Paul's Heart

Life As A Dad, And A Survivor

06 Jan 2013

Wills And Living Directives


It is the most unpleasant thing to think of, your own death.  We all know it is inevitable, yet so many of us do not want to think about it, let alone plan for it.  For many like myself, with several serious health issues, it should be a no-brainer.  To make the point even stronger, I have two young children who would need to be taken care of in the event of a premature passing of both my wife and I.

Over 22 years ago, I beat cancer.  Though companies refused to deal with me, because of the risk.  Four years ago, I underwent emergency life saving open heart surgery.  This past March, I battled sepsis and pneumonia.  Three major events in my life which could have ended much differently with consequences from family to adminstration.

So two days ago, Wendy and I met with our attorney to finally draw up a will, and a living directive.  I have seen all five “Final Destination” movies so I know when it is my time, it is my time, and it could happen just like that.  And there needs to be a paper trail to tell others what you want done.  Word of mouth, “knowledge” of me, political offiliation, even statements from my children would mean nothing in a court of law.

The first thing that Wendy and I had to decide was an Executor, the person for making sure the will is followed to the letter.  As our children are far from age to do this task, we decided on Wendy’s sister.  Easy enough.

Next, a trustee was needed.  Who is going to make sure that the money is used as it is directed by us?  Again, Wendy’s sister would be able to handle this, and she is quite good with money.  So no doubtedly, our daughters would be taken care of financially.

Finally, and it is a doozy, guardian.  Who would be placed in charge of the girls in the event of anything happening to Wendy or I?  This was not an easy thing for us to agree on, though for Wendy, her answer was quick and immediate, her sister Robin.

We had a conversation years ago, pre-kids about this very issue who would get our children?  Wendy was adamant, her sister and husband.  Mike had a great job with great income.  The conversation had been pre-children,  and only recently into the marriage.  But I had felt differently as I had a friend whom I looked at as a brother.  He was part of a very nice family, wife and two children as well.  But that discussion was a long time ago.

With time seemingly not on my side, especially as spontaneous as events have become, here we were sitting in front of our attorney having only a slight difference in opionion from those years ago.  Wendy was still strongly choosing her sister, while I still chose to rely on friends who showed strong family support, friends that we have kept relationships with since the day before we met our oldest daughter in China.

The difference?  I was concerned for her sister and current circumstances that would put impossible stress on an already stressful situation.  I am purely thinking of effects on our daughters.  They have already been exposed to health crisis one after another with me, which has not been fair to them.  They are small children and all I want is for them to live a child’s life during their child years.  There is no doubt that Robin and Mike would take them in as their guardians.

As in the past, I had been considering friends who had adopted with us.  Over time, we have become more like family than friends, and we have a large amount of trust in them.  But Wendy was firm, only family.  The only downside to one of our adoption families, is that most live a fair distance from us and that would mean less accessability during holidays and family get-togethers, though I am certain, that any family chosen would do their best to make sure our daughters saw our family members.  And then our attorney brought up a point that I had not even considered, even though I claim of doing what is best for them.  If our daughters end up without us, due to an unfortunate accident, their lives will be upset enough.  How unfair and upsetting would it be to them, if they were uprooted and forced to move away from their family and friends.

And so, in preparing for a situation that we never hope occurs, all the discussion over a hypothetical situation, we, we have decided on Aunt Robin and Uncle Mike.

The Living Directive… that is another post.

Posted in Family and Friends | Leave a comment
06 Jan 2013

What Goes Up, Must Come Down


Over recent years, I have had a number of people, personal and professional, make the comment, “you really live for drama”.  While I do handle crisis with precision and patience, nothing could be further from the truth that I seek out stressful situations.  I have been dealing with one thing or another for over three decades.  An argument can be made that maybe even longer.

This post is not about my survival or its issues, but an answer to one situation, and as usual, forced into another one.  I have come to accept, this is what I do.

I have my answer to the thyroid nodule.  Fortunately, it is not cancer.  In particular, it is not lymphoma as was mentioned to be the potential diagnosis.  While relieved the nodule issue is closed, it is still unnerving to hear lymphoma once again.  I have not dealt with lymphoma, in particular, Hodgkin’s Disease in twenty two years.  Whether new disease, or after all this time, recurrence, neither way is desirable.  Because of the module’s makeup, follow-up ultrasounds and of course bloodwork will be the plan for the next couple of years.  Perhaps before that time expires, I will be dealing with more nodules but for now, one door closes…

Pollo is the perfect example of “man’s best friend”.  For twelve years, our Golden Retriever has been just that to us.  A product of a puppy mill outside of Lancaster, we have given him refuge from a life no animal should ever have to endure.  Wendy and I have done our best to care for him and to make sure he lives up to his nickname, the Happy Golden”.  With unquestionable loyalty, his tail wags constantly whether we have a treat in our hand, or he has been by himself while we are at work.

On Friday, I took our friend to the vet, under emergency circumstances.  Not putting symptoms of the prior evening as something developing, Friday, he would have multiple episodes of vomiting.  In the past, this was usually caused by consuming mushrooms from the backyard.  But things are totally different this time.  He had become lethargic, something I am not accustomed to when he has been surrounded by children or at the vet hospital.  Over the next 24 hours, he seemed to improve enough for me to get the call to take him home this morning.

