Navel Maneuvers

Sorry that I haven't been keeping up with the blog. I am at home and you would think that I have plenty of time to do it.

I have been getting stronger each day and feel less and less like a beached whale. I am able to move with a lot more assurance and I do not live in dread of the occasional sneeze or cough. But I do find that I get tired very easily. I have Percocet for pain, but I find it makes me a bit sleepy.

First, the good news: The pathology report came back clear. All the lymph nodes were clear of cancer.

Yesterday, I went into the city for two doctor appointments. My friend Susi drove me down in my car and we parked in a parking lot. After last week's parking ticket fiasco, damned if I was going to park on the street.

I saw Dr. Caputo first. He took a look at my navel and put a new dressing on it. The main incision is healing very well, but my navel is not. It had started oozing quite a bit on Thursday and I had called Dr. Schwartz about it, but he said not to worry, especially since he would be seeing it the next day. I had been told to put silver nitrate ointment on the belly button and change the dressing once a day. It had oozed a bit since day one, but I was told this was to be expected. However, the amount increased greatly, which is what triggered the phone call.

Dr. Caputo said that I am healing very well, but that I need to be out of work for eight weeks from the surgery. Gee, twist my arm. He also gave me a full report on what he found. The adenocarcinoma was limited to the uterus and had penetrated only a couple of millimeters into the uterus wall. I have a thicker than average uterus due to fibroids, so this penetration was very minimal. He mentioned that there is some controversy over whether radiation is needed after this type of cancer. He is undecided as to whether radiation treatment is needed and appears to be leaning away from it. However, it would be a type of radiation delivered directly to what is called the vaginal cuff, the top end of my vagina right where my uterus used to be. I would undergo three sessions of this. Dr. Caputo said that he would make a final decision after I heal completely, but I get the idea that he will probably not use it.

Susi and I had lunch at a fast-food place called Chicken Bar and then went to Dr. Schwartz's office. Dr. Schwartz has the nicest staff! If wasn't for that god-awful mirror in his exam room, I would love going there. This is the floor-to-ceiling, wall-to-wall mirror that makes you want to have every type of plastic surgery ever invented and a few experimental ones for good measure. This mirror is so bad that you consider blinding yourself to prevent yourself from ever seeing your own body again.

I had full hopes that Dr. Schwartz would remove the final drain, but he decided to leave it in for another week. It is still collecting too much fluid to remove. He then took a good look at my belly button. He removed the sutures around the belly button, making it look a bit less like a hairy black eyeball. He also warned me that it appears to be healing from the inside out, which means that the top layer of skin may slough off. In other words, my navel may fall off. He gave me another prescription for antibiotics and told me to slather my navel with Bacitracin ointment instead of silver nitrate and change the dressing once a day.

I had still been holding out hope that I could go to my sister's house in Arizona with a side trip to Mexico next week. My brothers, sisters-in-laws, and I had been planning the trip since January. I finally realized that it would be foolish to travel with a surgical drain, sutures, and a belly button that might be about to fall off, especially to Mexico. I called Sue and gave her the bad news.

So what have I been doing, other than seeing doctors? Mostly sitting at home knitting and watching stupid movies. I am knitting a pair of socks and am about to start a sweater that I owe my friend Helen. Almost three years ago, I put up the offer to hand-knit a sweater at my church's auction. Helen won it, being the only person who bid on it, and has slowly come to the decision of what she wanted. She chose this lovely soft green alpaca and wants a cardigan with a bit of lace at the edges. So that is my big project for my time off.

Home, Sweet Home (Or How Many Parking Tickets Can You Get in One Day?)

I came home on Thursday. All the way home. I was so happy I could spit.

My pastor Terri was coming up to Putnam from the Philadelphia area and offered to pick me up and bring me home and I jumped at the idea. My family wanted me to stay with them for a few more days, but I was eager to get home. I did not need to have someone be around me continuously, I could walk up and down stairs when I needed to, and there were no physical reasons to stay.

Terri and I got to my house around 2:30 or so and I entered the domain of cat hair. I have two long-haired cats and it appears that both went into shedding overdrive while I was gone. The house smelled musty, but it was home. I made myself a sandwich and settled in.

At around 5 that night, my friend Wendy called and suggested that she bring over eggplant parmagiana fro the Riverside Restaurant in Cold Spring. She did and we ate like queens. I started to poop out around 9 p.m. and Wendy went home.

The next morning, Diane Picirilli picked me up to take me into Manhattan for my first post-surgical meeting with Dr. Schwartz. Diane is the youth minister at St. Andrew's and is a sweethart. She is strongly considering going into the priesthood and is in the period of the process called discernment. We discussed her calling, and the kids at St. Andrew's, and chatted about the church in general both going down and coming back.

