Saturday, December 31, 2016

Trying to make 2016 a little more EZ.

Saturday, December 31, 2016: The last day of the year. This morning I decided to review our iPhoto library for the past year. A lot happened in the world during 2016 for good and for ill. Joy and sadness were both to be part of the human condition. Nevertheless, we were blessed and enjoyed much. So, here in the modern version of the Christmas Newsletter, are a few of the events of 2016 as I was prompted by my iPhoto library (I've not uploaded the photos here as I'd have to export them from iPhoto first and I'm feeling lazy). 

I began the year with recuperation from prostate cancer surgery performed at Brooke Army Medical Center by Dr. Duffy and team on December 3, 2015. As of the end of the year, the recuperation continues (some side effects of treatment remain) and my last test showed cancer-free.

In January, we had some repair and renovation work done on our pool house. The work was done by John, a handyman who lives a few doors from us. We had a new frame baseplate installed, new siding, new doors, and new windows. Cost: About $2,000.

In mid-January, I contacted Mike Holloway in an attempt to learn the provenance of the ceramic tile artwork that is attached to the back wall of our home at 9315 Overton Road in San Antonio. This home was built by Mike Holloway's father in 1972 and Mike and his siblings grew up here. He is now a custom home builder in the San Antonio area. He told me that his parents bought the individual art tiles in Monterrey Mexico in the late '70s and had them assembled and fastened to the wall of the house. The art piece is signed but the signature is unreadable and Mike does not remember any more than that. Age and weather are beginning to damage the tiles, and they are not quite assembled in the right order. Viewing the tiled artwork closely you can see that a couple of the tiles are out of order. I contacted a couple of preservationists but no one had any good and simple advice for preserving the artwork.

On January 23rd, we celebrated Ian's 8th birthday at his families’ home.

On February 19th, we celebrated Derek's birthday early along with Glenda's birthday at Derek's home.

In March, son Joel visited Cuba and sent us some photos.

I attended Coffee and Cars in NW San Antonio a couple of times in 2016, the first time with Jennifer, on March 13th.

In late March, I bought a mini-quadcopter UAV and tried to learn to fly it. My skills were not top-of-the-line. On one event, I actually lost the drone in a tree in neighbor Martha Beard's yard. We were able to retrieve the lost toy.

On April 12th, a huge hailstorm swept across San Antonio, doing what was eventually estimated to be $5B in damage. Our home suffered a damaged roof, siding, screens and damage to garden and shrubs, but no broken glass or other serious damage. During the initial cleanup, we had over four tons of tree and shrub debris removed from our yard. It took the rest of 2016 working with insurance and contractors to get all of the repair work done, but by the end of the year we had a nice new roof on both the house and pool shed and new siding and solar screens on the house. Trees and shrubs have all recovered.

In May, Glenda and I drove from San Antonio to Idaho and back to visit friends and family. We spent two nights at the Faywood Hot Springs resort in southern New Mexico and while there visited the City of Rocks state park.

The next stop on the trip was in Tucson, AZ to visit Glenda's aunt Myrna Dillie, who passed away later in 2016. This was an amazing woman who was born and raised in Indian Country, supported a Navy officer husband over a noteworthy career, and spent time as a volunteer teacher and counselor later in life on Indian reservations in Arizona and New Mexico. After that short visit we proceeded to Gilbert, AZ, where we spent a couple of days with son Joel, his daughter Seville, and his beautiful wife, Orenda. We were there for Mother's Day and Orenda hosted a truly wonderful dinner and we got to meet her mother and other family members. Glenda and I attended Sacrament Meeting at an LDS church just a couple of blocks from Joel's home. There were over 500 from this one ward’s congregation in attendance and passing the Sacrament took over 30 minutes with a dozen deacons doing the duty. Four ward congregations meet in this building and, we were told, that not a single member of those four congregations live more than one mile from the building.

From Gilbert we drove to Flagstaff Arizona where we got to have lunch at an Olive Garden Restaurant with my cousin, Evelyn Patterson. Evelyn is a wonderful lady who was a good friend when I was just a child of 10 or so. We lost touch when her family moved from Idaho to Arizona so her father could work on the construction of the Glenn Canyon Dam. How we reconnected is a story unto itself. We now stay in touch via Facebook, and having lunch with her was a wonderful treat.

