Paul's Heart

Life As A Dad, And A Survivor

Archive for the category “Family and Friends”

A Lot To Catch Up On


I have “several irons in the fire” as they say, a reference to many things happening all at once.

First, still navigating my latest late side effect diagnosis, radiation fibrosis induced lymphedema, classified at Stage 2, meaning moderate to irreversible. I need to get some forward progress going, or I am going to end up in trouble. The healthcare system has not been my friend with this process for sure, taking days just going back in forth for simple communications and relays, wasting huge amounts of time.

As I am now frustrated enough, I have reached out in a new direction, and yet another health network, I am hoping will help me with this issue. I have surprisingly gotten in as a new patient, next week. Though I have to chuckle, the note says “1/2 hour visit”. Good luck with that, as it is going to take a half hour just to go through my history, another half hour to go through all the radiology studies that have been done, and then there is the exam, and then the plan. Surely this will take even more than an hour.

Unlike lymphedema caused by lymph node removal as performed with breast cancer, radiation fibrosis induced lymphedema is actually a scarring, fibrous tissue that compresses and damages lymph vessels. The cause in my case still has not been identified yet (as to where the blockage or restriction is), and I have been dealing with this since July. I am down to about 10% use of my arm and hand, and if this is allowed to progress to Stage 3, it will be much worse for me, if the skin begins to rupture and I develope any kind of infections.

To say I am frustrated is an understatement. At least I am not dealing with my heart and these delays.

Speaking of my heart, with everything going on, I blew right past the 5th anniversary of my TAVR, my aortic valve replacement. Amazing the additional time that I have been given by a procedure I was not going to be qualified for just ten years earlier. Today, the valve is doing just fine while my congestive heart failure continues to hold steady.

In a follow up to my last post, I know that my daughters occasionally read my blog, especially when I want themt to see what I had written about them. When it comes to my survivorship, my daughters have distinctively different approaches with my health, though both expect the same. All they have ever known is “Dad gets through it,” every time. So one daughter will just absorb the information and move on, letting me know “you got this Dad.” Whereas my other daughter is like McCauley Caulken in thhe movie “Uncle Buck,” lots of questions.

So I am not going to rehash the last post, but my daughter had one question, “was there anything ever that you were not going to tell us?” I was trying to figure out what she was looking for. I was hoping she was not referring to the ultimate end.

During my divorce, before my daughters turned 18, I always told them, I will answer everything they ask me honestly. But if there was a question that I did not feel comfortable with, I would let them know, “this is one of those questions I cannot answer right now.”

But now, with both adult age, I had a different answer, as both are told in real time what happens with my health. I explained that back when they were both under 18, still under the orders of a custody order, I needed to be careful what was discussed about my health.

Nothing to do with the divorce, their mother was not very empathetic when it came to my late effects. Many spouses and family members are like this because they do not understand the complexities of long term cancer survivorship. On more than one occasion, I heard her tell my daughters “your Daddy’s fine, there is nothing wrong with him,” which of course was not true. I had a reason for what my daughters were told or not told, but lying to them was not what I wanted. I have several examples of children being lied to in that way, things ending badly, and that trauma lasting a lifetime.

But all of a sudden, through the divorce, denial became a weapon with custody. Their mother saw an opportunity to assist her with custody arguments. Though I doubt she changed her mind in belief of the seriousness of the issues, she did realize that she might be able to use the information in her favor.

With one of my late side effects being my conditions with my heart, and having made five trips to the ER between 2012-2013, their mother would argue that it was unsafe for my daughters to be alone with me, should something go wrong. What may seem like a legit concern, actually more of a convenient argument, fortunately, legally it has not standing to discriminate against a parent over health concerns. Not to mention the fact that no one was more aware of my fragility than I was. Which meant that I had a “in case of emergency break glass” plan. I knew of other fellow survivors who were also in this similar situation. Because we know things can change all of a sudden, we have to have things prepared, and an emergency plan should I have any health issue was always in place before my daughters came to me.

