So Glad I'm Not Claustrophobic

So Glad I'm Not Claustrophobic

Since my tele-health follow-up call with Dr. Ingham, I was scheduled for an MRI at St. Elizabeth's in Brighton today (12/15/21) with a subsequent tele-health follow-up on December 27th.

I've been following the weather hoping for a 'weather-free' day (meaning no wet or frozen stuff) for my 8:30 AM appointment.  Given the unpredictability of Boston traffic, I set my alarm for 6AM and was out of the house by 6:30AM.  Traffic was busy, but moving along with the exception of the regular slow spots. Sunrise looked beautiful and they had predicted a warm spell.  I'll take it.  Once in the 'tunnel' it gets a bit tricky with exit ramps competing with incoming traffic.  Although I had my GPS on, I managed to get off at the wrong exit, but was able to get back on track quickly.  Mass Pike was busy, but moving.  The exit from the Pike in Alston/Bright is very confusing and there is no time to think with all the aggressive drivers trekking to work fully caffeinated.  But, with a few stumbles, I made it to Cambridge St. and was bale to get to the hospital parking deck by 7:45.  Not bad, considering.  Unlike my last visit, there was plenty of parking and no drama.

I arrived at the main building and was provided with very good instructions on how to proceed to Radiology.  The guy/greeter was very friendly.  In fact, everyone I dealt with was very courteous.

Arriving at Radiology at 7:55, I was given the obligatory SAT paperwork to complete.  I'm sure there's a reason, but they ask the same questions in different ways.  I wanted to write in 'see answer to #4", but I was a good boy and provided the same info on the different sheet of questions.  I handed in my assignment and was rewarded with a hospital bracelet.  I was directed to the next waiting room.

There were only a few patients waiting in Zone One.  But it appeared that all others were being called before me.  I was about to inquire about my status when my name was called at 9:05.  I was now graduating to Zone Two.  The technician, checked my answers and asked a few more questions.  I passed.  I was brought to a changing room where I had to put on two johnnies  (front and back).  Not long after I was called to enter Zone Three.  Whoa, this is happening.

I followed the technician to the MRI room and managed to get onto the slab.  A bit of 'scooching' was required and I was sternly told "do not move".  Also, I was told that it was going to take about 45 minutes including 'shots' with contrast.  I crossed my arms and I was given a bulb to press if I needed help.  [Wouldn't that be moving?]

The technician gave me some ear plugs and said that it gets loud.  She was nice to ask if I need a blanket.  I certainly did and was appreciative.  She then said she would start the first round and it would take about five minutes.  She left the room, but not before saying, "Don't Move!"

Shortly after, the slab began to pull me into the void.  Although it didn't really bother me, I could understand how some with claustrophobia might find this difficult.  There's not much room to move even if you had to.  The sides were pressing against my elbow bones and it began to get quite uncomfortable.  I guess I was trying to gently adjust when I heard a voice come through the speaker saying, "You moved." [Sorry]

It was noisy, got a bit warm, rattled, shook, vibrated and beeped...a lot.  The voice said, I'm coming in to give you the contrast.

The technician asked if I had a preference on which arm to use.  She was on my left so I said, "Left". Not sure, but she couldn't get what she wanted after a few jabs and decided to go through my hand.  Not painful, but uncomfortable.  She then said the next test will take about 5 minutes.  More of the same, then she said, "We are done".  [YAY]

She assisted me off the slab and insisted that I sit up for a few minutes so I wouldn't be dizzy.  I'm a good patient, so I did what I was told.  I got back to changing room and got dressed, then left.

No issues getting out of the garage and basically no traffic going home.  Took me a bit more than 30 minutes to get home.

So now I wait until 12/27 for the doctor to review the results and determine the best treatment.  Dr. Ingham did say that he did want to preform another Cystoscopy and I expect that to happen in January.  As the season progresses, there's always that chance for a weather incident to gum up the works.  But, you deal.

More to come!

  

Feeling Thankful

Feeling Thankful

I received a call at 4PM from Dr. Ingham's office just verifying that I would be available and to ensure that my insurance or other things haven't changed.  I was told that the doctor would call me after he was done with his in-person patient.

 

At 4:20 Dr. Ingham called.  I was all set for him with pen and paper to take notes. He got right into it after thanking me for having the scans done (up my way).  

He said:

- Scan of lungs look normal.  No masses or enlarged lymph nodes were seen.

- Scan of abdominal and pelvic area showed no metastatic growth.  (Meaning there is no sign of cancer spreading). No lesions were found in the kidney.  The drainage portion looked fine (it shares some of the cells of the bladder). The diverticulum (the outer pouch where the cancer is) looked less prominent than what the ultrasound showed. He was concerned with some thickening of the wall, but he indicated that sometimes it's not that clear with these scans.

The scans did show some cysts in the kidney, but he said not to worry about that. He did indicate that my aorta was slightly enlarged and suggested I let my vascular surgeon know.  [I know after my AAA repair, the sac was enlarged and was slowly beginning to shrink.  I have an appointment in a few months.  I'll mention it then.] Also, he said I have a hiatal hernia.  I had mentioned that I had a discussion with my primary care physician once I noticed this in my chart.  Dr. Ingham said it may be related to my GERD (reflux). I have a wellness appointment in a few months, I'll mention that.

He was, however,  concerned with a few things, and wants me to have an MRI.  After a review, he did indicate the need for another cystoscopy so he can have a better view of the anatomy.  From his latest observation the opening of the diverticulum is very close to the urator.  The proximity will define the surgery I'll be having.

Both the MRI and Cystoscopy are out patient.  However, the cystoscopy will require my being in the operating room.  I'm waiting for his office to contact me on scheduling.

More to come!

So It Starts

So It Starts

Dr. Ingham had ordered CT scans of by Lungs and Pelvic area.  I had requested that these be done 'up here' versus my having to drive to Brighton.  I was pleased to only have to go on the other side of town to the Merrimack Valley Holy Family Hospital.

