Sunday
Aug262012

21. Thoughts on Lance

Celebritology is an odd thing. Many people invest a lot in following the trevails of pop culture icons. Their entertainment value. Their personal lives. Even their politics. And when these people fail, we feel badly for those we like and mock those we don't.

So, when Lance Armstrong stopped contesting long-standing allegations that he had used performance-enhancing drugs to win a lot of races, judgment and emotion focused on him. If you thought Lance had been lying all along, you felt a collective "I told you so." If you believed that Lance won all these races on the up-and-up, you defended him.

Here's the problem with viewing Lance through this narrow lens. It doesn't matter as much to cancer survivors like me. That's because the Lance story isn't just about him, it's also about us. It isn't just about how many times a yellow shirt was donned. It's also about having the mental courage and physical strength to battle a life-threatening illness. It's about deciding how to live the rest of your days. It's about supporting others going through the same terrible experience you had.

Whatever his failings. Lance helped us by providing a window through which society could see what cancer is really about...the horrors of the disease and how hard it is to rebuild your life. Before Lance, cancer patients would often stay silent about their disease. After Lance, it became socially acceptable to come out. All those yellow bands weren't a branding of the medically ill, they were a sign to live life to its fullest.

LiveStrong built on this by providing tools that help cancer patients learn more about their disease and treatment options, manage their lives during treatments (trust me, it's an organizational nightmare), and connect with others. If there's a common thread to his work, it's that cancer patients need an extended support system to battle the disease. Based on my experience, that is spot on.

Does all this absolve Lance if he doped his way to the victory stand? Of course not. Cheating is cheating and it's wrong. But just because society raised up Lance to be a saint doesn't mean that he had to be one to validate his cause against cancer. Think about it this way.

For those lucky enough to survive cancer, we feel incredibly blessed. We confronted the very real possibility that we might die soon, and we were given a reprieve. That puts us in a whole different frame of mind. But it doesn't make us better people. After all, when God gave us extended life, he didn't transform us into perfect human beings. He simply gave us another shot, with the opportunity to use our remaining days to do more good than not.

When looked at this way, Lance passes the test. By getting back on the bike, he showed cancer patients how there is life after cancer. That is all we needed. That Lance might have done something wrong to win all those races shows that hubris could have gotten the better of him. That's too bad. But to us, it was never about all those yellow shirts anyway.

Lance is a man who faced cancer, is still living, and trying to do more good things than not. That is the real win in his life...whether he knows it or not.

Friday
Aug242012

20. Adjustment

I thought of titling this blog post "recovery." And there was definitely a great amount of that in the fall and winter of 2011-12. For instance, for the first few months after surgery, I would go to physical therapy twice each week. There, two terrific therapists, Dr. Mike Kecman and his assistant Christine, worked with me to rebuild my legs and arms, whose muscles had been wiped out by all the trauma to my body.

I also went to Dr. Ditaranto's office each week, where the nurses checked the therapeutic level of blood thinners designed to prevent another embolism. And then there was the general healing of body parts that had been ripped open, rearranged and who knows what else.

But when I think about this period, it really was one of adjustment. Adjustment to a body that had been weakened by cancer, chemotherapy and surgeries. Adjustment to a new type of bladder. Adjustment to a new nighttime ritual. Adjustment to intestines that were now shorter and rearranged. Adjustment to not having a prostate; I always wondered what that thing did.

The biggest adjustment, of course, was this new thing called a neobladder. Now, I'm discussing urology, which can quickly get a bit too, um, specific. So let me try to describe the neo without grossing you out.

To refresh your memory, a neobladder is actually a section of the small intestine that the surgeon removes, formulates into a receptacle, and hooks up to the ureters coming from the kidneys and the urethra connecting to the urinary tract. It's about the size of your fist -- maybe a little bigger -- and kinda works like a normal bladder. For instance, it stores bodily fluids coming from the kidneys, stretches a bit when it's filled, and is voided when you squeeze certain muscles.

