Bad News, Good News, Bad News

The bad news is that after a biopsy following the latest surgery, cells found, that were thought not to be cancerous, are. The good news is that they’re not invasive. They’re cells who sort of took a wrong turn somewhere and are wandering around my innards aimlessly. You might almost feel sorry for them. The bad news is because of these unfortunate peripatetic little invaders, I need more chemo.

I hate chemo. It’s invasive, demeaning, uncomfortable and, apparently, successful. I now calculate I’ve had a total of almost ninety injections of BCG, not one of which made me smile. Bacillus Calmette-Guerin therapy, is the most effective intravesical immunotherapy treatment against bladder cancer, but it does get old. It’s also vexing to me that it was invented in France, like the telephone and the airplane.

The treatment is six sessions. The first two hardly have any side effects. The third and fourth cause me a lot of discomfort. Since the treatment’s effects are cumulative, the fifth and six sessions make me bedridden. I get chills, tremor, nausea and a host of other nasty side-effects that can last from twelve to thirty-six hours.

The medical personnel administering the treatment wear hazmat suits that include eye protection, double-gloves, and gowns that cover them from head to toe.

“I wouldn’t want to get any of this stuff on me,” an Amazonian nurse once told me. “It’s really nasty.” She then added she’d gone to a special class to learn how to handle the chemical cocktail safely.

This is my seventh year dealing with this malady. I’m fortunate. It killed my oldest sister and one of my best friends, but since, in my case, it was discovered early, it’s been kept in check.

I bitch, I moan, and I whine. This being said, I’m also grateful.

 

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Post-op

The best thing about surgery is the little socks with treads on the bottom that they give you in pre-op. I collect them and so have several pairs. I’m wearing some now. I only wish they came in different colors than pukey tan; I’d like navy, and maybe mauve, which would go better with my wardrobe.

The worst part is the IV. Today, the nurse had difficulties finding a vein in the back of my hand; she poked around and it felt as if she was trying to insert a knitting needle. I yelled, “Ow!” a few times. She yelled back, “We’re not trying to hurt you!” I said, too loudly, “I know!” I stopped yelling when I noticed her brow was dewy with effort, and I apologized. Still, she was sort of frosty after that.

The surgery went well and was performed in record time; I was in at 6:15 a.m. and out by 10:30. I did not wake up during the operation. This happened twice before and was unpleasant. Today I slept through it; the surgeon pronounced himself optimistic, and since I know he’s a closet pessimist, this is indeed good news. I am not in pain or in need of painkilling drugs.

I took a Lyft to the hospital very early this morning and my friend Ellen picked me up at the clinic and dropped me off at home after the procedure. I am still a little loopy and fighting the urge to cook an 18-ounce steak. I was told to eat lightly for the rest of the day, drink lots of water, pee often, and rest. I have eaten a half-gallon of vanilla yogurt. Post-op munchies.

I’m grateful not to be the guy in the bay across from mine. He made frightening deathlike croaking sounds, waved his arms in the air and had bad hair. I, on the other hand, was congratulated by the nurses for being a great patient, possibly that morning’s best patient, as a matter of fact. Plus, when one of them put that little blue bonnet on my head, she said I had good hair. Little things like that count.

The best news is that I may not need to go through a round of chemo, as I’ve had to after all the prior surgeries. When I was told this, I wanted to do a little dance, but it might have been less than graceful because of all the tubes attached to me. So instead I thanked the surgeon, who smiled at work well done.

Saint Peregrine is the patron saint of cancer healing. I think he may have been around this morning.

 

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Fourteen, or Is It Fifteen?

Last night I dreamed the people I cared for the most had vanished and, worse, that a couple of them had sided with whatever dark thing was stalking me.

I seldom remember my dreams, but this one left me unsettled. I have surgery tomorrow at six in the morning and do not need the bad presentiments brought on by nightmares. I ascribe it to the procedure which has been delayed twice and, I fear, may bring bad news.

As Michael Scott once said, I am not superstitious, but I am a little stitious. When I awoke I could feel my heart beating a serious drum roll inside my chest. I got out of bed, walked around the apartment, drank a cup of tea, and visualized—as I often do—the good cells wearing white cowboy hats and routing the black-hatted cancer cells. Sometimes I imagine the good cells stampeding the bad ones into a mile-deep canyon.

This will be the 14th or 15th surgery; I have frankly lost count. I know what I am supposed to do tonight and tomorrow morning. The pre-op ritual. I’m acquainted with the full medical team almost by first name, the nurses, administrators, aides and counselors and anesthesiologists. I know exactly how the procedure will occur, the number of times I will be asked my name and age, the location of the vein they’ll find on the back of my hand for the IVs, the feel of the hospital bed as it is rolled into the operating theater. I know the chemo treatments I’ll undergo afterwards, how long the pain will last, and which drugs I can and cannot take. What I do not know is what the good surgeon will find.

I’ve been told that chronicling my bouts with cancer is self-indulgent. This may be true, but I don’t really care. It helps me, and if it helps the white hats—which I think it may—I’ll keep writing.