It was a beautiful day.  Sunny and close to 70 degrees.  I arrived at 11:15 for my appointment at 11:30.  My check-in was easy.  Having been here before, I knew where Radiology was located and got there at 11:20.  I was asked if I had lab work (blood work) in the last three weeks.  I had not.  So I was directed to the lab down the hall.  There were two ahead of me, so I sat and watched The Price Is Right until I was called.  I had to sign-in and my being tall didn't help my penmanship on the sign-in sheet taped to the wall.  When it was my turn the phlebotomist paused and said, "Is there someone here with a name that begins with an 'R'?"  That's me.  I did glance at the sign-in sheet and because of the angle I wrote, it did look like RIJ.  So I gave her my paperwork and we proceeded to the lab.  While she entered info into the computer and printed out some labels, I prepared myself by rolling up my sleeve. When she walked over, she seemed happy that I was ready.  She was good.  Really no pain and barely a pinch.  I was done.

I arrived back at Radiology.  I was given some paperwork to complete.  By the time I was done, the attendant had taken a break (or lunch) and someone else was covering.  Four people came in after me and they were all taken as I waited, for almost an hour.  All I could think of is my having to leave for lab work made me lose my place.  I wish I knew I had to have that done, I would have come earlier.  Oh well.

By this time nature was calling, but I was afraid to leave in case I'd lose my place again.  By this time the first attendant had returned and saw me standing.  She said, "Oh they haven't called you yet?"  Nope.  But I did ask where the rest room was.  I was instructed to walk down the hall and it would be on my right.  No sooner did I finish and walk out, a technician called my name and asked that I follow her.  Perfect timing.

Entering the CT scan room, I was instructed to hang up my coat, lay on the slab and pull my pants down to my knees.  She was nice enough to give me a blanket since it was chilly in the room. She told me that I would have a stint and would be given and IV of saline and then some dye.  I offered up my same arm used for the blood test and she inserted the needle but soon said  that my 'valve' wasn't working.  [What?  You have valves in your veins?].  I suggested she use the other arm.  By this time another technician arrived and assisted.  She was good.  Barely a pinch and she said the valve was working good.  So she 'flushed' me and I was told that I needed to extend my arms (so they stayed straight and out of scanning chamber).  I was told that I would take a few passes, then they would inject dye and I'd have a few more passes.

I've had scans done before and they may have been a different kind, but each pass only took a few minutes for this.  The machine told me when to take a deep breath, hold, then exhale. After the first round, the technician said that I would feel warm as the dye was injected.  It was a very weird feeling, but not painful.  I made a few more passes and she said, "You're done."

The stints were removed and I was told to get dressed.  She said have a great day.

So the images will be sent to Dr. Ingham and I have a tele-health appointment scheduled for 11/24 (day before Thanksgiving).  Now the waiting and hoping for a clear path for treatment.

More to come!

Here we go again!

Here we go again!

Dr. Hurley had referred me to a urologist that specializes in bladder cancer.  I had an appointment today at St Elizabeth's in Brighton with Dr. Matthew Ingham.

My ride into Brighton on this first Monday after the time change was fairly uneventful (thankfully).  I gave myself an hour and a half for travel.  I arrived at the hospital parking garage about a half hour before my appointment.  My luck, the garage attendant was setting up 'garage full' sign right in front of my car as I waited to enter.  I asked where should I park.  He instructed me to go to valet parking.  I'm not a fan.  So suggested that I wait until someone left the garage.  He thought it was a good idea so he asked that I move off to the side.  Other people behind me weren't too happy and some heated exchanges took place, as if the attendant had anything to do with the garage being filled.  One guy, recklessly back his truck up almost hitting my car then left rubber as he exited. I had pulled over so  I had clear sight of the attendant and could make eye contact when a vehicle left.

Not too long after, a car was exiting.  I got the visual cue to proceed.  Not knowing how things worked and hopeful that no one else would beat me to the opportunity, I drove up to the gate and was hoping he would lift it.  He walked up to me and said I needed to take a ticket so I could pay upon exit.  I told him I'm not with it today, and he was very pleasant and said no worries.  He pressed the button and gave me the ticket.  I'm in!   I went slowly looking for that elusive spot which happened to be on the top level.  I still had time.

I figured out which building I needed visit.  The directory in the lobby had the doctor's name and which floor/room he was in.  I rode the elevator to the third floor and looked for 303.  I couldn't find it, so I walked around looking for 303.  There was was no order, but I did find the room.  I checked in and was given my obligatory SAT's to complete.  I just started when my name was called.  I was directed to an examination room where the medical professional took my vitals.  She was having trouble with the blood pressure cuff and tried a few times.  She said she would return with another.  [She never did].

I sat and continued to complete my paper work and a doctor (didn't get the name). [Masks make communication challenging].  He asked some questions about my medical history, as well as family members.  After harvesting the information, he said Dr. Ingham would be in to talk to me.

Not too long after, Dr Ingham arrived.  After my health history monologue, he added that he did see some imaging (and apparently Dr. Hurley captured some during my TURBT procedure).  He did say that he needed more data and images. Because of how and where the cancer is.  He said he needed more data to define the best course of action.  Like Dr Hurley, he sketched out my condition and described the three possible action plans, but he did not commit to any and won't until he has more data. He wrote in my care summary the following:  [my comments and understanding will be in brackets]

"I am going to refer this patient down to Saint Elizabeth's Hospital for urologic consult concerning this diverticular bladder cancer. [The 'pouch' that has grown out from the bladder is very similar to diverticulitis in that it's not a normal structure and many times things grow there.  In my case cancerous tumors.] The fact that he has high-grade cancer invading the lamina propria in a diverticulum is somewhat concerning. [ In the doctor's sketch he indicated that there are layers around the bladder wall, scaffolding; muscle and fat.  Without imaging he is not sure of which layers may be with the pouch.]There is no muscularis propria behind this so I am unsure of whether or not how invasive this is. [ There is concern that the cancer may have spread.] Whether or not he can get away with may be a repeat fulguration with BCG instillation versus a diverticulectomy versus a radical cystectomy is difficult to say at this point and I need confirmation from of other urologist expert in this disease." 

That last statement sums up the three possible plans of action.  The repeated fulguration with BCG, pertains to the scraping, cauterizing and 'chemo-like' medicine.  Diverticlectomy is the removal of that bulge.  Radical cystectomy is complete bladder removal. 

There was a discussion about life altering radical cystectomy and the need for an ostomy bag.  The most common (based on my age) is creating an outlet for urine that empties into a bag.  At a high level, a piece of the small intestine is fashioned as a new drain that attached to a urine bag.  I also discussed the possibility of a neo bladder.  Although being an option, it's generally used on young men.  But he did say it's not off the table.