How is it different? Think about this way. When you use the restroom, you make a modest effort and fluids quickly leave your body. It's an easy function because the bladder has a muscle structure built right into it, which you engage without really thinking about it.

A neobladder, on the other hand, has no such muscle structure. To void, I engage abdominal muscles to squeeze the neo. There's a technique to all this, which Dr. Shenk taught me. Fluids leave the body more slowly, however, so I have to engage the abs a couple dozen times or so.

That doesn't sound so bad, does it? Well, there's a catch. A big one. To help pass food through the body, the small intestine produces mucus that helps break down food groups. The neobladder does the same thing. It thinks that it's still part of the small intenstine. Maybe it suffers from separation anxiety.

Problem is, the bladder is no place for mucus. Why? Mucus blocks bodily fluids from passing through the narrow canal that connects the bladder to the urinary tract. When blockages occur, you have a problem. Fluids cannot leave your body. Instead, the only way to void the bladder is by using a catheter. Moreover, the muscus must be removed, which is done by irrigating the bladder with sterile water through a syringe attached to the catheter.

When I first thought about the prospect of using a catheter, I thought, "Ick! I'm not doing that!" Kinda reminded me of the time before my first son was born, when I confronted the prospect of changing diapers; not real sure I could do that. But much like with diapers, I got past the initial ickiness of catheters and adjusted. Okay, it's not something I seek out to do. But at least I can do it when I need to.

And that's the important thing. Because if the bladder is not fully emptied, bacteria can form and infect surrounding areas. Indeed, when I was in the hospital, I was visited by another neo patient who was there due to kidney infections.

Now, you might be thinking, "Well, of course you'd want the bladder empty." But that's not an easy thing for people with neos. We don't have the nerves that tell a normal person, "hey, it's time to go" or "we're done now." I met other patients who told me that they thought their bladders were empty when they really had hundreds of cc's in them. Catheters, for all their trouble, give you a more accurate read.

So I tried out a variety of those long tubes, ordered a bunch of ones I thought worked best, and started taking them wherever I went. I would say this was kinda like shopping for clothes, but we're in whole different world here.

Of course, you can't just walk around with these things in the open. There's a certain delicacy I had to achieve in coping with changes to the plumbing system. So I bought a modern, leather, sling-over-the-shoulder bag designed for iPads and laptops, which I would carry everywhere along with my iPad, wallet, phone and keys. I might need catheters and the accompanying utensils, I thought, but at least I can look stylish doing so! Ah, vanity.

Early on, the neo presented a number of difficulties. The neo isn't big enough to contain a normal bladder's worth of fluids; it takes a while for the neo to stretch out. So I had to void every couple hours, including nights. That pretty much did in any hopes of getting past the insomnia caused by chemotherapy and finally having uninterrupted sleep. Even after my break-in period, bladder control (or lack thereof) prevented a regular sleep pattern. As any new parent can tell you, getting up every couple hours does a number on your body clock.

The biggest problem, though, was an unexpected complication caused by the use of blood thinners to prevent another embolism. In short, using catheters created trauma and inflamation; trauma and inflamation inhibitted my ability to void; but because of the blood thinners, I couldn't take anti-inflamatories to address the situation. Result: more cathing.

At my next exam, Dr. Shenk found more obstructions, my neo was "a muscus production factory" -- must be a technical term -- and the openings to my ureters were healing in a constricted manner.

To solve for all this, Dr. Shenk wanted to remove the obstructions, see if he could close the production factory, and open up the ureter openings. In other words, I needed more surgery. And Schenk explained that I might need this kind of housecleaning surgery every so often.

Okay, not a big deal, I told myself. After all, the last time I went under the knife, I feared what might happen. Instead, this one would be a simple clearn-up operation and dramatically improve my condition. What could go wrong with that?

By now, you should realize that's a really stupid question.