 

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Music

Music has always been a part of my life.

My grandfather wrote operas; my uncle was a celebrated concert pianist; my sister Isabelle is perhaps the best known composer of children’s operas, though she’s written film scores and symphonies as well. My other sister, Florence, discovered and promoted Patrick Juvet, France’s David Bowie. My dad played the violin and my mom was a good pianist. Heeding Oscar Wilde’s admonition to gentlemen, she was a lady. That is to say she could play the accordion but did not. I could go on.

When I was a kid, my mother insisted on sentencing me to piano lessons that were dismal failures. I got my first guitar when I was about ten, a nasty little Kay that was painted white and whose strings cut my fingers. The music teacher wanted me to play Frère Jacques; I insisted on learning Le Gorille, a George Brassens song about a gorilla loose in Paris.

Over the years I played in countless bands, never well. In fact, I’m a lousy guitarist, so I eventually opted to learn instruments that were guitar derivatives—the Dobro, Melobar, pedal steel, and dulcimer. I never got good at those either, but since relatively few people played them, I could pretend to shine. I often called myself the best French pedal-steel guitar player in Northern Virginia. It may still be true.

I’ve played with really good people, musicians such as Rich Forsen, who have a knack for arrangements and the patience to do it well. Rich took almost a year to mix the CD of Idylwood, the last band with whom I played live. He did it with equipment that, by modern standards, was primitive. Should you be interested, Say Goodnight is available on iTunes, and to this day, some of that disc’s songs are among the best mixed that I’ve heard.

I don’t play live anymore, but I do write and compose songs that my friend Mike Yablonski and I record in his basement studio. Mike is an amazing arranger, and I’m honored to work with him. We’ve done about a dozen tunes so far and plan to release a CD in the near future. Together, we are Cash & Carry, whose photo of two sullen black-hatted men scowling at a wooden albatross could put off potential buyers. We’ve worked with Cindy Callahan, Beth Kinzer and Jessica Frakes, women singers of amazing diversity and range.

A few years ago, I was given the opportunity to record one of our tunes, God Bless Me, for the good folks of Cancer Can Rock. That was a happy blast.

Mike and I just released our latest song, If I Thought. You can listen for free.

Let me know what you think, and many thanks.

 

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Self-Abuse

Is there anything sadder than an aging man abusing himself five or six times a day, alone in his cold and dark ap—.

Oh my God! No, not that, you bunch of disgusting perverts! Get your minds out of the gutter! I’m amazed social media even allows to sign on! I mean having to puncture myself with lancets and hypodermic needles… Jeez. So yes, four times a day I prick one of my fingers with a sharp little pointy machine, extract a drop of blood and let it ooze across a test strip attached to a meter. Within seconds the meter will tally my blood sugar count. This has varied from 110 to over 500, so I’m not quite out of the woods yet, though I have not eaten much of anything processed, except maybe the cheese and pâté I had for my birthday lunch, but if life were fair, that wouldn’t count.

I also inject myself five times daily with insulin solutions called Humalog and Lantus. The injections are not physically painful since the hypodermic needles are hair-thin, but the act of shooting up is positively weird. I’ve worked in enough rehabs to meet a lot of people who shot up a variety of non-insulin products, so there’s a feeling of kinship there I can’t escape.

All this is necessary because last week, my Type2 Diabetes and my prescription use of the steroid Prednisone collided. I spent a day in urgent care as nurses and doctors IVed a gallon of fluid into me and tried to bring the sugar in my blood down with large amounts of insulin. All told, it took nine hours. I understand it may take another few week or three to stabilize.

Do all of you know how Type 2 diabetes works? Here’s a simple explanation. You eat something. The sugar in the food goes into the bloodstream. Your cells are supposed to feed off this sugar, giving you energy. Insulin, a hormone you produce, facilitates this process.

But say your body doesn’t manufacture enough insulin. The sugar—glucose—stays in your bloodstream. The higher the sugar level, the less well you feel. Blood pressure rises, as do cholesterol levels, and your body tries to get rid of the sugar the best way it knows, by peeing it out. So you drink a phenomenal amount of liquids, but this doesn’t really work. Your blood sugar keeps circulating, eventually damaging the blood vessels and causing a lot of harm

It’s not a pretty sight.

My body—my pancreas, actually—does not make enough insulin, but I can, and try to, ameliorate this situation by eating right, and exercising. I add to my insulin by injecting small amounts five times a day.

I’m making progress. It’s been a week and today the count varies from the mid-100s to mid-200s. It’s not perfect, but it’s improving. Hopefully, in a week or two, I’ll be able to stop the insulin injections. The self-abuse will cease and we will never speak of this again.

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Something To Do on a Saturday

Yesterday I spent ten hours in intensive care. This was not what I had planned for a Saturday. I was going to meet a friend; we would stuff ourselves at an all-you-can-eat sushi bar, and then go to a movie.