From Flagstaff we continued on to Utah where we were guests in the home of my Niece, Denine Smith, for a couple of days so we could visit my brother, Warren (her father), and other family members in the area. Warren is aging, having been born on November 15, 1934, and is unfortunately no longer able to live on his own but resides in a memory care facility in Bountiful, UT. He could go out with us to lunch and for visits. One of the events we enjoyed was a chalk-art street festival in Bountiful, Utah. On our last morning there, we had breakfast with Denine's youngest sibling, Peri Griffin at Winger's Diner in Kaysville, UT, where we enjoyed fried-bread scones just as the ones my Danish mother made when I was wee.

From Utah, we proceeded to Blackfoot, Idaho to visit my Sister, Sarah Leane, who, born on August 28, 1931, is also living in a memory care facility. I think I see a glimpse of my own future. While there, we spent some time with her oldest son, Michael Jensen, who has recently retired from long-haul commercial driving.

After time with Sarah, we went to Twin Falls, where we stayed a few days with Glenda's sister Laurie and her partner, Deb Krause. While there, we were able to visit our grandsons, Michael  and Tyler Johnson, and their Mother, our daughter Glenda Anne Moyes. We took the boys to church on a Sunday and to Disney's live-action Jungle Book movie the next afternoon. While in Twin Falls, we also visited Glenda's step mother, Netta Baum, and took the two boys to see family grave sites in the Magic Valley. Both of my parents are in the Hazelton graveyard while most of Glenda's past family are laid to rest in Twin Falls. Glenda's father just passed away at Thanksgiving time in 2015, and she was able to fly to Idaho for the services.

Leaving Twin Falls, we drove to Nampa to visit with Glenda's other sister Carolyn Baum-Buttorff, and her husband Mark. While in Nampa, Glenda's sister, Janet Lambert, was also able to visit us from her home in Moscow, Idaho, so it was quite a satisfactory reunion.

While there, Carolyn entrusted me with a few hundred historical Baum family photos to digitize and return. As of the end of 2016, that work is about 95% complete, and one of my planned tasks for January of '17.

After our return to San Antonio, Glenda and I visited the San Antonio Zoo in late May, for the first time in many years.

On June 11th, we enjoyed Hot Rod night at Soda Pop's drive in in Boerne, TX, with the company of our eldest son, Derek, his wife Jillian, and their son, Ian.

I attended the drive-in hot rod meet up event again, by myself this time, on July 30th.
For most of the year, Glenda participated in the Eden Ward choir. They provided beautiful music for many of our Sunday worship services. I continued to perform some administrative duties for the Sunday School.

Through most of the summer, we attended grandson Ian's soccer games each Saturday morning. Sometimes, we'd go for brunch with his parents after the game.

In August, I travelled to Pittsburgh, PA for a week to provide training in the proper and safe management of hazardous waste materials to US Air Force members at the 911th Airlift Wing. This is work I've done annually for about 12 years. In 2015, Glenda went with me on this trip and we toured the museums of Pittsburgh and I got to check off one bucket list item by visiting Frank Lloyd Wright's masterpiece, the Fallingwater home in Laurel Highlands, PA.

Glenda and I celebrated our 47th anniversary with our first-ever ocean cruise aboard the Carnival Liberty from Galveston, TX to Cozumel, Mexico in mid-August. This short trip was very relaxing and a lot of fun, too!

One month later, on September 18, 2016, I completed my first-ever 5K run. The Zero Prostate Cancer run in San Antonio. There were around 3,000 participants. I finished far, far from first in my age group, but I did finish!

To celebrate the accomplshment, I took Glenda to a musical review, Lady Sings the Blues, at the Harliquin Theater later in the month.

We hosted our neighborhood's National Night Out get together on October 4th. I grilled hot dogs and we had chips and chilled soda or water for all. We had a great turn out and were supported by visits from our local city police, fire department and city councilman's office. Our neighborhood association helped with the set up and clean up and reimbursed me for the food costs. Around 60 neighbors dropped by for a visit and a snack over the course of the evening. A good time was had by all!

On October 8th, it was back to Boerne. This time we visited their Market Days and annual old-time car show. Hundreds of restored and customized cars. Some real beauties.

On October 10th, Glenda was still swimming daily in the back yard pool, although the night-time lows were into the 50s. I told her she was dedicated to her exercise routine to do that. Later that day, we signed her up for a Gold's Gym membership so she could use their indoor heated pool.

Grandson Ian, with his parents help, has been building and launching model rockets. On the 15th of October, we went with them to a launch at a field in Schertz, TX.

On October 16th, I rode my V-Star 1100 in the international Distinguished Gentleman's Ride. Attended by several hundred motorcyclists, we rode a scenic route through San Antonio, accompanied by a city police motorcycle escort team, while dressed in our finery. This event is an annual fundraiser for prostate cancer research and male health. Some of the riders went all-out in their costumes, and many of the motorcycles were rare or vintage models.