Next Steps

He wants imaging done (CT scans of plevic area and the lungs).  I asked why the lungs?  He said that if the cancer spreads, it's most likely to go there.  [HOLY SHIT!]

I asked if these imagings can be done locally, to which he said, yes.  I was informed later that they will be done at Holy Family.  [Waiting to hear back.]  He said that if I do need an MRI, based on other images, that would need to be done at St. E's.

No new news, but a better understanding of what's going on.  

More to come!

Well this was not what I had planned!

Well this was not what I had planned!

Had my post op follow-up with Dr. Hurley.  I had a number of things on my mind, the first being the results of the pathology and a new development 'down there'.  Since I had my catheter removed Wednesday, I had passed some clots (normal), then all of a sudden my stream was reduced.  Can still go, but a trickle compared to the fire hose effect I was used to.  I was hoping he would say, it will clear up.

Arrived at the Salem NH office on time and was the first patient of the day.  After check in, I was called and instructed to enter the examination room.  "The doctor will be right with you". I waited and prayed a bit.

Dr Hurley arrived, shock my hand and asked how I was doing.  He then sat down with some paperwork and began by telling me that he was surprised at what he found while inside.  He proceeded to sketch as he spoke.  Apparently, as he drew a circular shape, the mass he saw in the office, he scraped away.  However, (and I hated hearing that conjuncture), as he was 'in there' he discovered that I have an 'outer bladder'.  It seems that a pouch had grown outside of the bladder and was acting as a bladder (extension).  But, when he looked inside, it was 'very messy'.  Meaning there were tumors.

He looked at his paperwork and said the pathology came back as cancerous and because it was found in the outer bladder he used the word aggressive.  (Another word I don't like hearing with the term cancer).  Since the outer bladder does not have the muscle structure that the bladder has, there is a concern that it 'may' have spread.  He mentioned in his 20 years of doing this, he has never seen this condition.  [Lucky or unlucky me].  Because of this he wants me to see a specialist at St Elizabeth's Hospital in Brighton.  He indicated that there are multiple approaches to getting this, but he needs some guidance.  The easiest is to scrape out and monitor.  He also indicated chemo. Another approach would be to remove the outer bladder. And the final approach would be to remove the entire bladder.  None of this I wanted to hear.  

I asked how the outer bladder happened.  He said that it's been that way for a long time and I've had the cancer for a long time.  He said that an obstruction could cause an excessive amount of urine in the bladder and the pressure caused a breech and created a pouch. Hearing this, I added that I've begun to experience an obstruction which restricted my urine output, but I thought it was a clot waiting to pass.  He seemed to think it might be related to the prostate so he indicated that he would call in a prescription to help me 'go'.  Once it's cleared up, I can stop.

So he said he was going to get in touch with St Elizabeth's and schedule a consult.  In the interim, he scheduled a three month follow-up with him.

I'm a luck/unlucky SOB.  Between the breast cancer, AAA and this.  Geesh!

More to come!

Excess Baggage

Excess Baggage

I was able to get some decent sleep last night.  I was given a much larger urine bag to use at night.  Although the nurse gave me a tutorial, it was very difficult to set up.  Apparently it needs gravity to work better and it has to hang from the bottom of the bed.  Given I'm tall I have no foot board, so I rigged up a guitar stand to hang the bag.  The hose wasn't long enough and very thick, so it was insistent on curling, which would lead to excessive tugging.  So I made an executive decision to keep my 'day baggage' connected and just get up a few times in the night.  Since it's uncomfortable, that did not present a problem. I got up three times.  First time (after 2 hours of sleep), there wasn't much output.  The Velcro straps shifted a bit, so I made the adjustments.  Second time after about 3 hours of sleep, there was more output.  The last time, and when I got up, the bag was completely filled.

I received a voice mail from the doctor's office checking in with me.  I called back and reported on my current state and wondered how long I'd need the bag.  She said she'd contact the doctor to find out.  She asked if there was still blood and clots.  Well because of one of my meds the urine is florescent orange.  I saw no clots, but there was a red tinge.  She said the bag isn't removed until there's no blood.  OY VEY!

Later, after drinking coffee, it was time do maintenance.  I really looked and it definitely was more orange and to me, didn't appear to have blood. Drink plenty of fluids ran through my head.

A short time later, I received a call from the doctor's Salem office saying they would be removing the catheter tomorrow!  YAY!!.  I have an appointment at 8:30 with one of Dr Hurley's associates.  I can't wait.

I do have a slight sore throat and am a bit hoarse from the tubing, but that will clear up.  It's a gorgeous day, so I'm hoping to resume my walking that I could not do yesterday.  First time in years that I missed my walking goal.  I'll take it slow and not push myself, but standing (and moving) appears to have less discomfort than sitting or lying down.

More to come!

Two Bolts

Two Bolts

When I was younger with 7 siblings, my parents knew many ways to stretch a buck.  My father was a jack of all trades, but learned to create and fix things through trial and error from the school of hard knocks.  One of his acquired skills was auto repair.  Many kids meant many cars and we all know cars break down.  Whenever a car needed routine repair or maintenance, he would do it himself.  Over the years he amassed many types of specialized tools to do these repairs.  Of course, back then engines weren't as high tech as today's cars, there was room to maneuver within a slant 6 or V8.  So swapping out an alternator from a late model car from the local junk yard was his operational model.  The knowledge he acquired over the years was astounding.  Early on he provided hands-on (or stand back and watch) training.  Thanks to him, I could swap out, radiators, starters, celluloid switches, patch tires, use bond,o etc. However, he would often run into a job he thought simple and would say, "It's just two bolts".  But the job would take many hours and sometimes days. So in my family, the term: two bolts equates to something not so simple.

Day Surgery

After many pre-op calls from the hospital, surgical team, anesthesiologist, my arrival time was placed at 6:30 AM.  I figured since I was fasting, I didn't need time to drink coffee so took my shower the night before.  I decided to get up at 5:30AM.  My younger sister (who is an angel), offered to pick me up at 6AM and drive me to Holy Family in Methuen. Being anxious, I woke up at 3:30AM.  I tried to get back to sleep, but my mind was now awake.  Then it came to me that I set the alarm for 5:55 not 5:30.  I was startled and immediately turned on the light and re-set the alarm.  By this time I was even more awake, but I managed to cat nap until the alarm went off. [It sure is dark this time of year at 5:30]

My sister, Leslie arrived and we scooted off to Methuen.  Traffic was busy but moving.  Of course the drivers were up to their bad driving antics, but we made it.  Due to COVID I had to be dropped off.  After thanking her, I proceeded to the Hospital.  

