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!