Instead, I got a phone call at 10 a.m. from my primary care people telling me—not asking, telling­­—to get to their ER ASAP. My blood sugar was explosively high and had to be seen to immediately.

I’d gotten some bloodwork done the day before because for the past couple of weeks, I’d been feeling, well, shitty is the medical term. I was exhausted all the time, listless, and out of breath after a flight of stairs. I was drinking a gallon of fluids a day and losing my balance. My thinking was fuzzy. Mornings felt as if I’d spent the night in a cheap bar downing Popov vodka. I was not having fun. I thought it might be a heart thing, but it wasn’t. It was withdrawal from prednisone.

I’d been taken prednisone for over a month for chronic pain. Prednisone is a steroid, one of those miracle drugs with a dark side. It works on pain but also raises blood pressure, promotes hypoglycemia, leads to weight gain and insomnia, and, to put it simply, is not one of those drugs that makes you smile and want to hug people.

When I got to the clinic, I was immediately hooked up to an IV and given insulin. My blood sugar count very slowly diminished. By 9 p.m., after a gallon of IV fluid and four units of insulin, it was just above two hundred, still high, but manageable.

At the pharmacy, I picked up $100 worth of syringes, insulin, testing equipment and sharp little needles to prick my fingers four times a day to check for blood sugar. Every three hours, I inject insulin into myself, a remarkably painless yet queasy experience.

I spent a better part of the afternoon today ridding myself of cookies, muffins, pound cake, chocolate bars, peanut butter cups, and a remnant of blueberry pie. Each item caused a little sorrow as it thudded into the trash can.

I am now doing research on what I can eat safely—most fruit is safe, apparently—and learning all about Type 2 Diabetes, which I have. Type 2 can be controlled by diet most of the time, and, unlike the far more dangerous Type 1, does not lead to amputated limbs, so there is that silver lining.

I will learn to enjoy coffee and tea sans sugar, eschew the eight-layer black forest chocolate cake at a favorite restaurant, and give up the Trader Joe cranberry orange scones.

The latter will really hurt and proves once more that life is unfair..

 

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Gun Thoughts

So here is a question. Do crazy people who buy guns often kill people, or do people who buy guns often go crazy and kill people?

I ask because, as anyone even remotely aware of the news knows, more and more children, women and men, are getting murdered by gun-wielding assailants who do not necessarily have either criminal records, or diagnosed serious mental issues. In fact, such attacks are so sadly routine that they barely make the front page anymore. The exception of course is the recent killing of seventeen students in Florida. The sheer number made news.

It’s important to look into this chicken-and-egg relationship between sanity and gun crimes because for years, the National Rifle Association has trumpeted that random killings would cease if the government kept a record of who is crazy and who is not, and kept firearms away from those who are. It’s a ludicrous proposition only someone short of brain cells would put forward, and it violates every constitutional belief, but there you are. No one has ever accused the NRA of being rational. Almost as insane–no, come to think of it, even more delusional–is the idea of arming teachers. Let’s add another half-million handguns to the armory. What could go wrong? When the inmates run the asylum, this is the sort of rational we end up with.

The thing about guns is they inflict death without the physical involvement of the shooter. We are rarely told that someone went on a rampage with a baseball bat or a set of tire chains, or killed twelve colleagues at work by bashing them with a desk chair before escaping in a Ford Explorer. Such an attack could be stopped, and even if successful would be too messy. Blood, flesh and hair all over the miscreant… And so it doesn’t happen. People, be they deranged or not, very rarely commit such untidy acts. But a gun is a clean, shiny toy that kills from a distance; no fuss, no muss.

Even a  borderline mental case, a functioning member of society with, let’s say, severe anger issues really doesn’t want to be showered with blood and entrails, and this is what prevents him from truly going postal. Cleanliness is an American virtue, right up there with godliness, and our man will shrink away from violence that requires a personal touch.

Now give him a gun, a way to make his destructionist wishes come true without soiling his Costco jeans and shirt. Depending on his skills, he can kill from inches or yards away with nary a drop of body liquids to sully his day.

Honestly, I think there’s something to this. I believe a gun can be a catalyst, the impetus needed to push past the last restraint. A gun requires no physical strength, no effort or exertion, just a spasm of the index finger. There’s no skill needed if you’re blowing someone away from four or five feet.

Realistically, we’ll never get the unfortunate people with shattered realities off the streets, nor should we. Nor will we ever get the 300 million guns registered. We will not get really serious laws punishing gun theft, gun crimes, or illegal gun sales. The existing system is so overtaken with gun lobbyists that change doesn’t stand a chance.

So now we return to my favorite suggestion: Let’s legislate the purchase of ammo. Let’s pass laws to make sure bullets are sold to responsible people. Yes, of course it will take years to exhaust the existing supply, and certainly some enterprising bootleggers will manufacture projectiles, but still. It would be a start when, at this point, we have no start at all. In fact, we’re going backwards when it comes to gun control.

Come to think of it, the truly unbalanced people responsible for all the deaths are the legislators. If they were sane, we’d have laws in place already.

Really. We would.

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