The check-in process was very stream lined due to being a virtual ghost town.  I just had the obligatory questions and was given an 'OK to enter' sticker. I proceeded to Day Surgery and checked in.  There were three people in the waiting room.  My name was called.  My nurse was very pleasant and task driven.  I was shown to bay #3 and was instructed to remove all my clothes, place them in patient belonging bags and don the hospital johnnie. She went through all the paperwork and completed forms. She drew some blood and placed my IV stint and hooked me up the saline solution.  She then told me the order of appearance for my medical team then left but was replaced by one of my doctors of anesthesiology.  He went through his script and described how they work in teams and another anesthetist would be meeting with me.  Upon his leaving another nurse arrived.  She hooked me up to a vitals machine. A few more arrived and fitted me with electrode stickers.  The second anesthesiologist   arrived with yet another team member.  And they asked many of the same questions then walked me through the program.  Doctor Hurley arrived, went through the paperwork, signed off on some things then told me everything will be fine and my being the first patient of the day meant my procedure would start as scheduled.  He patted my shoulder then left. One by one a team of six cam and I was wheeled into operating room 5.  I was introduced to two more nurses and scooted onto the operating table. Immediately they all began getting me ready.  One of the anesthetists placed an oxygen make on me and said that I would begin to feel drowsy.  By the time she finished saying that I was out.

Recovery Room

I came consciousness at about 10:30 in the post op recovery room.  Feeling out of it, I did have some pain.  The nurse offered some pain meds.  Yes, please! She said the catheter will feel uncomfortable.  Oh, did it ever. Meds did kick in and it made it tolerable.  I was provided with some water and crackers and was told I would be moved back to where I started in about an hour once my vitals were normal.  

I had a quick visit by Doctor Hurley who ominously said, "It went well.  It was bigger than I had thought.  I hope I got it all.  I don't want you to have anymore bleeding". I guess I'll need a better discussion about this at my next visit. Doctor Moore stopped by to say hi.  He performed my breast surgery in 2015.

I was having stabbing pains in my upper left back and when I took deep breaths.  I tried to get into a comfortable position but I would set off the machine.  Apparently the position that felt the best crimped hoses. The pain got so bad that I got the attention of a few nurses.  No one seemed to know why I had this, but to be sure it wasn't my heart, they gave me an EKG.  A host of nurses descended and got me hooked up.  I purposely took deep breaths hoping the pain would register on the results.  But, the EKG came back normal! The nurse remained and continued to trouble-shoot to determine the cause (something external?), however as she was talking, I began to feel faint.  The vitals showed that my blood pressure was very low.  My vision began to 'grey out' and I felt myself fainting.  A bunch of nurses again descended and I could hear them say 'He's cold to the touch".  It seemed that all were placing their hands on my arms to either feel for themselves or provide me with heat.  Their heat felt nice.  It was decided that my pressure be taken on my other arm.  This reading was still low.  Not long after, I was beginning to feel 'normal' again.  The nurse said my color was back and my readings were normal. I was given some graham crackers and apple juice and remained until the readings were stable.  Yet another mystery.

Bon Voyage

I think it was close to 1:30 at this point so I was given the green light to advance to GO but NOT collect $200. I was wheeled to bay 3 and collected my personal belongings. The nurse explained that I had a Foley catheter and provided a detailed demonstration on how to use it, drain it, wear it and swap it over to a night-time collection bag.  She mentioned that the doctor had called in prescriptions for me and his office would schedule a follow-up to have the catheter removed.  She also provided instruction on what to do when things aren't right. One remedy being a visit to the ER. I was instructed to dress and take the night-time kit and urinal with me. My sister had been called and was already waiting outside for nearly 2 hours.  The nurse said she called 'transport', which meant someone would wheel me out in a wheel chair.  Got outside and the weather was gorgeous.  One of the first things Leslie said was, 'Two bolts".

Drugs Ready For Pick-up

Leslie suggested that I contact the drug store to see if my script was ready for pick up.  They were. So, she drove me there.  When I looked at the drugs, I saw that I was prescribed Ciprofloxasin.  I don't feel comfortable taking that.  I had it swapped out before.  So after I got home I contacted the doctors office and requested an alternative.  Not long after I was notified that a new script was ready for pick-up.  I was bad and drove the mile to the drug store.  I took a few back streets and was very cautious ;-)

I did manage to eat something and took a 4 hour nap.  Not looking forward to pee bag maneuvers tonight.  I hope they take this thing out soon.

More to come!

 

More tests

More tests

Had my pre-screening (pre-op)  for my procedure on the 13th.  I was instructed to visit the lab at Holy Family, Methuen for blood and urine work.  

Fairly non-eventful, but this pandemic has really changed how things proceed.  Upon entering the hospital, I traveled a maze to the first check point.  After given the interrogation (on covid), I was given a sticker that indicated I passed.  Next stop was registration.  Because I had my pre-screen via the phone I had no paperwork.  The representative didn't seem pleased, so I produced ID and she pulled up my file.  After a bit, I was cleared to continue to the lab.

I walked to the ground floor and easily found the lab.  There was one person waiting in the room and the guy at the check in window asked me to wait until he was finished doing whatever he was doing.  Finally, I was given the go ahead.  I mentioned that my paperwork was in the "rec" folder.  He pulled it out and asked my name and DOB.  He gave me paperwork and asked me to have a seat.

It wasn't long before the phlebotomist called me in.  After verifying my identity, she took a vial of blood.  Hardly any pain or discomfort and quick.  She then asked if I could provide a urine sample.  To which I said yes.  I was given a 'kit' and directed to the men's room where I completed my task.  I left my sample and was on my way.  Easy peasy.

More to come!

What now?

What now?

I had my second post-op follow-up with Dr. Song today at Mass Eye & Ear, Waltham.  It was a crisp Autumn day and traffic was moving right along so I arrived right when I had planned.  The parking lot was full, but luckily for me someone was leaving.  So I pulled right in after they left.

