More Sequels than Police Academy
Chapter 1: It Never
Sent: July 12, 2006
Oh, the irony. In the last e-mail, I thought I was signing off. Just after sending that e-mail, I found a 3mm hole under the bump beneath my eye. Within that hole was a gleaming bit of metal. (Kind of like Arnold Schwarzeneggar in Terminator I, but less buff.) The metal was a plate to hold my bone implant together. The excellent work of plastic surgeon the Fixer had been weakened by my radiation treatments, allowing the metal to wear a hole in the skin. Exposed metal in the body is a landing strip for bacteria. So, just hours after that e-mail, K and I found ourselves in the Ben and Jerry's emergency department.
I was there all night and into the next afternoon as the various doctors came to check me out. There was even a first-year infectious disease fellow (It was so 'meta!'). Of course, I couldn't shut-up about my own opinions. After a big initial hoo-ha, they eventually sent me home. I look and feel healthy-- with the exception of an extra nostril under my eye with some hardware in it.
It's not an emergency, but the metal must come out fast. Sometime in the next week or so, the Fixer will remove it and sew my face shut. He expects the operation to be quick and easy and without general anesthesia. The implant should now hold together by itself.
This has got to be the greatest jinx of all time. (Oops. Forget I said that.)
P.S. I really am OK. Neither the infectious disease attending at Ben and Jerry's nor my surgeon are terribly worried.
Sent: July 23, 2006
I sure hope this is the last tumoriffic update. Anyway, I'm doing just fine. I got some excellent advice from friends about uses for a third nostril. But just as I was getting good at playing three-part harmony on the nose flute while singing Cole Porter tunes, they went and sewed it shut. Ah, well. Great art must take a back seat to health. I actually enjoyed New York, ate well, and wandered around the Central Park Zoo with my family. The surgery took an hour, and they gave me some high quality drugs so that I remember almost nothing. I went to work the next day. I have a few stitches, and my cheek looks better than it has in months. It is now unholey.
Be well, so long, and thanks for all the fish. (Google it if you don't get the reference.)
I never sent an e-mail describing the events that took place in the last week of July and first two weeks of August. The story involves more anger than I usually like to write about and also, perhaps, too much information. I did not write anything about it at the time. However, anger and too much information make for good comedy, and it's a cautionary tale for cancer survivors who want to try in-vitro fertilization (or a specialty fellowship after chemo, for that matter). So, if you want to know THIS MUCH, then follow the link. Otherwise, continue on this page.
Date: August 14, 2007
Subj: Different Strokes for Different Folks
August 14, 2006
Apparently, my epi-epilogue was a bit premature. Maybe I should just get out of the whole business of epilogues.
Last time I wrote, the Fixer had just removed a bit of surgical hardware that had worn a hole underneath my eye. Barely a week later, the stitches pulled out, and the wound fell open. I returned to NYC, and the Fixer decided that after all the radiation it had endured, the skin was just too delicate to take stitches. Still, he was pretty unfazed. He had seen similar problems before. (This is what I love about my F'in' Famous Cancer Hospital surgeons. Nothing freaks them out.) The new plan is to wait and see if the wound heals itself over the next few months. If not, I will need a graft from my arm or leg.
In the meantime, I have a large opening in my upper cheek that shows off my bone graft quite nicely. I haven't decided on the best use for it yet. It's about 1 inch across, and if I cut a quarter of a ping pong ball and draw an iris on it, I could have a very convincing 3rd eye. Or I could just go with the au naturale look and have a heck of a Halloween costume. Really, a gaping facial wound can be whatever you want to make it.
But that's just the beginning. You see, last night, I had a stroke. Yup. No kidding. A stroke. Luckily, it was a very small one. I was in the car coming home from a wedding on Cape Cod. I was on the Sagamore Bridge, and I suddenly felt as if the world were tilted, and I was very tired. I promptly fell asleep. It's a very good thing that K was the one who was driving.
When we got home an hour or so later, I was very difficult to rouse, and K got worried. When I finally spoke, I calmly explained to her that there was nothing whatsoever wrong with my tennis racket, and she should stop worrying, because the Spic-and-Span is perfectly capable of eating the trombone. Oddly, she was not reassured, so I tried again, stating resolutely that there were no cats in the movie theater.* I was also having a little trouble with my balance. At this point, seeing the look on her face, even I had consider the possibility that something might be wrong with my brain. This was quite distressing, since, as Woody Allen said in Sleeper, "it's my second-favorite organ." ** So, off we went to the Ben and Jerry's Emergency Department. By the time we got there, I had recovered the ability to express myself, and there were only subtle physical findings left on examination. However, the MRI showed a small stroke in a part of my brain called the thalamus. It's right near the center of my radiation field from last fall.
