3 Month Update

Well several people asked me to update this blog and I kept promising to do so. But before I do, here's something that helped put it in perspective. The subtext for this is an email that's been circulating and some woman named Sue entered her brother's email for a radio contest for "worst job ever" and with this entry she won:
Hi Sue,
Just another note from your bottom-dwelling brother. Last week I had a bad day at the office. Before I can tell you what happened to me, I first must bore you with a few technicalities of my job. As you know, my office lies at the bottom of the sea. I wear a suit to the office. It's a wetsuit.
This time of year the water is quite cool. So here's what we do to keep warm: We have a diesel-powered industrial water heater. This $20,000 piece of equipment sucks the water out of the sea. It heats it to a delightful temp. It then pumps it down to the diver through a garden hose which is taped to the air hose. Now this sounds like a damn good plan, doesn't it? I've used it several times with no complaints.
When I get to the bottom and start working, what I do is take the hose and stuff it down the back of my neck and flood my whole suit with warm water. It's like working in a Jacuzzi. Everything was going well until my ass started to itch. So, of course, I scratched it. This only made things worse. Within a few seconds my itchy ass started to burn. I pulled the hose out from my back, but the damage was done.
In agony I realized what had happened. The hot-water machine had sucked up a jellyfish and pumped it into my suit. This is even worse than poison ivy under a cast. I had put that hose down my back, but I don't have any hair on my back, so the jellyfish couldn't get stuck to my back. My ass crack was not as fortunate.
When I scratched what I thought was an itch, I was actually grinding the jellyfish into my ass. I informed the dive supervisor of my dilemma over the communications system. His instructions were unclear due to the fact that he and 5 other divers were laughing hysterically.
Needless to say I aborted the dive. I was instructed to make 3 hellish in-water decompression stops totaling 35 minutes before I could reach the surface for my chamber dry decompression. I got to the surface wearing nothing but my brass helmet. My suit and gear were tied to the bell. When I got on board, the medic, with tears of laughter streaming down his face, handed me a tube of cream and told me to coat my ass when I got in the chamber. The cream put the fire out, but I couldn't shit for two days because my asshole was swollen shut.
We've since modified the equipment to filter out most sea creatures.
Anyway, the next time you have a bad day at the office, think of me. Think about how much worse your day would be if you were to squash a jellyfish on your ass. I hope you have no bad days at the office. But if you do, I hope this will make it more tolerable.
Original source: forwarded email in August 1999
Sound too bad to be true? Yep, an urban legend:
"You're absolutely right to classify this story as an urban legend. First off, if a commercial diver was working in cold water at depths requiring A 35-minute decompression time, he'd certainly use a drysuit which does not allow water to touch the skin. Second, the expense and pressures involved in pumping heated water down to the diver at such a depth would both be ridiculous. Third, the jellyfish would've been pulverized from the pump and the stew of stinging cells would have affected all sites of contact (i.e. all over the fellow's back), not just at one spot. Fourth, if the diver spent 35 minutes in safety stops and still had to spend time in a decompression chamber, he would have to have been incredibly deep and using mixed gases, which contraindicates hardhat diving. In short, it's a crock. Amusing, but a crock nonetheless."
Ok so how am I doing? My butt hurts. It hurts to sit. What do I do? Sit and talk to people all day. It's not as bad as that diver guy but certainly for a lot longer. Apparently I'm in the minority (but who knows?) of men who wound up with long-lasting pain after the surgery. Got up to about a 7 on a 10 point scale. Surgeons told me this and that, should go away any day, well, we've never seen it last this long, well never past 6 months, well we might have to "go back in there again." Don't think so.
So thanks to my old buddy and physical therapist Kathy White with backup from another friend Sara, I was told Donna Edwards at Mountain Spirit Physical Therapy was an expert in pelvic pain. Got a referral (no longer needed under the new open access law that says you can go straight to a physical therapist without a doctor's order) and went and have session #4 tomorrow. She's a wonderful woman. Fortunately another good friend Tracy gave me a "heads up" (hahaha) about what to expect and loaned me her TENS unit. The following paragraph is PG-13 and may be Too Much Info but I have a twisted sense of humor anyway. I'll clean it up.
So by now I've pretty much lost whatever modesty I had. Half of Knoxville has seen my bottom. One of the lovely things of prostatectomy is a persistent dribbling incontinence and I wound up getting a yeast infection from being wet all the time. Yes I am truly being "womanized" and so I call up my dermatologist after I can't clear it up (Desitin didn't work) and the helpful woman asked why I needed an appointment and I said "jock itch." She made an appointment. The same lady whom I guess is close to retirement age asked in person why I was there and must not have written it down the first time and I repeated "jock itch." So I see my dermatologist and in the middle of pulling my pants down and showing him my crotch and full frontal nudity, said matronly woman knocked on the door and came right on in. I just laughed. Now 50.1% of Knoxville has seen my bottom. So anyway that was a week or two before I saw the physical therapist and sign about 80 pages of forms and recalled reading in one page that pelvic floor therapy can be awfully uncomfortable and private and just to make sure there's no hanky-panky that the patient won't be alone. So in the middle of my first session the secretary (I am certain she has no LPN, RN or other medical initials after her name) comes in and stands in the corner. What does pelvic floor therapy entail? Well let's just say a glove and KY jelly are absolutely necessary. At this point I'm laughing. Up to 50.3% of Knoxville now can pick me out of a lineup of flashers. THEN at the conclusion (why not the beginning?) of the session I'm handed a form to sign that it's ok with me NOT to have a witness. In "hindsight" (hahaha) I guess I should have refused and made her secretary sit in each time and made some grunting noises or like that asshole Florida student cried just after he said, "Don't Taze me, bro!"
Ok, so now you know. Good news is I think it's getting better, strung together 2 days with no significant pain, can sit longer, and am cautiously optimistic about getting paroled from this pain jail. I talked to a guy who had his robotic surgery at Vanderbilt and had pain for 8 months and his surgeon's response was "well that happens sometimes."
The moral of the story is it really helps to be your own advocate and have good friends and resources. And as I tell my closest friends, "pray for my sorry butt." Thanks. I'm still able to find some things funny. Hope you do, too.

