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Wednesday, January 26, 2022

Purgatory and Hell

Purgatory and Hell

In Christian religions (and some others) there is a concept that only the truly righteous get to go into heaven.  Most sinners have to spend time in purgatory hoping that one day (there's no concept of time, but I'm referencing this as temporary), they will have received enough prayers from the living or spent enough time in Facebook-like jail before proceeding to their just rewards.  It's also believed that some will go directly to hell.  Not pleasant thoughts, but I grew up with them.

Today (1/25/22) was my scheduled day for my Cystoscopy/TURBT procedure at St. Elizabeth's in Brighton.  Much attention to detail was taken to ensure things would be smooth sailing. I religiously use the patient portal to communicate, verify, eCheck-in and complete all the required questionnaires so that there are no 'gotchas'. 

Earlier in the month, I had received a few calls to very things.  Of course in this pandemic there is always the COVID questions.  According to their procedures, they had required a negative PCR Covid test result 24 hours in advance.  At the time, the scheduler said she was trying to get me into one of their network hospitals in my area, but there were no appointments.  I had the option of going to St. E's on Monday.  But I informed them that I had Covid as of 1/6 and I was now symptom free.  In addition I did my isolation for 5 days and masked for an additional 5 according to current CDC guide- lines.  [I've been wearing a mask in public anyway]. The scheduler, upon hearing this said, "I'll get back to you".

About a week went by and I hadn't heard back.  In the mean time I received a call from the anesthesiologist's office who told me that a test (within 90 days of my having COVID) didn't make sense.  She said she would contact the other scheduler.  I went into my portal and left a message.  I referenced the discussion I had with the anesthesiologist's office and indicated that I had not heard back, and asked if I was correct in assuming that I did not need the COVID test.  I received a confirmation, that my assumption was correct.  So, I didn't need the test and I was all set for 1/25.

My sweetheart of a sister offered to give me a ride to and from the hospital.  Tuesday morning brought about an inch of snow, so I had cleared the driveway.  She showed up on time and suggested that we plug in the address into her GPS.  I told her I had been there a number of times and I knew the way.  So we went went on our way. The main roads were fine, traffic was moving well, but there was the typical slow-down just before the Zachim Bridge.   Leslie indicated that we had 2 + people in the car so we could use the carpool lane.  We had a brief discussion on what the + meant.  Did we need a third?  We proceeded and there was no police car monitoring the lane. So far so good.

We were just about to enter the O'Neil Tunnel and my phone rang.  It was the hospital.  They had indicated there was nothing in my file about my COVID test. I told her that we were in the tunnel and were well on our way.  She said, well come in and we'll find out if we can do the procedure.  [What?]

If you've ever driven in Boston, you know that people drive like jerks and you have to be a bit aggressive and really cognizant of all the lane shifts and on/off ramps.  My poor sister was hoping for my full attention, but with my talking on the phone, moving traffic, on coming exits and lane shifts it was all she could do to get through the frog jump.  At one point, she was beginning to have a panic attack.  Of course there was no place to pull over.  Any designated pull over was orange coned and traffic was zipping by.  I was trying to talk her off the ledge by providing detailed driving instruction (like a GPS would).  We were about 3-4 miles away.  We had a few lights and she seemed to be calming down. We made it to the hospital parking area and she was able to sit and collect herself.  With all that was going on at once, and not having her GPS talk to her as she normally does, it set her into panic attack mode. I felt so helpless.  I was glad we had the spot to sit.  We were a bit early so I waited until she had gained better composure.  We talked about the game plan.  If I got in, I'd put a call in to her so she could go to Fresh Pond and take a run.  If they canceled, she would be there so I could go home.

St. Elizabeth's is a big campus.  I didn't know exactly where to go.  But I went into the main building and the National Guard was assisting with directing people.  I made it to the 3rd floor.  I entered the pre-op registration area.  I was the only patient.  I sat at the window and signed  many forms, got my bracelet and was directed to the waiting room.  I contacted my sister and said 'I'm in.  Have a good run'.

About 15 minutes later a nurse, Mary Ann came out and was extremely apologetic.  Apparently, she entered the wrong date into my file which indicated that I had tested positive on the 19th.  So they were operating off of that date.  Now I could see the cause for concern.  She told me I had done everything right, even documenting in my portal and follow up.  However, because I didn't have any physical proof of positive result on the 6th, no one wanted to proceed.  [With no coffee in me and no food since 11PM, I wasn't processing this - shock maybe] She told me to sit tight and she was going to make more calls.