The appointment was at 10 a.m. and we made good time. We even found what we thought was a great parking spot on the street.

Dr. Schwartz's office staff greeted me like an old friend. His assistant even helped me undress in the exam room. He popped in and started looking at things and was very happy at how well I was healing. My navel looks very dark but he said that it appeared to be healing well and that the main incision looked beautiful.

But he would only remove two of the drains. He said that there was still a little too much drainage to remove all three. I argued and then tried whining, which didn't work. The removal hurt like bloody hell. He told me to say Poughkeepsie while he removed the first drain. I may have said something stronger. For the second drain, I asked to bite down on a gauze pad. That helped more than Poughkeepsie did. He bandaged me up and Diane and I left.

We left and went back to what I could have sworn up and down was a perfectly legal parking spot. I had read the signs, she had read the signs, and we both thought the signs said that it was legal to park there. We parked at around 9:40. Parking was not legal until 10 a.m. and Diane had had a parking ticket plastered on her windshield at 9:45.

So we were bitching and moaning about it most of the way home. I wanted to buy Diane lunch and suggested that we stop in Mount Kisco, to the Mount Kisco Kosher Deli. Sadly, the deli is no longer there. We walked a block or so and ate at Cosi's, a very crowded and very noisy place that made really good sandwiches. I found myself to be just a bit antsy in the crowd as we waiting in line to order and get our food. I was nervous about getting bumped into.

Diane and I walked back to her car and found a parking ticket on it. We had parked at a meter than had half an hour on it. Diane put more money into that meter. I saw her do it. She is going to contest this one and I will testify on her behalf if needed.

Two parking tickets in one day? On one car? On one mission of mercy? Yeesh.

Looking back over the last week

By the way, the title of the previous blog is a theft from Christopher Moore’s “The Stupidest Angel” In Chapter 15, all hell breaks loose. Chapter 16 consists completely of “Well, *that* happened.”

It is Tuesday night, a full week since my surgery. I am still at my brother Mike’s house and expect to be here until Thursday morning.

Today, I spent the day alone and took a shower, so I will do fine on my own. If I went up and down the stairs once, I did it about 10 times. I took a walk around the cul de sac my brother and sister-in-law live on and I power napped. It was tough work, but I was up to the job.

All I have taken for the pain today is Tylenol extra strength. I am also on antibiotics. As far as the abdomen and surgical incision, I ache, but it is not really painful. I do have to plan out moves like standing up from a chair, especially a couch, but I am able to maneuver myself around OK. Curiously, walking up stairs (and I normally run) is easier than walking down stairs. I was expecting the reverse. Sometimes I take it one step at a time (put left foot on step, put right foot on same step, repeat), sometimes I do better than that (put left foot on step, put right foot on next step, repeat).

The bane of my existence and the source of most of my discomfort are the three surgical drains that are still attached to me.

(GROSSNESS ALERT!!

A short diversion on the purpose and substance of surgical drains: Frequently after major surgery, the surgeon wishes to ensure that fluids do not collect in the surgical area or along the incision. These pockets of fluid are usually lymph and a bit of blood and whatever. Fluid build up can cause pressure on the incision, it can become infected, and is not a good thing.

A surgical drain is essentially a plastic tube with one end in the surgical field or along the incision and the other end routed out of the body to a clear plastic bulb about the size and general shape of a hand grenade. The fluid collects in the bulb instead of the incision and everyone is happy. The patient, or a nurse if you are still in the hospital, empties out the drains two or three times a day and measures the output.

So I have three ball-like contraptions dangling from plastic tubes coming out of the lowest part of my abdomen. They are sutured in place and I can pin them to my clothing as long as I pin them lower than where they exit.

I shall be blunt. I feel like a man with three testicles. These #$%^%@* things interfere with walking, are uncomfortable when they are resting against my leg, are uncomfortable anywhere else, and are the biggest pain in the ass of this whole experience. End of alert.)

I have an appointment Friday morning with Dr. Schwartz and, please dear baby Jesus, he will remove them then. This depends on how much fluid is still being collected.

So, where shall I start on the whole surgical experience?

First and foremost, New York Presbyterian Hospital is the most professional and best-run hospital I have ever been in. Everyone who came to visit me commented on how clean and nice it was. From the surgeons to the cleaning staff, everyone was cheerful and eager to help me get better. Even the doctors asked me if there was anything I needed.