Bye-bye catheter hello pads

They say the second best moment in a man's life is when he buys his boat and the best is when he sells it. I still have my ski boat (haven't got it out yet). I've had worst and best moments lately but first place this week goes to having my catheter out. There was some foreshadowing going on when the nurse on Monday told me to start taking shallow rapid breaths and I thought I was back in Lamaze training when she whipped it out on the second breath. As usual you get the vaguest idea of what'll happen next - "you'll be able to get your continence back over the next 4-6 weeks." What's the slope of the curve, y'all? For me it's been surprisingly fast, just 4 days later and it's pretty good! I do feel like an honorary woman, going from labor and delivery of a catheter (didn't take the baby home) to now having periods. Bear in mind I had 2 brothers and no sisters and was spared the sex talk with my daughter and step-daughter and somehow I didn't know the difference between absorbant, superabsorbant, light, heavy pads. Is a 3 pad day a light day or a heavy day? Being sure to wear dark clothes in case of a leak. So I experience Lamaze breathing, periods and now post-menopausal stress incontinence. I always knew I laughed a lot but never felt it in my pants. So I tell people not to tell me jokes, squeeze before I sneeze and am more serious. Well, a little. Wednesday was a washout (literally) due to nurse Jamie's presence, starting with her telling how she set off the burglar alarm and it went downhill from there. How she posed her first deceased patient as a nurse who "graduated fifteen minutes ago" sitting up all pretty in the bed. "How was I to know how fast rigor mortis sets up" and her supervisor yelling, "Who's the M-F who did this?" She had to lay on top of the old lady for the funeral home to get her coffin-ready. All day long Jamie stories and I'm wetting my pants. I gave up by 10am. It was worth it. Don't even get me started on diapers. But I'm alive and having that damn catheter out after 2 weeks has started a new round of gratitude.
It's funny how everyone I talk to who has survived cancer has come out with a new attitude. The tribal shaman or medicine man/woman in many cases survived a life-threatening illness, connected him or her with Spirit in way that those who haven't been through that ordeal wouldn't understand. I get it.