In early November, we attended the Olmos Park Art Shuffle, and saw a wide variety of works of art by local artists. One of the artists on show was John Garland, an acquaintance from my days in the Air Force.

On the evening of the 12th of November, Glenda and I attended the Classic Theater's production of School for Scandal.

Our Thanksgiving Day Dinner was a family success. We fed about 20 people, with Jennifer and Bre, Derek's family, Vincent's family. We had the food catered by D'Lish Cafe and they provided an excellent repast. The family gathering was very satisfying.

On the second of December, we were privileged to attend the Texas Children's Choir presentation at the 7th annual Windcrest Community Christmas Devotional, held at the Windcrest, TX LDS chapel. The choir is a non-denominational group and has leadership and participation from many congregations in the San Antonio area. They have performed for international heads of state, at Carnegie Hall, and with the Mormon Tabernacle Choir.

In early December, our son, Ben, and his wife, Samantha, gained full-time custody of our grandsons, Michael and Tyler Johnson. These are the two youngest sons of daughter, Glenda Anne, who has unfortunately had her parental rights terminated by the State of Idaho due to her inability (or refusal) to secure and maintain a suitable home for the boys. Ben and Sam traveled to Idaho on the 10th and 11th of December to take the boys to their home in Wisconsin. While Anne sees their actions as traitorous, everyone else sees a giving and loving act on their part.

2016 wound up with a Christmas celebration at our home, with family gathered from Arizona and Wisconsin as well as Texas. We got to play at a firing range, at a bowling alley, and a couple of cafes as well as having a great dinner at home on Christmas Sunday. Santa paid his annual visit, gifts were exchanged with love, and a warm feeling prevailed. The grandkids swam in the back yard pool (!! it was 80 F. Christmas afternoon) and we all sat around the fire pit pool side late into the night.

Through the year, there were a variety of birthday and anniversary celebrations too numerous to mention here.

At 5:00 PM on Friday, December 30, 2016, I officially ended my full time employment and became a retiree! I’ve filed for my Social Security stipend and we’ve been working on being prepared to live on a fixed income. I’ll still work with my company a little, hourly as needed, but no more punching a time clock for me.

So here we are, New Years Eve day. A lot happened in the world during 2016 for good and for ill. Joy and sadness were both to be part of the human condition. Nevertheless, we were blessed and enjoyed much. For all, we are grateful!

Friday, December 30, 2016

Good nursing care is not EZ to give.

Someone in the Prostate Cancer support group shared what he called his 'most embarrassing prostate cancer moment' where dignity was out of the question and asked if anyone else wished to share. This was my response from the day of my surgery, just over a year ago:

I feel like my worst moment goes beyond embarrassing--I'd just call it out and out humiliation. And it showed to me just how much nurses deserve to be called angels or even more. It was the evening after my DaVinci RP. I was in a hospital bed, thankfully in a private room, about 6 hours after surgery, catheterized and hooked to an IV and vital sign monitors. My family had just gone home after a loving visit when the nurse came in and reminded me that my surgeon wanted me to get up and walk some that same day if I could. Hell, why not? I felt pretty good. No pain, and I felt alert. So the nurse helped me deal with the various tubes and wires, got me out of the inflatable socks and into some slippers and holding my hand helped me to slowly stand beside the bed. As I stood, I suddenly felt a bit dizzy, so I sort of leaned back toward the bed. At the exact moment that the nurse asked if I felt OK a wave of nausea washed over me that shook me to the core and suddenly, with absolutely no chance to control it, everything that had been in my "core" was shooting violently out of me. At both ends. I'm told this sometimes happens when one comes out of anesthesia. The expelling must have only lasted a second or two and the dizziness passed just as quickly, but, oh, my! What an ungodly mess. With no exclamation, the nurse gently led me to the bathroom and asked me be seated on the toilet. Once I was seated, she asked if I would be OK to wait there a few moments. When I answered in the affirmative she fetched cleaning supplies, linens (and maybe help, I don't know). In what seemed no time, she had me cleaned and dressed in a clean gown, the room cleaned, my bed made with fresh linens, and me comfortably back in it. Never a word of complaint from her as she dealt with my mess that I found disgusting. With a smile she said, "Perhaps you should wait until morning to try to walk about." With that she left me to rest, and to my knowledge I have never seen her again. What a demonstration of human kindness. Yes, it was her job, but still...Did I mention she was truly a beautiful person? I inquired about her the next day and told that her shift rotation had taken her to another ward.  