I had hot and cold running medical students seeing me several times a day. NYP is the teaching hospital of Cornell’s medical school (excuse me, the Joan and Sanford I. Weil Medical College of Cornell University) and I had these three sweet kids looking in on me. Their main job was to take me for walks, including on Wednesday, the first day after surgery.

The student I got to know best was Ida Wong, a graduate of the University of California at San Diego. I asked her why she was going into medicine. She told me she decided to be a doctor because she came down with leukemia while she was a teenager. Ida was cheerful, funny, scary bright, and very nice. She will make a superb doctor. Her cohorts were Jake McSparron (I think I got his name right) and Veronica, whose last name escapes me completely. Jake was a card. As Ida and Veronica were helping me out of bed for the first time, for my first walk, he said he wanted to stretch because he didn’t want to pull a hamstring keeping up with me.

Now, down to the nitty gritty.

I had to be at NYP at 7:15 a.m. last Tuesday. On Monday, Dr. Luo, Dr. Caputo’s associate called me and asked me if I had any last minute questions, which I did.

My brother Mike drove me in and we went to the Admit-Day surgical unit. I told Mike to stick around for about 45 minutes and to go home once I was settled in. I spent too many hours waiting at hospitals during surgery while Bernie was alive and there is almost not really good reason to do it.

I put on the hospital gown and took off my watch and glasses and put them in the duffle bag containing all my stuff. They weighed me. I waited. Several other people were meandering around in hospital gowns. It was the world’s most boring pajama party.

At around 9:30, I was told that Dr. Caputo was done with his previous surgery and I walked down a couple of hallways to the surgical suite. No wheelchair, no gurney, just me walking. Again, stand around and wait.

Dr. Caputo came out in the hall and we chatted for a bit. I asked a couple of last minute questions and we chatted.

Dr. Schwartz came around and I stepped into the operating room so that he could mark up my belly with hieroglyphics or graffiti.

My last memory is getting up on the table and saying something about the egg-crate foam mattress. I don’t think I finished the sentence.

My next memory is being in the recovery room and being told that everything was very clean. I felt like a dump truck had run over me several dozen times but even then I thought that it wasn’t as bad as I was expecting and as long as I laid in the slightly head-up, slightly foot-up position I was in, I would be fine.

What I didn’t know was that it was around 9:30 at night. My brother Mike had started to get worried around 3 p.m. when he hadn’t heard anything. Dr. Caputo called him a couple of hours later to give him a report.

My friend Lori Beninson is an EMT at NYP. Actually, I think she is in charge of EMTs there. She knew I was having the surgery and stopped by the recovery area a couple of times and started to get worried when I didn’t show up by around 5. I finally showed up and started to come out of the anesthesia

The next day I was pretty groggy. I was never really awake, even during the walk, but I was never really asleep. The first thing I know is that Dr. Frank Chervenak pops in to see me with a big grin and the news that Dr. Caputo thought everything had gone extremely well. Frank is Judy Chervenak’s husband and is also head of OB/GYN at NYP and Weill Cornell.

Frank popped in to see me almost each day I was there and, each day he came, he brought me a Diet Coke and the New York Times. He is just the happiest, nicest man on the planet and I could not quite tell him that I hate diet soda. (Friday and Saturday, he skipped since he was taking his oldest son down to Atlanta to visit Emory University. I joked with Judy that he was going to visit the Coca Cola headquarters. He actually did.)

A couple of hours later, Judy popped in to say hello. She also brought me the most beautiful scarab necklace to replace the one that she gave me from Egypt that I briefly thought I lost. She was scared that she had given me bad luck Talk about friends!! If I so much as whispered that I might need something, Judy went and got it. I would kiss the ground that those two walk on if I could bend over that far without hurting.

I spent most of Wednesday in a blur, partly because of the meds and partly because my duffle bag still had not been brought to my room and I didn’t have my glasses. The bag finally arrived.

I was off to a good start and things went better from there. Friends stopped in to visit. Joan brought me lovely white flowers and read to me from a hysterically funny obit in the New York Times. Yes, she came to my hospital bed to read me an obituary, but she knows I love interesting ones. This was the widow of a man named Nudie who was famous for creating over-the-top rhinestone suits for country musicians. Her name was Nudie, too.

That evening, my cousins Virginia, Denise, and Michele came by with my Uncle Micky. They brought this rabbit doll that sang and danced to “Singing in the Rain.” And they sang and danced as they brought it in. I had to beg them to stop because it really hurt when I laughed.

I shall continue this tomorrow.

Well, That Happened.