Upon entering the waiting room, I noticed it was packed. Interesting, I thought.  After check in, I was told to have a seat, but there was none to be had.  I stood next to the wall, and once again, someone got up.  I quickly scooted into the seat.  As I observed what was going on, it appeared that they were doing lasik  procedures that day and there were a number of younger folks waiting their turn.  Each was with a parent.  I saw two doctors churning out the patients.  Each stopped by and explained to the parent, what was going to happen and how long it would take. So this explained the full parking lot.

I was finally called and the technician gave me the first eye test.  Upon completing that, I was asked to follow, Dianna to an examination room.  I once again had a barrage of eye tests.  I had mentioned that it was very busy.  She said that they were having surgeries today, but not for cataracts, as I had.  Those were performed at a surgical site.  Dianna completed her test and I was instructed to wait until the doctor was ready to see me.  By this time the waiting room had mostly cleared out. Not long after I was called.

I was brought to an examination room and told Dr. Song would be with me shortly.  It wasn't long before he showed up.  After exchanging pleasantries and asking how I was doing, he reviewed my test results and said he wanted to perform some additional tests.  He gave me more drops and arranged his machine to examine my eyes.  He did say the my left eye (one that had the recent surgery) was doing OK, but my right eye had a high reading for pressure.  "My right?", I said.  He said yes. What now? I thought.

He explained that my corneas are very thin and pressure was building up in my right eye, but my left eye was fine.  He once again looked into my eyes with his light and exclaimed that the 'drainage structures' appeared fine.  He said at this time there was nothing to worry about, but he wanted to monitor it.  He added that this pressure, if not corrected (either on it's own or with drops) could lead to glaucoma and in the worst case scenario, loss of vision.  [Lovely].

I asked if it's anything I did, or diet, or whatever?  I did have something salty the other day.  He chuckled and said, it has nothing to do with high blood pressure.  He said he wanted me to finish my drops (a few more days) and he will see in a few months.  He gave me paperwork and wished me a good day.

At check out, I was given a January 2022 appointment.  I sure hope the weather cooperates.

More to come!

Another follow-up

Another follow-up 

It's been a week since I had my eye surgery.  I had my one week follow-up with Dr Song at Mass Eye & Ear in Waltham. Traffic wasn't too bad and I arrived at my desired time.  Gorgeous day today.  

Inside, the waiting room wasn't as busy as my last time, but the front desk wasn't covered, so I waited for a few minutes before someone checked me in.  No biggie.  I was told to have a seat and wait to be called.  

Just as every visit, I see a number of nurses, doctors and medical professionals before seeing Dr Song.  I wasn't there too long before I heard my name, "Richard P".  Unfortunately, there was another patient with the same name, so the medical professional asked me to whisper my date of birth.  Once I did she said, "This is the Richard P., I want".  The other guy was upset and claimed to have been waiting 2 hours.  Of course, he was given an apology and was told that it shouldn't be too long.

I was brought over to a machine that took some eye measurements.  Then the attendant said, "Oops! Stay where you are the machine ran out of paper."  (Of course).  After refilling the paper holder, she needed to repeat the tests.  No biggie.  I was then instructed to follow her to an examination room.

In the examination room, more vision tests were administered.  I was having some difficulty with the smaller letters. Then a huge eye machine was put in place and I was asked if vision improved as she flipped different lenses.  I'm guessing it's to determine an eye prescription.  She seemed pleased and said that my newly operated eye was 20/20.  Impressive.  She then administered dilating eye drops and instructed me to wait in the waiting room.

Not too long after, my name was called and I followed to another examination room and was told that Dr. Song would be in briefly.  Soon after, the doctor arrived and after exchanging pleasantries, and asking how I was doing, he said that things were progressing as he expected.   He looked into my eyes with various light emitting devices and made audible 'pleased' sounds.  He then said that all my restrictions have been lifted and took me off two of my 4 eye drop meds.  He said I no longer have to use the eye guard when I sleep (Now that's a biggie). He added that I should take the remaining meds until they run out and follow the reduction schedule for the prednisone.  He said he'd see me in 3 weeks.  He did mention that I may need to undergo another laser procedure to clear up any cloudiness (like we did last time).  But we will know more in a few weeks.  I do recall that I was having some glare and halo effects and I believe I had laser again. He asked if I had any questions.  I asked how long it would take to be credited for the price of the Toric lens that I didn't get.  He said it normally doesn't take long.  I mentioned that I still had not seen it on my online statement.  He looked surprised and said he would remind 'them'

I checked out and received a date for my next visit in October.

More to come!

Murphy's Law and other stuff

Murphy's Law and other stuff

Yesterday (Sept 7), I received a notice from my sister informing me that her appointment for radiation was running late.  She mentioned Murphy's Law was in effect and the 'machine' was down with a number of people ahead of her. Although her procedure is generally very quick, she indicated that she would give it 10 minutes before she left to pick me up for my cataract and lens implant procedure.  I replied that I hope Murphy's Law wasn't contagious.

Not long after this, I received a call that had no caller ID. I waited until it went to voicemail and checked messages.  It was Doctor Hurley.  He was inquiring on the status of my bleeding (it had stopped the day after seeing him) and wondered if I could go in for my procedure Wednesday at 10:30.  He asked that I call his scheduler Kiara.  Of cousre I called the number he provided and it rang and rang then finally an automated voice saying that there was no one in office, and use the patient portal instead.  If I didn't have portal info leave my name and email and they will email me portal instructions.  Lastly, it said if you'd like to leave a voice message, I could.  I did.  I also used the portal.  OY!

Around 11:45, Leslie arrived.  Upon entering her car, I asked if the radiation machine came back and if she got her treatment.  She indicated no to both questions and added that she would just tack on her session at the end of her 20 sessions.

Weather was beautiful and being the day after Labor Day, traffic was surprisingly light and moved along nicely.  We chatted away and our exit came up.  I did have printed directions which were very thorough.  There were quite a few tricky turns.  The instructions included visual cues which really helped.  A GPS may have worked well, but since I had the directions we followed those.  We got there with 15 minutes to spare.

Due to Covid protocols, Leslie was not allowed into the waiting room, so after I checked in, she was told she could wait in the upstairs waiting room with the non-patients. I waited in a huge room with just three other people.  I was eventually called in to the 'prep' room after about a half hour.