Sunday
Jul152012

19. Home

Home. There's always been something special about home. Family. Familarity. Warm feeling. I would need all of them and more to recover from neobladder surgery and the whole host of medical complications that had come with it.

Due to my embolism, I couldn't take stairs. In fact, I had lost a good part of my muscle structure from my quads to my arms. Walking had become an aspiration. My strength was zilch. So a hospital bed had to be placed on the main level, which turned out to be in the family room. This meant disrputing things for Kate and the boys. The family room became the "let's visit Dad's room." The kitchen suddenly had a couch in it. A secretary's cabinet became storage for personal supplies. And the rest of the main level was littered with oxygen tanks, tubes, drain supplies and other medical stuff. Yuck.

My brother-in-law, Steve, arranged the family room. He situated my hospital bed in a way that I could watch television -- it was high season for football and baseball -- and see out to the back yard, where the colors were just beginning to change for the fall. All this improved my mood, but not my condition. I still had to go through the routine of flushing drains, cleaning up when they leaked, and forcing myself to get out of bed and sit in a chair.

Kate stayed home from work that first week, taking care of my drains while teaching me how to do this myself. Dr. Schenk had been adamant: Kate would stay home only for a week; after that, I had to take care of myself. And I did learn.

Another benefit of being home was seeing my boys. Kate had given Stephen a car to drive back and forth to James Madison University, where he attends college. So he was able to visit on weekends. Jack was in the throws of adjusting to high school, which can be daunting both academically and personally. And Michael was ever the organizer, telling me where things were, helping me out of bed, and walking with me across the house. I looked forward to the time when I would no longer be seen as the patient, but as a dad.

What else was great about being home? Having so many visitors. My parents. My sisters Cathy, Joan and Chris. Their husbands Steve, Phil and Paul. Steve came by the most, carving out time between teaching college classes. It was such a joy to have him around. My brother, Dr. Bob, helped me understand what I was experiencing medically. His wife, Leala, helped Kate with food for the boys. Kerri, my sister-in-law, was a regular. And my sister Betty, who lives outside Denver, had become such a texting machine throughout my ordeal that I seldom went a day with talking with her.

When you add in our friends, such as Paige, Joi, Kathy, the Scwabs and Ericksons, it became clear I was surrounded by a lot of love and affection. It was pretty powerful stuff. Their feelings gave me added incentive to keep pushing myself, accelerating my recovery.

Oh, yeah, recovery. Not very pretty at the start. A home nurse from the hospital visited a few times a week, as did a physical therapist. I finally built enough strength to walk outside, initially starting with just up and down the driveway. Since I still had drains in me, all I could do was throw on a bathrobe, hook up drains up to a walker, and slowly make my way onto our street. A pretty sight, it was not. But it was a beginning.

Then came the transforming event. To free up a car for Stephen, Kate had bought a red, convertible Mini Cooper for herself. I had never ridden in a convertible. One day, Kate took me out for a drive. Me, my drains and bathrobe. It was one of those beautiful fall days: sunshine, mild temperature, perfectly blue skies. She drove us through the mountains, the wind whipped through the car, and my favorate music (R.E.M.) played on the radio.

In this wonderful environment, I suddenly felt a jolt of emotion unlike anything I had experienced during my ordeal. It was joy. Sheer joy. Joy for being alive. Joy for being with Kate. Joy for a recovery that had finally begun. Joy that a whole new life awaited me. From this moment forward, I would be getting only better, not worse. Other than the birth of my first son, this was the greatest moment of my life. And I was so blessed, so privileged, that God let me live to enjoy it.

Things improved as more drains were removed from my body. It would take a full month for all the drains to leave. And as each drain was removed, my mobility improved. I was now able to take showers and otherwise making myself the cleanest in weeks. Being clean is such a big part of your self esteem.

