Paul's Heart

Life As A Dad, And A Survivor

03 Nov 2025

If You Could Really See It


This is an actual picture of my current handicap placard. Looks in pretty bad shape, doesn’t it? I have had this one just a little over two and a half years, with a year and a half to go. I have my personal identifications blocked out, but the things that should stand out to you, are the number of cracks this placard has (there is actually another located above the white portion holding the card to my rear view mirror), and the amount of tape I have used to hold this thing together.

Being someone who loves music, I often try to to quote some sort of lyric to connect my posts, but all I can really come up with, is the nursery rhyme, Humpty Dumpty. Now that I think of it, this might actually work.

Humpty Dumpty sat on a wall.

I completed 8 cycles of chemotherapy and 30 treatments of radiation therapy for Hodgkin’s Lymphoma back in 1988-1990. Got to remission, and was living life.

Humpty Dumpty had a great fall.

I was only watched by my oncologist for a possible relapse for five years. At that point, I was considered “cured” or likely free of it coming back, and nothing to worry about. But unbeknownst to my doctors (I was not being followed up anymore), my body was developing late side effects related to both of my treatments. The first of many issues, was discovered in a big way, a “widow maker” heart blockage of one of the main arteries of my heart, appropriately called that, because normally, someone does not survive that condition. Imagine if you will, Humpty Dumpty not only scrambled from his fall, but cooked in the sun on the pavement below.

All the king’s horses and all the king’s men,

An emergency double bypass for that main artery to my heart, the left anterior descending artery, literally saved my life. Comparing my life to Humpty Dumpty’s life, that heart crisis was just one piece of broken “shell” that would be discovered over the years. I have had two additional heart surgeries, I have several other conditions with my heart, a pending lung cancer diagnosis, I have a pre-cancerous condition with my esophagus and my thyroid, my carotid artery has been repaired, and the list goes on and on and on, literally. Take another look at my handicap placard. Then look at my recent photo. Of course, the main difference, you can see the horrible condition of my placard, but not what I am dealing with in regard to my health.

My “shell” looks pretty good (as far as health goes), as good as when Humpty Dumpty when he was still sitting on the wall. So you can guess, when I have to use my handicap placard in certain parking situations, and it is really not often but not without reason, I get stares, glares, and often times some pretty rude comments. My reactions or responses depend on my mood, or physically, how I am feeling at that moment. And if I am not feeling well, I am likely to respond quite negatively. Though I realize my outer appearance, “my shell” does not show my handicaps and disabilities, those unable to mind their own business or those who feel or suffer vigilantitis will bear the full brunt of my frustrations. Sure, “how could they know?” Of course, but it is also none of their business.

I have nearly a dozen doctors involved with my survivorship care from the late effects of my treatments: cardiology, pulmonology, cardiovascular, endocrinology, gastroenterology, physiatry, and many more including a primary care and a coordinator of my late side effects. This “Humpty Dumpty” has quite a few King’s men. If I were to walk around with all of my health issues on the outside, where everyone could see them, I would resemble my handicap placard. And then, you would be able to accept what I deal with. But then you would have to accept the burden that only I carry, the feelings of “that sucks” or “I would hate to have to go through all that” or anything else that may interrupt the good life you may be able to enjoy. So, I give everyone a smile when they see me, if you will, the tape that holds my placard together, you just won’t see the cracks. That keeps you safe, untraumatized.

Couldn’t put Humpty together again.

My doctors cannot stop what is happening. They cannot reverse anything that is happening. But what my doctors are able to do, is deal with each issue as it is discovered and repair what they can. I am enjoying a lot longer than I expected I would when I was told I had Hodgkin’s Lymphoma, cancer, and definitely more time than Humpty got with his four line story.

“But Paul, why not just get a new placard since that one is in such bad shape?” you might be asking. And a reasonable question, a simple question. I wish it was that simple. But just as it is with my body, the best I can do is get a replacement, however it will still have the same expiration date, and inconvenient paperwork still needs to be filled out. I wish my health were as simple as just “replacing” things. Unfortunately, there are so many extra risks associated with any corrective actions than if they were done to normally healthy people. And sometimes those risks are too risky to take.