The prep room was bustling with activity.  There were at least 10 people in recliner chairs all ready for the the assembly line.  I had a number of doctors, nurses and medical professionals attend to me.  Each had a specific task and once completed, they would put a sticker on my surgical head covering.  Think of that piece of paper you find in purchased items where it says "inspected by" and their mark, stamp, etc. I was finally prepped and was just waiting my turn.  Dr Song arrived and confirmed my info and asked which eye we were working on.  Upon providing the correct answer, he took a sharpie and placed an "X" above my eyebrow on my left eye.  He gave me some eye drops and took some strange looking tool out of some sealed bag.  It looked like a four pronged exact-o knife.  To me, it looked like he took a marker and marked the ends of each prong.  Then he placed it over my eye and applied pressure.  It didn't hurt but it was a strange sensation.  Then he said "I'll see you soon".  Of course by this time, nature was calling, so I had to ask to be 'unhitched' to visit the facilities.  I was apologetic, 'cause I was basically undoing what all the other had done.  But, my nurse said, 'No problem at all'. While in the restroom I did look at my eye and sure enough, there were four marks on my cornea.  I also noticed all the stickers on my head covering.  By the time I returned, someone said, "He's next".

As yet another came to perform their task, the reclining chair I was in decided to teeter totter so my feet were in the air and my head was almost to the floor.  It was quickly adjusted and I joked about how I felt like I was in a 3 Stooges movie.  Just a chuckle.  None of them probably know of the 3 Stooges. (Feeling old).

I was wheel into the laser room and was positioned onto the table.  Then my head was strapped into a fixed position. (Think Clock Work Orange).  Some kind of plastic device was placed on my eye (looked like an egg yoke separator).  Dr Song came in and was very good at providing instructions and how long each 'light show' would last.  This took less than 10 minutes.  He said, "You did great".  So that was the cataract part, now onto the surgical implant procedure.

I was wheeled into the operating room and once again a number of doctors and nurses all doing specific tasks.  Lots and lots of eye drops, then more.  The anesthesiologist arrived and said he was going to give me something to relax me.  They had put a stint in my hand's vein, so I felt a little discomfort when he was injecting.  I honestly didn't feel anything.  Maybe a little groggy, but the eye drops where like waterboarding. Someone covered both of my eyes and opened part of it so the surgical site was the only part exposed.  My eye was so dilated and drowned with drops, all I could see was a bright light.

Dr Song arrived again. Many weee reciting 'things' and repeating to verify what was going to happen.  Lots of medical jargon. The procedure was uncomfortable to say the least.  At one point I heard an audible "oh oh".  I immediately thought of Murphy's Law.  I could hear some more discussion and felt more prodding.  Finally we were done.  Still quite groggy, all I remember is the Doctor saying there were some tears to the capsule that the lens sits on and because he didn't want to make it worse he went with a back-up lens.  Knowing that I would be seeing him for a post op the following day, I figured I'd get more information then. Medical professionals descended on my with each doing their task.  An eye guard was taped to my forehead and I was eventually wheeled out to discharge.

I was 'parked' next to Nurse Rita who went over my discharge paperwork and my aftercare.  I'm glad she did, because I had a very difficult time reading anything that evening. I was given some sunglasses and  an extra eye guard.  I would have to wear the guard the rest of the day and through the night.  Then I'd have to use it just at night or when I napped, for a week.

I was discharged and Leslie was waiting for me in the vestibule.  The ride home we used her GPS.  It backed tracked us nicely and we made it home with just the normal slow-down spots.

Post Op Appointment

Knowing I had an early appointment, I woke up an hour before the alarm.  I managed to put in my eye drops and have coffee.  Traffic was OK for a work day.  I arrived 15 minutes before the appointment.  After check in I waited about a half hour before being called in.  An eye doctor gave me drops, measured my eye pressure and gave me an eye exam.  I was surprised that my left eye could see so much better than the previous night.  (That morning I was able to read the newspaper which surprised me considering all). After my exam and more drops I was told to wait.

I was called not too long after and was brought in to see Dr. Song.  He performed some tests and said the the pressure in my eye was high.  So he gave me some numbing medicine then it felt like he poked my eye with something.  He then remeasured and said the pressure had come down.  He said he'd prescribe more drops to take care of the pressure and to take it for a week (until my next follow-up).  I asked why there was this pressure.  After his explanation, my understanding is that for the procedure they had to inject a gel-type substance and the eye eventually drains it, but it wasn't draining sufficiently.  The prescription will assist that effort.

I then asked about the tears and the back-up lens.  Dr, Song said, "Your capsule was fragile.  The initial lens (Turic) wouldn't fit in the very small space between the capsule and the iris without further tearing.  If it did tear, it would require a much more intensive surgery.  So I decided to go with the back-up lens (to me sounded a bit smaller)."  I asked if the tears heal over time.  He said, No.  I then asked should I worry.  He said, No.  Asked what would happen if it tore further.  He said that the gel (acquiesce humor) would leak into the capsule area and iris resulting in a need for a bigger operation.  I then asked if the back up lens was less effective.  To my understanding, it appears that the Toric if used, would take care of all my astigmatisms (apparently you can have more than one).  The back-up may fix all or some, but he won't know more until next week.  He did say, "The fact that you were able to read the newspaper is a good sign".  The Doctor did say that I would be refunded for the cost of the Toric, since we didn't use it.  (Yay).

 More to come!

Schedules, schedules, schedules!!!

Schedules, schedules, schedules!!!

Received a call from a "restricted' telephone number. I didn't answer it since 99% of my incoming calls are robo-callers or scammers.  If it's legit (and sometimes not), the caller will leave a voice message.

I checked my voice mail and Kiara from Doctor Hurley's office requested that I call her back as soon as I could.  She left a call back number (and I'm glad she repeated it since she said it so fast I could get it all the first time).

I called the number and was asked if I could be placed on hold.  Yes, I said.  A few moments later the representative picked up and asked if she could help me.  I asked to speak with Kiara and was quickly told a that she wasn't in the office today.  Odd???   I then told the attendant that she had just called me and provided this number.  I was told that Kiara is Dr. Hurley's scheduler, but in another office.  She said she would message her to call me back.  Efficiency at its finest!