Thursday, December 15, 2016

Some times it isn't EZ to give a helping hand.

My wife and I were this morning (at 5:30 AM) at the same hospital where I had my DaVinci RP on December 3, 2015. She was being prepped for an elective surgery (which is complete now, and went well) when I overhead a very loud-speaking doctor a few curtained-bed spaces away briefing a patient about his DaVinci RP to be done today. Shy about violating anyone's privacy, after the doc left, and finding the curtains open, I stuck my head into the man's area and addressed him as Mr. "name taped to end of bed." I told him that I was one year out from the same procedure (with a very similar diagnosis from what I heard the doctor say) and that I was doing well. I said, "Be strong and confident, brother. You will have hard times, but you'll be fine." He thanked me, we shook hands, and I left him and his wife alone. Later, I saw his wife in the cafeteria and thought I'd take a moment to make sure that she was aware of the support groups (including this one) that will be available to them. I mentioned that the emotional struggle is surprisingly real, that as strong as her man was, he is likely to struggle. She basically brushed me off, saying that her husband is a minister and they have a strong basis of faith and she's sure they won't need any outside support. Wow. Later I thought that what she doesn't know is that he could help others by participating in support groups and thus extend his ministry of good works. I have strong faith in a higher power. I have a strong and loving family. I've needed outside support and I believe he probably will, too. He will be in my prayers for sure, and I wish them both the best.

Wednesday, November 30, 2016

PC is not EZ

The following was written today (November 20, 2016) as my response to a social network post about political correctness. One writer was holding that we must ensure political correctness (PC) to protect the sensitivities of others at all times. I posited that, while we are all responsible for being thoughtful and considerate, that too much PC stifles a free society, that taking offense was a choice, and by choosing to be offended we surrender our emotional power to others. There was some continued discussion and this was my most recent response:

I must admit that I have felt offended. Note that what I am acknowledging here is a feeling, an emotion. I believe that offense, like anger, is often a secondary emotion. What I determined to do some years ago is to take time to pause and consider why it is that I feel particular emotions, in particular, those that can lead to negative actions: anger, jealousy, offense. If that emotion is the result of something that is a direct threat to me or mine or our way of life, perhaps there are more effective courses of protective action, and actions that should be taken, rather than merely expressing my outrage. Often I find that my emotion is stirred by words or actions that, in examination, present no immediate or direct threat to me or to mine. In these cases, sometimes a smile and a shrug may be the best courses of action on my part. On occasion, the action or thought that stirs my emotion is something else, indeed--rather than presenting an existential threat--they run counter to a belief that I have held dear, and yet may bear serious reexamination. In these cases, sometimes further thoughtful discussion is in order. Thus, I may grow and improve. In a world where expression is bound by political correctness, I may never have had the opportunity to hear or see the thought or action that provides me an opportunity for growth. Without words and actions that challenge me, I would live in a never-ending echo chamber that would ultimately stifle me. My religious heritage teaches that there must needs be opposition in all things (The Book of Mormon 2 Ne. 2:11). If there is no wrong there can be no right. I hope that I have been able, here, to share the logic behind my belief that *enforced* political correctness is near to the ultimate sin in my eyes, and why, while I may not agree with what you say, I will defend to the death your right to say it. Even if, or perhaps especially if, I may find it to be offensive.

Wednesday, June 29, 2016

Empathy is not always EZ.

I participate in a Facebook-based support group for prostate cancer sufferers, patients, survivors, and their supporting family, friends, and lovers. There have been many discussions of the symptoms and impact on the body of the cancer and the effectiveness and side effects of the various treatments. Side effects that often include urinary incontinence and erectile dysfunction (ED) formerly known as impotence. Everyone's journey through this often fatal landscape is wildly unique and different. Today one of the partners of a cancer sufferer posted a note that ED just didn't matter and implied that forum members should just be glad to be still alive and shut up about that issue. A couple of men (both suffering extreme cancer-related life-threatening problems) posted that, in their dire situation, sex simply no longer mattered to them. The original poster (OP in today's language) then congratulated those two for "being comfortable in your own skin and for having good self esteem and for knowing what a REAL MAN is." I found her words to be insensitive and hurtful, and did not immediately have the words to respond. 

A couple of other cancer-suffering men did chime in and post to the effect that she simply did not understand. One man went so far as to call her patronizing. I'm not sure I'd have used that word. Anyway, after some time pondering, below is what I posted in reply to her REAL MAN comment:

Thank you, Robert and Henry. I wanted to respond to Patsy but needed some time to think so that I could, hopefully, respond in a way that does neither diminish those with greater problems and suffering nor hurt Patsy for her lack of understanding and empathy while making it plain that her words were hurtful.