So yes, I try to take the compliments “you look great!” and such, but it is hard because inside, my body could not feel further from it. If we are spending time with each other, family or friend, I do all that I can to not show you, or let you know, I am not okay. It is not how I want to be remembered. But… next time you see someone taking a handicap parking spot, climbing down from a monster-truck, thinking “that person can’t possibly be handicapped,” first, you have no idea what is under that person’s shell and the most likely legitimate reason they are parking in that space, and second, it’s none of your business. I do not get any satisfaction out of letting anyone know that if and when I get confronted. But if you want to make it your business with me, I will unload everything on you that I carry so that you can know the mess that laid at the bottom of the wall where Humpty landed.

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01 Nov 2025

Lung Cancer Awareness Month


November is Lung Cancer Awareness Month.

Waaaaaaay back when I was a pre-teenager in school, during “health class,” every year our teachers would teach us about the dangers of smoking, from emphazema to lung cancer. Heck, they even had a visual display of a blackened, diseased lung to hammer the point. Of course, we would go home and tell our parents that their smoking was bad for them. My parent’s response? “Won’t happen to me.”

Well, guess what. It did happen to my Father. Upon being given the diagnosis of lung cancer, his response to the oncologist’s news was, “so tell me Doc, what do you think caused this?” And my Father said it with a straight face! I jumped in, “Dad, you did not just ask him that question when you have been smoking since you were a teenager!” My Father responded, “I know. I was just hoping it could have been something else.” And it quite possibly could have been something else, though the odds of it being the cancer sticks were more likely.

And just as there are different types of Hodgkin’s Lymphoma as I was diagnosed with, and just as with different types of breast cancers (October being Breast Cancer Awareness Month), lung cancer is no different. I should know. It is all but official, pending a biopsy (or worse), I am likely to be diagnosed with lung cancer in the not so distant future.

Of the two treatment options I received for my Hodgkin’s back in 1988 and 1989, chemotherapy and radiation, back then, I was warned of the possibility of a secondary cancer, though it was thought to be in the way of a leukemia or something. In 2008, as I was being prepped for an emergency bypass due to progressive damage to my heart from that same radiation therapy’s late developing side effect, a small unidentified spot was discovered on my lung. At that time, it was of no concern, the doctor would just follow up on it for any growth. A few years later, not only had that spot grown every so slightly, there were a couple more that had been discovered. A CT scan would give only a slight more detail, but still unidentfied.

CT scans would become part of my annual surveillance and that one spot, now identified as a nodule was still growing, slowly, and a few more spots had popped up, and one of the other previous spots was now growing. Then it happened. A few years ago, that initial nodule, had grown enough, able to discern its characteristics better, now carried the comment, “presents as a possible indolent adenocarcinoma.” There it was, carcinoma, also known as cancer. I had to look up the word indolent, which means “slow growing, not producing any symptoms.” It was hard to believe, but my doctor still was not concerned at this point. A few questions later, I would understand as it was explained, many of those diagnosed with this type of cancer, often die of natural causes before this cancer becomes an issue. In other words, I would just live with this cancer, if it was cancer. We still have not made it official.

Until two years ago. The latest CT scan report changed from possible to “likely” as the nodule had grown some more, and at a slightly quicker pace. A referral to a pulmonologist had me being told I had two options, neither I would be thrilled with. He could do a needle biopsy but there risked a collapsing of my lung. And given my health history, I did not need to be taking any unnecessary risks. The other option, was to perform a “wedge” surgery, removing the portion of the lung with the nodule, and enough of the area around for any peripheral cells, but again, I have a higher risk with any surgeries, especially within the chest cavity.

My Father passed from lung cancer. He was staged at 1, but somehow following the surgery, which supposedly got everything, he underwent chemotherapy and radiation as preventative therapies, and ended up terminal. Anxiety and panic had now entered my head. My doctor had arranged for a second opinion with someone experienced with my type of health history. She had a totally different demeanor, and a much calmer direction. Together, we agreed that there would have to be a limit, a “line in the sand,” how much this nodule would be allowed to grow. There was no discussion on the other nodules and spots, but I am sure that those will eventually be included in any plan when the time comes. By my calculations, I have about three and a half years and a decision will need to be made then. Both the doctor and I are in agreement with this. And honestly, with all the issues I deal with related to my late side effects from my cancer treatments, a lot can happen in that time.