The most bizarre moment and I wasn't even there...

Several of you have written or told me they enjoyed the funny anecdotes interspersed in my writings. I have a story to be told of my surgery but it’s not funny, even to my warped sense of humor. This is for my brother Don, who dislikes funerals and thinks the open casket variety is especially primitive. Turns out to be good for something in an unexpected way.
So the hospital named after the mother of Jesus did a great job in surgical care with my fantastic urologist Paul Hatcher, M.D. Nursing care seemed to be either fabulous or not-so-fabulous. The care received pre-op and in recovery was excellent, one of the nurses knew me from a mutual friend and had another good news story about prostate cancer survival in her family. Here’s the bad news. Someone (volunteer, nurse, coordinator, wasn’t clear) told my family I’d been moved to the Oncology floor and wrote down a room number and to go up and see me. As my wife Judy said it was a good thing she wrote it down so the family couldn’t be accused of misunderstanding her. So Judy is walking into that room with Jeremy and Hayley literally on her heels (and her friend Evans behind them) when they are confronted with an obviously dead person in a bed. Judy put her arm out to stop them but it was too late. She said later the person looked quite jaundiced and they couldn’t really tell if it was a woman or man but didn’t stick around long enough to figure this out. Judy went straight to the nurse’s station, asked (demanded) to speak with the nursing supervisor. She told her what happened, showed her the piece of paper and issued her demands: a different and larger room, across from the nurse’s station and an investigation into their procedures so this wouldn’t happen again. These 4 people decided to withhold this info from me until after I got home; they worried I’d see it as an omen. When the secret emerged, I expressed my concerns to them about how bad that must have been when Hayley said, “Oh I’ve seen dead people before when they open the caskets at funerals.” So her great aunt and grandmother (once again) helped even in death. The law of unintended consequences, or in this case – benefit. Jeremy laughed it off but correctly pointing out, “At least it wasn’t you in that bed!”
The evening agency (temp) nurse promised me I had Demerol or hydrocodone pill ordered for pain. Still trying to shake off the anesthesia and morphine haze, I didn’t want Demerol/phenergan and asked for hydrocodone. Thirty minutes later I called them and they said it wasn’t ordered but they’d called my doctor for an order, which I got ten minutes later. Despite having recited my medication list at least five times, I was never offered my stomach med Protonix (not a real big deal) nor my maintenance asthma inhaler Advair which would have resulted in almost a guaranteed asthma attack. Fortunately I followed the rules I recommend to anyone going to a hospital – be prepared and take your own meds with you. I managed to sneak two Tylenol tabs and my Advair inhaler and managed just fine. God help you if you go into a hospital on a psychiatric medication – they will typically omit it, reduce the dose, tell you that you don’t need it or shame you. Take those with you, too. The night nurse apologized for giving me a suppository, rather than saying something like “this is going to help you.” The day nurses were fabulous and one was another LMU instructor who knew Lisa Pullen who works with me. I think that got me better care, Lisa!

Staples out but 6 days and counting...

Well I got my staples out. The waiting room was filled with grumpy old people and some woman across from me was quite vociferous (he ran 90 minutes behind). When I got in the nurse asked me how I was and from her body language she was braced for another complaint. When I said, "Great!" she heaved a big sigh, I laughed and told her the waiting room needed to be sprayed with Prozac. She said, "yeah, they take it out on us." I thought of giving some advice like telling people how far behind you're running but figured if you could run a prostatectomy through remote control, surely you could reason that out. Then the same nurse took out my staples which stung. She asked how she was doing and I said fine. She told me it was her first time. "Really?" I asked. "No, just kidding," she said. First humor in a pretty long time on the medical scene (wait until my next post and you'll see how grim it got).


Dr. Hatcher went over my path report. More info for those readers with prostates: my biopsies which were in 4 quadrants only showed cancer on one side/lobe but the pathology report on the removed gland showed cancer on both sides/lobes, involving 20% of the prostate. Gleason score still 3/4 but tumor stage went to 2C. Just shows how lucky I was. Still am ok, no PSA followup until October.