Just to drop you all a line that I made it through the surgery fine and am out of the hospital. I am spending a day or two at my brother Michael's house. I am typing this on my nephew Thomas's keyboard, which is annoyingly small.

The surgery went very very well. Dr. Caputo said that he thinks he got everything. Pathology reports won't be finished until sometime this week, but he thinks everything looks very very good.

I still have some surgical drains in the wound, which are as annoying as all get out. With any luck, they will be out by the end of the week.

The pain was bad, but less than I was expecting. Then again, I was expecting screaming agony. They did rig my up with a fun IV that gave me Dilaudid (a pretty potent painkiller) whenever I wanted. They refused to let me take it home.

So, I am moving slowly but steadily and each day is a bit better than the last. I took a shower at the hospital this morning, which was nirvana.

I do get tired easily so I will fill you in about my hospital adventures in small doses.

I cannot thank you all enough for your care, love, and prayers during all this.

(The spell check wanted to replace "painkiller" with "binuclear." I am trying so hard not to laugh because it hurts.)

The Calm Before the Storm

It is now Sunday night. My brother Gerald is picking me up tomorrow to take me to my brother Michael’s house. My bag is packed. I am bringing comfortable clothing. I am bringing books. I am bringing sock yarn to knit into socks. I have arranged for neighbors to watch the house and check my cats.

And I am also bringing with me a hell of a lot of prayers, good wishes, and nice thoughts. Perhaps I should say I am bringing a heaven of a lot.

And yes, I am finally nervous. I am nervous about the pain and about whether I can be on my own when I get out of the hospital. I have been told to ask for pain medication early and often. I intend to. What am I afraid of? The worst-case scenario is that I have to stay at Mike’s or Gerald’s for a couple of days of recuperation. Big deal.

(OK, I am a liar. As a medical writer with more than 20 years of experience, I can think of several worst-case scenarios that would curl your hair. I refuse to tell you about them.)

My mantra continues to be “But other than that, I’m fine.”

Heading Toward Surgery

So things are proceeding. My surgery is set for next Tuesday and I am trying to get my act together so that I can leave everything in as much order as possible. (I am laughing out loud as I write this at the idea that I can get some order into this house.)

Wednesday, I went to New York Presbyterian for the preadmission testing. They took blood, interviewed me about any allergies I had, did an electrocardiogram, and took a chest x-ray. I also learned that I have to undergo another freaking bowel prep before surgery.

The surgery I don’t mind. But another bowel prep!!! I am not a happy camper. Shouldn’t there a state law or something against making someone do one of these more than once in a month? And, of course, the directions for this one have to be different than the one I did for the colonoscopy! This time I start the liquid only diet on Sunday, drink 10 ounces of citrate of magnesia that evening, keep drinking only fluids all day Monday, and then drink another bottle of citrate of magnesia again Monday night. Then, nothing by mouth after midnight. For some reason, these directions ban apple cider.

Today, I met with plastic and reconstructive surgeon Dr. Mark Schwartz. I need a reconstructive surgeon to collaborate with Dr. Caputo, the gynecologic oncologist because I will be having a rather large abdominal incision with a repair of the hernia. Dr. Caputo suggested it and, what Dr. Caputo wants, Dr. Caputo gets. I was a bit worried about meeting a big-time Manhattan plastic surgeon. Would his office be full of siliconed and Botoxed blondes? Worse, would he have Picassos on the wall? I mean would you trust a plastic surgeon that admires a painter that puts three noses on a woman?

Dr. Schwartz turned out to be very nice and so was his office staff. He earned my eternal friendship by telling me that I don’t look my age, and I wasn’t even wearing makeup. He sat me down and discussed my surgery with me.

Then I went into an exam room, where I was confronted with an absolutely unforgiving wall-to-wall mirror. Lord, there was enough cellulite and fat for three people. Dr. Schwartz came in and actually put me at ease in front of that mirror. Then, he checked out my abdomen. He even took pictures of me practically naked. I told him that I have very little vanity and that maybe I should go out and buy some. He laughed.

The bad news is that my hernia is not a small one, according to Dr. Schwartz. He then discussed the possibility that a general surgeon might be called in to help. We are talking three surgeons, no waiting, here. At what point will they need a choreographer?

My friend Judy met me in Dr. Schwartz’ waiting room after the exam and we went to her apartment for lunch. She did her version of home cooking: she sent out for food. Judy has graduated college, medical school, and law school, but cannot cook. But she is wise enough to know she cannot cook (unlike some who try anyway) and brave enough to not have a problem with it. When I grow up, I want to be Judy.