My symptoms were apparently typical of a small thalamic stroke. A thalamic stroke often leaves no lasting signs and is generally looked down upon by real stroke connoisseurs. It may have been due to inflammation of blood vessels from the radiation. If I'm right about the cause, blood thinners and anti-inflammatory medications might be enough to prevent more in the future. I've been sitting in my hospital room since early this morning waiting for the fine crews in the various diagnostic departments to finish their cigarette breaks. I'll send a follow-up when I know what's going on.
P.S. Grump. 2:42am, 8/15/06-- I have truly entered doctor Hell. Having finally overcome my anxiety and fallen asleep, I was just now awakened by a neurology intern who clearly with the bedside manner of a Zamboni. Apparently thought it was appropriate to awaken me in the middle of the night, pull the covers off of me without asking, and do an overly exhaustive, if inept, history and physical and then explain to me how there are still no beds on the neurology service. No apologies. As a patient, I have never been angry at a house officer before. There is a first time for everything.
* These are not exact quotes, but I think they capture the general flavor.
** Credit for this line in this context must go to my fellow infectious disease fellow Yoram.
Date: August 17, 2007
Subj: Bad News, Good News
I am still in the hospital, but I feel well and ready to return to professional baseball. Oops. Work. That's the word. I'm not sure why it has taken them so long to finish working me up, but I'll refrain from harshing on the team and just grouse about them privately. Anyway, I am pretty sure now why I had a stroke. The bad news is, I have a patent foramen ovale (PFO). The good news is, I have a patent foramen ovale.
To explain: the foramen ovale is a small hole that all fetuses have between the left and the right sides of the heart. In most people, it closes permanently after birth, but about a quarter of us walk around with it open, and it's usually harmless. It can be dangerous if you have a source of intravenous blood clots, because it allows things in the veins to go into the arteries and from there into places like my brain. One great potential source of blood clots? A foreign body in the bloodstream--which I happen to have.
I have a port-a-cath, which is semi-permanent intravenous line that allowed me to get chemo and blood tests without beating up my tired veins. I was planning to have it removed in September. A tiny clot probably formed on my port, broke off, and took the express route to my thalamus through the PFO. Tonight, I will sleep in my own bed, and tomorrow, the port-a-cath will come out. Hopefully, we guessed right, and without the port, I won't be at risk for more strokes.
The PFO/port-a-cath was my original hunch for the cause of my stroke, but someone mentioned the possibility of radiation vasculitis and I changed my bet. I could have been filthy rich, but now there are a couple of bookies coming to take my car, LLC's train table and entire collection of Thomas the Tank Engine Toys. Never gamble on your own health. It only leads to ruin.
P.S. People keep asking me how I maintain my sense of humor at a time like this. It's my coping mechanism. If I think of the absurdity of the situation, I can keep from panicking, or, as was the case with the resident at 2:30am, from acting violently. Also, no matter how bad things get, I know I've caused someone in the world to snarf their milk.
Date: August 19, 2007
Subj: Bad News, Good News
Don't worry. No new disasters. I'm home and recovering. My fellowship program director has told me to take next week off. I suppose she has a point. However, I do feel a little sheepish about this whole event. It was such a small stroke. The technical name for stroke is cerebro-vascular accident (CVA). Perhaps I should take a page from Ben's book and refer to it as a cerebro-vascular boo-boo.
On Saturday, September 9th, I* am participating in the ninth annual Cycle for Life, a fundraising event to benefit The Balding Medical Center Hospital for Children's Cancer. I am now an infectious disease fellow at The Balding Medical Center, and I think it's a great place.
[What followed in the original e-mail was craven begging for sponsorship. I'll omit it here.]
* Alright, this may be a little unrealistic after a stroke, but I signed up before it happened. I'll have to see how I feel. My dear friend Alejandro has agreed to be my substitute if I don't feel up to it. He believes in method acting, and in order to more accurately portray me, he has decided that if he bikes, he will cut a large hole in his cheek underneath his eye. He draws the line at a fibula graft, however. One shouldn't take things too far.
Alejandro was going to do the whole 50 miles I pledged, but at the last minute, I decided I had the energy to do half the ride while simultaneously, Alejandro did the other half. Not only was it less work, but it was good company. I also took LLC along on a kid seat. We took a leisurely ride along the coast, stopping for a long break at the turn around point at the beach. LLC fell asleep on the back of my bike on the way back. I was feeling OK.
I thought wrong. I tried working under generously reduced schedules, but it's hard to do that while everyone around you is working 80 hour weeks. And I was just too tired. I took myself out of the fellowship hoping I might feel well enough to return later. I also hoped my facial wound would get better.
All comments, suggestions, compliments, insults, and hate-mail should be directed to Tom@tumoriffic.org.