Now able to wear normal clothes, I would take walks that weren't so embarrassing anymore. The physical therapist would visit and move me through specific exercises. The home nurse would draw blood and measure the effectiveness of my blood thinners. My family and friends would visit. And I was able to spend more time sitting in the chair than laying in bed.

Ah, the chair. On the day I was coming home from the hospital, Kate had gone to the furniture store to buy me a new leather chair to make me more comfortable at home. But the store staff couldn't fit the chair into her Mini Cooper. (Duh.) So she returned home and took Stephen's Honda CR-V back to the store. The only problem: the store was closed and no one was around. Not to be deterred, she broke into the warehouse, grabbed the chair, put it in the car, and peeled off for home. A criminal in the service of a cancer patient! To be clear, she had paid for the chair. But a break-in is still a break-in.

Kate's actions are a great example of how caregivers don't give a damn about rules when it comes to helping cancer patients. This mentality explains the use of things like medical marijuana that are effective in providing relief, but are not necessarly legal. It's pretty simple: who cares about legal consequences when you're staring at death? And yes, the chair is very comfy.

I would return to the hospital bed at night. Since my neobladder was smaller than what it replaced, Schenk has told me to empty the neobladder every two or three hours. Also, I discovered that my body would leak even after the drains had been removed. So I was up a lot. I took advantage of the technology in my family room, and watched Netflix through my Apple TV. I discovered the show "Frasier," which I had enjoyed when it originally ran. Since I wasn't going anywhere anytime soon, I started at episode 1, season 1. I had forgotten how so much of the dialogue was filled with one-liners that make you laugh. And that's exactly what I did.

Except this time, unlike the original broadcasts, my laughs were accompanied by screams. Each time I laughed, I pulled at the stiches that littered my stomach. And it hurt. So, "hah! hah! ouch!" became a regular noise in the wee hours of the night. Kate heard so many "ouches" that she thought I had a real problem. She came running downstairs, and asked me what was wrong. When I told her the show was making me laugh but also hurting me, she just rolled her eyes. "Just turn the show off," she said. Hmm, I hadn't thought about that.

My brain wasn't the only thing that wasn't working so well. I was still extremely weak. It became obvious how the disease, chemotherapy, surgery, embolism and possible stroke had ravaged my body. My legs had no muscle structure. I struggled to raise my arms. My endurance was zilch. It dawned on me that all that work I did before chemo to strengthen my body likely had saved me. Imagine if I had been weaker, older or with other medical complications? Cancer and its treatments would have torn me apart.

There was another complication. Adjusting to this thing called a neobladder. It's only something you have to deal with the rest of your life. Oh, my goodness.

Saturday
Jul072012

18. Chaos

My second stay in the hospital seemed longer than the first. Chronologically, it wasn't. They were both 7 or 8 days each. But I was much more aware upon my return trip. That must explain why that week seemed so damn chaotic.

There was the reason for my return: a pulmonary embolism and possible stroke. The battery of tests at all hours of the day and night. The revolving door of doctors who I didn't known from Adam, who naturally found more things wrong with me. And, oh yeah, the pain of recovering from surgery that ripped out much of my plumbing system, and left me with drains galore.

Let's start with all the docs. One had diagnosed me with an embolism, put me on blood thinners, and gave me the time-tested words -- "there's nothing we can do" -- regarding the blood clots currently in my system. He urged me to walk around to help with my circulation. But another doctor believed that I had an infectious disease, quarantined my room, and prevented me from moving around. Yet another doctor, who didn't seem to know the others, posed the idea of further surgery to block new clots from entering my lungs or heart. And Dr. Schenk, of course, checked on his patient.

When I asked the nurse who was in charge, she paused and looked away. That told me everything. No one was in charge. Indeed, as the docs visited me again and again -- always alone, never together -- they would start talking right away and use technical jargon, assuming I must be: a) awake (not always); b) with a mind not compromised by all the meds (umm); and c) a medical expert (hah!). Even better, they offered differing views on my medical condition.