So my answer to my daughter was, the only time I did not tell them anything about my health, was when I was concerned about it being used against me. Now in their 20’s, they understand that. But today, they are told before things happen, to be included in my treatment plan, to be aware, and hopefully, to not be afraid. Because after all, “Dad gets through every time. He just does it.”

Hurry Up And Wait!


Back in 1988, when I discovered a lump in my neck, I experienced several doctors rushing with intent to get me officially diagnosed with cancer. One doctor, included with his introduction to me, and no tests performed, was already giving me a lecture on Hodgkin’s Disease, now called Hodgkin’s Lymphoma. Unfortunately, I was in such strong denial it took nearly two months, along with the clear blood tests and CT scans, until I finally agreed to undergo the only procedure to correctly diagnose me, a biopsy. The whole time each and every one of them was stressing about the importance of getting on this sooner than later to give me the best chance at remission. My stubbornness fortunately did not hurt me, as here I am 37 years later. But the point was taken, when it comes to cancer, the sooner found, the sooner diagnosed, the sooner treated, the better the odds.

One would think I would have learned my lesson about “listening” to my body. I didn’t. Because in April of 2008, after experiencing severe tightness in the left side of my chest, I FINALLY got it looked at, by completing a nuclear stress test. Unlike my cancer diagnosis, I was not in control of what was occurring. As I got onto the treadmill, and the tightness began, the technicians in the room reacted, stopped the test, and had me wait to see a doctor. Within 36 hours I would find myself having a an emergency bypass for a “widow maker” level blockage of the main artery to my heart. Here the medical workers reacted to what they saw immediately, and I am still here to write about it. Let me tell you how unnerving it is to being told by your cardiologist how close I came, “it wasn’t a question if you were going to die, but when.”

Surely I would have had to have learned my lesson about recognizing symptoms in a timely fashion. Unfortunately, I have not. And it keeps happening. Septic pnuemonia was the diagnosis in 2012 when I did not realize I had an infection, and was taken out of my house on an ambulance stretcher at 3am. Or in 2019, when another major artery to my heart was blocked 90%, again, the stress test stopped, and be evaluated by the doctor.

Yes, I have been lucky. In spite of my ignorance and stubbornness, I have had the right doctors to deal with my health crisis. Which is what makes my current situation so frustrating.

It has now been over two months that I noticed my right arm and hand swollen, and still no answers. It took a month and a half to get a particular scan completed, a PET scan. That scan was done ten days ago. And here I wait.

I have told many that I do not believe in “putting the carriage before the horse,” but I have developed a lot of medical knowledge over my cancer survivorship. I know what I am dealing with, and I know what they suspect, and what it could possibly be. And I am prepared for whatever comes.

Remember at the beginning, how I wrote about timeliness being so important? What happened to that urgency? Like I said, I know the possibilities, and of course, time is going to make a difference. But for now, time has stopped. I can’t even go forward. Even the most simplest of diagnosis, and I still cannot get anything done until it is confirmed.

Even before the technology, I have never had to wait more than a day or two for answers. And now, the technology gets it to me within hours, at least until this moment. There is a known factor contributing to this, the collapse of our healthcare system creating a shortage of those in charge of reading these all important scans. But that does not help me. I am now going through my second weekend without an answer.

Several of my fellow survivors have offered encouragement with a belief I already have, “if there was something important, I would have heard sooner.” And that makes sense, as I have recieved that kind of attention before. The problem is, my background back in 1988 is so similar to what I am dealing with right now, the lack of certain symptoms with the current symptoms I am dealing with, is triggering the most dire of flashbacks for me. And like I said, until I get my report, if it ends up being my worst fear, I cannot do anything until I get that answer.

If just simple lymphedema, then likely just drainage massage. But if the two enlarged lymph nodes are any factor, the question becomes why, and it is pertinent that no massage be given, for fear of pushing “whatever” the lymph nodes contain, cancer or infection, into the lymph system, spreading. Or if there is any other source of the retention requiring further testing. So, not only am I just waiting, I am not getting better, and I could be in for further study with no resolve in sight.