I tried to get him to remove my catheter but no such luck. He asked if I wanted to do it myself and I thought of the brokerage commercial where the surgeon tells the guy with the steak knife to make an incision between the 3rd and 4th abdominal muscles and asked, "Shouldn't you be doing that?" So I go back in 6 days to have this dadgum thing removed. My step-daughter Christy (an RN) offered to do it. Said I could cover up. I told her if something (unlikely) went wrong like dragging some alien spider out or a turtle clamped down on the end of the catheter, I'd rather be in the doc's office. She seemed not to take too much offense. More later...


Lane

Cured !!!!!!!!!!!!

Cured. What a fabulous word. My new favorite verb. Dr. Mounger, Dr. Hatcher's partner who set up the robotic surgery for him and assisted came to do rounds this morning and said I'd go home around 2pm today. He said it would take about a week for the pathology report. Dr. Hatcher told Judy after the surgery that everything looked clean, took a few nodes for biopsy, didn't see any obvious cancer spread. Then just before discharge Dr. Mounger called the hospital room at St. Mary's and told Judy that the pathology report was in (maybe some special treatment for a doctor?) and there was no cancer in the nodes or outside the capsule and that my cancer is cured. Surreal. I am in shock. I'll write more later. Love and thanks to all those who care about me and prayed for me. It worked! I have taken one pain pill yesterday, none today. Hard to believe I've had major surgery.
Lane

The antidote to helplessness

I am reading Martin Seligman’s excellent book “Learned Optimism.” He pioneered the theory of learned helpnessness and depression. Simply put if whatever you do doesn’t work, you learn how to be helpless and give up. In an experiment with 3 groups of dogs, he made a sound followed by a shock. In the first group the dog could press a button with his nose and wouldn’t get shocked. In the 2nd group (helpless) they were “yoked” to the first group but nothing they did would prevent a shock. The 3rd control group had no shock. They they put them in a room with a low wall and ran the experiment. The first group was exposed to the noise and they jumped over the wall to keep from getting shocked. The control group jumped over the wall. The “helpless” group gave up and 85% of the dogs wouldn’t jump over the wall and just sat there and got shocked. Think of poverty, living in a dictatorship, being abused, being imprisoned as examples of chronically being unable to affect your environment. But what about the 15% of the “helpless” group who jumped the wall and those people who prosper in the face of adversity? They’re the optimists. They are the ones inoculated against getting depressed. His other point which I wrote earlier about is that the other significant factor in depression is rumination. He pointed out that women have more depression than men because they think about their problems. Seligman says if a person loses his/her job, the woman thinks about what she did wrong. The man is much more likely to take action and even if it’s “bad” action like arguing with their wife, gambling, violence or some other acting out (or healthy action like I did home repairs) they are avoiding the depression-inducing rumination. So I spent the morning flying my radio-controlled helicopter and watching TV with my son Jeremy and friend Terry. Note that this is not denial, which is the substitution of a wish-fulfilling fantasy for reality. I know my diagnosis and what’s in store tomorrow. I just am not going to dwell on it.

The Reluctant Fraternity

Thanks to Donny Pember for getting me in touch with his friend Mike. Mike had the da Vinci robotic surgery in February and told me how relatively easy it was, got his catheter out early in 8 days and went dancing at a wedding on day 9 which sounds good to me. He gave me lots of encouragement and nitty gritty details, said that I'd joined the group of men known as the Reluctant Fraternity. If only I could dance but I'd be willing to learn in exchange for losing the catheter early.
Connections are what nourishes us. I have read many a patient a chapter in that old best-seller Everything I Need to Know I Learned in Kindergarten by Robert Fulgum. It concerns a child hiding in a pile of leaves under his window while playing hide-and-go-seek and the others are giving up on him. He considers setting fire to the pile but just decides to yell, "Get found, kid!" He describes the grownup version, cites a physician who got cancer, decided to tell no one including his wife and family until the end. Some people said he was courageous but his family was privately very angry with him, felt betrayed. I am not advocating hiding. Tell someone. Tell a lot of someones. It comes back many-fold.