My only rescourse: I wouldn't do anything unless Schenk and my brother Bob approved. So tell those other docs to get to know Greg and Bob...fast. Sure enough, on his next visit, one doc announced that he had counseled with "Dr. Gregory Schenk" -- yeah, I've heard of that guy -- and they agreed to seek a pulminologist's opinion on the need for new surgery. Read: Schenk told the guy to call the pulmonologist. (Schenk actually was an advocate for surgery, but wanted to get a better read through the pulmonologist.)

Thus, a visit from yet another doc. But it was okay this time. The pulmonologist said he took care of me in the ICU after my initial surgery, when I had breathing problems. That calmed my nerves. The guy actually knew me and my condition. I told him that I really didn't want to go through another surgery unless it was absolutely necessary. The surgery in question was inserting a filter in my abdomen to block new clots from penetrating the lungs and heart. Schenk had told me that such a procedure could be done without ripping open my abdomen again; he would thread it through my groin.

But after a good discussion and examination, the pulmonologist weighed in: no need for surgery. If were able to stand, I would have kissed him. Take blood thinners for six months, whose effectiveness could be tracked by current doctors of mine, Ditaranto and Moreas.

All this proves a point. In the hospital, you need to take charge of your own care. Don't accept what the round-robin of doctors tell you. Push back. Force interaction. Seek addition opinions, if you need to. Trust in the one doctor who knows you the best. For me, that was Schenk and -- because I'm lucky enough to have a doctor as my brother -- Bob. Moreover, realize that your state of mind is likely compromised by all the meds you're taking. So trust in your spouse. Assuming, of course, that your spouse wants to help you, not hurt you. If they want to hurt you, well, you've got bigger problems that what I can address here.

Inbetween the comedy of doctors, I was still recovering. And the nurses saved me. Literally. John noticed that my leg was swelling, so he got me out of bed and moving around a bit, checking my oxygen levels throughout. His timing was impeccable becuase I could feel a molasses-like clump in my arm, which was not a good sign. Another John learned how to flush and irrigate my drains, and used his physical strength to remove many of the mucus build-ups that were causing me pain. Trust me, this was not an easy procedure. And Laura, who had been one of my nurses during my first stay, was back, creating a sense of deja vu for both of us. "When am I going to get rid of you?" she asked jokingly. At least I think it was jokingly.

Other nurses came to my aid when I couldn't walk very well. They would prop me up on a walker and slowly take me around the ward. I had to do this three times a day. And each time was a struggle. The hospital ward is really very supportive of one another. So the other nurses would root for me as I leaned on the walker and slowly lurched forward.

Thoughout chemotherapy and my hospital stays, I was surprised that my back had held up reasonably well. I have a history of lower back spams, disc problems, and other fun stuff. And I feared that all my immobility was sure to cause a spasm or worse. Sure enough, one night around 2 in the morning -- in the hospital, problems always occur at odd hours -- my back suffered a major spasm. Muscles tightened. My body contorted. Pain radiated. And I shouted out in agony.

Rushing in was Rod, my night nurse. He's a big guy, probably 6'5" and musclular. He knew I was having problems getting up and walking on my own. So he put his arms around me and dragged me out of bed. He pulled me across the room, propped my back against the cold of the hospital door, and proceeded to work my muscles. After a while, he dragged me to a chair, and continued physical therapy. Sure enough, my spasm was gone! Now, most hospital nurses are petite women, who obviously would not have been able to lift me out of bed. How lucky was I to have Rod as my nurse on that particular night?! Maybe God was watching out for me, after all.

Indeed, the hospital chaplain, Keith, paid me a visit. And we talked for quite a while. We talked about cancer. About God and faith. About the physical and emotional ordeal I had been going through. And what did it all mean. Deep stuff. I felt that God had given me a second chance at life. Keith pressed me on what that meant. So we talked some more about how I would like to live my life once I recovered from all this. "What's your plan?" he asked. I didn't have one just yet. But I understood his point: move forward. And with a purpose.