My dear wife and I have remained committed and faithful for over 48 years. We have raised a great family who are doing well and enjoying life. I am thankful for her and our children and grandchildren, for my life, remaining health, and capabilities, and I have great sadness for those, like [name withheld here] and many others, whose situation is really much more dire and difficult. My PC was originally diagnosed as stage 2 with a Gleason of 4+3 with “excursions to 5.” Twelve of fourteen biopsy cores were positive for cancer although my PSA had never been over 4 and all of my DREs had been unremarkable. The biopsy was recommended because my PSA went from 2 to 4 in a three-month period (followed because I did have BPH, and the PSA increase was verified with a follow up and a second lab). The RP surgery proved the cancer had spread outside the prostate capsule so my diagnosis was changed to stage 3. I have, and continue, to receive what, to the best of my ability to judge, is excellent medical care and I have excellent insurance. My oncologist, supported by post-surgery pathology, believes that all the cancer was removed. At six-months post-surgery, my PSA is ND. I do recognize that in many, many ways, I’ve been exceedingly blessed.

I have no idea how to communicate the loss that my wife and I both feel, other than to say that it hurts. Our hurt in no way diminishes anyone else’s pain. But it is real. We have benefited from joint counselling post-surgery. Depression meds (for both of us) have helped.

I am as “comfortable in my own skin” as I know how to be, take responsibility for my health where I can, and continue to work full-time now that I’m past my initial recuperative period. I provide for my family and provide emotional, intellectual, loving support for my family. I ride my motorcycle regularly. My youngest daughter and I rode our bicycles in a 20-mile fund-raising event for the American Diabetes Association. I’m training for my first 5K running event in support of funding for PrCa research. I try to be supportive to others through this forum and our local chapter of Us Too. I meditate daily and do yoga on non-running days. I share the housework and read to my vision-impaired wife. She and I do enjoy intimacy and I’ve tried to be a sensitive and giving lover within my current capabilities. But our loss still hurts. It hurts her and that hurts me. And, deep down, there are the fears voiced by Henry (Explanatory note here -- Henry voiced fears on Facebook that his wife would leave him for a more capable lover) —and I do not mean to slight my wife nor disrespect her in any way when I voice this. I believe that if you have not suffered the loss of something that, for your adult life, has been part of your being and part of what you could offer in a loving relationship you probably don’t really understand. And for that, you must be forgiven.

So, Patsy, what is a real man?  And how can anyone define that for any other person?

I await her reply.

Saturday, June 11, 2016

Tracking blog visitors is not EZ.

So, this morning, ClustrMaps tells me that my blog has had one visitor from Seguin, Texas, 10 visits in the past five minutes. What's that all about?

Fitness Trackers are not EZ.

Yesteday I noted that my FitBit Charge HR fitness activity tracker was behaving badly. Occasionally I would get no response at all from it. Other times it would display a stop-watch like display that I didn't even know it had. I tried to do a reset per the company's web site support but no change. Then I noted that a fully charged battery was only lasting about 2 hours vs. the 5 days advertised. This morning I called FitBit Customer Support at 1-877-623-4997. FitBit Customer Support was courteous and friendly, but didn't seem to really know any more about the device than I do. So, they are sending me a new one under warranty, which, I've been promised, will arrive in 7 - 10 business days.

Friday, June 10, 2016

Winter wasn't EZ.

TL;DR: Among the many things your body may need, oxygenated blood is rather high on the list.

I have, once again, begun the C25K (Couch to 5K run) program. You may note the word, “again.” The word is appropriate because I first started the program in early February of this year, but failed in that attempt. In case you are not familiar with the C25K program, I offer the following from the C25K Website []: “C25K is a fantastic program that's been designed to get just about anyone from the couch to running 5 kilometers or 30 minutes in just 9 weeks.”  There, they claim, “Josh [Clark] wrote the C25K program in 1996. Since then many thousands of couch potatoes have become runners because of Josh's work.”  As stated, the program intends to help get people up off their butts and into a better state of fitness. That goal is reached by providing promptings that lead the participant through an increasingly strenuous 30-minute-three-times-weekly exercise routine. It starts off being seemingly really, really, easy. The first day of week one includes a 5-min warm-up walk and a 5-minute cool off walk at the end, with short periods of walking and jogging interspersed through the other 20 minutes of the routine. Initially the walking periods are longer than the jogging periods. The C25K app on a smart phone (I use an iPhone 5) provides verbal and vibration prompts like, “OK! Let’s jog now.” and “Whew, now let’s just walk.” in a soothing and encouraging voice in the gender of your choice.