When I arrived, I saw his wagging tail as he was clearly happy to see me.  But that excitement was only temporary as his legs gave out from under him.  For the next half hour, I tried to coax him to come home as the vet told me that symptoms were clearing up with the medicine taking its course.  Prior to getting him to my car, and multiple attempts of walking under his own power, he once again collapsed, this time his blatter was uncontrolled,  and he release urine while never attempting to avoid contact with it by moving aside.  He had gotten worse, not better.

Repeated bloodwork confirms that certain levels have gotten worse.  And following my departure this morning, a bruising has appeared on his abdomen, with no apparent cause.  A phone call from the vet has increased my anxiety, and once again, revved up my logical persona.  Like every crisis before, I need to maintain composure, and make rational, emotionless decisions for what is best for my canine friend.  But I cannot this time.  He has been by our side, no matter what event has occurred.  Each time, simply satisfied just to have his belly scratched.

Tomorrow, they will repeat the bloodwork again, to see if the levels continue the prior tests’ progress, or improve.  But in the morning, a decision will be made either way.  I can either bring him home, and continue to help him recover, or perhaps, be faced with having to choose how much more to put him through.

Pollo, I miss you my friend.  I am totally off my game without your here.  The routines that I have carried out for twelve years currently are displayed in silence and awkward absence.   I pray that tomorrow morning when I wake, and the first part of the day is gone, the voice on the other end of the phone says, “his tail is wagging, he stands when we enter the room, and he looks ‘happy”, and I will be there to bring you home.

Posted in Animals | Leave a comment
06 Jan 2013

While I Wait


The only thing worse than being told by your doctor than “I want you to have…” is waiting after you have had…

I am probably well into triple digits of medical tests done to me over the years.  To the uneducated and ill-informed, I would be one of those patients putting a strain on medical costs.  To my daughters, the tests are what keep their father alive.  So for the fifth time in four years, and the fourth time over the last year, I am faced with the possibility of another medical malady thanks to the cancer treatments that saved my life.  Of course, that means another expensive test.

Admittedly, I can be a bit of a baby, in fact, go into a full-blown panic attack when it comes to the sight of a syringe.  Surgical stuff, no problem.  You want to go in through where?!?  Problem.  Needle what?  Uh oh.  There are countless stories of my scenes with syringes.  But for this particular test, the needle will be going into my neck.

An ultrasound of my thyroid reveals a nodule, a solid something something with vascular yada yada.  I actually lost all track of what was being said to me, once I heard the word biopsy.  But having had exposure to radiation to treat my Hodgkin’s Disease decades ago, especially to my neck area, left me with an increase risk of thyroid issues.  Out of all the late side effects I have had to deal with over recent years, the thyroid has not really been on the radar before.  I have been on Synthroid (Levothyroxine) for hypothroidism courtesy of my treatments, even before I finished the treatments.

A needle biopsy (technically referred to as a Fine Needle Aspiration – FNA) had been ordered a couple of weeks ago.  Clearly the needle would be going into my neck.  I had a needle in my neck before, actually it was a port, during my heart surgery, but I was out cold for that.  I knew I would be awake for this one.  It can take up to a half an hour just to draw blood from me because of my irratiional aversion to needles.  But in spite of the circumstances, there is a calmness about this particular test.  I have done my research, anesthesia, the biopsy lasts less than a minute, extremely small gauge needle (thickness).

I arrived at MSKCC yesterday, not having a good start to my day.  I overslept in spite of two alarm clocks.  So I missed my train, to catch my bus to NYC.  I now had to drive, and because it was later in the morning, I was going to hit major traffic, especially at the Lincoln Tunnel.  I needed to get to this appointment on time.

I did arrive on time, in fact a little early.  Okay, got the karma back on track.  I put the robe on so as not to get my shirt messy.  Why is it that in the same hospital network, there are different quality gowns you make us wear?  Anyway, the tech comes in, does another ultrasound to show the doctor, and then the doctor comes in.  I’ll call him, Dr. G.  He proceeds to tell me what he has probably told hundreds of patients, “I do not like to use anesthesia.”  Cue the tire sounds of screeching to a screaming halt.  Normally, I would have been back on the NJ Turnpike before he even got to the next sentence.  “It is a very small needle.  If I inject an anesthetic first, there is a chance that could cause a pocket of air, which would make it difficult to guide the needle with the ultrasound wand.  Besides, does it make sense to give you a needle (a bigger one) just to do the small one?”

Surprisingly, it is harder for me to eat vegetables than it is to have tolerated this particular test.  Although clearly one thing that made it easy, I did not check out the surroundings before I got on the table.  The last thing that I wanted to see was the equipment that would be used on me, especially the needle.  Prior to my radiation therapy, I had four tatoo dots placed on me to line up the linear accelerator (the radiation machine).  I assumed this would be the same level of discomfort, but maybe a little more intense as I have had a bone marrow biopsy and know what is involved in aspiration.  All that had to happen then, was make sure the insertion point did not swell up with blood (a hematoma), or get infected (something I do not take for granted not having a spleen).

I will be okay with any diagnosis or none.  I will be okay with any plan of treatment or correction, or none.  But some things do concern me that this has the potential to be something serious.  A needle biopsy on a smaller sized nodule than usually performed.  A phone call from a very close, trusted, and valued family physcian following up on a report for a test that was not ordered by her, but results shared.  I am trying not to get ahead of myself.  You would think with my being so cooperative in such a potentially stressful situation, karma would give me a break, and an earlier phone call with the results.  Yet here I wait.  As long as I get them before the weekend.  That really would suck.

Posted in Cancer | Leave a comment

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