In the mean time I had a call from the scheduler asking for proof.  I indicated that DPH sent me a text with a link that expired in 24 hours. I did take a screen shot of the text cause it was date-time stamped 1/9/22 12:15PM.  I sent it to her.  Never heard back.  

About an hour later, Mary Ann came back and said he talked to everyone except God, and he's next.  She was like Sherlock Holmes.  She discovered that I had the test in Haverhill, at the Aamvets and the lab that processed the same was in Cambridge.  Unfortunately she couldn't get through to a person at the lab.  She called so many numbers at DPH and left  messages.  She did get a return call and the person (an epidemiologist) looked at her system and said she found me but couldn't provide any information other than a yes or no.  (HIPPA at it's worst).  So Mary Ann was able to provide enough info that she gleaned to get a yes to all her questions.  So she got a name, telephone number and badge number, but nothing in writing for 'the file'.  She typed a memo recounting everything she had done as well as who she spoke with and basically confirming that I was positive on the 6th and now exempt from the COVID test.  She said she won't stop until it's resolved.

Enter the purgatory reference here.  I waited.  The receptionist took a lunch break, had someone cover, then returned.  In the interim, I was the only one in the waiting room (aka purgatory). Mary Ann returned and said 'we are good'.  Yay! Phone rings, it's the doctor from anesthesiologist office saying there's nothing the file and the surgery is off.  I indicated that I just spoke with Mary Ann and she said it was on.  He said, 'I'll call her.'

Now, Hell must be right next to Purgatory with very thin walls.  The demons were screaming and trying to come through the very thin walls.  This was now hell.  The receptionist went home for the day.  I didn't know what was going on. It was now 4PM.  I was in brain fog and feeling famished.

There was a phone in the lobby with a number to call for assistance.  I called it.  The attendant said someone will be out to see me shorty.  What ring of hell have I descended?

I was pacing trying to get my steps in and kill time and someone walked in and asked if I was alright.  Just a concerned health care worker.  I told her I was just waiting.  She left.  Shortly after, Mary Ann appeared and said, "You are cleared".  [Only took 6 hours.  But thank you Mary Ann.]

The Show Begins

I was called into the 'holy of holies', instructed to disrobe and Johnny-up. Had many members of the team come in and verify info, ask questions, explain their role and have me sign things.  [Didn't notice any blank checks.]

Dr. Ingham arrived and discussed what was going to happen and the expected results and the not expected results.  We had a discussion about my lack of catheter love.  He said that he doesn't expect that, but there's a possibility of my getting it.  He was happy that things finnally turned out OK.  He said he heard the procedure was on/off six times (seems right), but was glad we've reached this juncture.  He said he would talk to my sister following the procedure (she's my health proxy).  On that, he said someone will be wheeling me into the O.R. briefly.  

A team arrived and took me for a nice ride through the corridors to the very bright and cold O.R.  They gave me some warm blankets and like a pit crew, all doing their designated tasks at once.  Impressive!  I was given an IV.  One pinch and done. Hitched up to the satellite; given a sedative; given an oxygen mask and asked to breath deeply.  I was out.

I woke up, back in my 'room' and the nurse gave me water and a pill.  I immediately felt for the catheter and there was none. Slowly coming out of it I felt the urge to go.  I produced 1200 ml of urine, slightly tinged with red. Good sign.  I was asked to sit up on the side of the bed to make sure I wasn't too dizzy to stand and dress. I was woozy, but OK to dress.  The said they would call Leslie.  

I got dressed and collected my things, my discharge paperwork, instructions on what to do/not to do, then wheel chaired to the front entrance where I met Leslie. It was about 7PM -ish.  We talked about what the doctor had told her, but I was so foggy I don't remember the details.  I do recall her saying he found some more cancer to remove and she also said something about chemo in the future.  I'm sure I'll have all the information when I have a follow up tele-health appointment on 2/2/22 We needed to get to Walgreens in Haverhill to pick up some meds before they closed at 8.