Another saving grace was a nurse called LeighAnn. She came in, simplified a lot of my physical care -- getting some restrictions lifted -- and expanded my medical care to include emotional support. More than anyone, Kate and I clicked with LeighAnn the way people do when they meet new friends. She's a single mom, has a long commute to work, and for 12 hours each day tends to the needs of patients on the ward. Like the other nurses, she doesn't get paid a whole lot -- and that's a crime -- but it doesn't stop her from helping others when they are most vulnerable.

More than anyone, LeighAnn gave me a roadmap for my life ahead. Recovery, she said, is part physical, part emotional, and part spiritual. Don't sell any of the them short. It would take a while for me to physically recover from what had happened to my body. A year or so. It would take longer to adjust to a new plumbing system in my body. In year two, my new normal could make me emotionally depressed. How to cope with all this? Lean on Kate and my family as much as possible for emotional support. Take solace in my faith in God for spiritual support. And every morning, keep telling myself, "I've been given another day of life; let's make it count."

She is so right. Even now, many months later, I wonder where I would be had I not met LeighAnn. She is caretaker, minister and friend all wrapped up in one wonderful person. I'm blessed that she has been part of my life.

As the days went by, I didn't feel like I was getting any better. All these complications kept popping up. I was convinced that I would only get sicker the longer I stayed in the hospital. So I called Schenk and asked him to break me out of this place.

As he put that process into motion, one event almost changed my mnd. One night, my pain was so bad that Rod injected me with morphine. Knowing that the drug would put me to sleep, he waved goodnight with one hand as he injected with the other. I must say, morphine is unlike any other drug I've experienced. It made me feel like I was floating in air, without pain or worries to consume my mind. I could get used to this thing.

The next morning, LeighAnn lobbied for me to stay in the hospital, saying that the nurses would take care of me so Kate doesn't have to been burdened with me at home just yet. As she talked, all I could think about was that feeling, the feeling caused by morphine. I wanted to feel more like that. And the nurses could do that for me. Maybe I should call Schenk and tell him to hold off on the discharge.

I said I still wanted to go home. I'm not sure what inside me led me to that decision. Maybe it was my yearning for home. Maybe it was my fear of addiction. Maybe it was just time. Whatever it was, it was time to go. On the morning of my discharge, I showered and shaved myself for the first time in a while. Kate went to get the car. LeighAnn wheeled me out of the hospital. As I rose from the chair, we embraced. We cried. We said we loved each other. Kate gave her a big hug.

Now it was time to go home. Finally.

Monday
Jun112012

17. Uh-Oh

When the drains and I got home from the hospital -- I had come to think of pelvic tubes as part of me now -- nothing went right. Not that I expected a fast recovery. After all, my body had endured 12 hours under the knife for a radical cystectomy. And they don't call it radical for nothing. But now, I was clearly struggling. Struggling to get up the stairs to our bedroom. Struggling to clean myself, change clothes, and get settled on the bed. I was in pain. I was short of breath. I was exhausted. Boy, I needed to lay down and get some rest.

What could help? Hydrocodone for pain. Ambien for sleep. Opened up the bottles, and down went the pills. I soon discovered that these meds don't mix well. I noticed a problem when I laid in my bed and used the iPad. Got the fingers moving from app to app. Only problem: there was no iPad. I was moving my fingers in the air. Repeatedly. Kept trying. Same result. I believe they call it hellucinating.

Sensing that something was wrong, I tried to get out of bed. But I immediately fell down. Tried again, and fell on a side table and against a wall, giving myself a nasty gash in the back of my head. Tried again, and fell on the broken table. Kate and Michael came to my rescue. But by now, I was too far gone. I kept trying to get up. And I kept falling down. Kate even had to resort to bracing my falls with her body, Oh my goodness, that had to hurt. She kept Jack away by telling him to go to his room and put his headphones on. In one of the rarest moments in our lives, he did what he was told.

