Paul's Heart

Life As A Dad, And A Survivor

Archive for the category “Recreation”

26 Apr 2023

When You Are Prepared For The Unexpected


I have a very exciting weekend planned. But somewhere in the cards or the universe, there were other plans. In my life, at least the last four decades or so, that is the way it has gone anyway. So I got a visit from “Mr. Murphy” last evening. You know Mr. Murphy, who states his law that “if something can go wrong it will?”

I had just completed packing for a visit to my daughters this weekend. I was relaxing before turning in for the night, enjoying a light snack of some Edy’s vanilla ice cream. About half-way through with my tasty treat, I felt a small “nugget” of some sort, that I thought might have just been a crystalized piece of the ice cream as I keep my freezer a bit colder than many. As my treat swished from one side of my mouth to the other, my teeth hit that “nugget” again. Clearly, it should have been thawed out, and softer. I know I was eating plain vanilla so it could not be a nut or a chocolate chip, which can be a disaster for teeth when frozen. It did not make sense to me. And then it hit me.

Being careful not to swallow the portion currently in my mouth, I began to sweep my upper jaw with my tongue from left to right. Nothing. I lowered my tongue to the bottom jaw, and began to sweep from right to left. Instinctively, or perhaps in apprehension of what I felt I was about to discover, the pace of the lower sweep was much slower, as if I could prevent what I was about to discover. Half way around the lower jaw, so far so good. Only about seven more teeth to go, then I would spit out what was in my mouth to see what foreign object was in my ice cream. Six, five, four, three… nothing yet, maybe my mind had tricked me into thinking the worst… two, DAMMIT!!!!!!!

Not the first time that I have ever broken a tooth (a reason that I will get into shortly), I knew what had happened, though I could not figure how, as I was only eating ice cream. This particular tooth and I have a long history with each other (an explanation that I will also get into shortly). With this trip coming up tomorrow, I did not have time to waste. I needed to get the tooth dealt with before I got on my plane. I had to get an appointment today. There was no other choice.

As I said, this is not the first time that I have ever broken a tooth. In fact, it is quite common for me, being a long term cancer survivor of thirty-three years, an issue created by the treatments for my Hodgkin’s Lymphoma. The first time occurred back in 2008 soon after I had my emergency bypass surgery. One of the first things brought up to any heart patient, not just a cancer survivor cardiac patient, is the need to prevent this type of situation to develop an infection. It is very common for heart disease to be discovered by a dentist, as bacteria being dealt with during cleanings, can all too easily enter the blood stream and go right for the heart. So, with that, I learned that when this situation would occur, it was urgent that I prevent any opportunity for infection, and get the tooth dealt with right away. Unfortunately, dental bills are expensive enough when you do not have dental insurance, so really anything more than a cleaning or cavity being filled was going to be out of my price range. The recommendation by the dentist, was a procedure called a “crown,” simply a replica replacement of the tooth. This option however was way out of my budget. The only other certain choice, was to pull the tooth, which I did not want to happen. After a lengthy discussion, my dentist had one more thought. She offered no guarantee that it would even work, let alone last. But she was willing to give it a try, if I was willing to allow it. She would restore the tooth, damaged probably up to 85% using filling material. The only remnant left of the original tooth, would be the outer wall of enamel, and the inside wall of enamel. Her hopes would be that it would last at minimum, maybe two or three years.

To the surprise of my dentist with each subsequent visit, the tooth still held for almost fifteen years. That’s right, this tooth finally decided it could not last any longer, the inside wall of enamel had broken off from the filling, yesterday.

Having already had the doomsday conversation with my dentist about this dreadful day, I already knew there would be only one option available, extraction, pulling what was left of the tooth. With my flight leaving tomorrow, and several factors to consider, a rather important one of being on blood thinners, and needing time to stop taking the blood thinner and needing the tooth pulled, I had only a small window to get this done, this morning.