In the mean time, I continue on in life, living life, reaching for more milestones. I do not let these medical issues prevent me from my experiences. But at least with the awareness, I can have a plan. I can have hope. I can have time.

Posted in Cancer, Education, Family and Friends, Inspired By..., Side Effects, The Heart and tagged , , , | Leave a comment
29 Oct 2025

The Photograph


(top photo is mine, bottom photo is also mine courtesy of CHATGPT)

I swore I would not do it. I considered messing around with AI the equivalent to screwing around with a Ouija board. And yet, I did it. A recent diagnosis, yet another thing my body is betraying me with, put my mindset into a rare status yesterday, a feeling of worthlessness, something I do not let myself go to that place. If I am being honest, this new diagnosis does not change anything for me, well, with the exception of yet another medication I need to take. But the diagnosis was yet another reminder, not that I needed any, of what my body went through nearly 37 years ago, and because of that, must deal with the late effects today.

Myocardial ischemia, simply put, the lower chambers of my heart are not receiving enough oxygenated blood. It is a condition that is not cureable, but can be managed to a degree. This is now the eigth issue diagnosed with my heart since I was treated with high dose radiation (40gy) and MOPP-ABV chemotherapy for my Hodgkin’s Lymphoma back in 1988. In fact, I have now begun to nickname my heart “Timex,” after the advertising campaign decades ago, about Times watches “take a licking and keep on ticking.”

The status with my heart, is congestive heart failure. That was jarring the first time I saw those words in my chart. And it took a few moments for my brain to reset, CHF does not mean anything is imminent, just that my heart is working a lot harder than it should. I have now had a double bypass of the Left Anterior Descending artery (LAD), a main artery of the heart, a stent of the Right Coronary Artery (RCA), the other main artery of the heart, aortic valve replacement, a left bundle branch block (an electrical issue with the heart), an inverted T-wave, reversed septal wall motion, potential issues with my mitral valve, and now myocardial ischemia. And just for shits and giggles, I have a very pronounced murmur, which gets a lot of attention, and audience who wants to hear what a clear murmur sounds like. Yes, my heart is taking a beating. And whether by surgical intervention or medicinal maintenance, the things that have been done are not permanent, some will need to be redone again (my bypass, my stent, and my valve), and some will finally require intervention, again, none of these are permanent solutions. There is really only one option, one that I do not have, and due to the complications with the rest of my body, combined with the overall risks of another open heart surgery, the odds of me getting, or surviving a heart transplant are not favorable at all.

So, I need to do what I can, with what I know and am aware of, be kinder to my body. Unlike past situations, I am actually aware of the symptoms I am living with, shortness of breath (SOB), fluid retention, and a few others, all symptoms related to my CHF and current diagnosis of Myocardial Ischemia. I have a higher risk of having a heart attack, one thing I have yet to experience with all of my medical issues, and knock on wood, do not want to experience. Along with modifying my diet, best I can, and with mild exercise (limited to periods of walking), and medicine, there are other things I try to do to help my heart out, such as keeping my legs elevated to reduce the swelling. I live in Florida, so wearing compression socks is not an option for me.

And then yesterday, my meltdown. For the first time, these words have ever left my lips, “I am feeling worthless,” as I made a choice to allow my legs a break instead of taking on a task immediately, also focusing on not approaching stressing my heart to the level of a heart attack. Everything that I have been through, especially the last seventeen years of my survivorship, even being branded with the label “disabled,” I have never allowed myself to feel useless or worthless.

The thing is, I know I am stronger than that mentally. And that is what prompted my dance with AI. I asked to create a personna or spirit, from my image, of someone who has faced multiple challenges in life, health and otherwise. Because all of these years, I have had something in me, that has gotten me through everything. I wanted to see what “it” looked like.

I will not name it, but this is what the “fighter” in me looks like. And I can actually see it in me, and understand why I fight so hard. As I approach a major milestone toward the end of the year, and have other important milestones within reach, I am going to trust this “inner spirit” of me to keep on fighting. He looks like he can still do it. Being a big believer in “Positive Imaging” (thank you Norman Vincent Peale), this newest diagnosis is just something else for me to deal with.

Posted in Bullying, Cancer, Education, Family and Friends, Inspired By..., Side Effects, The Heart | Leave a comment

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