Not too long after, the phone rang and I reluctantly answered it, not wanting to get caught in a scam.  So I was prepared to give short answers without a 'yes' or an 'OK" since it's been reported that scammers will record that sound byte and use it as proof that you agreed to something nefarious.  Well she did identify herself as Kiara.  After verifying it was me (last name and DOB), she said she had a time for my cystectomy procedure.  However it was for 8:30 AM on September 8th.  I told her that I had a follow-up appointment for my cataract surgery that morning.  She paused and said, "He only does these procedures once a month.  The next one would be October 13th, but at Holy Family in Methuen."  

Having no other option, I said yes, then asked what time?  I was told that the procedure would be at 8:30AM but I had to be there an hour and a half prior to.  She added that she will be sending me an informational packet.

So I'm now scheduled for my procedure in October.  I reached out to my sister to arrange a ride to and from on the new date.  She was so kind to oblige.  What a great little sister I have!

More to come!

Fears Confirmed

Fears Confirmed

Had my visit with Dr. Hurley in Salem NH this morning.  I was a bit confused as to what was actually going to happen today.  I knew that after reviewing my ultra-sound on my last visit, the Doctor did say that I have bladder cancer.  Today's cystoscopy (I now know) was his way of confirming his previous diagnosis.  I was under the impression that he was going to be scraping away the cancer today.  That was not the case.

Upon my arrival and check-in everyone was masked (I was glad).  Waiting room was arranged so each seat was at least 6 feet from the other.  There were only about 4 people waiting and the room was rather large.  My name was called and I was directed to an examination room through a number of corridors.  Upon entry, two attendants told me to remove my pants and sit covered using a disposable blanket.

Shortly after, Dr. Hurley arrived, shook my hand and asked, "How are things going?" and, "Have you had anymore bleeding?".  I mentioned that I was (relatively) fine and I did have bleeding the previous day, but it was now clearing up.  He did mention that with bleeding comes clots and those clots could obstruct my urine flow and he said, "We don't want that."

He then said that he was going to add some goo then proceeded to gingerly guide the medical instrument up my urethra.  It was quite unpleasant and I didn't want to watch. He did say, "You'll feel a pinch" as he passed my prostate.  Yup, I felt it.  A few moments went by and he said, "Yes my man, you have bladder cancer."  Even though I was resigned to that fact, just hearing it again was disconcerting.  He then said, "We need to get that out.  If we don't, the bleeding will continue and you will eventually have a clot that doesn't pass."  I did mention that once I had a brief obstruction, but the flow forced it out.  I know when that happened, it was distressing, but when it cleared, I did see a huge clot come out.  (I could actually feel it being passed.)

Dr Hurley said that he would schedule the day surgical procedure for next week.  He gave me some towels to clean up and asked that I see his receptionist for scheduling.  He then left.

After cleaning up and dressing, I proceeded to the receptionist, who informed me that the next opening was September 8th.  I had mentioned that I was having cataract surgery the day before and a subsequent post op follow up on the 8th.  She went into inform the doctor.  He came out of his office and said he could schedule something for the afternoon.  I looked at my calendar and saw that my eye doctor appointment was at 9:30 in Waltham, so I estimated that I'd be home by noon. The doctor said, "We'll make it work.  We need to get that out of there."

The receptionist indicated that the day surgery would take place in Andover and she would call me with the time and other information.  She did mention that I would need a ride to and from.

Luckily for me, my little sister said she would give me the ride.  I'm fortunate that she's able to help me out and she's also taking me to my cataract surgery on Tuesday.  Thank you so much Leslie.

More to come!

Where did the summer go?

Where did the summer go?

Some new developments since my last entry.  My bladder cancer procedure has been moved up to 8/31.  And, yesterday I had my annual check-up with Dr Song at Mass Eye and Ear in Waltham.  

I've been going to Dr Song for a number of years since my chemo therapy (the gift that keeps giving) caused a cataract in my right eye.  About 5 years ago, Dr Song performed laser surgery to remove my cataract so I took that opportunity to have in-ocular lens (IOL) implanted.  After a consult it was decided that the lens would provide better distance vision.  At the time my left eye had a 'slow growing' cataract and the end result was near 20/20 vision. It's referred to as 'mono vision' the brain adjusts and corrects what it sees.

 

Over this last year, I really noticed that my left eye (cataract) was worsening. It seemed like I had vaseline smeared on my eye and my vision was obviously not clear. I don't wear glasses but noticed I needed more light when reading.  In addition I noticed that the TV didn't seem as clear to me.  Luckily my right eye was carrying the vision load and I was still able to function 'normally'.  But as of late, I found myself rubbing my left eye and it seemed to be tearing much more.  So when I had my appointment I was expecting that my next step would be cataract surgery and implanting of an IOL for reading (near sighted).  The doctor did indicate that I had an astigmatism and there might be a chance that I would need reading glasses (or cheaters).  He also indicate that I may need to hold reading material closer than I had been.  But he also said that it might be just fine.

I do recall the 'break in' period of adjustment and dealing with the halo effect that eventually cleared up.  So I'm prepared for the body's adjustment.

So, September will be a busy one health-wise.  Already four appointments booked.  I do recall that the most difficult part was the regimen of eye drops.  Small price to pay for better vision.

 

Post Script:

Had a call from Dr. Song's office.  It sounded like a review of the measurements showed that my astigmatism had changed (?).  They asked if I could come in the next day to be measured again.  I do recall that the doctor said something about a need to re-measure because my eyes were dialated.  I guess that had something to do with it.

 

I arrived a very busy waiting room.  It wasn't too long before I was called.  I sat in front of two machines and the attendant once completing the tests, said that the doctor wanted to talk to me.  Hmmm, sounded ominous.

 

I waited for Doctor Song and once he was free he discussed the new developments. Apparently, for my astigmatism, the lens we discussed would not work.  I had two options: get a lens and a have to wear prescription glasses for reading or, have a Toric lens implanted.  I had a Toric implanted on my other eye.  Unfortunately the Toric was an additional thousand dollars.  I'm worth it and vision is important so I chose to pay the additional amount.  However, the person who takes the money was not in the office.  He indicated that she would call me.  [As of this writing 8/31, I haven't had a call back.  I did call the office today but got a voice mail.  I'm sure they will find me]

More to come!