As I said, this is not the first time that I am dealing with a tooth having to come out. This is actually my fifth tooth, fortunately, all unseen to anyone not going spellunking (cave exploring) directly into my mouth. More importantly, because of my complicated health history, this type of procedure needed to be done by someone with knowledge and experience of radiation and chemotherapy damage, or, be willing to to listen to the information I had for them about my health.

The above three photos are from a file on potential late side effects for various treatments as compiled by oncologists of the Childrens Oncology Group, who created these Survivorship Guidelines. This document is nearly 300 pages long, so all I needed to do, was pull the pages that pertained to my current crisis and bring them with me. I did this only for the first visit. He knew what to do with me every other time this happened.

But there was one more step in the procedure he needs to perform while doing an extraction on me, and it is vital for my jaw to heal. Because radiation has caused the damage that it has, the jaw was likely to have difficulty healing. For many, hyperbaric treatments may be prescribed to increase oxygen to enhance healing. That is a problem for some cancer survivors, like me. Having received the drug Bleomycin with my chemo, I cannot have hyperbaric treatments, due to something called “bleotoxicity,” a different discussion on a separate post. The surgeon explained a procedure available called “PRP”, protein rich plasma being injected into the empty space where the tooth once was, prior to closing up the hole. Blood is drawn, and spun in a centrifuge, leaving the plasma. I have now gone through this several times, all successful, and with no complications in healing. An antibiotic mouthwash for the next two weeks, and I will be good to go.

I knew what had to be done, that it could be done, and I had no time for anything else. There was one problem, the surgeon. Dentists do not like pulling teeth if they do not have to for multiple reasons. But he is a surgeon, not a dentist. Realizing I have lost a number of teeth (common for us long term survivors), he felt this was one time, I should consider fixing the tooth, with a crown. If I do say so, he offered multiple risks to dissuade my decision . I explained the history of this tooth to him, and that my dentist said, the tooth would not be fixable once the filling no longer held. With the Novacaine working, the surgeon went to work. In the end, everything went as expected with a final comment from the good doctor. “In hindsight, this was the right call. The tooth just crumbled with each attempt to extract it. A crown would not have been possible.” Had I listened to him, I would be stuck with this until I returned home.

And so, I packed before my appointment, all I needed to do, was chill the rest of today, then head to the airport tomorrow. The bleeding has stopped and the pain is lessening, and I can look forward to a wonderful weekend with my daughters. My diet will not be as it normally would be, unable to chew anything hard or chewy so I do not risk the stitches. But all the better excuse to have more ice cream. Did I just end this post that way?

Posted in Cancer, Education, Family and Friends, Inspired By..., Recreation, Side Effects, The Heart | Leave a comment
19 Mar 2023

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?

Posted in Adoption, Education, Family and Friends, Inspired By..., Recreation | Leave a comment
20 Feb 2023
1 Comment

A Super Side Story


(apologies for the delay in this story, but life happens.)

As many who have no vested interest in the Super Bowl (meaning my team was not playing), I am prone to want to pay attention to the extra stories that occur over the two weeks, and the game itself. This is a tradition that began for me back in 2006, when the Seattle Seahawks (my team) went to their first Super Bowl, and I completely missed the game, as I was in the process of adopting my youngest daughter. Every year, as Super Bowl rolls around, regardless who is playing, including the two additional appearances by the Seahawks, the first thing that always comes to mind, is that trip all the way around the world.

This year’s game, had many special stories behind the game. There was the first match up of biological brothers playing on opposite teams. This story so entertaining, even their mother, any time she was seen, was wearing “split” clothing, representing both the Philadelphia Eagles for her son Jason, and the Kansas City Chiefs for her son Travis.

There was the historical milestone of having two black quarterbacks starting the Super Bowl.

And then, there was the fact that the head coach of the Chiefs, at one time, had been the coach of the Eagles, and while haven gotten the birds to the Super Bowl, the did not win. “Big Red” as Andy Reid was known by, soon found himself out of favor with the fans, and the team, landing in Kansas City, where he won his first Super Bowl as a coach last year.

