pedestrians and cyclists are constantly getting hit by vehicles. Did I mention aggressive drivers?

And so, we have a tragedy like just occurred. There needs to be discussions about the circumstances. I know we are a country of people that do not want to be told what to do, but dammit, when we do not use common sense, such as drunken driving or texting while driving, something needs to be done to protect the innocence.

My biggest fear next to my own daughters driving, has always been them, being driven by someone else. Of course, them driving the family car, we would be aware of. But going for a ride with a friend or classmate, as the expression goes, “what we don’t know…” Well, my daughters as of now, still do not have their licenses, and it is likely they will not anytime soon, because they have realized they do not need them at their current stage. They will get their licenses eventually, but right now, they do not need them. They know this. That means, their friends do the driving. I have no idea when or how often this happens. And yes, they are to offer gas money. But as I pass cars filled with teenagers today, I see my biggest nightmare, the passengers all carrying on inside (and outside) of the vehicle, while the driver focuses on the roadway.

This tragedy is just that, a tragedy. What was a fun night for a family, has now become a nightmare. There will be lots of “coulda-woulda-shoulda”, and changes made in families who knew them, and perhaps by others who heard of the accident. But in this area particularly, the county needs to do something. Aggressive and reckless driving (such as drag racing) is at an all time high. This is not the first time a child’s life has been lost on our roads here. The first thing to dealing with a problem however, is recognizing there is a problem. And while authorities may admit to a problem, they do not publicly publicize it, you know, it is called “awareness.” If you don’t talk about the problem, it does not exist, right?

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