So, if it’s so easy (and as I completed Day 1 of Week 1 yesterday it did seem quite easy) why did I fail in February?  I’ve had a rough winter. I’ve written in an earlier post (January 31, 2016) of my run-in with cancer and the initial surgical treatment that I received. As part of my patient education, my oncology surgeon told me that among the side effects I should expect would be fatigue and shortness of breath that would likely last a “few months,” but would get better with time. The more I walked and exercised, he said, the more quickly those side effects would pass. So, by early February, still suffering from fatigue and shortness of breath, I decided to try the C25K. In my suburban San Antonio neighborhood February weather is often perfect for outdoors exercise and I’ve got a great around-the-block route of just over ¼ mile on flat land right at my front door (and observant neighbors to call 9-1-1 if I drop out); perfect conditions for a beginner. So I downloaded the app and spent some time configuring and getting to be familiar with its features. I bought some new running shoes and pulled some running shorts and a t-shirt out of my dresser. By golly, let’s do this!

And I could not. The five minute warm-up left me puffing. I could not sustain the first minute and 30-seconds of jogging. Before I had completed the first ¼ mile lap around the block, I was stopped, leaning on my knees, gasping for breath between gagging and hoping somebody would call 9-1-1.

A little background: By February of 2016 I was 65 years old. My BMI is greater than my doctors would like it to be by about 10 or 15% (at 5’ and (nearly) 11” tall, I weigh about 215 pounds which puts my BMI at about 30 to 31—right on the border between overweight and medically obese). I’ve never been a runner as it’s not something that I’ve found pleasurable. But, prior to my surgery, I was not exactly just a couch potato, either. I have always walked a LOT and enjoyed that. On travels, I could generally walk younger and thinner companions into the ground while touring places we visited. For several years I had been doing a morning routine at least 5-days-week that included about 30 minutes of yoga-like stretching and light exercise (I’ve even taken a couple of yoga classes – call me Yogi). I had been using a pedometer app on my phone to encourage and track walking for about a year. In fall of 2015, my youngest daughter, Jennifer, and I successfully completed a 20 mile bicycle ride as part of the Tour de Cure raising funds for diabetes research and treatment. So, not an athlete by any stretch, but not totally sedentary either. The recuperation from my December, 2015 surgery had put nearly all of my physical activities on hold. By February I had decided it was time to get active again, hence, the C25K. But I failed—after that first attempt at Day 1 Week 1, I could not get myself to try again.

Over the next few days and weeks, the fatigue and shortness of breath did not get better, if anything, it seemed to be getting worse. On a cool and blustery Saturday, while on a shopping trip with Glenda, I was unable to walk up a slight incline 20 meters from our vehicle to the store. Finally, by mid-March, I determined that there must be something other than the side-effects of the December surgery bothering me and made an appointment to see my primary care physician. After a cursory unremarkable exam and her review of my records, she said, “It’s been nearly 13 years since you’ve had a complete cardiology workup, why don’t we refer you to the cardio clinic and get that done.” So a week or so later, on the 22nd of March, 2016, off I went for my appointment at the cardio clinic. As is normal procedure for a medical appointment, my vital signs were checked and recorded. Then, as the first step of the cardio evaluation, I removed my shirt, laid back on the exam table, and was wired for an EKG. As the machine began to hum, I noted the technician’s eyebrows quickly raise, and she asked, “How long have you had atrial fibrillation?

“What? Never, that I know of. I had an EKG prior to my surgery in December last year and it was normal then.”

“Well,” she said, “You’ve got a pretty severe case of it now.”

A few minutes later I was visited by the clinic’s lead cardiologist. She explained atrial fibrillation (A-Fib) to me. Basically it’s when the upper and lower chambers of the heart are not working in the proper rhythmic order. This diminishes the heart’s ability to supply the body with enough oxygenated blood. Symptoms: Fatigue and shortness of breath. Huh. Some people can feel palpitations in their chest, and, if it gets severe, tingling or numbness in the extremities or light-headed feelings. Because the blood pools and is not moved properly, clotting can develop and that can be fatal. So A-Fib is something you don’t want to ignore, and, this diagnosis goes a long way toward explaining why my fatigue and shortness of breath had only gotten worse rather than better after my surgery. So, what’s next?