But the most special moment for me, occurred at two separate moments, both before the game had begun. The first happened in the hour before the game, an interview was held by former New York Giant Michael Strahan, with Buffalo Bills Damar Hamlin, who gained unintended fame having collapsed on the field, during a game between the Bills and the Bengals near the end of the season.

After some questions to Hamlin about how the day began, and what was at stake, Strahan then asked a most difficult question. I am paraphrasing it, as this happened to be an emotional moment for me watching this interview, explanation will be coming shortly, “what went through your mind, as you got up after making the tackle, only to collapse right after.” Hamlin responded that he was not able to answer that question yet, as tears started rolling down his face.

Of course, the question was likely to provoke a response about the sudden blackout, fear, helplessness, and as his heart beat stopped on the field, would he have had any memory of that moment? The interview ended soon after that.

Whether for good or for bad, when the body decides to allow or disallow memory of certain trauma, whether remembered or not, often stirs an emotional upheaval, none felt like ever before. While I will not speak for Hamlin, myself, a cardiac patient as Hamlin, I often still struggle with my emotions every since my first major open heart surgery almost fifteen years ago. And I cannot explain it. I do not personally remember anything after the oxygen mask had been placed over my mouth. Reading the surgical report, I know my heart had been stopped, drained of its blood so that the surgery could be done. And then my heart was filled back up with blood, and restarted. I offer my apologies to my surgeon as it was really way more complicated than I made it sound. But my point is this, I remember nothing about what happened, once I was put under anesthesia until I came to after the surgery. And yet, whenever I witness or hear of someone else go through an experience with the heart, or cancer, I lose control of my emotions.

As I write this post, I am aware of a fellow long term Hodgkin’s survivor like me, going on over a month now since his heart surgery. He is also facing new emotions as he struggles with his recovery, as well as the trauma of what his body had been put through.

When Hamlin is ready, he may finally discuss what he has been feeling, struggling with. Maybe his won’t. But one thing that I truly admire about Hamlin, like many other survivors, they take the experience of that traumatic event, and try to make something good come of it.

Hamlin is alive for only one reason, CPR being performed on him, almost right away. Time is the most critical when the heart stops beating, and medical personnel were able to begin CPR right away, buying the time necessary for better methods to be employed, eventually saving this young man’s life. It is truly an inspirational story, fan of football or not.

And so, the second moment of yesterday’s telecast came, during introductions of the game, many medical personnel who tended to Hamlin, and training staff from both teams were all introduced on the field. And yes, it was predictable, but wow, what a powerful moment, Hamlin was introduced, and embraced all who were there. Yes, the tears were not only falling, but out of control for me. Hamlin was wearing sunglasses, but anyone watching knew what was happening in that moment.

I reunited with my hospital caregivers a couple months after my emergency bypass had been completed. I wanted to let them all know, their care was responsible for saving my life, and I was not only going to live, but make the most of my life, and I would forever be grateful for the care that they gave me.

In the meantime for Hamlin, he is using his “event” to raise awareness and advocate for everyone to learn a newer version of CPR, his life definitely being saved from someone immediately able to perform CPR on him after he collapsed. As anyone knows, timeliness is critical in reviving someone whose heart has stopped.

The newer procedure for CPR came about for several reasons, from reluctance due to Covid-19 risk and sadly homophobia in some cases, to discovering that chest compressions were more critical to keep blood flowing until emergency personnel arrives. The American Heart Association now recommends up to 120 chest compressions per minute, and if possible, using a chain of rescuers. Even if you have never performed CPR on someone with the older method, and just been certified using a “dummy,” performing chest compressions for a long period of time, combined with the emotional adrenaline, can be exhausting.

But learning this new technique, is not only easier, it just might make a difference when you least expect it. Like in front of 65,000 fans during a football game.

Posted in Adoption, Education, Family and Friends, Inspired By..., Recreation, Side Effects, The Heart

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