Well there was no traffic going home.  We got to Walgreens at about 7:50PM.  Got my drugs and went home.  I understand why they don't want you to drive, cause I had Leslie take a wrong turn on my way home.  That was a shock. Made it home and unpacked stuff, took one of the meds and made myself a sandwich.  I do recall 'drink lots of liquids' being said by many.  I watched TV and the weather report (Yucky storm coming).  Watched an episode of Ozark then went to bed.

At this point the fluids where going through my system and the need to go, was very frequent.  However, it felt like razor blades and the output was very little.  I did began having second thoughts about the catheter.  I went to bed and was smart enough to put a towel the bed, just in case.  It seemed that every hour on the hour, I had a very strong urge to go.  Hurt like the dickens to go and the output was 100mm.  Manged to soil 7 pairs of underwear and only manage to get a drop on the sheet (orange cause of the meds).  I took cat naps and 'ran' to the toilet every time I had the urge.  Never making it in time (more underwear).  I decided to have the disposable urine bottle handy.  That was a mistake.  It takes precious time to pick up, open and strategically place it to do my business.  Now I had to change underwear and clean the floor.  [more thoughts on catheter].  So I abandoned that idea and went back to the quick run to the toilet.  After 7 pairs of underwear and seven hours of supposed sleep, I made coffee and did a load of laundry.  I need new changes for tonight??

Coffee is good.  Although I didn't get the sleep I needed, I'm less in a fog.  I'm able to jaunt to the toilet..and make it in time, but the razor blades are still active.  I need to take the orange pee pill 3 times a day for five days.  I recall that after a day of two, things calm down.  I'm refraining from taking my walk today for fear of having to 'go' while walking.  I don't need a lewd and lascivious infraction on my record if I have to visit the bushes.  So home I'll stay.  The tubes they put in my throat had me hoarse, so there's no music (singing) today either.  I can't believe how long it took to write this.

So as it stands, I'm out of purgatory/hell and back to life, although that can be hell...interesting thought!

More to come!

Monday, January 24, 2022

Cataract post-op follow-up

Cataract post-op follow-up

Due to a snow storm on January 7th, I had to reschedule my follow-up with Dr Song to today.

Happy that mother nature cooperated and people remembered how to drive today.  I arrived 15 minutes early for my appointment in Waltham.  The office was busy, but things were moving along.  Around 2:45, my name was called and one of the medical professionals brought me over to one of the eye machines where she performed some tests (glaucoma).  I was then whisked away to another room where I was given an extensive vision test.  Upon completion, I was handed over to Steve, who brought me to another examination room where he checked peripheral vision.  

I had not used (or don't recall using) those machines.  One had me looking into a toilet bowl-like opening and needing to use a clicker to identify when I saw various flashes of light.  Very similar to counting stars, one eye at a time.  I'm sure I missed a few since some looked like floaters, so I hesitated registering those.  There's no way of knowing how well I did since I didn't get any audible sounds from Steve other than, "We are almost done."

I was given some drops and was asked to wait for the doctor in yet another examination room.  While waiting, Steve was explaining the advantages of having a barber use a straight edge for a real close shave.  All this while we were wearing masks.  He seemed to recall that I had a 'pringles-style' mustache.  Oh, the impressions we make on others. He was called away and I sat waiting for Dr Song.

Dr Song arrived and after exchanging pleasantries, he indicated that my glaucoma test was good and things looked OK, but he was concerned with a high pressure reading in my right eye (the one that had the cataract surgery first in 2016).  He told me the reading, but it didn't mean anything to me, but the two numbers were far from each other, meaning one eye had higher pressure.  He took more measurements and said his reading was higher than the test I had earlier.  He said, 'We are going to prescribe eye drops'. He went on to say that Timolol was a gel-like drop that I would be using every day on my right eye.  He said that sometimes insurance doesn't cover it.  If that's the case, he would prescribe a different drop that needed to be taken twice daily.  So I said, this is probably something I'll be taking going forward?  He said yes.  [It is what it is.]  He asked if I had any questions to which I responded, yes: Why? and How?

He said they were good questions.  He indicated (and he mentioned this before) that the eye has a drainage system and mine isn't working well enough.  The eye drops will reduce the pressure.  I asked what are the long term consequences of the pressure if not addressed?  He indicated that the pressure over time will cause the retina to get thinner until I lose portions of my vision.  He also said that it's not reversible.   [For joy].  I asked why this eye and not the one just operated on?  He said that he suspects that the same problem will eventually happen on the other eye.  [For joy X2].