After a thorough review of my health and medical history (including the very complete cardio workup from 2003) the cardiologist prescribed a procedure called an electrical cardioversion (CV), where the medics basically stop and then restart the heart with electric shock much like that delivered by an automated external defibrillator (AED) device. The procedure is done as an outpatient day-procedure and the patient must be on blood thinner for at least two to three weeks prior to the procedure to prevent blood clots (and lawsuits) that might occur with the CV. So I was prescribed twice-daily oral doses of 5 mg of apixaban, told to confine myself to “gentle” exercise—but to walk as much as I was comfortable with, and scheduled for the CV procedure at that same clinic on April 29, 2016. In the meantime, the doctor said, if you feel tingling in the extremities, light-headedness, or sever palpitations in the chest, get to the emergency room as quickly as you can. The date of the scheduled CV was significant, as Glenda and I had planned to leave on or about the first of May for a three-week long trip visiting family across the Intermountain West. If the CV went well, we could still go. If not, the family could all gather here in San Antonio.

Crank the clock hands forward to Sunday, April 24, 2016. On the way home from church, I told Glenda, “I am feeling truly exhausted, probably just tired from overwork on the yard Saturday. When we get home I don’t want to eat, I just want a nap.” Which I got, but after sleeping two hours I didn’t feel any better. We retired early that night and I slept nearly 10 hours but got up Monday morning feeling, if anything, worse. By now all of my long muscles were aching—surely an artifact from all that Saturday yard work. I went to work anyway as there were things I needed to get done. By 9:30 AM in my 72o F. office I felt like I was freezing. I had the shivers so bad that my gut was shaking internally. I thought to myself, “Well, it’s warmer outside (this is San Antonio, after all) I’ll go out and walk a bit, stretch my muscles, warm up, I’ll feel better.” Walking outside did NOT make me feel better. In fact, I noticed that I was feeling a tingling in my fingers, felt a little bit light-headed, and could feel the palpitations of my heart racing in my chest. Let’s see, what was it the cardiologist said, if I feel….or….or, wait, I’m feeling all three symptoms at once! So, being the sensible fellow I am, I drove myself the 11 miles or so from my workplace to the hospital’s ER.

At the ER, the triage nurse did not ask me to have a seat in the waiting room. She seated me in a wheelchair and immediately took me to a treatment room where I was stripped and gowned and, again, wired for an EKG. The EKG tech asked if I knew I had A-Fib, and I was able, this time, to say that, yes, I did know. Reviewing my medicine list, he asked if I had been taking my blood thinner per instructions and I answered in the affirmative. “OK, he said. We’ll get you on a gurney and a monitor and I’ll have the cardio doc on call come see you soonest.”

Lying on the gurney, under four blankets, I was nearly asleep when the cardio doc came to see me. After a few cursory checks and discussion, he said, “Well, you seem stable. Let’s send you home now and we’ll see you back on Friday morning in the cardio clinic for your CV.” With that he left.

Less than five minutes later, he was back: “We’ve changed our minds. We are going to admit you overnight and do the CV here tomorrow morning.”   OK. So, I’ll be spending the night in a hospital for only the second time in my life. The first was last December when I had the prostatectomy.

During the admission process, the staff finally got around to checking all of my vital signs. Wait, repeat that temperature. Let’s use a different thermometer. 104.8 o F.! Note, reader, that my normal is around 97 o F. As a result of the fever, the medics decided they needed every possible diagnostic sample to look for the cause of the fever so I was stuck, swabbed, drained, and swiped everywhere you can think of (and a couple places that surprised me). I was moved to an isolation room on the ward and sedated with a saline solution IV and there I drifted off to blissful sleep.

Shortly after awakening in the morning, the entire cardio doc team showed up in my room. My hospital is a teaching hospital so there was a cadre of students, interns, residents, fellows, and attending physicians. The attending physician introduced the team and told me, “We have good news and we have bad news.” Great.

“Give me the good news first—I need some good news.”

“The good news is there is nothing wrong with you that would have a negative impact on the CV. We will still do the CV this morning, probably around 9:00 AM.  The bad news is that the tests confirm that you have influenza-b and it will take you 10 – 14 days to really feel well again, no matter what we do.”

Another note for the reader: I had been administered a flu shot in October of 2015. I have not generally made it a practice to get the flu shot, but happened to be in a clinic one day when they were being administered at no cost, so... Alanis Morissette would see the humor in the situation as it developed.