Finally, I resigned myself to stay in bed. But I was delusional. Frustrated at my inability to stand, I began pulling on my drains, stopped only by the greater physical strength of my wife and son. Kate knew something was very wrong and called the home nurse who was supposed to visit the next day. She found me unconscious, my oxygen levels low, and my cognitive abilities impaired. She quickly called for an ambulance.

With the ambulance came ENTs as well as the police. They examined me and interviewed Kate and Michael. They were trying to determine whether I suffered from a non drug related ailment, an accidental overdose, a suicide attempt or attempted murder. Murder?! Whoa! As if Kate and Michael weren't already over the deep end emotionally.

The next thing I recall was waking up to see several people hovering over me. Kate. The nurse. And two EMTs. (Judging my wife and son to not be the murdering kind, the policeman must have left before I woke up.) Um, great to see everyone. But what are you doing here? They had been measuring my vitals. Oxygen level too low. Blood pressure too high. Memory spotty. Awareness even spottier. My caretakers decision: back to the hospital I go. So I had entered my house hours before on my own two feet, and now was leaving on a stretcher. Not the way I had planned it.

I was taken to the ER, and placed through a variety of tests. CT-scan. X-rays. And more. Kate told the ER doctor to call Schenk and Bob. Fortunately, Schenk was in the hospital and stopped by. "What are you doing back here? Nothing better to do?" For all his toughness, Schenk has an affectionate side to him that, as a patient, I found calming. He proceeded to check his handiwork, pronounced everything in tact, and said the docs will know what to do once the other test results came in. In the meantime, sit tight. Like I had any other option.

Now the ER doc returned with the test results. And they weren't good. There was an anomaly in my brain, which might have been caused by a stroke. And I was at risk of a recurrence. Let's see if I got this straight: I survive stage 4 cancer and a radical surgery, but I might die of this stuff? God, are you playing a joke on me?

Bob intervened with hope. Remember, he's a neurologist. So brain injuries are up his alley. After reading the report and seeing the scan, he thought the injury might well be one that happened a long time ago. Still, the ER doc wanted to admit me into the hospital. Having just gone through a rather miserable experience there, I was in no mood for a return engagement. I really wanted to go home. So I argued and argued. But Bob and Kate convinced me to stay. So, reluctantly, off I went. Back upstairs. Back to a hospital room. Back to more misery.

I was admitted into the telemetry ward of the hospital, which is less chaotic than post surgical. My nurses, John and Donna, were focused on my heart and brain activity. But they also had to deal with my drains, which were foreign to them. My oxygen levels were in the 70s and 80s. And I was massively dehydrated.

I didn't stay in the room for long. First trip was for an ultrasound of my lungs. Then, around midnight, for an MRI exam of my head. Once in the tube, so many thoughts were racing through my head. A stroke? What else will go wrong? How can Kate and the kids endure all this? The exam lasted longer than I remember for previous MRIs. The buzzing sound seemed a lot louder, too. And, boy, what I wouldn't give for a glass of water.

Finally, the exam was done and I wheeled back up to my room. I don't know how, but I fell asleep for the first time in a long time. I was woken up by the morning nurse who draws blood. I still felt really dehydrated. Coming to my rescue was Dr. Gaynor, who noticed that I wasn't being fed intravenously. So she ordered bags and bags for me. Thank you, Darlene.

Then the hospitalist, the chief doctor on the floor, sat down next to me. "We have the results of the ultrasound. How much detail do you want to know?" Um, how about the high points? "Well, you've suffered a pulmonary embolism. You have blood clots - many clots -- in your lungs." Okay, what's the treatment? Normally, the docs would break up the clots through surgery much like an angioplasty. But since I had problems from the surgery I just had, that was not an option. Then what? Hope that the body absorbs the clots.

If not, "there's nothing we can do."