* * *

There is the possibility that this will be the last time I can post before my surgery. Since this is a very public forum, I figure it is the right place to make a couple of announcements. Here goes:

If something goes wrong and I go into a persistent vegetative state, like Terry Schiavo, please have someone come in and shoot me, OK? I do not want a feeding tube unless I am well enough to ask for one myself. Anything that is expected to give me back a reasonable quality of life—meaning that I am able to think and do most things for myself—is OK. If it looks like I will become a basket case, do not resuscitate me. Are we all clear?

And if, God forbid, I do end up like poor Terry, please make sure that Senator Bill Frist, Terry Randolph, Governor Jeb Bush, Jerry Falwell, Pat Robertson, or anyone of similar ilk comes no where near me.

And if someone goes onto my computer and sees some suspicious, and perhaps salubrious, sites in the history of my Internet browser, I have absolutely no idea how they got there. And I am sticking to that story.

A Doctor a Day Keeps the Apples Away

Last week, I banked another pint of blood and saw three different medical specialists. At this point, I am trying to figure out if there is any area of medicine that is not going to get a chance at poking or prodding me.

As I said in a previous post, I donated another pint of blood to myself. That bruised the insides of both of my elbows since it took them two tries to get a vein.

Tuesday, I saw Dr. Han, the radiologist who treated me for my eye problem last fall, for a follow-up session. She is such a sweetheart! I told her about the cancer diagnosis and she reiterated what everyone else has said: that this is common and that a total hysterectomy will take care of it.

She also told me that she had had a hysterectomy and had done well during it.

Wednesday, I started the clear liquid diet for the colonoscopy and I saw a cardiologist. Generally, I have never like cardiologists, or cardiology for that matter. Cardiologists tend to be pompous and, in my experience, not the warmest of individuals. This dates back to my time spent as a staff writer for Cardiology Times. It is the only medical specialty that I have never felt any affinity for.

However, Dr. Jeffrey Fisher was wonderful, and for that matter, so is his office staff. His main office is packed will all kinds of neat knick-knacks, mostly golf and Sherlock Holmes memorabilia, as well as many paintings and art of shore and country scenes. I know a lot of doctors who love golf, but I’ve never seen one before who had a set of clubs in every room of his office, including the exam room!

He and I immediately started discussing such trivia as the friendship between Arthur Conan Doyle and Harry Houdini and other amusements. He said that he was going to administer an echocardiogram in that office and then I would have to go across 72nd Street and down a block to his other office, where I would take a cardiac stress test on a treadmill.

I got into the paper gown and Dr. Fisher administered the echocardiogram, running the ultrasound probe around my chest and commenting on how healthy my heart looked. I told him I was happy to hear that, but that most men commented on my breasts first. He laughed.

Dr. Fisher then gave me a puzzle to figure out. I was to guess what magazine title décor in his two offices represented. I am nothing if not a sucker for a puzzle.

I trotted across the street and into the second office. The décor here was different. The walls were all white and all the art was black and white photographs of New York City. Not a golf club in sight.

At this office, I met a lovely lady named Natalia, who said she was from the Ukraine and had a daughter named Valeria. She explained the whole stress test to me and attached a handful of sensors to my chest. She also double-tied my shoelaces for me. The whole while I pondered the puzzle.

I got on the treadmill and Dr. Fisher came in. I told him that I thought his offices represented Time Out New York, because the first office was all about his hobbies and the second was all about New York. He said it was a good guess, but that the correct answer was Town and Country. Close, but no cigar.

The stress test went very well. If you’ve never had one of these, they start you out at a very slow walk on the level and then increase the speed and incline of the treadmill until you reach a maximum heart rate. You are basically having an electrocardiogram while you are exercising. The test was supposed to end when my heart rate was 146 beats per minute, but he let me go all the way to 160 with no problems whatsoever.

The bottom line is that my heart is in excellent shape.

Thursday, I had the colonoscopy. As everyone said, the test was not bad, but the preparation for it is a pain. I could not have anything to eat that I could not see through all day Wednesday. At 6 p.m., I had to drink a cleansing solution. I had feared that I was going to have bad stomach cramps. I had no cramps but did get intimately acquainted with my bathroom. I also woke up four or five times during the night to go, which meant that I was tired by the time I got to Putnam Hospital Center.

My friend, Gail Kalinoski, picked me up and drove me to the hospital. The only problem was that they had a bit of trouble finding a good vein to use for the anesthesia. The anesthesiologist too two tries to find a good one, adding more bruises to my poor arms.

Less than 2 hours after I got there, my friend, Linda Press, picked me up. I hit Blockbuster and treated myself to three movie rentals. And my lower intestine is also in good shape.