My mother used to say you have to worry 'just enough'

My mother used to say you have to worry 'just enough'

When my primary care doctor set me up for an ultrasound of my carotid arteries, I was dreading the results.  For the last 10 plus years, I've been taking good care of myself.  I've managed to lose more than 80 pounds (and keep it off); walk 3 to 5 miles a day; eat healthy; and stay clear of 'things' not good for you.  In addition, my cholesterol numbers have always been stellar and (knock on wood) I've not needed to take meds to control it.  (I really hate taking meds, but if I have to...I have to).  So the thoughts of plaque build up and subsequent prescription of a 'statin' made me worry.  My mother always said, 'You have to worry just enough'.  It seems to still hold true.

 

I went in for my ultra-sound and it was very quick.  The technician was frantically taking 'shots' and annotating the slides.  I could hear audible snippets of rushing blood (whoosh whoosh).  At the end, she said, "We are all done.  The doctor will review and send the results to your primary care doctor.  It may take a few days."  Ok then, now the waiting.

In the early afternoon, the phone rang (it's always ringing with robo callers and telemarketers).  I screen all my calls.  I did hear the voice say that it was Dr Rees's office calling.  I quickly picked it up, fearing that this speedy return call was ominous, not the 'few days' I was told.  I was elated to hear her say, "Your test results came back normal".

Hallelujah!  Some good news for a change.

More to come!

 

New Meds, a New Date and Something Else

New Meds, a New Date and Something Else

Dr Hurley prescribed Ciprofloxasin (six tablets: 2 for the day before; 2 for the day of the procedure; 2 for day after).  I hate taking medication, but I also read all the literature that comes with it.  I was shocked to hear of the possible side effects.  The most disturbing being irritated tendons, separation of tendons and neuropathy to name a few.  

I had an upcoming visit with my primary care doctor and I discussed my concerns.  When I told him what I received and I was concerned with side effects, he immediately named the two that were most troubling to me.  He did say that I was only prescribed 6 tablets and the chances of my experiencing those side effects in particular were rare. I mentioned that male breast cancer is also rare.

Dr. Rees did mention that there are other antibiotics that could be substituted in lieu of Ciprofloxasin.  He suggested that I contact Dr. Hurley's office and indicated that I was uncomfortable with the prescription.  He said they would probably give me something else.

During my visit with Dr. Rees, while 'checking my vitals', I could hear an audible 'hmmmm' as he was feeling my glands in my neck.  I asked if something was wrong.  The doctor indicated that he was going to schedule me for an ultra-sound of my carotid artery.  He said, my left side had a good flow, but the right side not as good.  He indicated that as we age, these arteries get a build up of plaque.  Since my cholesterol numbers have always been stellar and I don't need meds for that he just wanted to be certain there was no blockage, which could lead to a stroke.

Yikes!  I'm scheduled for an ultra sound on August 5th.  So there will more to come on that.

I received a call from Dr. Hurley's office and they moved up my procedure date to August 31st (from September 15th).  In addition, I was told that the doctor sent in a new script to replace the Ciprofloxasin. I checked my online account and saw that an order of NITROFURANTOIN MONOHYDRATE was in process.  I quickly looked at the list of side effects (again scary), but not as concerning as the other.

More to come!

P.S. To those that have subscribed to email notification of my blog update, I was informed that the notification will be discontinued in August 2021.  So if you signed up for this type of notification, you will no longer received notice when I have updates.  Until I determine a work around, you'll have to bookmark this blog and check from time to time.  Sorry!

I'm Back!

It's been awhile since I needed to post updates on my challenge.  Obviously there have been some changes in my health.  So, that being said, I'll be adding to my blog with my latest challenge: Bladder Cancer.

Something's Not Right

A few weeks a go while visiting a friend post-covid.  I had some green tea with ginger.  After a spell I had the urge to urinate so I meandered to the bathroom and went.  I noticed a tinge of redness to the color and something that looked like a scab (clot) that was passed.  I didn't think too much about it, but I was concerned.  I looked at my pee every time and the color cleared up on its own.  So I didn't give it a second thought, but I was always looking.

Tuesday morning (June 15th) I was awakened by some noise outside. I was awake enough to know that I had to pee. Figured I'd do that then go back to sleep.

With one eye open I was shocked to see blood red urine. Well I couldn't go back to sleep. Went online and did symptom checker. Could be anything from kidney stones to...even worse. I had no new pain. Drank plenty of fluids hoping to flush it out. No change. I called my primary care and they fit me right in.

At the doctor's office, he did all his questioning, feeling etc. I peed in a cup (guess he needed proof). He sent me for blood work and scheduled me for an ultra sound.

Later that day, I received a call indicating blood tests were normal and I had no infection. Kidney(s) were functioning normal.

Had an ultrasound on my kidneys and pelvic region Thursday (June 17th). Bleeding had stopped, but urine was very dark and cloudy. Got a call that evening indicating kidneys looked good, but there was a 'change' to the bladder. Said I'd get a call about info/appointment with Urologist.

Received a call with info on my appointment with Dr Liam Hurley (who has an office in Salem NH). I received an appointment for Wednesday (June 23rd). Apparently they were able to squeeze me in since they were booking for September. The nurse mentioned that I had a growth. I guess that's a change.

So bleeding had stopped. Urine is normal color. 

Urologist Appointment

Today I had my appointment with Dr. Hurley at his office at Keewadin Dr, Salem NH.  Masks were still required, but there were very few patients in the waiting room.  After an easy check in, I was told to wait until called.  It wasn't long before I heard my name being called.  A medical associate guided me to an examination room and provided me with a clip board and paperwork that needed completing (I call them SAT's).  I didn't get too far when Dr Hurley arrived with my file.  After introductions and pleasantries, he got right to business and said that I have bladder cancer.  Absolutely not what I wanted to hear.

He explained that I needed a procedure so he can 'get in there' and look around and scrape away the cancer.  He said it's done as an out patient procedure.  I would be put to sleep and he would 'go in' through the penis and see what's there and do clean up.  He did mention that I would have bleeding episodes again and once he knew for certain the extent, he would be able to provide more input for treatment.  The procedure is scheduled at the surgical unit of the site on September 15th.  I asked if I need someone to drive me/pick me up and he said no.  Oh the wonders of medicine.  He shook my hand and said 'I'll take care of you".  That actually made me feel a bit better although I think I'm still in shock.  I was told to complete my paperwork in the waiting room then drop it off at check out.

More to come!