He called in the prescription to Walgreens.  He said he would see me in 6 to 8 weeks.  On the way out I got an appointment for March 28th.

When I got home I had a message from Walgreens saying the prescription was out of stock and will be ready tomorrow.  I checked my online account and saw that a price was not listed yet.  So we'll see.

I have my Cystoscopy schedule for tomorrow, so more to come!

Thursday, January 13, 2022

Omicron Found Me

Omicron found me

I finally got notification on Sunday that I had tested positive for Covid-19.  Already in isolation since mid-week, there was nothing for me to do other than wait it out.  Fortunately for me, my symptoms were mild.  I had a sore throat one day then runny nose and bouts of coughing.  I've been sleeping about 10 hours a night, mostly uninterrupted. I took a day off from singing and performed a set of instrumentals for a live-stream.  Eventually I eased back into singing.  A little scratchy, but happy to be able to.  I believe my isolation period is over and I'll just need to mask up (something I do anyway).  A friend of mine dropped off a home testing kit that I will take, but since I'm still home-bound, I'll wait until I plan to go out in public.  It's been brutally cold and I've skipped a few days of taking my walk.   Hoping to resume.

Cystoscopy

Dr Ingham's office was able to schedule a cystoscopy at St Elizabeth's, Brighton for January 25th.  Given the current state of affairs, they require a PCR test 24 hours in advance with a negative finding.  They were insistent that a home test would not suffice.  The scheduler said that she was looking at hospitals in my area (and in their network), but she indicated that there were no appointments.  She asked if I could go there on 1/24.  I informed her that I currently have Covid and would not prefer to go to Brighton, just to test and turn around home.  She said she'd get back to me.  I'm hoping that Omicrom will wind down enough to have me tested 'up here'.

So at this point, my sister Leslie agreed to take me to my procedure.  It's a 10:15 check in and 12pm procedure.  It generally takes about an hour.  Dr Ingham indicated that he may find and scrap out a nodule that showed up in the MRI.  I really, really hope that I don't have a catheter.  But, I pray that once he's in there, his feelings are validated on how to proceed.  Please, not radical treatment!

More to come!


Friday, January 7, 2022

Well 2022 isn't starting off so well

Well 2022 isn't starting off so well

Was supposed to have a tele-health follow-up with Dr. Ingham on 12/27.  Got a notification that it needed to be rescheduled.  I could have sworn the scheduler said Friday 12/31, but I was wrong.  It ended up being today.

According to Dr Ingham, the MRI looked OK and there was no concerning findings.  However, the doctor did say that on one of the 'views' it looked like I had a 6mm nodule near the juncture of the diverticulum and the urator.  He said that it was only seen on one of the views, so it could be something, or maybe not.

The next steps (and this was planned), I'm going in for an operating room cystoscopy, where the doctor can get in there and look around.  He said that if he does see the node, he'll scrape out and send it to pathology.  Because this procedure requires my being sedated, I'll have to have someone drive me in and drive me home. I was concerned with the need for a catheter and he said he doesn't think it will be needed.  But if I do need it, he'd make arrangements with Dr Hurley's office to have it removed so I don't have to trek to Brighton.

Unfortunately due to the current omicron surge, there are staffing shortages and elective procedures will have to wait.  He said this is non-elective, so it's a matter of fining a slot.  So I wait.

I did have a follow-up cystoscopy with Dr Hurley, but Dr Ingham said to cancel that seeing I'll be having one (hopefully soon)

On another front, I was notified that I have been exposed to Covid.  I was advised to get tested.  Conveniently for me the Aamvets down the street was having a walkin-in clinic.  I went yesterday and waited outside in the cold for nearly 3 hours.  I haven't heard any results yet.  However, I have been experiencing a runny nose, slight sore throat and sporadic coughing.  I'm generally fatigued.  I don't have a fever and I can smell and taste.  I've been in isolation since Wednesday.

There is also a nasty cold going around so it could be that.  I'm vaxxed and boosted, so I'm hopeful it will be mild if I do have it. Scary times indeed.  And I've always been safe and haven't attended any live performances except one.  It was only me and another and we are both vaxxed.  We used our own mics and wore masks, however there were a few times that I forgot to put it back on.

More to come!