There used to be a joke about someone who went to the doctor with an injured arm, and asked the doctor if they would ever be able to play the violin, and the doctor assured them they would. And then the patient told the doctor that was good news as they had never played it before. Well, I can play the guitar, and piano, but not currently as my fingers are two swollen for dexterity. Even as I type this story, it is with only one hand, fortunately my dominant hand. But there are many things I realize that I do with my non-dominant hand, and I need to be able to do that again.

I know I won’t hear anything yet tomorrow, Sunday. But man am I hoping for anything come Monday, day 12.

Is This Thing On?


A couple of months ago, I did a comedy routine around cancer. Yes, cancer. To be clear, I did not make fun of having cancer, but found ways of dealing with some of the situations with some humor. Of course, if you were someone who has never had cancer, besides being fortunate, you may not have been able to “get” the jokes. Well, I am back at it again. This time, I am dealing with the issue with my right arm and hand, lymphedema, swelling through my lymph system (as opposed to blood caused by the heart – which I also deal with). Again, imagine if you will, I am referring to the swelling in one arm, not both, and not only how uncomfortable it is, but awkard. While I wait for my doctors to come up with a plan, they say laughter is the best medicine, so here goes…

So I have this new condition in my survivorship, called lymphedema. It is when lymph fluid cannot flow through the lymph vessels properly because of some sort of restriction. Looks painful. Feels weird. I have currently lost about 75% of use of that right side appendage because of this issue. But not all is lost. I have my sense of humor.

First, there is no need to worry, I am not turning into the incredible hulk, my right arm just got the wrong memo. My left hand looks normal while my right hand looks like it has been hitting the all-you-can-eat sodium buffet. Both my arms are like if they were in a long distance relationship, clearly having stopped communicating. I call my left hand Paul, my right hand Paul XL.

One of my goals working out was to have bigger arms. Evidently the universe only heard half of that request. Where I live in Florida, people pay thousands for asymmetrical fashion. My lymph system gave it to me for free. If I am going out for dinner, my left arm says “business casual”, but my right arm says “professional wrestler.”

So to understand, one of my arms and hands are retaining fluid, the other is just retaining its dignity. If I were a boxer, my two hands would be in different weight classes.

I’m saving money when I go to sports events currently. I don’t need to buy a large foam finger. Nature provided me one.

A swollen hand walks into a bar. The bartender said, “holy crap buddy, you buying drinks for all five of those sausages?” I can still give someone the finger while I am driving, which is important in Florida. The bad news is, it just looks like a bratwurst.

Yes, this is another one of those late side effects from my treatments for Hodgkin’s Lymphoma 37 years ago. We survivors call treatments, “the gift that keeps giving, long after you’ve lost the receipt.” Nothing a cancer survivor needs to hear is, “you know what this person needs? A freaking sequel.” So surviving cancer isn’t enough with everything else I have gone through survivorship, I now have the limited-edition oversized hand.

Late side effects from treatments are basically your old cancer treatments drunk-texting you decades later. “Hey! You awake?”

Having one hand larger than the other isn’t all bad. I can use one for everyday use, and the other for intimidating people. I might just say I have a regular arm, and a Costco-sized arm. I keep waiting for this swelling to go down, but my body keeps telling me to lower my expectations.

I have tried wearing a compression sleeve, also known as arm spanx. That has not helped. It just made my arm feel vacuum-sealed. There is enough fluid in my right arm and hand to qualify as waterfront property. If my arm and hand get any bigger, I will be able to claim it as a dependent.

The upside to the swelling, nobody asks me to reach into narrow spaces anymore. One hand says “handshake,” the other says “medieval weapon.” It’s like if my lymph system was put in by a plumber, it was done by the lowest bidder.

So that is all I have for my over-agressively confident right hand and arm. I never asked for Popeye’s forearm, especially just one of them. It looks like I was thumbwrestling myself, and my right hand ate my left hand. I finally understand what “thick-skinned” means, unfortunately, literally. Of course if I wanted to brag, when asked why one is bigger than the other, I could just respond “you should see the other guy.” I could just become a Bond villain, I already have the wierd hand.

Thank you all, you’ve been great!

Now back to watching my phone.

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