So, true to their word, I was taken for the CV by way of rolling gurney 9-ish. I was prepped by a nurse-practitioner with the connection of the necessary IV tools for administering the sedative and the shaving of my chest. The electrical terminal pads are adhered to the chest in front and on the back just opposite rather than paddles to the left and right as with an AED. Shaving minimizes pain later when the terminal pads are removed. With some additional explanation, then introduction to the physician and team who would be administering the CV, I received some sedative through the IV and drifted off to sleep.

Now, for those who have never been anesthetized, it is not like regular sleep. When you sleep, upon awakening you have a sense that time has passed. You may not have an accurate sense of how much time, but you will know that time has, indeed, passed. When you awake from anesthesia there is absolutely no sense of time having passed. It is as if you had simply not existed from the time you lost consciousness until awakening. Death must surely be something similar. On that day, when I awoke, still achy from the flu, the very first thought in my head, fully formed but unbidden, was, “Wow! I have not felt this good in weeks!” I almost wanted to jump up and run around. It is absolutely amazing what a difference having a decent blood supply to your entire body makes. I highly recommend it!

The rest of the recuperation was unremarkable. During the day, after the CV, an echocardiogram and other tests were done to evaluate my heart health. At the end of the day, the docs told me that all was well. The heart and valves seemed very good for my age; no artery blockages noted. The hospital staff sent me home later that same day. Glenda and Derek’s family came to take me home, and they were a welcome sight! My only new restriction was to wear a breathing mask to reduce the chance of spreading the flu. Within a few days I was back at work. At the advice of my cardiologist, I bought a FitBit and started tracking my walking – 4,000 steps per day, increasing to 10,000 as a goal now. And yesterday, I, again, started the C25K challenge. This time I was able to complete the full 30 minute workout without undue distress. The app tells me that I covered 1.92 miles in the 30 minutes. My FitBit tells me that I ran for 24 minutes, burned 293 additional calories, and had an average heart rate of 124 bpm during the exercise. I feel pretty good about that. I also did my morning yoga routine today for the first time in ages and ages. It wasn't pretty (it never was or will be), but I got through it.

So, that’s why the word “again” is important in my lead sentence. And, as usual, shows that nothing truly is ever easy.

Friday, March 4, 2016

My election decision has been made more EZ.

I did not watch last night's Republican candidate debate from Detroit, but I'm sure hearing a lot about it via water cooler talk, Twitter, Facebook, and various news outlets. One topic that seems to be on a lot of minds this morning is, "What was on Ted Cruz' lip?"

I'm much more concerned about what was on Donald Trump's mind and what came out of his lips!

I have a new life goal: I want to live long enough to cast a vote against Donald Trump.

Sunday, January 31, 2016

It's not an EZ road to recovery.

I've joined a support group for prostate cancer victims on Facebook. I also attend a live support group that meets once a month. Here is a description of my experience that I have shared with those groups.

I'm 65 yo, reasonably healthy but about 10% over ideal weight. I had the DaVinci radical prostatectomy on 3 December 15. 12 of 14 biopsy cores had been positive, Gleason of 7 (4+3 with "excursions" to 5) and some evidence of extra-capsule malignancy. Both the radiation oncologist and the surgical oncologist (and second opinion) agreed surgery was the best first choice for me, as it can be followed by radiation if not fully successful but, for some reason, it's less desirable to do surgery if the radiation doesn't fully work. I spent two nights in hospital, had next to no pain, painkillers for only two days post-discharge. I took the month of December off (slept  and went back to work 1st workday of January. Will go back for F/U with first post-surgery PSA early February. The surgeon was able to do "nerve sparing" surgery on one, but not both sides, of the prostate area. They took the seminal vesicles and samples of the lymph nodes as well. Pathology after surgery was good with all "clean edges" but it did show some extra-capsular malignancy which was removed. At this point, I'm finding that I still have excess fatigue and tire VERY easily. The incontinence is my big gripe, very demoralizing, and I've not seen any improvement, yet. I had a catheter for one week. Since it's removal, if I'm standing or walking, I'm leaking. I can hold it no problem sitting or laying down. Coughing, sneezing, laughing no problem unless standing. I'm using "prompted toileting" using the timer on my iPhone to remind me to void every hour while awake. I am receiving rehabilitative care once a week with biofeedback on the Kegels and electrostimulation for the pelvic floor muscle. I find I do better on holding the urine when I'm fresh than when I'm tired. I've been prescribed daily Viagra and issued an expensive pump, but there's no sign of life there yet. My wife is demonstrating the meaning of patience. A deciding factor for me: every Dr. I consulted said side effects are initially worse with surgery but they get better -- with radiation, side effects are minimal up front but a significant number of men so treated have onset of incontinence and impotence later on and the side effects then get worse over time and never get better.